Rohleder, Poul; Swartz, Leslie; Schneider, Marguerite; Groce, Nora; Eide, Arne Henning
Despite the seriousness of the HIV epidemic globally, and in South Africa in particular, little is known about how HIV/AIDS affects disabled people. One important and little explored area is the role that organisations that represent disabled people or that work on behalf of disabled people, are playing in addressing the HIV/AIDS epidemic among the disabled people they represent or serve. This paper presents the findings of a nationwide survey of disability organisations in South Africa. The purpose of this study was to explore the role of disability organisations in addressing the HIV epidemic among disabled people in South Africa. The findings suggest that while organisations recognise the importance of providing HIV education, and many have taken steps to do so, disabled people are largely excluded from general HIV prevention messages. Disabled people also have significant difficulties in accessing general health care, relevant for HIV testing and treatment. In a country trying to manage serious social problems with limited resources, this paper highlights the need for increased cooperation and collaboration between relevant parties in order to facilitate the changes necessary for disabled people to access needed health information and care.
Kirkham, Thomas; Winfield, Sandra; Smallwood, Angela; Coolin, Kirstie; Wood, Stuart; Searchwell, Louis
This paper presents a platform on which a new generation of applications targeted to aid the self-organised learner can be presented. The new application is enabled by innovations in trust-based security of data built upon emerging infrastructures to aid federated data access in the UK education sector. Within the proposed architecture, users and…
Agadjanian, Victor; Menjívar, Cecilia
Religious organisations (ROs) are often said to play an important role in mitigating the impact of HIV/AIDS. Yet, limitations of that role have also been acknowledged. While most of the literature has focused on ideological and individual-level implications of religion for HIV/AIDS, in this study, we shift the focus to the organisational factors that shape and constrain ROs' involvement in both HIV prevention and HIV/AIDS care and support. Using primarily qualitative data collected in a predominantly Christian area in southern Mozambique, we show that the organisational vitality of a RO as determined by its membership size and its relationships with other churches and with governmental and non-governmental agencies is a pervasive priority of RO leaders. Therefore, all church activities, including those related to HIV/AIDS, are instrumentalised by the religious leadership to achieve the church's organisational aims—maintaining and growing its membership, safeguarding the often precarious coexistence with other churches, and enhancing its standing vis-à-vis the government and powerful non-governmental organisations. As a result, the effectiveness of ROs' involvement in HIV/AIDS prevention and assistance is often compromised. PMID:21787253
Kavya, Sharma; Sanjay, Zodpey; Syed Zahiruddin, Quazi; Abhay, Gaidhane; Shailendra, Sawleshwarkar; Sunil, Khaparde
Human resource capacity building is a key strategy in the design, delivery, sustainability and scale up HIV treatment and prevention programmes. The review aims to present human resource capacity building initiatives undertaken by the National AIDS Control Organisation (NACO) and to discuss the available opportunities in India.There was minimal emphasis on human resource capacity building in National AIDS control programme (NACP)-I. The focus of capacity building in NACP-II was on strengthening the capacity of partners implementing various HIV/AIDS interventions. NACP-III (2007-2012) focussed on capacity building as a priority agenda. Other than short-term training programmes, NACP-III is strengthening the capacity of partners through the State Training and Resource Centre, Technical Support Unit, District AIDS Prevention Control Unit, Fellowship Programme and Network of Indian Institutions for HIV/AIDS Research.Various opportunities to enhance and consolidate capacity building responses in HIV/AIDS in India may include mainstreaming of capacity building, appropriate management of knowledge and resources, effective delivery of training, measuring and documenting impact,accreditation of programmes and institutes,use of information technology, identifying and implementing innovations and working for sustainability.Growing demand for capacity-building in HIV/AIDS needs substantial efforts to ensure that these are implemented effectively and efficiently. NACO had made significant strides in these regards, but at the same time there are arduous challenges like measuring impact, quality, documentation, operational research, and sustainability. NACO is formulating Phase-IV of NACP. This review will provide feedback to the NACO for strengthening its strategic document for human resource capacity building.
Casteleyn, Jordi; Mottart, Andre; Valcke, Martin
Instead of the traditional set of slides, the visual aids of a presentation can now be graphic organisers (concept maps, knowledge maps, mind maps) on an infinite canvas. Constructing graphic organisers has a beneficial impact on learning, but this topic has not been studied in the context of giving a presentation. The present study examined this…
Keikelame, Mpoe Johannah; Murphy, Colleen K; Ringheim, Karin E; Woldehanna, Sara
The extent of the HIV pandemic-particularly in the hardest-hit countries, including South Africa-has prompted a call for greater engagement of all groups, including faith-based organisations (FBOs). Although FBOs are known to play a substantial role in providing care and support to those affected by HIV and AIDS, empirical evidence in regard to their actions in the broader context of stigma is limited. A qualitative, key-informant survey was conducted in South Africa as part of a six-country international study to examine perceptions of how FBOs have contributed to reduction in HIV risk, vulnerability and related impacts. The special emphasis of this paper is the influence of FBOs on stigma and discrimination. In-depth interviews were held with 34 senior-level key informants who act as key decision-makers in the response to HIV and AIDS in South Africa. Secular and faith-based respondents shared their perceptions of the faith-based response, including FBOs' actions in relation to HIV/AIDS stigma and discrimination. Our study revealed that while FBOs were perceived as taking some action to address stigma in South Africa, FBOs were also thought to contribute to HIV/AIDS- discrimination through conflating issues of sexuality and morality, and through associating HIV and AIDS with sin. The interviewees indicated a number of internal and external challenges faced by FBOs to deal effectively with stigma, including lack of information and skills, the difficulty of maintaining confidentiality in health services, and self-stigmatisation which prevents HIV-infected persons from revealing their status. Findings from this study may help both faith-based and secular groups capitalise on the perceived strengths of FBOs as well as to elucidate their perceived weaknesses so that these areas of concern can be further explored and addressed.
Stewart, Jim; Keegan, Anne; Stevens, Pam
Purpose: This paper aims to explore how teaching and assessing reflective learning skills can support postgraduate practitioners studying organisational change and explores the challenges for tutors in assessing these journals. Design/methodology/approach: Assessment criteria were developed from the literature on reflective practice and…
Lancaster, Sue; Di Milia, Lee
Purpose: The aim of this study was to examine the factors that employees perceived were important in creating a supportive learning environment in a recently merged organisation. The study provides rich qualitative data from the employees' perspective. Design/methodology/approach: This case study used a qualitative phenomenological constructivist…
De Cordier, Bruno
This paper focuses on the emergence and modus operandi of Muslim faith-based aid organisations from the West, particularly those from the United Kingdom. Through case studies of Islamic Relief Worldwide and Muslim Hands, it examines the actual and potential added value generated by these humanitarian players in Muslim-majority contexts at times when aid actors from or associated with the West are being perceived by some as instrumental to the political agendas of Western powers, or are being confronted with the consequences thereof. The study analyses Muslim faith-based aid organisations' transnational networks, their implementing partnerships with local faith-based non-governmental organisations (NGOs), and their security position within and their access to insecure contexts, drawing on field examples and opinion from Central Asia, Iraq and Pakistan. It thereby argues that there is ground for an expansion of the role of Muslim aid actors, because of the existence of social and political realities in the field that cannot be always effectively tackled by the dominant international development approaches.
Prust, Margaret L; Mellor-Crummey, Lauren; Sullivan, Tami P; Lang, Shawn; Hansen, Nathan B
Although intimate partner violence (IPV) is prevalent among women living with HIV and negatively impacts their health, few studies have examined the ability of AIDS service organisations (ASOs) to address IPV. This study used a qualitative approach to identify facilitators of and barriers to addressing IPV in female clients of ASOs in the United States. In-depth interviews were conducted between March and August 2011 with 20 ASO staff members and 19 female clients who reported a current or past history of IPV. Interviews were audio recorded, transcribed and analysed using the constant comparative method. These data identify barriers to addressing IPV at the organisation, provider and client levels, and include suggestions from both clients and providers about improving access to care. Client and provider suggestions differed in some areas. While providers emphasised structural changes such as increased training on IPV provided by their organisation, clients highlighted the importance of trusting personal relationships with staff to increase client disclosure of IPV experiences. Given the differing opinions of clients and staff, ASOs should consider involving women with histories of IPV in the process of programme and policy development. ASOs have the unique opportunity to provide comprehensive and holistic care by addressing IPV. The extent to which ASOs are able to recognise and address IPV and strategies for increasing this ability warrant greater attention from funders, ASO administrators and researchers.
Tammets, Kairit; Pata, Kai; Laanpere, Mart
This study proposed using the elaborated learning and knowledge building model (LKB model) derived from Nonaka and Takeuchi's knowledge management model for supporting cross-organisational teacher development in the temporarily extended organisations composed of universities and schools. It investigated the main LKB model components in the context…
Bentley, T A; Teo, S T T; McLeod, L; Tan, F; Bosua, R; Gloet, M
The prevalence of telework and other forms of mobile working enabled by digital technology is increasing markedly. Following a socio-technical systems approach, this study aims to examine the role of organisational social support and specific support for teleworkers in influencing teleworker wellbeing, the mediating role of social isolation, potentially resulting from a person-environment mismatch in these relationships, and possible differences in these relationships between low-intensity and hybrid teleworkers. Teleworkers' (n = 804) perceptions of support and telework outcomes (psychological strain, job satisfaction, and social isolation) were collected using an on-line survey of teleworking employees distributed within 28 New Zealand organisations where knowledge work was undertaken. Organisational social support and teleworker support was associated with increased job satisfaction and reduced psychological strain. Social isolation mediated the relationship between organisational social support and the two outcome variables, and some differences were observed in the structural relationships for hybrid and low-intensity teleworker sub-samples. These findings suggest that providing the necessary organisational and teleworker support is important for enhancing the teleworker-environment fit and thereby ensuring desirable telework outcomes.
Cawyer, Carol Stringer; Smith-Dupre, Athena
Describes supportive episodes in an HIV/AIDS support group and the role of social support for group members. Finds that members used communication as a healing agent, as a preparatory mechanism for living with AIDS, as an outlet for expressing emotions, and as a means for changing society. Identifies feedback and self-disclosure as essential…
Petchey, R; Williams, J; Farnsworth, B; Starkey, K
In the field of HIV/AIDS, social movement organisations (SMOs) have been identified as powerful potential catalysts for change through their impact on formal organisational structures and the policy process. In addition, they have the capacity to be important providers of services in their own right, through the community resources they are capable of mobilising. In the United Kingdom, however, their role in policy formation is disputed. Previous studies have concluded that they have been most influential at national policy and ward level. At the level of local policy making, their influence has been found to be patchy and confined largely to securing recognition of HIV as an issue. Most previous research has, however, been conducted in high prevalence, metropolitan settings with functional SMOs. This paper presents the results of a comparative case study of two neighbouring provincial low prevalence district health authorities (HAs) in England. We describe the changing national policy context from 1986 to 1995 and use a strategic change model to analyse the local development of care and treatment services for people with HIV/AIDS, in particular the relationship between SMOs and HAs. Despite being demographically, socioeconomically and epidemiologically similar, and sharing an identical national policy framework, the two districts demonstrate completely divergent organisational responses to the HIV/AIDS epidemic. We conclude that the level of prior social movement mobilisation and the degree of receptivity for change within the HA are the key variables for explaining variations in the scale of strategic change observed in the two districts.
Kunasegaran, Mageswari; Ismail, Maimunah; Rasdi, Roziah Mohd; Ismail, Ismi Arif; Ramayah, T.
Purpose: This study aims to examine the relationship between talent development environment (TDE) variables of job focus and long-term development with the workplace adaptation (WA) of Malaysian professional returnees as mediated by the organisational support. Design/methodology/approach: A total of 130 respondents who are Malaysian professional…
Fyffe, Chris; McCubbery, Jeffrey; Reid, Katharine J.
Background: Active support (AS) has been shown to increase the amount of time that residents in shared residential settings are involved in purposeful activities. The organisational processes required to implement AS have been less well researched. Method: Staff in community houses answered questions about the occurrence of organisational…
Barnett, Belinda Renee; Bradley, Lisa
Purpose: The purpose of this study was to examine the relationship between organisational support for career development (OSCD) and employees' career satisfaction. Based on an extended model of social cognitive career theory (SCCT) and an integrative model of proactive behaviours, the study proposed that career management behaviours would mediate…
Drachsler, Hendrik; Hummel, Hans; van den Berg, Bert; Eshuis, Jannes; Waterink, Wim; Nadolski, Rob; Berlanga, Adriana; Boers, Nanda; Koper, Rob
The need to support users of the Internet with the selection of information is becoming more important. Learners in complex, self-organising Learning Networks have similar problems and need guidance to find and select most suitable learning activities, in order to attain their lifelong learning goals in the most efficient way. Several research…
Carroll, J; Quijada, M
Professionals in healthcare organisations who seek to enhance safety and quality in an increasingly demanding industry environment often identify culture as a barrier to change. The cultural focus on individual autonomy, for example, seems to conflict with desired norms of teamwork, problem reporting, and learning. We offer a definition and explication of why culture is important to change efforts. A cultural analysis of health care suggests professional values that can be redirected to support change. We offer examples of organisations that drew upon cultural strengths to create new ways of working and gradually shifted the culture. PMID:15576686
Blake, Tim; Whallett, Andrew
Medical registrars have been described as the 'workhorses' of National Health Service hospitals, being at the interface of acute and chronic health services. They are expected to demonstrate effective leadership skills. There are concerns from the Royal College of Physicians that medical registrars are being overwhelmed and unsupported by organisations, and are struggling in their ability to provide safe, high-quality patient care. Junior colleagues are also being deterred by general medical specialties by the prospect of becoming the 'Med Reg'. There is a growing need to support medical registrars in several key aspects of training, not least medical leadership. Thus far, there has been a distinct disparity in the provision of medical leadership training for junior doctors in the UK that has adversely affected the standard of care given to patients. Recent landmark reviews and initiatives, principally the Medical Leadership Competency Framework, have raised awareness of leadership competencies for all doctors and the need for their incorporation into undergraduate and postgraduate curricula. It is hoped that interactive strategies to engage medical registrars in leadership training will lead to positive results including improvements in interdisciplinary communication, patient outcomes and fulfilment of curriculum competencies. Organisations have a duty to improve the quality of medical leadership training so that doctors feel equipped to influence change throughout their careers and be tomorrow's leaders. This review outlines the deficiencies in training, the importance of developing leadership skills in medical registrars and educational strategies that could be implemented by organisations in a cost-effective manner.
Background While sustainability of health programmes has been the subject of empirical studies, there is little evidence specifically on the sustainability of Community Based Organisations (CBOs) for HIV/AIDS. Debates around optimal approaches in community health have centred on utilitarian versus empowerment approaches. This paper, using the World Bank Multi-Country AIDS Program (MAP) in Zambia as a case study, seeks to evaluate whether or not this global programme contributed to the sustainability of CBOs working in the area of HIV/AIDS in Zambia. Lessons for optimising sustainability of CBOs in lower income countries are drawn. Methods In-depth interviews with representatives of all CBOs that received CRAIDS funding (n = 18) and district stakeholders (n= 10) in Mumbwa rural district in Zambia, in 2010; and national stakeholders (n=6) in 2011. Results Funding: All eighteen CBOs in Mumbwa that received MAP funding between 2003 and 2008 had existed prior to receiving MAP grants, some from as early as 1992. This was contrary to national level perceptions that CBOs were established to access funds rather than from the needs of communities. Funding opportunities for CBOs in Mumbwa in 2010 were scarce. Health services: While all CBOs were functioning in 2010, most reported reductions in service provision. Home visits had reduced due to a shortage of food to bring to people living with HIV/AIDS and scarcity of funding for transport, which reduced antiretroviral treatment adherence support and transport of patients to clinics. Organisational capacity and viability: Sustainability had been promoted during MAP through funding Income Generating Activities. However, there was a lack of infrastructure and training to make these sustainable. Links between health facilities and communities improved over time, however volunteers’ skills levels had reduced. Conclusions Whilst the World Bank espoused the idea of sustainability in their plans, it remained on the periphery of
Vassos, Maria V; Nankervis, Karen L
Previous research has highlighted that factors such as large workload, role ambiguity, lack of support from colleagues, and challenging behaviour are associated with higher levels of burnout within the disability support worker (DSW) population. The aim of this research was to investigate which factors contribute the most to the prediction of the three facets of burnout--feeling exhausted and overextended by one's work (emotional exhaustion), detached and callous responses towards work (depersonalisation) and a lack of achievement and productivity within one's role (personal accomplishment). The factors chosen for analysis within this research were analysed within four categories linked to theories of burnout development (individual, interpersonal, organisational and demographic). A sample of 108 DSWs completed a questionnaire booklet that contained standardised measures of burnout and job stressors related to disability work. Results highlighted the importance of predictors such as challenging behaviour (interpersonal), workload (individual), supervisor support (individual), work-home conflict (individual), job feedback (individual), role ambiguity (organisational), low job status (organisational), role conflict (organisational), gender (demographic) and work hours (demographic) when predicting one or more of the facets of burnout. In conclusion, disability services and organisations may benefit from focusing on remodelling their staff-related organisational practices in order to prevent the development of burnout in their DSWs (e.g., increase supervision and support practices).
Local authorities in the United Kingdom are required to 'lead' multi-agency humanitarian responses to major disasters. Concerns mounted in the late twentieth century that responses to people bereaved in the immediate aftermath of such events at best failed to meet their needs and at worst compounded their distress. Subsequent reviews and reforms reframed some victim needs as 'rights' and established legal, administrative, and practice frameworks to improve matters. Local authority 'crisis support', provided in partnership with other actors, lies at the heart of the UK's contemporary emergency response to the bereaved. Drawing on primary research on the development and the deployment of crisis support in a local authority, and while acknowledging both incident- and context-related difficulties, this paper considers the significance of challenges with their origins in organisational factors. Recent developments within and between responders may exacerbate them. This paper argues, therefore, that further research into such developments is necessary.
de Witt, Marike W; Lessing, Ansie C
Objective - Educators' perceptions of the psychosocial needs of HIV/AIDS orphans are important in supporting these children. The objective of this research is to determine the view of educators regarding the psychosocial needs of HIV/AIDS affected children. Method - A questionnaire, based on a thorough literature study was administered to determine the views of teachers. A convenient sample of 120 teachers from different schools, who attended a workshop organised for the primary schools in a particular school district in Tswane was used. Results - Only about half of the educators indicated that their schools provided support for HIV/AIDS orphans. Lack of food and clothing were viewed as the most pressing physical needs of the orphans. The desire for security, acceptance, dealing with stress, managing fears and psychological support services were identified as important psychological needs. Lack of security was seen as the most important factor affecting the psychosocial behaviour of these learners. Depression, sadness and stigmatisation were viewed as primary influences on behaviour. Teaching position, gender and age significantly influenced educators' views of various aspects of the learners' needs and behaviours. Conclusion - These findings have important implications for the training of educators to support learners and caregivers of children affected by the disease.
Nguwi, Yok-Yen; Cho, Siu-Yeung
This study discusses the computational analysis of general emotion understanding from questionnaires methodology. The questionnaires method approaches the subject by investigating the real experience that accompanied the emotions, whereas the other laboratory approaches are generally associated with exaggerated elements. We adopted a connectionist model called support-vector-based emergent self-organising map (SVESOM) to analyse the emotion profiling from the questionnaires method. The SVESOM first identifies the important variables by giving discriminative features with high ranking. The classifier then performs the classification based on the selected features. Experimental results show that the top rank features are in line with the work of Scherer and Wallbott [(1994), 'Evidence for Universality and Cultural Variation of Differential Emotion Response Patterning', Journal of Personality and Social Psychology, 66, 310-328], which approached the emotions physiologically. While the performance measures show that using the full features for classifications can degrade the performance, the selected features provide superior results in terms of accuracy and generalisation.
Grossman, Arnold H.; Silverstein, Charles
Describes support groups for health care professionals who work with people with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) and who are experiencing burnout from excessive demands on their energy, strength, and resources. Discusses group administration, effective intervention techniques, and issues of health…
Ford, Norma J.
Purpose: The purpose of this article is to evaluate the diffusion of and user response to an information technology support system (ITSS) which was designed to facilitate inter-organisational coordination and collaboration in the professional development of officers employed by local authorities (LAs). Design/methodology/approach: An action…
This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. In this article, we address ways of organising efforts to support evidence-informed health policymaking. Efforts to link research to action may include a range of activities related to the production of research that is both highly relevant to – and appropriately synthesised for – policymakers. Such activities may include a mix of efforts used to link research to action, as well as the evaluation of such efforts. Little is known about how best to organise the range of activity options available and, until recently, there have been relatively few organisations responsible for supporting the use of research evidence in developing health policy. We suggest five questions that can help guide considerations of how to improve organisational arrangements to support the use of research evidence to inform health policy decision making. These are: 1. What is the capacity of your organisation to use research evidence to inform decision making? 2. What strategies should be used to ensure collaboration between policymakers, researchers and stakeholders? 3. What strategies should be used to ensure independence as well as the effective management of conflicts of interest? 4. What strategies should be used to ensure the use of systematic and transparent methods for accessing, appraising and using research evidence? 5. What strategies should be used to ensure adequate capacity to employ these methods? PMID:20018109
Laszig, P; Clement, U; Gramatikov, L
An explorative meta-analytic study analysed all published empirical studies on social support of HIV/AIDS patients (n = 57 studies with 347 data sets). Empirical and conceptual questions are addressed. The focus of the empirical questions is to identify meta-analytically confirmed correlates of social support. The conceptual question aims at differentiating the large-scale construct "social support". Results indicate that social support 1. is independent of objective physical parameters, 2. is positively correlated with approach coping and negatively with avoidance coping, 3. shows a substantial negative correlation with indicators of psychological distress, 4. is positively correlated with condom use. The conceptual analysis shows that 5. there is no consensus on how to operationalise the construct of "social support".
Richter, Linda M.; Sherr, Lorraine; Adato, Michèle; Belsey, Mark; Chandan, Upjeet; Desmond, Chris; Drimie, Scott; Haour-Knipe, Mary; Hosegood, Victoria; Kimou, Jose; Madhavan, Sangeetha; Mathambo, Vuyiswa; Wakhweya, Angela
This paper provides an overview of the arguments for the central role of families, defined very broadly, and we emphasise the importance of efforts to strengthen families to support children affected by HIV and AIDS. We draw on work conducted in the Joint Learning Initiative on Children and AIDS's Learning Group 1: Strengthening Families, as well as published data and empirical literature to provide the rationale for family strengthening. We close with the following recommendations for strengthening families to ameliorate the effects of HIV and AIDS on children. Firstly, a developmental approach to poverty is an essential feature of responses to protect children affected by HIV and AIDS, necessary to safeguard their human capital. For this reason, access to essential services, such as health and education, as well as basic income security, must be at the heart of national strategic approaches. Secondly, we need to ensure that support garnered for children is directed to families. Unless we adopt a family oriented approach, we will not be in a position to interrupt the cycle of infection, provide treatment to all who need it and enable affected individuals to be cared for by those who love and feel responsible for them. Thirdly, income transfers, in a variety of forms, are desperately needed and positively indicated by available research. Basic economic security will relieve the worst distress experienced by families and enable them to continue to invest in the health care and education of their children. Lastly, interventions are needed to support distressed families and prevent knock-on negative outcomes through programmes such as home visiting, and protection and enhancement of children's potential through early child development efforts. PMID:22380973
This project seeks to establish the current state of human resource management practice in RTOs in Australia. The project takes a strategic approach, particularly in the case study phase where the research will attempt to examine the links between human resource management and the strategy of the organisation. The results of the project will…
Originally developed in the context of family therapy, system constellations are introduced using an organisational learning and system theoretical framework. Constellations are systemic group interventions using a spatial representation of the system elements. They correspond to deutero-learning processes and use higher-order systemic thinking.…
In this paper, I analyse the relationship between US high schools' organisational cultures and student perceptions of responses to anti-gay language in their school. Using data from 67 interviews with young people who identified as gay, lesbian or bisexual, I compare teachers' responses to anti-gay language in schools that do and schools that do…
Sherr, Lorraine; Yakubovich, Alexa R.; Skeen, Sarah; Cluver, Lucie D.; Hensels, Imca S.; Macedo, Ana; Tomlinson, Mark
Community-based responses have a lengthy history. The ravages of HIV on family functioning has included a widespread community response. Although much funding has been invested in front line community-based organisations (CBO), there was no equal investment in evaluations. This study was set up to compare children aged 9–13 years old, randomly sampled from two South African provinces, who had not received CBO support over time (YC) with a group of similarly aged children who were CBO attenders (CCC). YC baseline refusal rate was 2.5% and retention rate was 97%. CCC baseline refusal rate was 0.7% and retention rate was 86.5%. 1848 children were included—446 CBO attenders compared to 1402 9–13 year olds drawn from a random sample of high-HIV prevalence areas. Data were gathered at baseline and 12–15 months follow-up. Standardised measures recorded demographics, violence and abuse, mental health, social and educational factors. Multivariate regression analyses revealed that children attending CBOs had lower odds of experiencing weekly domestic conflict between adults in their home (OR 0.17; 95% CI 0.09, 0.32), domestic violence (OR 0.22; 95% CI 0.08, 0.62), or abuse (OR 0.11; 95% CI 0.05, 0.25) at follow-up compared to participants without CBO contact. CBO attenders had lower odds of suicidal ideation (OR 0.41; 95% CI 0.18, 0.91), fewer depressive symptoms (B = -0.40; 95% CI -0.62, -0.17), less perceived stigma (B = -0.37; 95% CI -0.57, -0.18), fewer peer problems (B = -1.08; 95% CI -1.29, -0.86) and fewer conduct problems (B = -0.77; 95% CI -0.95, -0.60) at follow-up. In addition, CBO contact was associated with more prosocial behaviours at follow-up (B = 1.40; 95% CI 1.13, 1.67). No associations were observed between CBO contact and parental praise or post-traumatic symptoms. These results suggest that CBO exposure is associated with behavioural and mental health benefits for children over time. More severe psychopathology was not affected by attendance and
Visser, Maretha J
The implementation and evaluation of a peer education and support programme in secondary schools to prevent and reduce high-risk sexual behaviour amongst adolescents is discussed.The aims of the programme were to provide accurate information about HIV/AIDS, discuss and reconsider peer group norms, and establish support for learners. In the programme that was implemented in 13 secondary schools in Tshwane, South Africa, peer educators were identified, trained and supported to implement the programme in their schools with the assistance of a teacher and postgraduate students as facilitators. Peer educators organised HIV awareness activities, facilitated class discussions on risk behaviour and gender relationships, and supported learners in solving personal problems. Process evaluation included weekly reports and focus group discussions with peer educators and teachers. A quasiexperimental design involving an experimental and control group, as well as pre- and post-assessments, was used to evaluate the impact of the programme on psychological well-being, personal control, school climate and reported high-risk behaviour of learners aged between 13 and 20 years.The results showed that the percentage of learners in the experimental group who were sexually experienced remained unchanged over the time period of 18 months. In contrast, a significantly increased percentage of learners in the control group were sexually experienced after the same time period.The control group also perceived more of their friends to be sexually experienced. No differences were reported in condom use in either of the groups.The findings of this study suggest that peer education can contribute to a delayed onset of sexual activity, and can therefore contribute to the prevention of HIV/AIDS amongst adolescents.
Abrefa-Gyan, Tina; Wu, Liyun; Lewis, Marilyn W
HIV/AIDS, a chronic burden in Ghana, poses social and health outcome concerns to those infected. Examining the Medical Outcome Study Social Support Survey (MOS-SSS) instrument among 300 Ghanaians from a cross-sectional design, Principal Component Analysis yielded four factors (positive interaction, trust building, information giving, and essential support), which accounted for 85.73% of the total variance in the MOS-SSS. A logistic regression analysis showed that essential support was the strongest predictor of the length of time an individual stayed in the support group, whereas positive interaction indicated negative association. The study's implications for policy, research, and practice were discussed.
Lawton, Clare; Cook, Sharon; May, Andrew; Clemo, Keith; Brown, Susan
The paper discusses a series of driving trials that were conducted to investigate postural stability of disabled drivers and to assess the effectiveness of a representative sample of support aids. Twenty-three disabled drivers with varying levels of physical disability and seven non disabled drivers participated in the study. The test car was equipped with transducers to measure vehicle velocity and acceleration (longitudinal and lateral), steering wheel movement and torque, and the bracing forces exerted by the driver on the steering wheel. Video cameras were installed to record postural support strategies and displacement of the driver and to record deviation of the car from the specified path. Subjective data regarding driver attitudes and acceptance were also collected through the administration of questionnaires. Findings from the study showed that support aids significantly improved driving performance and reduced physical exertion to maintain an upright driving position for disabled drivers. However, ergonomics design aspects regarding the ease of use and acceptance of the support aids by the end users were identified as obstacles to their sustained use in everyday driving.
A group of women formed the Women and AIDS Support Network (WASN) in Zimbabwe in June 1989 to improve women;s self-esteem and confidence and to bring about changes in attitudes and reactions toward AIDS-related problems. Both HIV-positive and HIV-negative women are WASN members. Women have limited control over sexual relationships. Women who know their partners are having intercourse with other women have few options, e.g., they may depend on their partners. A family council settles marital disagreements, but husbands do not always cooperate. Increased peer pressure could change societal acceptance of male infidelity to positive attitudes toward friendship and partnership in marriage. Therefore, WASN explores sexual relationships, especially control and power in them. These discussions should lead to affirmation of positive behavior. For example, men can promote condom use and monogamy to their male peers. They can also talk to their partners and their sons about HIV. Rural women should not blame urban women for their partner's HIV status. WASN also targets schoolgirls. Most early and some current messages of AIDS campaigns reinforces the dichotomy of good and bad women, supported by an earlier link between urban women and sexually transmitted diseases. Yet, they ignored men's role in HIV transmission. WASN speaks out against such negative images, e.g., dramas that depict the HIV-infected woman as evil and the innocent as good while the man worries about which woman infected him instead of feeling awful about infecting other women. WASN also addressee AIDS-related discrimination on the job and stigmatization issues. It now is conducting 2 research projects: information needs of urban and rural women and capacities of family support systems to assist HIV-positive women.
Lippmann, John; Livingston, Patricia; Craike, Melinda J.
Aims: Flexible-learning first aid courses are increasingly common due to reduced classroom contact time. This study compared retention of first aid knowledge and basic life support (BLS) skills three months after a two-day, classroom-based first aid course (STD) to one utilizing on-line theory learning at home followed by one day of classroom…
Faraday, Sally; Harris, Richard
Technical aids and information technology are the subjects of this document, one of 9 modules in an 11-unit resource pack designed to help trainers and postsecondary and continuing education staff meet the needs of special needs students in Great Britain. Having completed the module, staff should be able to: (1) identify technical aids; (2)…
Timmins, Paul; Shepherd, Deborah; Kelly, Tom
This paper describes the evaluation of a local authority behaviour support initiative that involved the re-location of four behaviour support teachers from pupil referral units into three mainstream secondary schools to work with pupils at risk of exclusion. The evaluation was largely illuminative (Parlett, 1981) and focused on the effect of…
Presents findings from interviews conducted with 18 African American women living with HIV/AIDS. Presents their perceptions of ways in which their families function as a source of support and as a source of stress in their dealings with HIV/AIDS issues. Provides information on supportive aspects provided by family in emotional, concrete, and…
Wood, Lesley; Ntaote, Grace Makeletso; Theron, Linda
HIV and AIDS threaten to erode the wellbeing of teachers who are faced with an increasing number of children rendered vulnerable by the pandemic. This article explores the usefulness of a supportive group intervention, Resilient Educators (REds), in supporting Lesotho teachers to respond to the HIV and AIDS-related challenges. A time-series pre-…
Dewar, Belinda; Sharp, Cathy
This article discusses the use of action learning as a structured and deliberate learning process to support practitioners to implement change in an action research project. It discusses both action learning and action research before describing the context of the study. The article then goes on to discuss how the process of action learning…
Williams, Shirley; Spiret, Claire; Dimitriadi, Yota; McCrindle, Rachel
The World Association of Girl Guides and Girl Scouts (WAGGGS) is the umbrella organisation for Member Organisations from 145 countries, with a total membership of 10 million. While Member Organisations offer training and development within their own countries, WAGGGS offers international opportunities, such as leadership development at…
National Centre for Vocational Education Research (NCVER), 2006
An understanding of organisational structure can provide guidance for organisations that want to change and innovate. Many writers agree that this understanding allows organisations to shape how their work is done to ultimately achieve their business goals--and that too often structure is given little consideration in business strategy and…
Li, Li; Wu, Sheng; Wu, Zunyou; Sun, Stephanie; Cui, Haixia; Jia, Manhong
This study examines how family support affects people living with HIV/AIDS (PLHA) in China. In-depth, semi-structured interviews (n=30) were conducted with people living with HIV/AIDS who were infected through different routes (e.g., intravenous drug use, sex) and of different age groups. Findings showed that all of the participants were in great need of help and the primary source of support came from their families. Family support included financial assistance, support in the disclosure process, daily routine activities, medical assistance, or psychological support. This study illustrates that the support provided by family makes multiple levels of positive impact on people living with HIV/AIDS, suggesting the importance of including families in HIV/AIDS interventions. PMID:16741672
... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...
American School Health Association, Kent, OH.
This booklet describes a multi-disciplinary approach to student support services related to the Human Immunodeficiency Virus (HIV) epidemic. The guidelines can be used by student support services personnel to evaluate the quality of services they are providing, by school administrators to design a comprehensive student support services delivery…
Purpose: Seeks to explore the notion of organisational intelligence as a simple extension of the notion of the idea of collective intelligence. Design/methodology/approach: Discusses organisational intelligence using previous research, which includes the Purpose, Properties and Practice model of Dealtry, and the Viable Systems model. Findings: The…
This article reviews the literature on the relationships between gay men with AIDS and their families of origin to determine why the family is not a principal source of social support. Several reasons explain the absence of the family from the support network, including the family's lack of acceptance of homosexuality and the relationship with a male partner; the stigma associated with AIDS; the inability of family members to communicate openly about homosexuality and AIDS; the lack of competence among family members in dealing with HIV issues; and overprotective, infantilizing behavior by parents. A sibling, most often a sister, is the family member to whom the gay man with AIDS feels closest and from whom he is most likely to seek support. Implications for practice and research are discussed.
Lavis, John N; Boyko, Jennifer A; Oxman, Andrew D; Lewin, Simon; Fretheim, Atle
This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policy dialogues allow research evidence to be considered together with the views, experiences and tacit knowledge of those who will be involved in, or affected by, future decisions about a high-priority issue. Increasing interest in the use of policy dialogues has been fuelled by a number of factors: 1. The recognition of the need for locally contextualised 'decision support' for policymakers and other stakeholders 2. The recognition that research evidence is only one input into the decision-making processes of policymakers and other stakeholders 3. The recognition that many stakeholders can add significant value to these processes, and 4. The recognition that many stakeholders can take action to address high-priority issues, and not just policymakers. In this article, we suggest questions to guide those organising and using policy dialogues to support evidence-informed policymaking. These are: 1. Does the dialogue address a high-priority issue? 2. Does the dialogue provide opportunities to discuss the problem, options to address the problem, and key implementation considerations? 3. Is the dialogue informed by a pre-circulated policy brief and by a discussion about the full range of factors that can influence the policymaking process? 4. Does the dialogue ensure fair representation among those who will be involved in, or affected by, future decisions related to the issue? 5. Does the dialogue engage a facilitator, follow a rule about not attributing comments to individuals, and not aim for consensus? 6. Are outputs produced and follow-up activities undertaken to support action?
Nie, Youyan; Chua, Bee Leng; Yeung, Alexander Seeshing; Ryan, Richard M; Chan, Wai Yen
We examine relations between perceived organisational autonomy support and different types of work motivation and well-being outcomes in 266 teachers from two government schools in China. We hypothesised that greater autonomy support would be associated with more autonomous forms of employee motivation, and that teacher motivation would in turn mediate the effects of autonomy support on indicators of work well-being (i.e., job satisfaction, work stress and physical ill symptoms). Results generally supported the hypothesised relations between perceived autonomy support and SDT's five types of motivations. Findings also showed that perceived autonomy support predicted job satisfaction directly and indirectly through the mediating roles of intrinsic motivation, identified regulation, introjected regulation and external regulation. Perceived autonomy support predicted work stress directly and indirectly through the mediating roles of external regulation and amotivation. Autonomy support also predicted illness symptoms via the mediating roles of intrinsic motivation, introjected regulation and amotivation. The current findings highlight how perceived organisational support for autonomy relates to motivational differences in a Chinese work context, and the potential relevance of autonomy support for employee well-being.
Irving, G; Bor, R; Catalan, J
To date, there has been little research to examine how much psychological distress is caused to people providing care and support to a lover or partner with AIDS. This study aimed to determine the level of psychological distress experienced by a sample of gay men providing care and support to a lover or partner with AIDS. It was conducted as a cross-sectional questionnaire survey. A control group was not enlisted, thus the study was descriptive in nature. The experimental hypothesis proposed that providing care and support would result in a high level of psychological distress. Thirty-eight gay men, some of whom themselves were infected with HIV, who were the primary carer of a lover or partner with an AIDS diagnosis were assessed using a self-report questionnaire. The 28-item General Health Questionnaire was used as a measure of global psychological distress. In addition, Martin's (1988) Traumatic Stress Response Scale was used as a measure of psychological distress arising specifically from AIDS. The sample reported high levels of global and AIDS-specific psychological distress. The levels of distress reported were of such a degree to indicate that the majority of the sample were probably suffering from significant psychiatric problems. The results strongly suggest that providing care and support to a lover or partner with AIDS may have an adverse affect on the carer's own psychological health: however, because of the design of the study it is impossible to state this conclusively.
Stewart, Greig M.; Gregory, Barry C.
Support groups are established psychosocial treatment modalities where clients address particular problems or diagnoses. Discusses a long-term (five year) AIDS support group and examines the following issues: (1) marginality; (2) making choices; (3) coping with emotions; (4) premature confrontation of life issues; (5) chronic illness versus…
Jefferson, David K.
Viewgraphs and discussion on data management standards in computer-aided acquisition and logistic support (CALS) are presented. CALS is intended to reduce cost, increase quality, and improve timeliness of weapon system acquisition and support by greatly improving the flow of technical information. The phase 2 standards, industrial environment, are discussed. The information resource dictionary system (IRDS) is described.
Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys
Aged care staff are often seen as holding power in care relationships, particularly in client engagement. Such a perception, however, may limit our understanding and analysis of the dynamics and politics within care spaces. This paper uses interview and focus group data from both staff and clients of an Australian aged care provider to identify the positions given to, and taken up by, staff in client engagement. Focusing on one of these positions, in which staff are seen as managing and negotiating constraints, the paper uses an ethic of care lens to examine the context in which engagement - and this position taking - occurs. Findings reflect the importance of the organisational and systemic context to the practice of care ethics and the potential vulnerability and disempowerment of care giving staff. Implications for the support of staff in client engagement and the role of care organisations beyond structures and processes to an active participant in an ethic of care are discussed.
Low-income students face a number of obstacles that go beyond the cost of tuition and fees. For instance, their schooling often requires expenses that aren't covered by financial aid, such as books and commuting costs. What's more, education is often competing for their time with other responsibilities, such as the need to work or take care of…
Liedlgruber, Michael; Uhl, Andreas
Today, medical endoscopy is a widely used procedure to inspect the inner cavities of the human body. The advent of endoscopic imaging techniques-allowing the acquisition of images or videos-created the possibility for the development of the whole new branch of computer-aided decision support systems. Such systems aim at helping physicians to identify possibly malignant abnormalities more accurately. At the beginning of this paper, we give a brief introduction to the history of endoscopy, followed by introducing the main types of endoscopes which emerged so far (flexible endoscope, wireless capsule endoscope, and confocal laser endomicroscope). We then give a brief introduction to computer-aided decision support systems specifically targeted at endoscopy in the gastrointestinal tract. Then we present general facts and figures concerning computer-aided decision support systems and summarize work specifically targeted at computer-aided decision support in the gastrointestinal tract. This summary is followed by a discussion of some common issues concerning the approaches reviewed and suggestions of possible ways to resolve them.
Chitiyo, Jonathan; Chitiyo, Argnue; Chitiyo, Morgan
Healthy psychosocial development during childhood is a key determinant to the future well-being of all individuals. In many areas of Africa, demand for psychosocial support continues to grow in response to the increasing number of children left orphaned as a result of the HIV/AIDS pandemic. These orphans face various challenges and yet, in most…
General Accounting Office, Washington, DC.
This report from the General Accounting Office reviews selected aspects of Wisconsin's Aid to Families with Dependent Children (AFDC) program. Chapter 1 describes AFDC and specifies the scope of the program review. In Chapter 2 the potential for increasing child support collections from parents is explored. Actions which could increase collections…
Kuo, Caroline; Fitzgerald, Jane; Operario, Don; Casale, Marisa
Drawing upon a sample of 1,599 adults caring for children in HIV-endemic Umlazi Township in South Africa, this cross-sectional survey investigated whether perceived social support varied among caregivers of AIDS-orphaned children (n=359) as compared to caregivers of children orphaned by other causes (n=171) and caregivers of non-orphaned children (n=1,069). Results of multivariate linear regressions indicate that caregivers of AIDS-orphaned children reported significantly lower levels of social support compared to caregivers of other-orphaned children and non-orphaned children independent of socio-demographic covariates. Caregivers of other-orphaned and non-orphaned children reported similar levels of social support. In terms of sources of support, all caregivers were more likely to draw support from family and significant others rather than friends. These findings indicate a need to develop interventions that can increase levels of social support for caregivers of AIDS-orphaned children, particularly networks that include friends and significant others. PMID:22904575
Abrefa-Gyan, Tina; Cornelius, Llewellyn J; Okundaye, Joshua
The increase in the access to biomedical interventions for people living with HIV/AIDS in the developing world has not been adequately matched with the requisite psychosocial treatments to help improve the effectiveness of biomedical interventions. Therefore, in this study the author seeks to determine whether socio-demographic characteristics and social support are associated with quality of life in individuals diagnosed with HIV/AIDS in Ghana. A convenience sample of 300 HIV/AIDS support group members was obtained via cross-sectional design survey. The Medical Outcome Studies (MOS) HIV Health Survey, the MOS Social Support Survey (MOS-SSS), and demographic questionnaire instruments were used to assess quality of life, social support, and demographic information respectively. Multiple regression analysis showed that there was a positive association between overall social support and overall quality of life (r = .51). It also showed that being younger, male, attending support group meetings for over a year, and having ≥ 13 years of schooling related to higher quality of life. Implications of the findings for practice, policy, and research in Ghana and the rest of the developing world are discussed.
Kagan, Jonathan M; Gupta, Nitin; Varghese, Suresh; Virkar, Hemant
The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs.
Mo, Phoenix K H; Coulson, Neil S
The present study examined the nature of social support exchanged within an online HIV/AIDS support group. Content analysis was conducted with reference to five types of social support (information support, tangible assistance, esteem support, network support, and emotional support) on 85 threads (1,138 messages). Our analysis revealed that many of the messages offered informational and emotional support, followed by esteem support and network support, with tangible assistance the least frequently offered. Results suggest that this online support group is a popular forum through which individuals living with HIV/AIDS can offer social support. Our findings have implications for health care professionals who support individuals living with HIV/AIDS.
Atkins, Jana H; Rubenstein, Sarah L; Sota, Teresa L; Rueda, Sergio; Fenta, Haile; Bacon, Jean; Rourke, Sean B
As many as 50% of people living with HIV/AIDS report cognitive difficulties, which can be associated with objective neuropsychological impairments and depression. A number of studies have demonstrated an association between higher social support and lower rates of depression. Using a cross-sectional design, we examined the role social support may play in attenuating the effects of both neuropsychological status and depression on cognitive difficulties. A total of 357 participants completed a battery of neuropsychological tests, questionnaires about cognitive difficulties and depression, and an interview that included an assessment of perceived level of social support. A multivariate linear regression analysis revealed that higher levels of cognitive symptom burden were significantly associated with depression (P<0.05) while lower levels of cognitive symptom burden were significantly associated with greater social support (P<0.01) and higher level of education (P<0.05). There was a significant interaction between neuropsychological status and depression (P<0.001); the presence of neuropsychological impairment with depression was associated with higher levels of cognitive symptom burden. There was also a significant interaction between social support and depression (P<0.05). Interestingly, social support was also associated with a lower cognitive symptom burden for non-depressed individuals living with HIV/AIDS. These findings have important clinical implications for promoting psychological well-being in persons living with HIV/AIDS. To improve quality of life, it is important to screen for and identify individuals with HIV/AIDS who may be depressed and to intervene appropriately. Further research should examine the potential role of social support interventions in modifying the effects of both depression and neuropsychological status on cognitive symptom burden.
Zhao, Guoxiang; Li, Xiaoming; Fang, Xiaoyi; Zhao, Junfeng; Hong, Yan; Lin, Xiuyun; Stanton, Bonita
While the relationship between perceived social support (PSS) and psychosocial well-being has been well documented in the global literature, existing studies also suggest the existence of multiple domains in definition and measurement of PSS. The current study, utilizing data from 1299 rural children affected by HIV/AIDS in central China, examines the relative importance of PSS functional measures (informational/emotional, material/tangible, affectionate, and social interaction) and PSS structural measures (family/relatives, teachers, friends, and significant others) in predicting psychosocial outcomes including internalizing problems, externalizing problems, and educational resilience. Both functional and structural measures of PSS provided reliable measures of related but unique aspects of PSS. The findings of the current study confirmed the previous results that PSS is highly correlated with children's psychosocial well-being and such correlations vary by functions and sources of the PSS as well as different psychosocial outcomes. The findings in the current study suggested the roles of specific social support functions or resources may need to be assessed in relation to specific psychosocial outcome and the context of children's lives. The strong association between PSS and psychosocial outcomes underscores the importance of adequate social support to alleviate stressful life events and improve psychosocial well-being of children affected by HIV/AIDS. Meanwhile, the study findings call for gender and developmentally appropriate and situation-specific social support for children and families affected by HIV/AIDS.
Gilat, Itzhak; Shahar, Golan
In the last two decades, online support groups have become a valuable source of help for individuals in suicidal crisis. Their attractiveness is attributed to features that enhance help-seeking and self-disclosure such as availability, anonymity, and use of written communication. However, online support groups also suffer from limitations and potential risks as agents of suicide prevention. The Israeli Association for Emotional First Aid (ERAN) has developed a practical model that seeks to maximize the benefits and minimize the risks of online suicide prevention. The model applies the Action Theory concepts whereby individuals shape their own environment. The present paper presents the model, which is based on an online support group combined with personal chat and a telephonic help line. The online support group is moderated by paraprofessionals who function as both process regulators and support providers. The principles and practice of the model are described, the theoretical rationale is presented, and directions for future research are suggested.
Nyberg, Beverly J; Yates, Dee Dee; Lovich, Ronnie; Coulibaly-Traore, Djeneba; Sherr, Lorraine; Thurman, Tonya Renee; Sampson, Anita; Howard, Brian
President's Emergency Plan for AIDS Relief (PEPFAR's) response to the millions of children impacted by HIV/AIDS was to designate 10% of its budget to securing their futures, making it the leading supporter of programs reaching orphan and vulnerable children (OVC) programs globally. This article describes the evolution of PEPFAR's OVC response based on programmatic lessons learned and an evergrowing understanding of the impacts of HIV/AIDS. In launching this international emergency effort and transitioning it toward sustainable local systems, PEPFAR helped establish both the technical content and the central importance of care and support for OVC as a necessary complement to biomedical efforts to end the HIV/AIDS epidemic. Critical services are reaching millions of HIV-affected children and families through vast networks of community-based responders and strengthened national systems of care. But rapid program scale-up has at times resulted in inconsistent responses, failure to match resources to properly assessed needs, and a dearth of rigorous program evaluations. Key investments should continue to be directed toward more sustainable and effective responses. These include greater attention to children's most significant developmental stages, a focus on building the resilience of families and communities, a proper balance of government and civil society investments, and more rigorous evaluation and research to ensure evidence-based programming. Even as HIV prevalence declines and medical treatment improves and expands, the impacts of HIV/AIDS on children, families, communities, economies, and societies will continue to accumulate for generations. Protecting the full potential of children-and thus of societies-requires sustained and strategic global investments aligned with experience and science.
Caixeta, Camila Roberto da Costa Borges; Nascimento, Lucila Castanheira; Pedro, Iara Cristina da Silva; Rocha, Semiramis Melani Melo
In this exploratory and descriptive research, we identified the meaning of religion and spirituality in the experience of patients at a public health service for treatment of HIV/AIDS in a Brazilian upcountry town. Eight participants were selected through theoretical sampling. Data were collected through semistructured interviews, and analyzed by means of qualitative content analysis. The emerging themes were religion: a path to support, and God is everything. Religion, as a path that leads patients to different sources of support, included exploration of different churches, acknowledgment of guilt, and finding strength to cope with the disease, rationalization of the disease process, meeting other churchgoers, and finding God and faith. God, an important source of support, was present in prayers, in the belief in healing through faith, and in the feeling of comfort and relief. Because spirituality and religion were seen as important sources of support, in this study we that health professionals include these aspects in care planning.
Yang, Kun; Luo, Huasong; Peng, Shungyun; Xu, Quanli
Based on the deeply analysis of the current status and the existing problems of GIS technology applications in Epidemiology, this paper has proposed the method and process for establishing the spatial decision support systems of AIDS epidemic prevention by integrating the COM GIS, Spatial Database, GPS, Remote Sensing, and Communication technologies, as well as ASP and ActiveX software development technologies. One of the most important issues for constructing the spatial decision support systems of AIDS epidemic prevention is how to integrate the AIDS spreading models with GIS. The capabilities of GIS applications in the AIDS epidemic prevention have been described here in this paper firstly. Then some mature epidemic spreading models have also been discussed for extracting the computation parameters. Furthermore, a technical schema has been proposed for integrating the AIDS spreading models with GIS and relevant geospatial technologies, in which the GIS and model running platforms share a common spatial database and the computing results can be spatially visualized on Desktop or Web GIS clients. Finally, a complete solution for establishing the decision support systems of AIDS epidemic prevention has been offered in this paper based on the model integrating methods and ESRI COM GIS software packages. The general decision support systems are composed of data acquisition sub-systems, network communication sub-systems, model integrating sub-systems, AIDS epidemic information spatial database sub-systems, AIDS epidemic information querying and statistical analysis sub-systems, AIDS epidemic dynamic surveillance sub-systems, AIDS epidemic information spatial analysis and decision support sub-systems, as well as AIDS epidemic information publishing sub-systems based on Web GIS.
Vassos, Maria V.; Nankervis, Karen L.
Previous research has highlighted that factors such as large workload, role ambiguity, lack of support from colleagues, and challenging behaviour are associated with higher levels of burnout within the disability support worker (DSW) population. The aim of this research was to investigate which factors contribute the most to the prediction of the…
Ruiller, Caroline; Van Der Heijden, Beatrice I J M
In spite of the differences in human resource management (HRM) practices between the non-profit health care sector and business life, the majority of health care sector research appears to be based on the HRM (for human resources management) blueprint for business life staff policy and practice. This study is aimed to better understand the impact of workplace social support in the context of French hospitals. Concrete, the first objective of this article comprises a thorough conceptualization and operationalization of workplace social support (i.e. both professional and personal social support). Data were collected in a French hospital among a sample of 62 respondents (for the qualitative part of our study), and among a sample of 171 health care professionals (nurses and nurse aids) (for the quantitative part of our study). Our outcomes indicate that, especially, personal support given by one's supervisor is strongly and positively related to nurses' and nurse aides' affective commitment. After a discussion about the outcomes, followed by some recommendations for future research, the article concludes with some practical implications for management in hospitals.
Iwakiri, Kazuyuki; Kunisue, Reiko; Sotoyama, Midori; Udo, Hiroshi
In this study, we evaluated the effects on subjective discomfort among cooks during food preparation through use of a standing aid that we developed to alleviate the workload on the low back in the forward-bent posture. Twelve female cooks who worked in a kitchen in a nursing home were asked to prepare foods in 2 working postures: (a) supported by the standing aid (Aid) and (b) without the aid (No aid). They were instructed to evaluate discomfort in 13-body regions during food preparation and the degree of fatigue at the day's end and to enter their ratings after the end of the workday. Since a significant correlation was observed between body height and the improvement effect of discomfort through use of the standing aid, cooks were divided into two groups according to the height, and ratings were analyzed in each group. Among the tall cooks, subjective discomfort in the low back and the front and back of thighs was significantly less with the Aid posture than with the No aid posture. However, in short cooks these values tended to increase in the Aid posture compared with the No aid posture. The results suggest that the standing aid was effective in alleviating tall cooks' workload on the low back in the forward-bent posture.
This article offers an analysis of the significance of public pedagogy for how community-based organizations that provide prevention, support, and educational services to people infected and affected by HIV/AIDS operate. The article reports on a case study analysis of a local AIDS service organization (ASO) in a small town in Ontario, Canada. The…
Under the Marine Strategy Framework Directive (MSFD), EU Member States are mandated to achieve or maintain 'Good Environmental Status' (GES) in their marine areas by 2020, through a series of Programme of Measures (PoMs). The Celtic Seas Partnership (CSP), an EU LIFE+ project, aims to support policy makers, special-interest groups, users of the marine environment, and other interested stakeholders on MSFD implementation in the Celtic Seas geographical area. As part of this support, a metadata portal has been built to provide a signposting service to datasets that are relevant to MSFD within the Celtic Seas. To ensure that the metadata has the widest possible reach, a linked data approach was employed to construct the database. Although the metadata are stored in a traditional RDBS, the metadata are exposed as linked data via the D2RQ platform, allowing virtual RDF graphs to be generated. SPARQL queries can be executed against the end-point allowing any user to manipulate the metadata. D2RQ's mapping language, based on turtle, was used to map a wide range of relevant ontologies to the metadata (e.g. The Provenance Ontology (prov-o), Ocean Data Ontology (odo), Dublin Core Elements and Terms (dc & dcterms), Friend of a Friend (foaf), and Geospatial ontologies (geo)) allowing users to browse the metadata, either via SPARQL queries or by using D2RQ's HTML interface. The metadata were further enhanced by mapping relevant parameters to the NERC Vocabulary Server, itself built on a SPARQL endpoint. Additionally, a custom web front-end was built to enable users to browse the metadata and express queries through an intuitive graphical user interface that requires no prior knowledge of SPARQL. As well as providing means to browse the data via MSFD-related parameters (Descriptor, Criteria, and Indicator), the metadata records include the dataset's country of origin, the list of organisations involved in the management of the data, and links to any relevant INSPIRE
Cummins, John; And Others
This handbook is part of a British series of publications written for part-time tutors, volunteers, organizers, and trainers in the adult continuing education and training sectors. It offers practical advice on audiovisual aids and educational technology for tutors and organizers. The first chapter discusses how one learns. Chapter 2 addresses how…
Su, Xiaoyou; Lau, Joseph T F; Mak, Winnie W S; Chen, Lin; Choi, K C; Song, Junmin; Zhang, Yan; Zhao, Guanglu; Feng, Tiejian; Chen, Xi; Liu, Chuliang; Liu, Jun; Liu, De; Cheng, Jinquan
Perceived stress among people living with HIV/AIDS (PLWH) was associated with severe mental health problems and risk behaviors. Discrimination toward PLWH in China is prevalent. Both perceived discrimination and social supports are determinants of the stress level among PLWH. Psychological support services for PLWH in China are scarce. It is unknown whether social support is a buffer between the perceived discrimination and perceived stress. With written consent, this study surveyed 258 PLWH recruited from multiple sources in two cities in China. Instruments were validated in previous or the present study, including the perceived stress scale for PLWH (PSSHIV), the perceived social support scale (PSSS), and the perceived discrimination scale for PLWH (PDSHIV). Pearson correlations and multiple regression models were fit. PDSHIV was associated with the Overall Scale and all subscales of PSSHIV, whilst lower socioeconomic status in general and lower scores of PSSS were associated with various subscales of PSSHIV. The interaction item (PSSS×PSDHIV) was nonsignificant in modeling PSSHIV, hence no significant moderating effect was detected. Whilst perceived discrimination is a major source of stress and social support can reduce stress among PLWH in China, improved social support cannot buffer the stressful consequences due to perceived discrimination. The results highlight the importance to reduce discrimination toward PLWH and the difficulty to alleviate its negative consequences. It is warranted to improve mental health among PLWH in China and it is still important to foster social support among PLWH as it has direct effects on perceived stress.
Hunt, D. L.; Haynes, R. B.; Morgan, D.
BACKGROUND: Implementation rates of interventions known to be beneficial for people with diabetes mellitus are often suboptimal. Computer-aided decision support systems (CDSSs) can improve these rates. The complexity of establishing a fully integrated electronic medical record that provides decision support, however, often prevents their use. OBJECTIVE: To develop a CDSS for diabetes care that can be easily introduced into primary care settings and diabetes clinics. THE SYSTEM: The CDSS uses fax-machine-based optical character recognition software for acquiring patient information. Simple, 1-page paper forms, completed by patients or health practitioners, are faxed to a central location. The information is interpreted and recorded in a database. This initiates a routine that matches the information against a knowledge base so that patient-specific recommendations can be generated. These are formatted and faxed back within 4-5 minutes. IMPLEMENTATION: The system is being introduced into 2 diabetes clinics. We are collecting information on frequency of use of the system, as well as satisfaction with the information provided. CONCLUSION: Computer-aided decision support can be provided in any setting with a fax machine, without the need for integrated electronic medical records or computerized data-collection devices. PMID:11825194
Belle, Ashwin; Kon, Mark A; Najarian, Kayvan
The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest.
Belle, Ashwin; Kon, Mark A.; Najarian, Kayvan
The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest. PMID:23431259
Salas-Gonzalez, D.; Górriz, J. M.; Ramírez, J.; López, M.; Álvarez, I.; Segovia, F.; Chaves, R.; Puntonet, C. G.
This paper presents a computer-aided diagnosis technique for improving the accuracy of early diagnosis of Alzheimer-type dementia. The proposed methodology is based on the selection of voxels which present Welch's t-test between both classes, normal and Alzheimer images, greater than a given threshold. The mean and standard deviation of intensity values are calculated for selected voxels. They are chosen as feature vectors for two different classifiers: support vector machines with linear kernel and classification trees. The proposed methodology reaches greater than 95% accuracy in the classification task.
Khedher, Laila; Illán, Ignacio A; Górriz, Juan M; Ramírez, Javier; Brahim, Abdelbasset; Meyer-Baese, Anke
Computer-aided diagnosis (CAD) systems constitute a powerful tool for early diagnosis of Alzheimer's disease (AD), but limitations on interpretability and performance exist. In this work, a fully automatic CAD system based on supervised learning methods is proposed to be applied on segmented brain magnetic resonance imaging (MRI) from Alzheimer's disease neuroimaging initiative (ADNI) participants for automatic classification. The proposed CAD system possesses two relevant characteristics: optimal performance and visual support for decision making. The CAD is built in two stages: a first feature extraction based on independent component analysis (ICA) on class mean images and, secondly, a support vector machine (SVM) training and classification. The obtained features for classification offer a full graphical representation of the images, giving an understandable logic in the CAD output, that can increase confidence in the CAD support. The proposed method yields classification results up to 89% of accuracy (with 92% of sensitivity and 86% of specificity) for normal controls (NC) and AD patients, 79% of accuracy (with 82% of sensitivity and 76% of specificity) for NC and mild cognitive impairment (MCI), and 85% of accuracy (with 85% of sensitivity and 86% of specificity) for MCI and AD patients.
Siminoff, L A; Sandberg, D E
Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach.
Attawell, Kathy; Elder, Katharine
Although there is a need for enhanced evidence-based information on successful HIV and AIDS education interventions, much has already been learnt about good practices and policies in the education sector's response to the pandemic. This booklet, to be used in tandem with others in the series, aims to further expand our knowledge by highlighting…
DeLaura, F.L.; Sharp, S.J.; Clark, R.
The Department of Defense is committed to applying the best in modern technology toward improving the transfer of design, engineering, and manufacturing technical information among weapon-system contractors and DoD organizations. The Military Services, the Defense Logistics Agency (DLA), the Defense Communications Agency (DCA), and industry are undertaking or planning telecommunications support for such transfer. In view of these many and diverse efforts, the Computer Aided Logistics Support (CALS) Steering Group through the CALS Communications Working Group has recognized the need for evaluating them. The report presents an evaluation of CALS-related telecommunications requirements in DoD, the major efforts for automating engineering drawing and technical data repositories, and various intelligent-gateway efforts in each of the Services. The overall direction within each Service for telecommunication support and transitioning to the OSI (Open Systems Interconnection) standards is presented, as well as the status of commercial efforts for defining and implementing the OSI standards and improving long-haul telecommunications support.
Marquez, Jessica J.; Pyrzak, Guy; Hashemi, Sam; Ahmed, Samia; McMillin, Kevin Edward; Medwid, Joseph Daniel; Chen, Diana; Hurtle, Esten
Since 2003, the NASA Ames Research Center has been actively involved in researching and advancing the state-of-the-art of planning and scheduling tools for NASA mission operations. Our planning toolkit SPIFe (Scheduling and Planning Interface for Exploration) has supported a variety of missions and field tests, scheduling activities for Mars rovers as well as crew on-board International Space Station and NASA earth analogs. The scheduled plan is the integration of all the activities for the day/s. In turn, the agents (rovers, landers, spaceships, crew) execute from this schedule while the mission support team members (e.g., flight controllers) follow the schedule during execution. Over the last couple of years, our team has begun to research and validate methods that will better support users during realtime operations and execution of scheduled activities. Our team utilizes human-computer interaction principles to research user needs, identify workflow processes, prototype software aids, and user test these. This paper discusses three specific prototypes developed and user tested to support real-time operations: Score Mobile, Playbook, and Mobile Assistant for Task Execution (MATE).
Guillon, Myrtille; Mace, Ruth
The classification of kin into structured groups is a diverse phenomenon which is ubiquitous in human culture. For populations which are organized into large agropastoral groupings of sedentary residence but not governed within the context of a centralised state, such as our study sample of 83 historical Bantu-speaking groups of sub-Saharan Africa, cultural kinship norms guide all aspects of everyday life and social organization. Such rules operate in part through the use of differing terminological referential systems of familial organization. Although the cross-cultural study of kinship terminology was foundational in Anthropology, few modern studies have made use of statistical advances to further our sparse understanding of the structuring and diversification of terminological systems of kinship over time. In this study we use Bayesian Markov Chain Monte Carlo methods of phylogenetic comparison to investigate the evolution of Bantu kinship terminology and reconstruct the ancestral state and diversification of cousin terminology in this family of sub-Saharan ethnolinguistic groups. Using a phylogenetic tree of Bantu languages, we then test the prominent hypothesis that structured variation in systems of cousin terminology has co-evolved alongside adaptive change in patterns of descent organization, as well as rules of residence. We find limited support for this hypothesis, and argue that the shaping of systems of kinship terminology is a multifactorial process, concluding with possible avenues of future research.
Guillon, Myrtille; Mace, Ruth
The classification of kin into structured groups is a diverse phenomenon which is ubiquitous in human culture. For populations which are organized into large agropastoral groupings of sedentary residence but not governed within the context of a centralised state, such as our study sample of 83 historical Bantu-speaking groups of sub-Saharan Africa, cultural kinship norms guide all aspects of everyday life and social organization. Such rules operate in part through the use of differing terminological referential systems of familial organization. Although the cross-cultural study of kinship terminology was foundational in Anthropology, few modern studies have made use of statistical advances to further our sparse understanding of the structuring and diversification of terminological systems of kinship over time. In this study we use Bayesian Markov Chain Monte Carlo methods of phylogenetic comparison to investigate the evolution of Bantu kinship terminology and reconstruct the ancestral state and diversification of cousin terminology in this family of sub-Saharan ethnolinguistic groups. Using a phylogenetic tree of Bantu languages, we then test the prominent hypothesis that structured variation in systems of cousin terminology has co-evolved alongside adaptive change in patterns of descent organization, as well as rules of residence. We find limited support for this hypothesis, and argue that the shaping of systems of kinship terminology is a multifactorial process, concluding with possible avenues of future research. PMID:27008364
Iwakiri, Kazuyuki; Sotoyama, Midori; Mori, Ippei; Jonai, Hiroshi; Saito, Susumu
In order to prevent low back pain (LBP) during dishwashing, we developed three types of aid with a thick cushion for supporting the shins and evaluated the effects of the standing aid on the subjective discomfort and muscle activities. Nine female volunteers were asked to wash plates in each of four working postures: (a) without the standing aid, (b) with the round type of aid, (c) with the small rectangular type of aid, and (d) with the large rectangular type of aid. With the three types of aid, the subjects were instructed to support the shins with the standing aid and to support the abdomen with the edge of a kitchen counter. In the three postures with the standing aid, 21.5 +/- 10.0% of the weight was supported with the standing aid and the kitchen counter. The subjective discomfort was milder and the muscle activity level in the low back was lower in the three postures with the standing aid than in the posture without the aid. It was thought that the round type of aid would be more effective in decreasing the discomfort in many of body regions and the muscle load on the low back than either of the rectangular types of aid. Therefore, it was suggested that the standing aid had the desired effect in decreasing discomfort and muscle load on the low back during dishwashing.
McHunu, Gugu; Ncama, Busisiwe; Naidoo, Joanne Rachel; Majeke, Sisana; Myeza, Thandazile; Ndebele, Thandiwe; Pillay, Padmini
In South Africa, the minibus taxi drivers are largely becoming another high-risk category in the HIV and AIDS epidemic. Although previous studies have shown that knowledge of HIV and AIDS is relatively high among the taxi drivers it is still not clear how this sub-population perceive the support rendered to them with regard to HIV and AIDS prevention strategies. This study aimed to focus on this atypical workplace and explore the KwaZulu-Natal, minibus taxi drivers' perceptions on HIV and AIDS. In this study, qualitative methods were utilized to determine the minibus taxi drivers' understanding of HIV and AIDS infection, HIV prevention strategies, existing support strategies and effects of HIV and AIDS on the taxi industry. Focus-group discussions were conducted, to collect data. The results showed that even though the taxi drivers had some understanding on HIV and AIDS there was still a dire need for interventions that were geared towards addressing HIV-related needs of the drivers in this industry.
Chen, Liang; Shi, Jingyuan
In recent years, social media has become an important source of social support. People living with HIV/AIDS in China created an online support group (the HIV/AIDS Weibo Group) on Weibo, the Chinese version of Twitter, in January 2011. The current study examined how social support transmitted in this social media community. First, messages over five successive weeks (2 May 2011 to 13 June 2011) were randomly selected from the HIV/AIDS Weibo Group on Weibo. Next, we employed social network analysis to map the HIV/AIDS Weibo Group's structure and to measure the study variables. After that, a multivariate analysis of variance was applied to examine the influence of frequency of contact and reciprocity on informational and emotional social support exchanged in each dyad. The results revealed that pairs with a high level of contact frequency or reciprocity exchanged more informational support than do pairs with a low level of contact frequency or reciprocity. Moreover, dyadic partners with high frequency of contact exchanged a larger amount of emotional support than those with a low level frequency of contact; but strongly reciprocal dyads did not exchange significantly more emotional social support than their counterparts with a low level of reciprocity.
Bloomfield, Jacqueline; Pegram, Anne
Organisational aspects of care, the second essential skills cluster, identifies the need for registered nurses to systematically assess, plan and provide holistic patient care in accordance with individual needs. Safeguarding, supporting and protecting adults and children in vulnerable situations; leading, co-ordinating and managing care; functioning as an effective and confident member of the multidisciplinary team; and managing risk while maintaining a safe environment for patients and colleagues, are vital aspects of this cluster. This article discusses the roles and responsibilities of the newly registered graduate nurse. Throughout their education, nursing students work towards attaining this knowledge and these skills in preparation for their future roles as nurses.
Burkina Faso is among the largest recipients of development aid in West Africa. The new aid terminology emphasizes partnership and a sectoral approach. Yet, recent research suggests more continuity than change in the aid relationship. Projects persist. Funding and technical assistance agencies cooperate more but adhere to their interests,…
Gray, Eric; Maducdoc, Marlon; Manuel, Cyrus; Wong, Brian J. F.
IMPORTANCE Palpation of the nasal tip is an essential component of the preoperative rhinoplasty examination. Measuring tip support is challenging, and the forces that correspond to ideal tip support are unknown. OBJECTIVE To identify the integrated reaction force and the minimum and ideal mechanical properties associated with nasal tip support. DESIGN, SETTING, AND PARTICIPANTS Three-dimensional (3-D) printed anatomic silicone nasal models were created using a computed tomographic scan and computer-aided design software. From this model, 3-D printing and casting methods were used to create 5 anatomically correct nasal models of varying constitutive Young moduli (0.042, 0.086, 0.098, 0.252, and 0.302 MPa) from silicone. Thirty rhinoplasty surgeons who attended a regional rhinoplasty course evaluated the reaction force (nasal tip recoil) of each model by palpation and selected the model that satisfied their requirements for minimum and ideal tip support. Data were collected from May 3 to 4, 2014. RESULTS Of the 30 respondents, 4 surgeons had been in practice for 1 to 5 years; 9 surgeons, 6 to 15 years; 7 surgeons, 16 to 25 years; and 10 surgeons, 26 or more years. Seventeen surgeons considered themselves in the advanced to expert skill competency levels. Logistic regression estimated the minimum threshold for the Young moduli for adequate and ideal tip support to be 0.096 and 0.154 MPa, respectively. Logistic regression estimated the thresholds for the reaction force associated with the absolute minimum and ideal requirements for good tip recoil to be 0.26 to 4.74 N and 0.37 to 7.19 N during 1- to 8-mm displacement, respectively. CONCLUSIONS AND RELEVANCE This study presents a method to estimate clinically relevant nasal tip reaction forces, which serve as a proxy for nasal tip support. This information will become increasingly important in computational modeling of nasal tip mechanics and ultimately will enhance surgical planning for rhinoplasty. LEVEL OF EVIDENCE
Sharer, Melissa; Cluver, Lucie; Shields, Joseph J.; Ahearn, Frederick
ABSTRACT Children affected by HIV and AIDS have significantly higher rates of mental health problems than unaffected children. There is a need for research to examine how social support functions as a source of resiliency for children in high HIV-prevalence settings such as South Africa. The purpose of this research was to explore how family social support relates to depression, anxiety, and post-traumatic stress (PTS). Using the ecological model as a frame, data were drawn from a 2011 cross-sectional study of 1380 children classified as either orphaned by AIDS and/or living with an AIDS sick family member. The children were from high-poverty, high HIV-prevalent rural and urban communities in South Africa. Social support was analyzed in depth by examining the source (e.g. caregiver, sibling) and the type (e.g. emotional, instrumental, quality). These variables were entered into multiple regression analyses to estimate the most parsimonious regression models to show the relationships between social support and depression, anxiety, and PTS symptoms among the children. Siblings emerged as the most consistent source of social support on mental health. Overall caregiver and sibling support explained 13% variance in depression, 12% in anxiety, and 11% in PTS. Emotional support was the most frequent type of social support associated with mental health in all regression models, with higher levels of quality and instrumental support having the strongest relation to positive mental health outcomes. Although instrumental and quality support from siblings were related to positive mental health, unexpectedly, the higher the level of emotional support received from a sibling resulted in the child reporting more symptoms of depression, anxiety, and PTS. The opposite was true for emotional support provided via caregivers, higher levels of this support was related to lower levels of all mental health symptoms. Sex was significant in all regressions, indicating the presence of
Aid Delivery System: Phase 2 January 29, 2016 Approved for public release; distribution is unlimited. Lauryn E. DEGrEEff SuSan L. roSE-PEhrSSon Navy...Characterization, and Optimization of a Canine Training Aid Delivery System: Phase 2 Lauryn E. DeGreeff, Susan L. Rose-Pehrsson, Michael Malito,* and...Evaluation of homemade explosives (HMEs)........................................ 6 Evaluation of ammonium nitrate and aluminum (AN-Al) training aids
Hegenbart, Sebastian; Uhl, Andreas; Vécsei, Andreas
Celiac disease (CD) is a complex autoimmune disorder in genetically predisposed individuals of all age groups triggered by the ingestion of food containing gluten. A reliable diagnosis is of high interest in view of embarking on a strict gluten-free diet, which is the CD treatment modality of first choice. The gold standard for diagnosis of CD is currently based on a histological confirmation of serology, using biopsies performed during upper endoscopy. Computer aided decision support is an emerging option in medicine and endoscopy in particular. Such systems could potentially save costs and manpower while simultaneously increasing the safety of the procedure. Research focused on computer-assisted systems in the context of automated diagnosis of CD has started in 2008. Since then, over 40 publications on the topic have appeared. In this context, data from classical flexible endoscopy as well as wireless capsule endoscopy (WCE) and confocal laser endomicrosopy (CLE) has been used. In this survey paper, we try to give a comprehensive overview of the research focused on computer-assisted diagnosis of CD. PMID:25770906
de Ruijter, Pim A.; Biersteker, Heleen A.; Biert, Jan; van Goor, Harry; Tan, Edward C.
Background Undergraduate medical students follow a compulsory first aid (FA) and basic life support (BLS) course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in undergraduate medical students. Methods One hundred and twenty students were randomly selected from first year (n=349) medical students who successfully followed a compulsory FA and BLS course. From these 120 students, 94 (78%) and 69 (58%) participated in retention tests of FA and BLS skills after 1 and 2 years, respectively. The assessment consisted of two FA stations and one BLS station. Results After 1 year, only 2% passed both FA and BLS stations and 68% failed both FA and BLS stations. After 2 years, 5% passed and 50% failed both FA and BLS stations. Despite the high failure rate at the stations, 90% adequately checked vital signs and started cardiopulmonary resuscitation appropriately. Conclusions The long-term retention of FA and BLS skills after a compulsory course in the first year is poor. Adequate check of vital signs and commencing cardiopulmonary resuscitation retained longer. PMID:25382803
Capone, P L; Lane, J C; Kerr, C S; Safar, P
Accidents in developing countries are frequent and have high mortality and morbidity rates. In Brazil, in 1995-1996, the year of this study, life supporting first aid (LSFA), which includes cardiopulmonary resuscitation (CPR) basic life support (BLS) was not taught in schools. With the population of 165 million, the only way to teach the adult population on a large scale would be by television (TV), that is widely viewed. This study compares two groups of factory employees - 86 controls without TV exposure to LSFA and 116 exposed to brief LSFA skill demonstrations on TV. Their ability to acquire eight LSFA skills was evaluated: external hemorrhage control; immobilization of a suspected forearm fracture; treatment of a skin burn by cold flush; body alignment after a fall; positioning for shock and coma; airway control by backward tilt of the head; and CPR (steps A-B-C). Simulated skill performance on the evaluating nurse or manikin was tested at 1 week, 1 month, and 13 months. In the control group, 1-31% performed individual skills correctly; as compared to 9-96% of the television group (P<0.001). There was excellent retention over 13 months. Over 50% of the television group performed correctly five of the eight skills, including positioning and hemorrhage control. Television viewing increased correct airway control performance from 5 to 25% of trainees, while it remained at 3% in the control group. CPR-ABC performance, however, was very poor in both groups. We conclude that a significant proportion of factory workers can acquire simple LSFA skills through television viewing alone, except for the skill acquisition of CPR steps B (mouth-to-mouth ventilation) and C (external chest compressions) which need coached manikin practice.
National Centre for Vocational Education Research (NCVER), 2006
Structural change is seen as a way to meet the challenges of the future that face many organisations. While some writers agree that broad-ranging structural change may not always transform an organisation or enhance its performance, others claim that innovation will be a major source of competitive advantage to organisations, particularly when…
Gustafson, D. H.; Hawkins, R. P.; Boberg, E. W.; Bricker, E.; Pingree, S.; Chan, C. L.
CHESS (the Comprehensive Health Enhancement Support System) is an interactive, computer-based system to support people facing AIDS/HIV Infection and other health-related crises or concerns. CHESS provides information, referral to service providers, support in making tough decisions and networking to experts and others facing the same concerns. CHESS is designed to improve access to health and human services for people who would otherwise face psychological, social, economic or geographic barriers to receiving services. CHESS has been evaluated in a random-assignment study with over 200 men and women living with AIDS and HIV infection. When CHESS was placed in subjects' homes for 3-6 months, use of CHESS was extremely heavy, with the average subject using CHESS 138 times for 39 hours. Compared with a control group which did not receive CHESS, subjects who used CHESS reported significantly higher quality of life in several dimensions, including social support and cognitive functioning. Users also reported significant reductions in some types of health care costs, especially inpatient services (hospitalizations). All segments of the study population used and benefited from CHESS, including women, minorities and those subjects with lower levels of education. Thus, CHESS appears to be an effective means of delivering education and support to the diverse populations which are affected by AIDS and HIV infection. PMID:7949999
International and African discourses on the HIV/AIDS pandemic and intervention neglect the role of religion and religious organizations. Social science perspectives in tackling health and disease neglect religious doctrines and faith central to worldviews and praxis of religious groups. Both aspects are important for religious groups and individuals affected by HIV/AIDS. Informed by a religious studies paradigm and through the religious ethnography of the Redeemed Christian Church of God (RCCG) in Nigeria and the Diaspora, this article demonstrates mechanisms employed by African Pentecostals to combat the epidemic and provide support for infected members. The RCCG conceptualization of disease and healing is central to understanding responses and measures in combating HIV/AIDS.
Attaran, A; Sachs, J
The international aid effort against AIDS is greatly incommensurate with the severity of the epidemic. Drawing on the data that international aid donors self-reported to the Organization for Economic Cooperation and Development (OECD), we find that, between 1996 and 1998, finance from all rich countries to sub-Saharan Africa for projects designated as AIDS control averaged US $69 million annually, and, assuming a safe margin for under-reporting and misreporting, we estimate that total donor spending on HIV/AIDS control was perhaps twice that at most. Since the late 1980s, aid levels have dropped relative to the prevalence of HIV infection, and stood recently at about $3 per HIV-infected person. Lack of finance is now the primary constraint on progress against AIDS, notwithstanding the widespread belief that a lack of interest from the goveements of poor countries is limiting. We argue that to produce a meaningful response to the pandemic, international assistance must be based on grants, not loans, for the poorest countries; be increased within the next 3 years to a minimum of $7.5 billion or more; be directed toward funding projects which are proposed and desired by the affected countries themselves, and which are judged as having epidemiological merit against the pandemic by a panel of independent scientific experts; and fund concurrent needs, including prevention, drug treatment (such as highly active antiretroviral therapy), and blocking mother-to-child HIV transmission. An effort of this scope and scale will both radically alter the prospects for intervention against AIDS in poor countries, and together with comparable efforts to control other infectious diseases, is easily afforded by the OECD donor economies, whose aggregate national income recently surpassed $21 trillion annually.
Tsai, Alexander C; Bangsberg, David R; Frongillo, Edward A; Hunt, Peter W; Muzoora, Conrad; Martin, Jeffrey N; Weiser, Sheri D
Depression is common among people living with HIV/AIDS and contributes to a wide range of worsened HIV-related outcomes, including AIDS-related mortality. Targeting modifiable causes of depression, either through primary or secondary prevention, may reduce suffering as well as improve HIV-related outcomes. Food insecurity is a pervasive source of uncertainty for those living in resource-limited settings, and cross-sectional studies have increasingly recognized it as a critical determinant of poor mental health. Using cohort data from 456 men and women living with HIV/AIDS initiating HIV antiretroviral therapy in rural Uganda, we sought to (a) estimate the association between food insecurity and depression symptom severity, (b) assess the extent to which social support may serve as a buffer against the adverse effects of food insecurity, and (c) determine whether the buffering effects are specific to certain types of social support. Quarterly data were collected by structured interviews and blood draws. The primary outcome was depression symptom severity, measured by a modified Hopkins Symptom Checklist for Depression. The primary explanatory variables were food insecurity, measured with the Household Food Insecurity Access Scale, and social support, measured with a modified version of the Functional Social Support Questionnaire. We found that food insecurity was associated with depression symptom severity among women but not men, and that social support buffered the impacts of food insecurity on depression. We also found that instrumental support had a greater buffering influence than emotional social support. Interventions aimed at improving food security and strengthening instrumental social support may have synergistic beneficial effects on both mental health and HIV outcomes among PLWHA in resource-limited settings.
Prosthetic rehabilitation with an implant-supported fixed prosthesis using computer-aided design and computer-aided manufacturing dental technology for a patient with a mandibulectomy: A clinical report.
Yoon, Hyung-In; Han, Jung-Suk
The fabrication of dental prostheses with computer-aided design and computer-aided manufacturing shows acceptable marginal fits and favorable treatment outcomes. This clinical report describes the management of a patient who had undergone a mandibulectomy and received an implant-supported fixed prosthesis by using additive manufacturing for the framework and subtractive manufacturing for the monolithic zirconia restorations.
Globally, acquired immunodeficiency syndrome (AIDS) is an epidemic, severe and fatal disease. Along with the etiological factors of human immunodeficiency virus infection (HIV+) and decreased immunity, there are a number of other risk factors including opportunistic infection, malnutrition, wasting syndrome, and oxidative stress. The nutritional problems have been shown to be significant and contribute to health and death in HIV+/AIDS patients. Weight loss, lean tissue depletion, lipoatrophy, loss of appetite, diarrhea, and the hypermetabolic state each increase risk of death. The role of nutrition and how oxidative stress is involved in the pathogenesis of HIV+ leading to AIDS is reviewed. Studies consistently show that serum antioxidant vitamins and minerals decrease while oxidative stress increases during AIDS progression. The optimization of nutritional status, intervention with foods and supplements, including nutrients and other bio-active food components, are needed to maintain the immune system. Various food components may be recommended to reduce the incidence and severity of infectious illnesses by forms of bio-protection which include reduced oxidative stress due to reactive oxygen species which stimulate HIV replication and AIDS progression. Probiotics or lactic acid bacteria and prebiotics are sometimes given on the presumed basis that they help maintain integrity of mucosal surfaces, improve antibody responses and increase white blood cell production. People with HIV+/AIDS can be informed about the basic concepts of optimal nutrition by identifying key foods and nutrients, along with lifestyle changes, that contribute to a strengthened immune system. Moreover, nutritional management, counseling and education should be beneficial to the quality and extension of life in AIDS.
This article discusses the identity of HIV/AIDS caregivers as constructed by a group of HIV/AIDS caregivers at a non-profit organisation in South Africa. During a 12-month period data were collected through interviews with the organisation's staff and volunteers. Using discourse analysis, the study identified a caregiver identity constructed by participants. This caregiving identity acts as a double-edged sword: while the rewards of caregiving act as a buffer against stressful experiences, the prescriptive nature of the caregiver identity is taxing, and may explain burnout among HIV/AIDS caregivers. The study concludes that for support systems for HIV/AIDS caregivers to be effective, the social culture and identity of HIV/AIDS caregivers must be considered.
Mohammed, Meca B.; Welch, Jennie; Hazle Bussey, Leslie
A growing number of organisations are emerging as partners to districts pursuing systemic improvement. Given the critical role a consulting organisation could play in supporting system reform efforts, how does a district leader looking to establish a consulting partnership determine what characteristics in a consulting organisation may be more…
Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie
As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance
Kautz, Tim; Bendavid, Eran; Bhattacharya, Jay
Objectives To determine the relation between the HIV/AIDS epidemic and support for dependent elderly people in Africa. Design Retrospective analysis using data from Demographic and Health Surveys. Setting 22 African countries between 1991 and 2006. Participants 123 176 individuals over the age of 60. Main outcome measures We investigated how three measures of the living arrangements of older people have been affected by the HIV/AIDS epidemic: the number of older individuals living alone (that is, the number of unattended elderly people); the number of older individuals living with only dependent children under the age of 10 (that is, in missing generation households); and the number of adults age 18-59 (that is, prime age adults) per household where an older person lives. Results An increase in annual AIDS mortality of one death per 1000 people was associated with a 1.5% increase in the proportion of older individuals living alone (95% CI 1.2% to 1.9%) and a 0.4% increase in the number of older individuals living in missing generation households (95% CI 0.3% to 0.6%). Increases in AIDS mortality were also associated with fewer prime age adults in households with at least one older person and at least one prime age adult (P<0.001). These findings suggest that in our study countries, which encompass 70% of the sub-Saharan population, the HIV/AIDS epidemic could be responsible for 582 200-917 000 older individuals living alone without prime age adults and 141 000-323 100 older individuals being the sole caregivers for young children. Conclusions Africa’s HIV/AIDS epidemic might be responsible for a large number of older people losing their support and having to care for young children. This population has previously been under-recognised. Efforts to reduce HIV/AIDS deaths could have large “spillover” benefits for elderly people in Africa. PMID:20554660
Kraut, Robert E; Levine, John M
Background Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites. Objective The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities. Methods Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65. Results Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative
The paper reports the results of a randomised control trial investigating the use of computer-aided instruction (CAI) for practising phonological awareness skills with beginning readers. Two intervention groups followed the same phonological awareness programme: one group undertook practice exercises using a computer and the other group undertook…
In the context of low-income countries, the role of donors in public policymaking is of great importance. Donors use a combination of lending and non-lending instruments as pathways of influence to shape policy directions in aid-recipient countries. This paper reports some findings from a doctoral study on the role of the World Bank in the recent…
With the economy sputtering and Congress pressuring colleges to be more affordable, many institutions feel a heightened need to provide more financial aid--and they are turning to alumni and other private donors for help. While specifics vary from college to college, all types of institutions are feeling the pressure. Many smaller, private…
Raiden, Ani B.; Dainty, Andrew R. J.
Purpose: The concept of the learning organisation (LO) is associated with an advanced approach to human resource development (HRD) characterised by an ethos of self-responsibility and self-development. The learning climate that this engenders is supported by temporary organisational structures responsive to environmental change. The purpose of his…
Asikhia, Olubusayo Aduke; Mohangi, Kesh
Various studies have reported a huge increase in the numbers of orphaned adolescents in Sub-Saharan Africa and its effects on their psychological, emotional and behavioural development. Yet, their needs are seldom recognised or adequately addressed in policy and programmes.This article uses a qualitative study to report the experiences of 11 orphaned adolescents (5 boys and 6 girls aged between 15 and 18 years) affected by HIV and AIDS in a secondary school (in Atteridgeville, Pretoria, South Africa) and the school support provided by them. The primary data-generation strategies were informal interviews and the Beck Youth Inventories-II (BYI-II) (adopted to measure the participants' level of emotional, behavioural and psychological problems). All interview transcriptions with the participants were thematically analysed. BYI-II data were subjected to T scores (in percentages) to know the participant's psychological, behavioural and emotional problems in order to compare it with their perceptions on the degree of support provided by the school. Result shows that participants have a high prevalence of psychological, behavioural and emotional problems and that the school support provided to them (teachers' support, the general school environment and the degree of discrimination, labelling and bullying that exists in the school) was not sufficient. The participants, however, reported a high level of support from the principal. In conclusion, we have suggested the urgent need for teachers to acquire and possess basic knowledge and skills in caring and paying attention to learners affected by HIV and AIDS and for government agencies and NGOs working with HIV-and AIDS-affected children, to focus on proposals that address the psychological, behavioural and emotional problems in such affected adolescents.
Escobar-Rodriguez, Tomas; Bartual-Sopena, Lourdes
Enterprise resources planning (ERP) systems enable central and integrative control over all processes throughout an organisation by ensuring one data entry point and the use of a common database. T his paper analyses the attitude of healthcare personnel towards the use of an ERP system in a Spanish public hospital, identifying influencing factors. This research is based on a regression analysis of latent variables using the optimisation technique of partial least squares. We propose a research model including possible relationships among different constructs using the technology acceptance model. Our results show that the personal characteristics of potential users are key factors in explaining attitude towards using ERP systems.
Miller, D; Green, J
The growing numbers of patients with the acquired immune deficiency syndrome (AIDS) in England had led to the development of a counselling service for patients, their sexual partners, contacts, and others. The nature of the counselling is described with reference to the primary qualitative issues arising from diagnosis. The necessity for preventative education for patients and those at risk is stressed, and guidelines for low risk sexual activities are outlined. PMID:2991121
Cuesta-Vargas, Antonio Ignacio; Paz-Lourido, Berta; Lee, Miyoung; Peterson-Besse, Jana J.
Background: In this study we aimed to develop a Spanish version of the Self-Efficacy/Social Support Scales for Activity for persons with Intellectual Disability (SE/SS-AID). Method: A cross-sectional study was carried out in a sample of 117 individuals with intellectual disability (ID). The SE/SS-AID scales were translated into Spanish and their…
This paper presents an overview of the nature of corporate information systems and their applications in health organisations. It emphasises the importance of financial and human resource information in the creation of a corporate data model. The paper summarises the main features of finance and human resource systems as they are used in health organisations. It looks at a series of case studies carried out in health organisations, which were selected on the basis of their representation of different aspects of service delivery. It also discusses the theoretical and practical perspectives of the systems themselves, their roles in information management, executive and decision support, and in planning and forecasting.
Rodicio, H. Garcia; Sanchez, E.
Learners are usually provided with support devices because they find it difficult to learn from multimedia presentations. A key question, with no clear answer so far, is how best to present these support devices. One possibility is to insert them into the multimedia presentation (canned support), while another is to have a human agent provide them…
While this article mainly applies to practitioners who have responsibilities for leading teams or supervising practitioners, many of the skills and tools described here may also apply to students or junior practitioners. The purpose of this article is to highlight some of the main points about organisation, some of the organisational skills and tools that are available, and some examples of how these skills and tools can be used to make practitioners more effective at organising their workload. It is important to realise that organising work and doing work are two completely different things and shouldn't be mixed up. For example, it would be very difficult to start organising work in the middle of a busy operating list: the organisation of the work must come before the work starts and therefore preparation is often an important first step in organising work. As such, some of the tools and skills described in this article may need to be used hours or even days prior to the actual work taking place.
Barenbaum, Edna; Smith, Tamarah
ABSTRACT The literature on the psychological well-being of children impacted by HIV/AIDS in Africa highlights increased vulnerability due to loss of parents and environmental stressors (e.g., hunger). Research shows that the lack of attachment and social support due to loss limits the grieving process in children. Access to trusting adults and social support through caregivers can be an important protective factor to allow for coping and better emotional adjustment in the future. This study examined social support systems across varying living environments to determine if social support promoted higher levels of well-being in children orphaned and made vulnerable by HIV/AIDS. The participants included 100 children from a small targeted population in southern Africa who receive varying levels of support from a private not-for-profit organization. Children’s well-being was assessed through the Psycho-Social Adjustment Scale-Adolescents developed specifically for vulnerable child populations in Africa. Children were individually interviewed either on their homestead, school or hostel. Data demonstrated that children who do not share their feelings had significantly lower measures of positive well-being (M = 2.61 (0.87) vs. M = 3.10 (0.57), d = 0.60). Children with trusted adults were significantly more likely to share their feelings and had lower incidence of hunger (49.1% vs. 62.5%), suicide ideation (15.1% vs. 62.5%) and witnessing violence (69.8% vs. 87.5%). Sharing feelings with caregivers was more pronounced among children who had greater access to trusted adults and correlated with stronger attachment scores (r = .30, p < .01). An important component to decrease levels of anxiety and depression in this vulnerable population is providing access to trusted individuals. Social support interventions are discussed. PMID:27392004
Sun, Y-H; Sun, L; Wu, H-Y; Zhang, Z-K; Wang, B; Yu, C; Cao, H-Y
The main purpose of this study was to investigate how loneliness was associated with social support and family function among people living with HIV/AIDS (PLWHA) in an HIV-stricken area of China. Two hundred and nineteen PLWHA were surveyed using the UCLA (University of California at Los Angeles)-Loneliness Scale, the Social Support Rate Scale and the Family APGAR (Adaptability, Partnership, Growth, Affection and Resolve) Index. The results indicated that the majority (84.5%) of PLWHA had moderate to high levels of loneliness, with a mean score of 47.62 and a standardized score of 59.53. The level of loneliness was significantly different in subjects' occupations, but not in other sociodemographic variables. Social support, family function and all dimensions except utilizations of support were significantly negatively associated with loneliness. Multiple regression revealed that less social support and poor family function were associated with more loneliness. In conclusion, loneliness prevails among PLWHA. It may limit PLWHA's ability or access to social relationship. These findings support the hypothesis that if PLWHA are better supported and cared for, their negative psychosocial consequences might be prevented or at least reduced.
TITLE: Proposal for Development of EBM-CDSS (Evidence-based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients...SUBTITLE Proposal for development of EBM-CDSS (Evidence-based Clinical Decision Support System) to aid prognostication in terminally ill patients 5a...to improve prognostication of the life expectancy of terminally ill patients to improve referral of patients to hospice. In addition, the EBM-CDSS
Burke, Jessica G.; Chander, Geetanjali; Gielen, Andrea C.
Intimate partner violence, HIV/AIDS and substance use are described as the SAVA “syndemic” among low-income urban women because of their intersecting and synergistic presence in these women's lives. Depressive symptoms are significantly associated with these SAVA factors and while social support is potentially protective for depression, little is understood about its impact on depression associated with the SAVA syndemic. This paper investigates how women living with SAVA experience and describe depressive symptoms, and examines how the types of social support they access impact their experiences of SAVA and depressive symptoms. Qualitative in-depth interviews were conducted with 24 HIV-positive low-income urban women who experienced IPV and used cocaine or heroin in their lifetime. Interviews were analyzed based on study aims, principles of thematic content analysis, and grounded theory. Women identified multiple SAVA factors as catalysts for depression and noted their synergistic effect on depressive symptoms, which were both a trigger for and result of drug use. Women accessed varying sources of social support to address their SAVA factors and associated symptoms of depression, relying on informal sources for instrumental support related to IPV and formal sources for support related to HIV, drug use, and depression. These findings have important implications for health providers who serve SAVA-affected women, and suggest that comprehensively addressing all SAVA factors (and IPV in particular) and improving their access to quality social support at critical times is essential in order to improve their mental health. PMID:25213747
Al-Abri, Rashid K; Al-Hashmi, Intisar S
The 'Learning Organisation' is a concept first described by Peter Senge as an organisation where people continuously learn and enhance their capabilities to create. It consists of five main disciplines: team learning, shared vision, mental models, personal mastery and systems thinking. These disciplines are dynamic and interact with each other. System thinking is the cornerstone of a true learning organisation and is described as the discipline used to implement the disciplines. In a learning organisation, health care education aims to educate its members with up to date knowledge to produce competent and safe personnel, who can promote quality in health care services. In addition, there are some educational concepts and theoretical models, which are of relevance to the learning organisation, and can provide a framework for managerial decisions. The stages required to achieve the principles of a learning organisation will be described in detail. Moreover, in a proper culture which supports the learning organisation, members continuously learn to improve the environment and never remain passive recipients.
Campbell, Catherine; Andersen, Louise; Mutsikiwa, Alice; Madanhire, Claudius; Nyamukapa, Constance; Gregson, Simon
How realistic is the international policy emphasis on schools 'substituting for families' of HIV/AIDS-affected children? We explore the ethic of care in Zimbabwean schools to highlight the poor fit between the western caring schools literature and daily realities of schools in different material and cultural contexts. Interviews and focus groups were conducted with 44 teachers and 55 community members, analysed in light of a companion study of HIV/AIDS-affected pupils' own accounts of their care-related experiences. We conceptualise schools as spaces of engagement between groups with diverse needs and interests (teachers, pupils and surrounding community members), with attention to the pathways through which extreme adversity impacts on those institutional contexts and social identifications central to giving and receiving care. Whilst teachers were aware of how they might support children, they seldom put these ideas into action. Multiple factors undermined caring teacher-pupil relationships in wider contexts of poverty and political uncertainty: loss of morale from low salaries and falling professional status; the inability of teachers to solve HIV/AIDS-related problems in their own lives; the role of stigma in deterring HIV/AIDS-affected children from disclosing their situations to teachers; authoritarian teacher-learner relations and harsh punishments fuelling pupil fear of teachers; and lack of trust in the wider community. These factors undermined: teacher confidence in their skills and capacity to support affected pupils and motivation to help children with complex problems; solidarity and common purpose amongst teachers, and between teachers and affected children; and effective bridging alliances between schools and their surrounding communities-all hallmarks of HIV-competent communities. We caution against ambitious policy expansions of teachers' roles without recognition of the personal and social costs of emotional labour, and the need for significant
Campbell, Catherine; Andersen, Louise; Mutsikiwa, Alice; Madanhire, Claudius; Nyamukapa, Constance; Gregson, Simon
How realistic is the international policy emphasis on schools ‘substituting for families’ of HIV/AIDS-affected children? We explore the ethic of care in Zimbabwean schools to highlight the poor fit between the western caring schools literature and daily realities of schools in different material and cultural contexts. Interviews and focus groups were conducted with 44 teachers and 55 community members, analysed in light of a companion study of HIV/AIDS-affected pupils’ own accounts of their care-related experiences. We conceptualise schools as spaces of engagement between groups with diverse needs and interests (teachers, pupils and surrounding community members), with attention to the pathways through which extreme adversity impacts on those institutional contexts and social identifications central to giving and receiving care. Whilst teachers were aware of how they might support children, they seldom put these ideas into action. Multiple factors undermined caring teacher-pupil relationships in wider contexts of poverty and political uncertainty: loss of morale from low salaries and falling professional status; the inability of teachers to solve HIV/AIDS-related problems in their own lives; the role of stigma in deterring HIV/AIDS-affected children from disclosing their situations to teachers; authoritarian teacher-learner relations and harsh punishments fuelling pupil fear of teachers; and lack of trust in the wider community. These factors undermined: teacher confidence in their skills and capacity to support affected pupils and motivation to help children with complex problems; solidarity and common purpose amongst teachers, and between teachers and affected children; and effective bridging alliances between schools and their surrounding communities–all hallmarks of HIV-competent communities. We caution against ambitious policy expansions of teachers' roles without recognition of the personal and social costs of emotional labour, and the need for
Dittrich, Peter; di Fenizio, Pietro Speroni
Complex dynamical reaction networks consisting of many components that interact and produce each other are difficult to understand, especially, when new component types may appear and present component types may vanish completely. Inspired by Fontana and Buss (Bull. Math. Biol., 56, 1-64) we outline a theory to deal with such systems. The theory consists of two parts. The first part introduces the concept of a chemical organisation as a closed and self-maintaining set of components. This concept allows to map a complex (reaction) network to the set of organisations, providing a new view on the system's structure. The second part connects dynamics with the set of organisations, which allows to map a movement of the system in state space to a movement in the set of organisations. The relevancy of our theory is underlined by a theorem that says that given a differential equation describing the chemical dynamics of the network, then every stationary state is an instance of an organisation. For demonstration, the theory is applied to a small model of HIV-immune system interaction by Wodarz and Nowak (Proc. Natl. Acad. USA, 96, 14464-14469) and to a large model of the sugar metabolism of E. Coli by Puchalka and Kierzek (Biophys. J., 86, 1357-1372). In both cases organisations where uncovered, which could be related to functions.
Masood, Ammara; Al-Jumaily, Adel Ali
Image-based computer aided diagnosis systems have significant potential for screening and early detection of malignant melanoma. We review the state of the art in these systems and examine current practices, problems, and prospects of image acquisition, pre-processing, segmentation, feature extraction and selection, and classification of dermoscopic images. This paper reports statistics and results from the most important implementations reported to date. We compared the performance of several classifiers specifically developed for skin lesion diagnosis and discussed the corresponding findings. Whenever available, indication of various conditions that affect the technique's performance is reported. We suggest a framework for comparative assessment of skin cancer diagnostic models and review the results based on these models. The deficiencies in some of the existing studies are highlighted and suggestions for future research are provided. PMID:24575126
Everly, George S.; Brown, Lisa M.; Wendelboe, Aaron M.; Abd Hamid, Nor Hashidah; Tallchief, Vicki L.; Links, Jonathan M.
Surges in demand for professional mental health services occasioned by disasters represent a major public health challenge. To build response capacity, numerous psychological first aid (PFA) training models for professional and lay audiences have been developed that, although often concurring on broad intervention aims, have not systematically addressed pedagogical elements necessary for optimal learning or teaching. We describe a competency-based model of PFA training developed under the auspices of the Centers for Disease Control and Prevention and the Association of Schools of Public Health. We explain the approach used for developing and refining the competency set and summarize the observable knowledge, skills, and attitudes underlying the 6 core competency domains. We discuss the strategies for model dissemination, validation, and adoption in professional and lay communities. PMID:23865656
Background There is a need for studies that can highlight principles of addiction recovery. Because social relationships are involved in all change processes, understanding how social motivations affect the recovery process is vital to guide support programs. Methods The objective was to develop a model of recovery by examining addicted individuals’ social motivations through longitudinal assessment of non-professional support dyads. A qualitative, longitudinal study design was used, combining focus groups and in-depth interviews with addicted individuals and their sponsors. Data were analyzed using the principles of grounded theory: open coding and memos for conceptual labelling, axial coding for category building, and selective coding for theory building. The setting was an addiction recovery social support program in Oslo, Norway. The informants included nine adults affected by addiction, six sponsors, and the program coordinator. The participants were addicted to either alcohol (2), benzodiazepines (1), pain killers (1) or polydrug-use (5). The sponsors were unpaid, and had no history of addiction problems. Results Support perceived to be ineffective emerged in dyads with no operationalized goal, and high emotional availability with low degree of practical support. Support perceived to be effective was signified by the sponsor attending to power imbalance and the addict coming into position to help others and feel useful. Conclusions The findings appear best understood as a positive identity-model of recovery, indicated by the pursuit of skill building relevant to a non-drug using identity, and enabled by the on-going availability of instrumental support. This produced situations where role reversals were made possible, leading to increased self-esteem. Social support programs should be based on a positive identity-model of recovery that enable the building of a life-sustainable identity. PMID:23898827
Government Organisations Organisation OIM Level 0 r anisation OIM Level 1 OIM Level 2 OIM Level 4 OIM Level 3 Layer for one Operational Type I l Figure...Government Organisations Organisation OIM Level 0 r anisation OIM Level 1 OIM Level 2 OIM Level 4 OIM Level 3 Layer for one Operational Type I l
Sauer, J; Wastell, D G; Schmeink, C
The study examined the influence of different types of enhanced system support on user performance during the management of a central heating system. A computer-based simulation of a central heating system, called CHESS V2.0, was used to model different interface options, providing different support facilities to the user (e.g., historical, predictive, and instructional displays). Seventy-five participants took part in the study and completed a series of operational scenarios under different support conditions. The simulation environment allowed the collection of performance measures (e.g., energy consumption), information sampling, and system control behaviour. Subjective user evaluations of various aspects of the system were also measured. The results showed performance gains for predictive displays whereas no such benefits were observed for the other display types. The data also revealed that status and predictive displays were valued most highly by users. The implications of the findings for designers of central heating systems are discussed.
Preisig, H. A.; Lee, Tae-Yeong; Little, Frank
Based on the canonical decomposition of physical-chemical-biological systems, a prototype kernel has been developed to efficiently model alternative life-support systems. It supports (1) the work in an interdisciplinary group through an easy-to-use mostly graphical interface, (2) modularized object-oriented model representation, (3) reuse of models, (4) inheritance of structures from model object to model object, and (5) model data base. The kernel is implemented in Modula-II and presently operates on an IBM PC.
Xu, Yongfang; Lin, Xinqin; Chen, Shiyi; Liu, Yanfen; Liu, Hongjie
Although the HIV epidemic continues to spread among older adults over 50 years old in China, little empirical research has investigated the interrelationships among ageism, adaptability, family support, and quality of life among older people living with HIV/AIDS (PLWHAs). In this cross-sectional study, among 197 older PLWHAs over 50 years old, path analytic modelling was used to assess the interrelationships among ageism, resilience, coping, family support, and quality of life. Compared with female PLWHAs, male PLWHAs had a higher level of resilience and coping. There were no significant differences in the scores of quality of life, ageism, family support, HIV knowledge, and duration since HIV diagnosis between males and females. The following relationships were statistically significant in the path analysis: (1) family support → resilience [β (standardised coefficient) = 0.18], (2) resilience → ageism (β = -0.29), (3) resilience → coping (β = 0.48), and (4) coping → quality of life (β = 0.24). In addition, male PLWHAs were more resilient than female PLWHAs (β = 0.16). The findings indicate that older PLWHAs do not only negatively accept adversity, but build their adaptability to positively manage the challenges. Family-based interventions need take this adaptability to adversity into consideration.
Drabo, Koine Maxime; Konfe, Salifou; Macq, Jean
There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to develop a comprehensive assessment of the health services capacity to provide tuberculosis (TB) and human immunodeficiency virus (HIV) care but also to enhance patient empowerment, social network and community support. A cross-sectional study was conducted from 1 to 31 of August 2007 in 3 districts of Burkina Faso. We used a step-by-step model and the assessment of chronic illness care (ACIC) scale to assess capacities of 24 first line health centres (FLHC) and 3 district hospitals (DH) for providing TB and HIV/AIDS care. Data for the step-by-step model were extracted from medical records of 75 TB and 66 HIV patients. The ACIC scale was completed by health professionals, 6 medical doctors and 18 nurses, working at the DH level and at the FLHC level, respectively. The biological test for confirmation was free of charge for all the TB patients but only for 10.6% (7/66) HIV cases. Up to the time of the survey, 5 TB (6.6%) and 18 HIV+ patients (27.3%) have been hospitalised for care at least once, 64 TB (85.3%) had been declared cured and 38 HIV (54.5%) were under antiretroviral treatment. Health care process organisation for TB and HIV care had distinct areas of weaknesses. From a maximum ACIC score of 11, the overall score for TB care ranged between 1.9 and 4.9 with a median of 3.7 and for HIV care between 2.1 and 6.7 with a median of 4.1. This study provides an illustration of assessing the HIV and TB care combining data from the routine information system and from the chronic illness care assessment tool, to encompass both disease control and patient health perspective. It provides to health managers arguments for clear conclusions and sufficient data for action. PMID:28299038
Hall, J. B., Jr.; Pickett, S. J.; Sage, K. H.
A computer program for assessing manned space station environmental control and life support systems technology is described. The methodology, mission model parameters, evaluation criteria, and data base for 17 candidate technologies for providing metabolic oxygen and water to the crew are discussed. Examples are presented which demonstrate the capability of the program to evaluate candidate technology options for evolving space station requirements.
Barnett, Erin R; Boucher, Elizabeth A; Daviss, William B; Elwyn, Glyn
There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence. Using semi-structured qualitative interviews (n = 18), we conducted user testing with four parents and four clinical prescribers and field testing with four parents, four clinical prescribers, and two clinic administrators. The researchers coded and synthesized the interview responses using mixed inductive and deductive methods. Parents, clinicians, and administrators felt the Option Grid had significant value, although they reported that additional training and other support would be required in order to successfully implement the Option Grid and achieve shared decision-making in clinical practice.
In a recent issue of Globalization and Health, Yu et al. examine the impact of HIV/AIDS programs on health care systems. This editorial considers their position and confirms that the former actually supports the latter aim; the two approaches are not at odds with one another, but could be viewed as complementary. A key requirement towards meeting both objectives is to ensure sustained international aid. PMID:19017377
In a recent issue of Globalization and Health, Yu et al. examine the impact of HIV/AIDS programs on health care systems. This editorial considers their position and confirms that the former actually supports the latter aim; the two approaches are not at odds with one another, but could be viewed as complementary. A key requirement towards meeting both objectives is to ensure sustained international aid.
St-Gallay, Steve A.; Sambrook-Smith, Colin P.
Computer-aided drug design encompasses a wide variety of tools and techniques, and can be implemented with a range of organisational structures and focus in different organisations. Here we outline the computational chemistry skills within Sygnature Discovery, along with the software and hardware at our disposal, and briefly discuss the methods that are not employed and why. The goal of the group is to provide support for design and analysis in order to improve the quality of compounds synthesised and reduce the timelines of drug discovery projects, and we reveal how this is achieved at Sygnature. Impact on medicinal chemistry is vital to demonstrating the value of computational chemistry, and we discuss the approaches taken to influence the list of compounds for synthesis, and how we recognise success. Finally we touch on some of the areas being developed within the team in order to provide further value to the projects and clients.
St-Gallay, Steve A; Sambrook-Smith, Colin P
Computer-aided drug design encompasses a wide variety of tools and techniques, and can be implemented with a range of organisational structures and focus in different organisations. Here we outline the computational chemistry skills within Sygnature Discovery, along with the software and hardware at our disposal, and briefly discuss the methods that are not employed and why. The goal of the group is to provide support for design and analysis in order to improve the quality of compounds synthesised and reduce the timelines of drug discovery projects, and we reveal how this is achieved at Sygnature. Impact on medicinal chemistry is vital to demonstrating the value of computational chemistry, and we discuss the approaches taken to influence the list of compounds for synthesis, and how we recognise success. Finally we touch on some of the areas being developed within the team in order to provide further value to the projects and clients.
Al-Abri, Rashid K; Al-Hashmi, Intisar S
The ‘Learning Organisation’ is a concept first described by Peter Senge as an organisation where people continuously learn and enhance their capabilities to create. It consists of five main disciplines: team learning, shared vision, mental models, personal mastery and systems thinking. These disciplines are dynamic and interact with each other. System thinking is the cornerstone of a true learning organisation and is described as the discipline used to implement the disciplines. In a learning organisation, health care education aims to educate its members with up to date knowledge to produce competent and safe personnel, who can promote quality in health care services. In addition, there are some educational concepts and theoretical models, which are of relevance to the learning organisation, and can provide a framework for managerial decisions. The stages required to achieve the principles of a learning organisation will be described in detail. Moreover, in a proper culture which supports the learning organisation, members continuously learn to improve the environment and never remain passive recipients. PMID:21748105
Kelly, Kevin J; Birdsall, Karen
The study takes stock of the exponential growth in the number of new civil-society organisations (CSOs) working in the HIV/AIDS field in East and Southern Africa during the period 1996-2004. We researched this development through a survey of 439 CSOs in six countries and case studies focused on the evolution of community responses to HIV/AIDS in specific communities in eight countries. We describe the types of CSOs that emerged, their relationships with governments and donors, and their activities, organisational characteristics and funding requirements. The data presented show that the vision of social mobilisation of HIV/AIDS responses through community-level organisations has faced strong external challenges. Evidence from survey data, national HIV/AIDS spending assessments and case studies shows that in some respects the changing international aid environment undermines the prospects for development of the civil-society sector's contributions in HIV/AIDS responses. Of particular interest is to understand how the "Three Ones" and the Paris Declaration on Aid Effectiveness have reshaped international funding for HIV/AIDS responses. There has been relatively little attention paid to the impact of the new management and funding modalities--including national performance frameworks, general budget support, joint funding arrangements and basket funds--on civil-society agencies at the forefront of community HIV/AIDS responses. Evidence is presented to show that in important respects the new modalities limit the unique contribution that CSOs can make to national HIV/AIDS responses. It is also shown that the drive to rapidly intensify the scale of HIV/AIDS responses has involved using community organisations as service providers for externally formulated programmes. We discuss this as a strong threat to the development of sustainable civil-society economies as well as to CSOs' diversity and responsiveness. The ways in which CSOs are responding to these challenges are
Bourgeois, N.C.; Greer, D.K.
This CALS Concept of Operations for Depot Maintenance provides the foundation strategy and the near term tactical plan for CALS implementation in the depot maintenance environment. The user requirements enumerated and the overarching architecture outlined serve as the primary framework for implementation planning. The seamless integration of depot maintenance business processes and supporting information systems with the emerging global CALS environment will be critical to the efficient realization of depot user's information requirements, and as, such will be a fundamental theme in depot implementations.
Abrefa-Gyan, Tina; Cornelius, Llewellyn; Okundaye, Joshua
Although gender differences persist in the receipt of social support and the report of quality of life among people living with HIV/AIDS in Sub-Saharan Africa, the knowledge base on this topic is scant. For those living with HIV/AIDS, women tend to participate more than men in support group activities, but their gender predisposes them to lower quality of life. Therefore, this study seeks to determine what demographic factors moderate the relationship between social support and quality of life among those living with HIV/AIDS in Ghana. A convenience sample of 300 HIV/AIDS support group members who have experience participating in research studies and was obtained for use via cross-sectional design survey in September and October 2013. The Medical Outcome Studies (MOS) HIV Health Survey, the MOS Social Support Survey, and demographic questionnaire instruments were used to assess quality of life, social support, and demographic information respectively. Gender (male) F(3, 296) = 66.04, t = 2.26, p = .024) and having children (have children) (F(5, 294) = 40.34, t = 2.50, p = .013) moderated the relationship between social support and quality of life. Implications of the findings for practice, policy, and research in Ghana and the rest of the developing world were discussed.
Braga, Roberto A.; Godinho, Robson P.; Nozela, José Roberto A.; Silva, Michel M.
The use of dynamic speckle laser, also called biospeckle laser (BSL), presents a series of challenges to its adoption, as it is the case for its use in real time, and when ones desires to adjust the experimental setup. The technical analysis of the BSL adopted in real time has reduced spatial resolution of the captured image, while the adjustment of preparing an experiment still demands the trial of a specialist. In this work two approaches have been proposed to improve the efficiency of BSL real-time adjustments to support the experimental setup. The use of the method known as Motion History Image (MHI) was carry out over a series of BSL images. The MHI was the basis for the implementation of a graphical interface for real-time identification of areas of activity, and then delimiting the regions of interest. The results showed that the MHI was effective in the reproduction of the activities of speckle patterns in real time without reducing image resolution, and as an instrument for delimit of regions of activity, supporting the analyst in the choice of lighting adjustments and image assembling.
Prevedoros, H P; Lee, R P; Marriot, D
Human Immunodeficiency Virus (HIV) related Pneumocystis carinii pneumonia (PCP) associated with severe respiratory failure is an increasingly common problem in major centres and is associated with a high mortality in previous and recent studies. Early in the epidemic, alternatives to invasive intensive care treatment were utilized in our institution and found to be successful. When respiratory failure developed, mask CPAP was used instead of intubation and ventilation. A retrospective review of 175 cases of HIV infected patients with confirmed first presentation PCP was undertaken. Treatment with our protocol resulted in an overall hospital mortality of 9%. Those patients who did not require supplemental oxygen or respiratory support had no in-hospital mortality. The group who required supplemental oxygen had a mortality of 10%. If respiratory failure supervened (severe respiratory distress, PaO2 less than 50 mmHg, SaO2 less than 90% on mask oxygen), CPAP was introduced. The mortality in this group was 22%. Only two patients were admitted to the intensive care unit for respiratory support after failure of CPAP. Both patients were intubated and received intermittent positive pressure ventilation (IPPV). Both patients died.
Lester, M.; Liebow, E.; Holm, J.
The Department of Energy (DOE) plans to honor its commitment to government-to-government interactions by providing advance notice of DOE spent fuel and high-level waste shipments to Indian tribes whose jurisdictions are crossed by or adjacent to transportation routes. The tribes are important contributors to a regional response network, and providing tribes with advance notice of DOE shipping plans marks the start -- not the end -- of direct, government-to-government interactions with DOE. The Tribal Prenotification Analysis Support System (PASS) is being developed for the Office of Special Programs within the Department`s Office of Environmental Restoration and Waste Management. PASS will help DOE-Headquarters to coordinate field office activities and provide technical and institutional support to the DOE field offices. PASS is designed to be used by anyone with minimum computer literacy and having contemporary computer hardware and software. It uses on-screen maps to choose and display a shipment route, and to display the tribal jurisdictions. With forms that are easy to understand, it provides information about each jurisdiction and points of contact. PASS records all contacts, commitments made, and actions taken.
Stasolla, Fabrizio; Perilli, Viviana; Di Leone, Antonia; Damiani, Rita; Albano, Vincenza; Stella, Anna; Damato, Concetta
This study was aimed at extending the use of assistive technology (i.e., photocells, interface and personal computer) to support choice strategies by three girls with Rett syndrome and severe to profound developmental disabilities. A second purpose of the study was to reduce stereotypic behaviors exhibited by the participants involved (i.e., body rocking, hand washing and hand mouthing). Finally, a third goal of the study was to monitor the effects of such program on the participants' indices of happiness. The study was carried out according to a multiple probe design across responses for each participant. Results showed that the three girls increased the adaptive responses and decreased the stereotyped behaviors during intervention phases compared to baseline. Moreover, during intervention phases, the indices of happiness augmented for each girl as well. Clinical, psychological and rehabilitative implications of the findings are discussed.
Chitiyo, Morgan; Changara, Darlington; Chitiyo, George
The AIDS epidemic has created many orphans around the globe. A majority of these orphans live in sub-Saharan Africa. Children orphaned by HIV/AIDS face many daunting challenges in their struggle to cope with life. The issues they face due to the loss of their parent(s) include poverty, the stigma associated with HIV/AIDS and stress. This study…
Bischoff, S C; Kester, L; Meier, R; Radziwill, R; Schwab, D; Thul, P
PN (parenteral nutrition) should be standardised to ensure quality and to reduce complications, and it should be carried out in consultation with a specialised nutrition support team whenever possible. Interdisciplinary nutrition support teams should be established in all hospitals because effectiveness and efficiency in the implementation of PN are increased. The tasks of the team include improvements of quality of care as well as enhancing the benefit to cost ratio. Therapeutic decisions must be taken by attending physicians, who should collaborate with the nutrition support team. "All-in-One" bags are generally preferred for PN in hospitals and may be industrially manufactured, industrially manufactured with the necessity to add micronutrients, or be prepared "on-demand" within or outside the hospital according to a standardised or individual composition and under consideration of sterile and aseptic conditions. A standardised procedure should be established for introduction and advancement of enteral or oral nutrition. Home PN may be indicated if the expected duration of when PN exceeds 4 weeks. Home PN is a well established method for providing long-term PN, which should be indicated by the attending physician and be reviewed by the nutrition support team. The care of home PN patients should be standardised whenever possible. The indication for home PN should be regularly reviewed during the course of PN.
Vitorino de Souza Melaré, Angelina; Montenegro González, Sahudy; Faceli, Katti; Casadei, Vitor
Population growth associated with population migration to urban areas and industrial development have led to a consumption relation that results in environmental, social, and economic problems. With respect to the environment, a critical concern is the lack of control and the inadequate management of the solid waste generated in urban centers. Among the challenges are proper waste-collection management, treatment, and disposal, with an emphasis on sustainable management. This paper presents a systematic review on scientific publications concerning decision support systems applied to Solid Waste Management (SWM) using ICTs and OR in the period of 2010-2013. A statistical analysis of the eighty-seven most relevant publications is presented, encompassing the ICTs and OR methods adopted in SWM, the processes of solid-waste management where they were adopted, and which countries are investigating solutions for the management of solid waste. A detailed discussion on how the ICTs and OR methods have been combined in the solutions was also presented. The analysis and discussion provided aims to help researchers and managers to gather insights on technologies/methods suitable the SWM challenges they have at hand, and on gaps that can be explored regarding technologies/methods that could be useful as well as the processes in SWM that currently do not benefit from using ICTs and OR methods.
Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; van Wyk, Brian; Hausler, Harry; Van Damme, Wim
In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that–in all social interventions–the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA) seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs). Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient’s hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA’s household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his
Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; van Wyk, Brian; Hausler, Harry; Van Damme, Wim
In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that-in all social interventions-the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA) seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs). Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient's hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA's household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his/her household
World Organisation for Animal Health Home About us Presentation Director general office Biography Photos Strategic plan Our ... Food safety and animal welfare History General organisation World Assembly Council Headquarters OIE Regional Representations OIE Regional ...
Knowledge Management DALO DSTO Army Learning Organisation DASS Defence Assisted Study Scheme DLOQ Dimensions of a Learning Organisation Questionnaire...realised. Facilitation was provided through external (academic/subject matter expert) and internal (DALO Research Team) providers. The external...being an organisational archetype characterised by the existence of certain internal conditions and proclivities which facilitate learning at
Jackson, Cath; Cheater, Francine M.; Peacock, Rose; Leask, Julie; Trevena, Lyndal
Objective: The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from…
Enenkel, M.; Dorigo, W.; See, L. M.; Vinck, P.; Pham, P.
Droughts statistically exceed all other natural disasters in spatio-temporal extent, number of people affected or financial loss. Triggered by crop failure, food insecurity is a major manifestation of agricultural drought and water scarcity. However, other socio-economic precursors, such as chronically low levels of disaster preparedness, hampered access to food security or a lack of social safety nets are equally important factors. Consequently, this study is focused on two complementary developments - a new satellite-derived agricultural drought index and a mobile phone application. The Combined Drought Index (CDI) is enhanced by replacing field measurements of temperature and rainfall modelled/assimilated data. The vegetation component is replaced by a smoothed NDVI dataset. A soil moisture component is introduced to close the gap between rainfall deficiencies and the first visible impacts of atmospheric anomalies on vegetation. The mobile phone application enables the validation of drought index outputs and gives aid organizations an opportunity to increase the speed of socio-economic vulnerability assessments. Supported by Doctors without Borders (MSF) this approach aims at decreasing uncertainties in decision-making via a more holistic risk framework.
Chang, Larry W; Kagaayi, Joseph; Nakigozi, Gertrude; Serwada, David; Quinn, Thomas C; Gray, Ronald H; Bollinger, Robert C; Reynolds, Steven J; Holtgrave, David
A cost analysis study calculates resources needed to deliver an intervention and can provide useful information on affordability for service providers and policy-makers. We conducted cost analyses of both a peer health worker (PHW) and a mHealth (mobile phone) support intervention. Excluding supervisory staffing costs, total yearly costs for the PHW intervention was $8475, resulting in a yearly cost per patient of $8.74, per virologic failure averted cost of $189, and per patient lost to follow-up averted cost of $1025. Including supervisory staffing costs increased total yearly costs to $14,991. Yearly costs of the mHealth intervention were an additional $1046, resulting in a yearly cost per patient of $2.35. In a threshold analysis, the PHW intervention was found to be cost saving if it was able to avert 1.50 patients per year from switching to second-line antiretroviral therapy. Other AIDS care programs may find these intervention costs affordable.
Schindler, Karsten; Lang, Dustin; Moore, Liz; Hümmer, Martin; Wolf, Jürgen; Krabbe, Alfred
SOFIA is an airborne observatory, operating a gyroscopically stabilized telescope with an effective aperture of 2.5 m on-board a modified Boeing 747SP. Its primary objective is to conduct observations at mid- to far-infrared wavelengths. When SOFIA opens its door to the night sky, the initial telescope pointing is estimated from the aircraft's position and heading as well as the telescope's attitude relative to the aircraft. This initial pointing estimate needs to be corrected using stars that are manually identified in tracking camera images; telescope pointing also needs to be verified and refined at the beginning of each flight leg. We report about the implementation of the astrometry.net package on the telescope operator workstations on-board SOFIA. This package provides a very robust, reliable and fast algorithm for blind astrometric image calibration. Using images from SOFIA's Wide Field Imager, we are able to display an almost instant, continuous feedback of calculated right ascension, declination and field rotation in the GUI for the telescope operator. The computer-aided recognition of star patterns will support telescope pointing calibrations in the future, further increasing the efficiency of the observatory. We also discuss other current and future use cases of the astrometry.net package in the SOFIA project and at the German SOFIA Institute (DSI).
Jongkreangkrai, C.; Vichianin, Y.; Tocharoenchai, C.; Arimura, H.; Alzheimer's Disease Neuroimaging Initiative
Several studies have differentiated Alzheimer's disease (AD) using cerebral image features derived from MR brain images. In this study, we were interested in combining hippocampus and amygdala volumes and entorhinal cortex thickness to improve the performance of AD differentiation. Thus, our objective was to investigate the useful features obtained from MRI for classification of AD patients using support vector machine (SVM). T1-weighted MR brain images of 100 AD patients and 100 normal subjects were processed using FreeSurfer software to measure hippocampus and amygdala volumes and entorhinal cortex thicknesses in both brain hemispheres. Relative volumes of hippocampus and amygdala were calculated to correct variation in individual head size. SVM was employed with five combinations of features (H: hippocampus relative volumes, A: amygdala relative volumes, E: entorhinal cortex thicknesses, HA: hippocampus and amygdala relative volumes and ALL: all features). Receiver operating characteristic (ROC) analysis was used to evaluate the method. AUC values of five combinations were 0.8575 (H), 0.8374 (A), 0.8422 (E), 0.8631 (HA) and 0.8906 (ALL). Although “ALL” provided the highest AUC, there were no statistically significant differences among them except for “A” feature. Our results showed that all suggested features may be feasible for computer-aided classification of AD patients.
Alexander, Carla S; Memiah, Peter; Henley, Yvonne B; Kaiza-Kangalawe, Angela; Shumbusho, Anna Joyce; Obiefune, Michael; Enejoh, Victor; Stanis-Ezeobi, Winifred; Eze, Charity; Odion, Ehekhaye; Akpenna, Donald; Effiong, Amana; Miriti, Kenneth; Aduda, Samson; Oko, John; Melaku, Gebremedhin D; Baribwira, Cyprien; Umutesi, Hassina; Shimabale, Mope; Mugisa, Emmanuel; Amoroso, Anthony
To combat morbidity and mortality from the worldwide epidemic of the human immunodeficiency virus (HIV), the United States Congress implemented a President's Emergency Plan for AIDS Relief (PEPFAR) in 30 resource-limited countries to integrate combination antiretroviral therapy (ART) for both prevention and cure. Over 35% of eligible persons have been successfully treated. Initial legislation cited palliative care as an essential aspect of this plan but overall health strengthening became critical to sustainability of programming and funding priorities shifted to assure staffing for care delivery sites; laboratory and pharmaceutical infrastructure; data collection and reporting; and financial management as individual countries are being encouraged to assume control of in-country funding. Given infrastructure requisites, individual care delivery beyond ART management alone has received minimal funding yet care remains necessary for durable viral suppression and overall quality of life for individuals. Technical assistance staff of one implementing partner representing seven African countries met to clarify domains of palliative care compared with the substituted term "care and support" to understand potential gaps in on-going HIV care. They prioritized care needs as: 1) mental health (depression and other mood disorders); 2) communication skills (age-appropriate disclosure of HIV status); 3) support of care-providers (stress management for sustainability of a skilled HIV workforce); 4) Tied Priorities: symptom management in opportunistic infections; end-of-life care; spiritual history-taking; and 5) Tied Priorities: attention to grief-related needs of patients, their families and staff; and management of HIV co-morbidities. This process can inform health policy as funding transitions to new priorities.
Canas, Lina; Cheung, Sze Leung
The Office for Astronomy Outreach has devoted intensive means to create and support a global network of public astronomical organisations around the world. Focused on bringing established and newly formed amateur astronomy organizations together, providing communications channels and platforms for disseminating news to the global community and the sharing of best practices and resources among these associations around the world. In establishing the importance that these organizations have for the dissemination of activities globally and acting as key participants in IAU various campaigns social media has played a key role in keeping this network engaged and connected. Here we discuss the implementation process of maintaining this extensive network, the processing and gathering of information and the interactions between local active members at a national and international level.
Park, Julie J.; Denson, Nida; Johnson, Matthew
Financial aid plays a critical role in college access and student success. It plays an increasingly important role as the college-going population continues to diversify and the cost of college continues to rise at both public and private institutions. In this study, the authors examined whether institutional level financial aid has any direct…
Rothberg, Alan; Van Huyssteen, Karen
It is estimated that 18-20% of South Africa's more than 5 million HIV-positive individuals are formally employed. Disease management programmes for these employees vary in scope and sophistication, with services provided by the employer, or third-party specialist disease managers, or through medical aid schemes. This study surveyed 215 HIV-positive employees in two organisations contracted to the Aid for AIDS (AfA) disease management programme through their in-house medical aid schemes. The two organisations differed in their overall approach to HIV and AIDS: one mainly relies on on-site access to voluntary counselling and testing (VCT) and AfA's management of registered HIV-positive employees, while the other has invested in and actively developed a comprehensive programme that also extends to families and the community as well as links employees to the AfA programme. Responses received from 28 of the 215 employees surveyed indicate that fear of disclosure of one's HIV status and of stigmatisation are reasons for late registration with the AfA programme or non-utilisation of other available support programmes. Respondents mentioned that confidence in the employer's ability to maintain confidentiality was also an issue. Respondents' important suggestions for change included: a) on-site educational and awareness programmes for management personnel and staff in order to reduce HIV discrimination and stigmatisation; b) information directed at HIV-positive employees publicising the benefits and effectiveness of medical treatment; c) support groups for HIV-positive employees; and d) management personnel to engage with HIV-infected employees who are willing to take an active role in staff education and the development of workplace policies and programmes.
Okeke, Bernedette Okwuchukwu
This study examined the relative efficacy of social support seeking (SSS) and self-efficacy building (SEB) in the management of emotional well-being of caregivers of people suffering from HIV/AIDS. It was based at the United States President's Emergency Plan for AIDS Relief (PEPFAR) center in the University College Hospital, Ibadan, Oyo state, being the first and the largest teaching hospital in Nigeria. A 3 × 2 factorial design consisting of treatment and a control group was used. The columns have two levels of gender being male and female caregivers. One-hundred and sixty-five (165) caregivers who were taking care of people that are suffering from HIV/AIDS were purposively selected and randomly assigned to the treatment groups and control. The treatment was carried out for a period of eight weeks. Two null hypotheses were tested, both at .05 levels of significance. Data were collected with the use of standardized intruments rating scale; social support scale, general self-efficacy scale and emotional well-being scale. ANCOVA was used to establish significant treatment effects with the pretest as covariate. Even though SSS and SEB were both found to be effective in enhancing the emotional well-being of informal caregivers in this study when compared to the controls, SSS was significantly more effective than SEB in achieving this goal. Since the HIV/AIDS patients cannot be adequately cared for in the hospital settings due to severe shortages of material, personnel and time, serious efforts should be made by the three levels of the health care system viz: the primary, secondary and tertiary health care systems, to encourage the employment of the psychological management of caregivers of people suffering from HIV/AIDS. Also, the psychologists, clinical psychologists and the significant others should be encouraged to employ this psychological management in the care of HIV/AIDS informal caregivers.
Homsy, Jaco; King, Rachel; Tenywa, Joseph; Kyeyune, Primrose; Opio, Alex; Balaba, Dorothy
In many resource-poor settings of Africa, a majority of people living with HIV/AIDS depend on and choose traditional healers for psychosocial counseling and health care. If the current pan-African prevention and care efforts spurred by the HIV pandemic do not actively engage African Traditional Medicine, they will effectively miss 80%, the vast majority of the African people who, according to the World Health Organization, rely on traditional medicine for their primary health care needs. In 2001, the Ugandan nongovernmental organization, Traditional and Modern Health Practitioners Together Against AIDS and Other Diseases, in Kampala, identified the need for a concerted, systematic, and sustained effort at both local and regional levels to support and validate African Traditional Medicine on several fronts. The Eastern & Southern Africa Regional Initiative on Traditional Medicine and AIDS was borne out of this assessment. It convened a regional consultation in May 2003, which produced a series of proposed standards around six main themes related to traditional medicine and HIV/AIDS: the systematic evaluation of traditional remedies; spiritual aspects of healing; HIV prevention and care; processing and packaging of traditional remedies; protection of indigenous knowledge; and intellectual property rights related to traditional health systems. These standards, summarized in this paper, will be incorporated into programs on traditional medicine and HIV/AIDS by various implementers in the region. A number of strategies to test and implement these recommendations are also defined.
Tönsing, Kerstin M; Dada, Shakila
Although the provision of assistive technology for students with disabilities has been mandated in South African education policy documents, limited data are available on the implementation of aided augmentative and alternative communication (AAC) in classrooms. This pilot investigation used a concurrent mixed-methods survey design to determine the extent to which aided AAC was implemented to foster students' expressive communication in preschool to Grade 3 classrooms in special schools from six urban school districts in the Gauteng (the smallest, most affluent and most densely populated of the nine South African provinces), and also obtained teachers' perceptions of this process. A total of 26 teachers who taught students who used aided AAC for expression participated. Although there is evidence of provision and also implementation of aided AAC in classrooms, various limitations still exist. Teachers identified an array of factors that influenced the implementation of aided AAC, including those related to themselves, the classroom context, the characteristics of aided AAC, students using AAC, and other stakeholders. These factors are discussed in the light of international literature as well as the local context, and are used as a basis to suggest a research agenda for AAC in the South African education system.
Nyamathi, A; Flaskerud, J; Keenan, C; Leake, B
This research examined the impact of including a supportive person on the outcomes of two culturally sensitive AIDS education programs, an education-only (traditional) program and a program combining education with self-esteem and coping enhancement (specialized). Research participants in this quasi-experimental study included 241 homeless women, who were randomly assigned by residence (drug treatment program or shelter) to one of four treatment groups. The outcomes measured at baseline, 6, and 12 months were risk behaviors, cognitive factors, and psychological functioning. Study results demonstrated significant improvements at both 6 and 12 months for the entire sample in all psychological, behavioral and cognitive outcome variables except active coping. Women in the specialized program improved more on AIDS knowledge and reduction in non-injection drug use than did those in the traditional program, but their active coping scores declined. Participation of a supportive person did not appear to have any effect on outcome.
Over the past few years a constellation of social movements and organisations concerned with issues of globalisation and world poverty have exploded onto the world stage. They have mobilised demonstrations, organised mass gatherings and conferences, created e-networks and websites and become major players in international political lobbying and…
Dennis, Louise; Tinnemeier, Nick; Meyer, John-Jules
We present the integration of a normative programming language in the MCAPL framework for model checking multi-agent systems. The result is a framework facilitating the implementation and verification of multi-agent systems coordinated via a normative organisation. The organisation can be programmed in the normative language while the constituent agents may be implemented in a number of (BDI) agent programming languages.
In analysing the safety strategies of organisations successfully managing hazardous systems it is apparent that safety itself is a problematic, and even risky, concept. It is less the valuation of safety per se than the disvalue surrounding mis-specification, misidentification, and misunderstanding that drives reliability in these organisations. Two contrasting models of high reliability can be identified in precluded event and resilience focused organisations. Each model is adapted to different properties in the raw material, process variances, and knowledge base of the organisation. These two models bound the reliability approaches available to medicine. The implications of each for medical reliability strategy are explored, and the possible adaptation of features from each for medical organisations are assessed. PMID:15576691
Organisational capability is recognised as a key to organisational success. The combination of human capital (peoples' skills and knowledge), social capital (relationships between people) and organisational capital (the organisation's processes), is central to building an organisation's capability. This paper, presented at the 2008 annual…
Knowlton, Amy R.; Curry, Aaron; Hua, Wei; Wissow, Lawrence
Social support is associated with better health outcomes among chronically ill individuals, yet support receipt can be stressful. The study examined supporter relationship factors, among n = 156 main-supporter-HIV+support-recipient dyads, associated with recipient's depression (CES-D greater than or equal to 16). Results indicated that support…
Lancioni, Giulio E.; Perilli, Viviana; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Cassano, Germana; Pinto, Katia; Minervini, Mauro G.; Oliva, Doretta
We developed a technology-aided intervention strategy relying on pictorial cues alone or in combination with verbal instructions and assessed these two versions of the strategy with three persons with moderate Alzheimer's disease. In Section I of the study, the strategy version with pictorial cues plus verbal instructions was compared with an…
Bunta, Ferenc; Douglas, Michael; Dickson, Hanna; Cantu, Amy; Wickesberg, Jennifer; Gifford, René H.
Background: There is a critical need to understand better speech and language development in bilingual children learning two spoken languages who use cochlear implants (CIs) and hearing aids (HAs). The paucity of knowledge in this area poses a significant barrier to providing maximal communicative outcomes to a growing number of children who have…
da Silva, Leonara Maria Souza; Tavares, Jeane Saskya Campos
The study of HIV transmission and the implementation of AIDS prevention actions recognize the importance of social networks in the transmission of the disease, the adherence to treatment and the quality of life of those infected. For this relevance there was a review of articles on social support networks to people living with HIV /AIDS available in the Virtual Health Library (VHL) were published in Brazil between 2002 and 2012. In this study 31 articles were used from journals covering the following áreas: Nursing (n = 15), Psychology (n = 6) and Science Health / Biomedica (n = 6), were included, which some principal authors were affiliated to higher education public institutions (n = 17). In relation to the methodology used, priority wasgiven to conducting: qualitative research (n = 18), cross-sectional studies (n = 19) and studies that involved talking to people living with HIV/AIDS (n = 13). Particular importance was placed on analytic categories related to: adherence to treatment (n = 6), the family (n = 4), vulnerability (n = 3) and support from social networks (n = 5). Within this paper we argue for more investments into studies that focus on the family, carers and their households, as well as deepening the theoretical study of the themes discussed and the use of developed theories for the analysis of Social Networks.
Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S.; Aguirre, Alejandra N.; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D.; Kukafka, Rita
The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%–94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention. PMID:26958276
Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita
The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.
In everyone's day-to-day jobs there is constant need to deal with current and newly detected matters. This is now a world of immediacy, driven by the cadence of the business and its needs. These concerns should not be ignored, as failing to deal with these issues would not bode well for the future. It is essential that the gears are kept spinning. The challenge for any security organisation is to identify its short-term tactical requirements, while developing longer-term strategic needs. Once done, the differences can be accounted for and strides can be made toward a desired future state. This paper highlights several steps that the author and his team have taken in their own journey. There is no magic answer, each organisation will have its own unique challenges. Nevertheless, some of the approaches to building a strategic security organisation described in this paper are applicable to all organisations, irrespective of their size.
There is wide belief that organisational culture shapes many aspects of performance, including safety. Yet proof of this relationship in a medical context is hard to find. In contrast to human factors, whose contributions are many and notable, culture's impact remains a commonsense, rather than a scientific, concept. The objectives of this paper are to show that organisational culture bears a predictive relationship with safety and that particular kinds of organisational culture improve safety, and to develop a typology predictive of safety performance. Because information flow is both influential and also indicative of other aspects of culture, it can be used to predict how organisations or parts of them will behave when signs of trouble arise. From case studies and some systematic research it appears that information culture is indeed associated with error reporting and with performance, including safety. Yet this relationship between culture and safety requires more exploration before the connection can be considered definitive. PMID:15576687
Flickinger, Tabor E; DeBolt, Claire; Waldman, Ava Lena; Reynolds, George; Cohn, Wendy F; Beach, Mary Catherine; Ingersoll, Karen; Dillingham, Rebecca
Social support can improve outcomes for people living with HIV (PLWH) and could be provided through online support groups. The Positive Links smartphone app is a multicomponent intervention that allows users to interact in a clinic-affiliated anonymous online support group. We investigated how social support was exchanged in a group of 55 participants over 8 months, using an adaptation of the Social Support Behavior Code. Participant interviews assessed their experiences and perceptions of the app. Of 840 posts analyzed, 115 (14 %) were coded as eliciting social support and 433 (52 %) as providing social support. Messages providing support were predominantly emotional (41 %), followed by network (27 %), esteem (24 %), informational (18 %), and instrumental (2 %) support. Participants perceived connection and support as key benefits of the app. Technical issues and interpersonal barriers limited some participants in fully using the app. Mobile technology offers a useful tool to reach populations with barriers to in-person support and may improve care for PLWH.
... Health Info » Hearing, Ear Infections, and Deafness Hearing Aids On this page: What is a hearing aid? ... the ear through a speaker. How can hearing aids help? Hearing aids are primarily useful in improving ...
Mitchell, Mary M; Maragh-Bass, Allysha C; Nguyen, Trang Q; Isenberg, Sarina; Knowlton, Amy R
Chronic pain and substance use can strain the supportive relationships of persons with serious chronic illness, which may increase the likelihood of receiving negative, rather than positive, social support from informal caregivers and social network members. To our knowledge, this is the first study to longitudinally examine the effects of chronic pain and substance use on negative social support. The sample (N = 383) comprised disadvantaged, primarily African-American, persons living with HIV/AIDS with a history of injection drug use, 32.4% of whom reported frequent or constant pain in the prior 6 months. Using factor analysis and structural equation modeling, current substance use and greater levels of chronic pain positively predicted negative social support 12 months later, after controlling for baseline negative support, viral load, age and sex. We also found a significant interaction effect such that among those not using substances, there was a significant positive association between pain and negative support, but no such association among those currently using substances. The findings emphasize the importance of treatment of chronic pain and substance use in the supportive functioning of social networks of a disadvantaged population with serious chronic conditions and persistent health disparities.
Bekele, Tsegaye; Rourke, Sean B; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, Laverne; Rueda, Sergio; Bacon, Jean; Watson, James; Hwang, Stephen W; Dunn, James; Guenter, Dale
Research has established a link between perceived social support and health-related quality of life (HRQOL) among persons living with HIV/AIDS. However, little is known about the ways through which social support influences HRQOL. This study examined the direct and indirect effects of perceived social support on physical and mental HRQOL in a sample of 602 adults living with HIV in Ontario, Canada. Participants completed the Medical Outcomes Study-HIV (MOS-HIV) health survey, the MOS-HIV Social Support Scale (MOS-HIV-SSS), and the Center for Epidemiological Studies Depression-Revised scale. Data on demographic and clinical characteristics were also collected. The direct and indirect effects of social support on the two MOS-HIV HRQOL summary measures, that is, physical health summary (PHS) and mental health summary (MHS), were estimated in multiple linear regression analyses. Perceived social support had significant direct effects on PHS (B=0.04, p<0.01) and MHS (B=0.05, p<0.01). It also had significant indirect effect on both PHS (B=0.04, p<0.01) and MHS (B=0.11, p<0.01), mediated by depressive symptoms. Interventions that enhance social support have the potential to contribute to better HRQOL either directly or indirectly by decreasing the deleterious effect of depressive symptoms on HRQOL.
Oetzel, John; Wilcox, Bryan; Archiopoli, Ashley; Avila, Magdalena; Hell, Cia; Hill, Ricky; Muhammad, Michael
This study aimed to examine the influence of social support (from personal networks and health care providers) and social undermining (from personal networks) on health-related quality of life (HRQOL; general health perceptions, physical functioning, and depression). Specifically, the authors aimed to identify the nature of the effects (direct, mediating, or moderating) of social support and social undermining on HRQOL. A total of 344 people living with HIV/AIDS and who were patients in a federally funded clinic in New Mexico completed a self-report survey questionnaire. The major findings of this study are the following: (a) social support and social undermining had direct and indirect effects on HRQOL-there was no evidence of a moderating effect of social support and social undermining; (b) for direct effects, social undermining was a stronger predictor of HRQOL than social support with social support variables having positive relations and social undermining variables having negative relations with HRQOL; and (c) for indirect effects, providers' social support partially mediated the influence of unstable employment/unemployment and social undermining on HRQOL.
Amiya, Rachel M.; Poudel, Krishna C.; Poudel-Tandukar, Kalpana; Pandey, Basu D.; Jimba, Masamine
Background Depression and suicidal thinking occur frequently alongside HIV/AIDS, triggering profound detrimental impacts on quality of life, treatment adherence, disease progression, and mortality. Yet the psychosocial factors contributing to these psychiatric comorbidities remain underexplored, particularly in the developing country context. This study thus examined different dimensions of perceived family support in relation to depression and suicidal ideation among people living with HIV/AIDS (PLWHA) in Nepal. Methods A cross-sectional survey of 322 adult PLWHA residing in the Kathmandu Valley, Nepal was conducted. Data were analyzed using multiple logistic regressions for correlates of Beck Depression Inventory (BDI)-Ia-defined depressive symptoms and suicidal ideation in the past 2 weeks. Perceived family support, measured using the 10-item Nepali Family Support and Difficulty Scale, was entered into separate models, in turn, as a composite score, for each sub-scale (emotional, instrumental, and negative support), and for each individual item. Results Overall, 25.5% of participants registered BDI-Ia-defined depression, with significantly lower rates among those with perceived family support scores in the highest (AOR = 0.19; 95% CI = 0.07, 0.55) and middle (AOR = 0.38; 95% CI = 0.17, 0.86) tertiles relative to those with lowest-tertile scores. Meanwhile, 14.0% reported suicidal thinking, with significantly lower rates among those in the highest perceived family support tertile relative to the lowest (AOR = 0.25; 95% CI = 0.07, 0.91). Broken down by support sub-scale, only negative support (i.e. family difficulty) was significant in its correlations with both outcomes – a trend similarly reflected in the item-wise analyses. Conclusions Our findings highlight an important role for family support in determining experiences of depression and suicidality among PLWHA. Incorporating family counseling and support services – with special
1989 U.S. DEPARTMENT OF COMMERCEVOLUME 1 : TEST National Institute of Standards and Technology National Computer Systems LaboratoryREQUIREMENTS...Galthersburg, MD 208999 DOCUMENT, may 19. EXTENDED CGM Accesioro For NTIS CRA&I (CGEM) D,,’ ,i 1 r KI , |iI iu U.S. DEPARTMENT OF COMMERCE93-03 667 Robert A...STANDARDS IN THE COMPUTER-AIDED ACQUISITION AND LOGISTIC SUPPORT (CALS) PROGRAM, Daniel R. BenigniEditor FISCAL YEAR 1989 U.S. DI[PAJ"TMDr Of COMM[EM[VOLUME 1
Graybeal, G. E.; Hall, F. G.; Moore, B. H.; Schlosser, E. H.
A computer-aided procedure, for use in the detection and location of areas of surface water, has been developed. The procedure was developed in support of the National Program of Inspection of Dams established by Public Law 92-367. The procedure utilizes data acquired by the unmanned Earth Resources Technology Satellite in conjunction with ancillary data in the form of topographic and highway maps, and meteorological data summaries. The procedure is divided into several distinct phases. A five-volume manual has been prepared to instruct potential users of the procedure.
Wood, P. W., Jr.
The requirements for mobility aids and restraint devices for use by personnel of the space shuttle were investigated. The devices considered were as follows: (1) translational devices to assist crewmen in moving from place to place and in moving equipment, (2) restraint devices for crewman at the worksite to prevent undesired induced motion between the crewman and the worksite, and (3) other necessary worksite provisions. Existing devices in each category are reviewed and new concepts are generated as required. Diagrams and line drawings of items of equipment are provided.
Diaz, Aaron A.; Burghard, Brion J.; Skorpik, James R.; Shepard, Chester L.; Samuel, Todd J.; Pappas, Richard A.
The Pacific Northwest National Laboratory (PNNL) has developed a portable, battery-operated handheld ultrasonic device that provides non-invasive container interrogation and material identification capabilities. The Acoustic Inspection Device (AID) performs an automated analysis of the return echoes to identify the material, and detect contraband in the form of submerged packages and concealed compartments in liquid filled containers and solid-form commodities. This device utilizes a database consisting of material property measurements acquired from an automated ultrasonic fluid characterization system called the Velocity-Attenuation Measurement System (VAMS).
Karimi, Leila; Leggat, Sandra G; Cheng, Cindy; Donohue, Lisa; Bartram, Timothy; Oakman, Jodi
Objective The aim of the present study was to investigate the effects of work organisation on the emotional labour withdrawal behaviour of Australian community nurses.Methods Using a paper-based survey, a sample of 312 Australian community nurses reported on their emotional dissonance, withdrawal behaviours (i.e. job neglect, job dissatisfaction, stress-related presenteeism) and work organisation. A model to determine the partial mediation effect of work organisation was developed based on a literature review. The fit of the proposed model was assessed via structural equation modelling using Analysis of Moment Structures (AMOS; IMB).Results Community nurses with higher levels of emotional dissonance were less likely to be satisfied with their job and work organisation and had a higher tendency to exhibit withdrawal behaviours. Work organisational factors mediated this relationship.Conclusion Emotional dissonance can be a potential stressor for community nurses that can trigger withdrawal behaviours. Improving work organisational factors may help reduce emotional conflict and its effect on withdrawal behaviours.What is known about the topic? Although emotional labour has been broadly investigated in the literature, very few studies have addressed the effect of the quality of work organisation on nurses' withdrawal behaviours in a nursing setting.What does this paper add? This paper provides evidence that work organisation affects levels of emotional dissonance and has an effect on job neglect through stress-related presenteeism.What are the implications for practitioners? In order to minimise stress-related presenteeism and job neglect, healthcare organisations need to establish a positive working environment, designed to improve the quality of relationships with management, provide appropriate rewards, recognition and effective workload management and support high-quality relationships with colleagues.
Yajima, Midori; van Huis, Arnold; Jiggins, Janice
The "New Variant Famine" hypothesis proposed that AIDS offers a major challenge to food security in this part of Africa by impairing the functioning of traditional support systems, leading to the collapse of "social immunity". This study explores the changing perceptions of HIV and AIDS and peoples' responses to its impact by eliciting life history narratives of 30 respondents in Northern Malawi. We classified respondents by means of gender, livelihood systems and AIDS impact levels. Respondents reported a range of critical events, recorded in the life histories, that threatened their "social immunity", including deaths, sicknesses, migration, marriages and divorces, and dropping out of school; i.e., a greater range of risks than AIDS alone, that need to be recognised in HIV and AIDS programming. For the respondents who were classified as "AIDS-affected", learning about their seropositive status was found to be an important, and in some cases a positive, turning point in their lives in terms of behavioural changes, such as joining support groups and opening up to discussion of the implications of their status. The emerging social organisations could re-create social capacity and check the downward spiral proposed by the "New Variant Famine" hypothesis. To promote this shift and to confer a higher level of "social immunity", investments in expanding access to voluntary counselling and testing and antiretroviral therapy services, and assistance to community-based organisations would be essential.
Lan, Guilian; Yuan, Zhaokang; Cook, Angelie; Xu, Qunying; Jiang, Hongying; Zheng, Huilie; Wang, Li; Yuan, Lingling; Xie, Xiaoxu; Lu, Yuanan
Several empirical studies, particularly those conducted in developed countries, have linked social support to quality of life among persons living with HIV/AIDS (PLWA). However, few studies have been conducted in developing countries, such as China; therefore, the question of any association being present between social support and quality of life in PLWA in China remains unanswered. This retrospective cross-sectional study was conducted to examine the relationships between social support and quality of life among PLWA in the Jiangxi and Zhejiang provinces of China. A total of 377 PLWA participated in this study, and questionnaires used included demographics, the Chinese Medical Outcomes Study Short Form-36, and a Social Support Rating Scale, all of which were collected through face-to-face interviews between 1 March and 15 April 2013 in six different County Centers of Disease Control and Prevention in Jiangxi and Zhejiang provinces, and one hospital in the Jiangxi. The health-related quality of life score was 64.7±13.5 (out of a total score of 100), which was significantly lower than the national norm level of 78.2±15.9. The total score of social support was 29.4±7.8 (full score 66). The canonical correlation between social support and quality of participants' lives was shown to be statistically significant (p<0.0001). The relationship between subjective support and quality of life among PLWA was also significant (p=0.004). Subjective support and the use of social support showed a positive correlation with vitality, role-physical, and role-emotional, and a negative correlation with body pain. The current study suggests that PLWA with lower social support have diminished quality of life.
Sanchez, Ana M; Denny, Thomas N; O'Gorman, Maurice
This Special Issue of the Journal of Immunological Methods includes 16 manuscripts describing quality assurance activities related to virologic and immunologic monitoring of six global laboratory resource programs that support international HIV/AIDS clinical trial studies: Collaboration for AIDS Vaccine Discovery (CAVD); Center for HIV/AIDS Vaccine Immunology (CHAVI); External Quality Assurance Program Oversight Laboratory (EQAPOL); HIV Vaccine Trial Network (HVTN); International AIDS Vaccine Initiative (IAVI); and Immunology Quality Assessment (IQA). The reports from these programs address the many components required to develop comprehensive quality control activities and subsequent quality assurance programs for immune monitoring in global clinical trials including: all aspects of processing, storing, and quality assessment of PBMC preparations used ubiquitously in HIV clinical trials, the development and optimization of assays for CD8 HIV responses and HIV neutralization, a comprehensive global HIV virus repository, and reports on the development and execution of novel external proficiency testing programs for immunophenotyping, intracellular cytokine staining, ELISPOT and luminex based cytokine measurements. In addition, there are articles describing the implementation of Good Clinical Laboratory Practices (GCLP) in a large quality assurance laboratory, the development of statistical methods specific for external proficiency testing assessment, a discussion on the ability to set objective thresholds for measuring rare events by flow cytometry, and finally, a manuscript which addresses a framework for the structured reporting of T cell immune function based assays. It is anticipated that this series of manuscripts covering a wide range of quality assurance activities associated with the conduct of global clinical trials will provide a resource for individuals and programs involved in improving the harmonization, standardization, accuracy, and sensitivity of
Rolston, Imara Ajani
An increasing focus on the relationship between AIDS prevalence and socio-economic inequality signals the need for a revaluation of the role of "politics" and "power" in AIDS prevention. This revaluation bears great significance when considering the future trajectories of the AIDS prevention efforts that target highly marginalised populations with high prevalence rates. An emphasis on intersecting forms of inequality has direct implications for the future of AIDS prevention practice. This study explores the experiences of participants, facilitators and local stakeholders applying the United Nations Development Programme (UNDP) Community Capacity Enhancement-Community Conversations (CCE-CC) approach to AIDS prevention in the Eastern Cape province of South Africa. It uses the political narrative analysis of life histories and semi-structured interviews as a means to interrogate the lived experiences of local actors participating in or influenced by this popularised form of community mobilisation used throughout sub-Saharan Africa. Findings suggest the need for a more explicit and intentional valuation for the intersection between the social and political determinants of health in programmes that use community mobilisation as prevention. They also signal a need to critically re-evaluate "community mobilisation" as an AIDS prevention tradition. Intersecting social and political power dynamics play a significant role in both opening up and constraining community mobilisation efforts. This paper proposes the need for a pedagogical turn to "deep organising" and "participatory forms of democracy", as a necessary frontier for programmes working with highly marginalised populations with high prevalence rates. Programmes need to more explicitly support, protect, and advocate for the ability of affected communities to engage in political processes, discourse and long-term organising.
Bowen, Elizabeth A; Canfield, James; Moore, Suzanne; Hines, Midge; Hartke, Brent; Rademacher, Chrissy
Stable housing is key to improving health outcomes for people living with HIV/AIDS. Though many formerly homeless HIV positive individuals reside in supportive housing, little research has examined biometric HIV health outcomes for residents of these programs. Through a community-based research partnership, this study analyzed secondary data from a Shelter Plus Care supportive housing program in Cincinnati, Ohio to examine the likelihood of participants achieving a healthy CD4 count (>500 cells/mm(3)) and viral suppression (viral load <200 copies/mL) while in supportive housing and to identify participant characteristics associated with these outcomes. The study sample was 86 participants who entered the program between 2008 and 2016, including 50 current residents and 36 exited participants. Participants' average length of stay in Shelter Plus Care was 35.2 months (range 3.2-108.1 months) during the study period. Bivariate analysis indicated statistically significant improvements on both outcome variables, with 45% of participants achieving a healthy CD4 count and 79% achieving viral suppression by program exit or most recent time point. Participants who had health insurance at intake and who had never been incarcerated were more likely to achieve viral suppression, and longer length of stay in the program was also positively associated with viral suppression. These results add to the literature on the relationship between housing conditions and HIV health outcomes by demonstrating that residence in supportive housing is associated with improvements in CD4 count and viral load for a sample of formerly homeless persons living with HIV/AIDS, two-thirds of whom had co-occurring physical health, mental health, or substance abuse problems. Further research collaborations should expand on these findings to examine the service packages that are associated with optimal HIV health outcomes for supportive housing residents.
Snell, Robin; And Others
Includes "Joining Forces" (Lindamood); "Spiritual Dimension of the Learning Organisation" (Hawkins); "Management--A 'Spiritual' Foundation?" (Nevard); "Hermit in Organisations" (Murray); "Towards a Spiritual Perspective on Behavior at Work" (Henson); "On Uncertainty" (Adlam); "Spirituality in Organisations" (Lee); "Ecological Organisation" (Conn);…
Garrett County, Maryland volunteered to act as a pre-overseas learning laboratory for AID (Agency for International Development) interns who practiced data collection and planning techniques with the help of local citizenry. (JC)
Laisaar, Kaja-Triin; Uusküla, Anneli; Sharma, Anjali; DeHovitz, Jack A; Amico, K Rivet
There is limited data on and experience with interventions for antiretroviral therapy (ART) adherence support for patients on ART in Eastern Europe. We sought to identify a feasible adherence support intervention for delivery amongst HIV-positive adults receiving care in Estonia, where the HIV/AIDS epidemic has been mainly concentrated among injection drug users (IDUs). Our application of intervention mapping (IM) strategies used existing literature, formative research and multidisciplinary team input to produce a brief clinic-based intervention entitled the Situated Optimal Adherence Intervention Estonia (sOAI Estonia) which uses both Next-Step Counseling (NSC) and Information-Motivation-Behavioral Skills (IMB) Model approach to facilitate integration of ART into the context and demands of daily life. We present the intervention development process, the resulting sOAI Estonia approach, and describe a randomized controlled trial (RCT) which is under way to evaluate the intervention (results due in spring 2013).
Lee, Myungeun; Kim, Jong Hyo; Park, Moon Ho; Kim, Ye-Hoon; Seong, Yeong Kyeong; Cho, Baek Hwan; Woo, Kyoung-Gu
In this study, we propose a computer-aided classification scheme of liver tumor in 3D ultrasound by using a combination of deformable model segmentation and support vector machine. For segmentation of tumors in 3D ultrasound images, a novel segmentation model was used which combined edge, region, and contour smoothness energies. Then four features were extracted from the segmented tumor including tumor edge, roundness, contrast, and internal texture. We used a support vector machine for the classification of features. The performance of the developed method was evaluated with a dataset of 79 cases including 20 cysts, 20 hemangiomas, and 39 hepatocellular carcinomas, as determined by the radiologist's visual scoring. Evaluation of the results showed that our proposed method produced tumor boundaries that were equal to or better than acceptable in 89.8% of cases, and achieved 93.7% accuracy in classification of cyst and hemangioma.
Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Perilli, Viviana; Campodonico, Francesca; Marchiani, Paola; Lang, Russell
Technology-aided programs have been reported to help persons with disabilities develop adaptive responding and control problem behavior/posture. This study assessed one such program in which choice of stimulus events was used as adaptive responding for three adults with multiple disabilities. A computer system presented the participants stimulus samples. For each sample, they could perform a choice response (gaining access to the related stimulus whose length they could extend) or abstain from responding (making the system proceed to the next sample). Once choice responding had strengthened, the program also targeted the participants' problem posture (i.e., head and trunk forward bending). The stimulus exposure gained with a choice response was interrupted if the problem posture occurred. All three participants successfully (a) managed choice responses and access to preferred stimuli and (b) gained postural control (i.e., reducing the problem posture to very low levels). The practical implications of those results are discussed.
Richter, Linda; Louw, Julia; Naicker, Sara
Many programs to support young children and families affected by HIV and AIDS depend substantially on a model of cascaded training from international nongovernmental organizations, through in-country groups and organizations to services on the ground. In this paper, we describe the training and capacity building – as described in proposals, progress reports, and individualized questionnaires – offered by 10 international organizations funded by the Conrad N. Hilton Foundation to provide supportive services for young children and their families in five southern and eastern African countries. We related the findings to effective features of training described in the literature. Training and capacity development were found to be the most substantial activities in rendering services to children and families, both in terms of effort and human and financial resources. A total of 67 trainings were conducted over a period of 18 months. Almost all trainings combine lecture-based instruction, group work/discussions, and role play, but only half of the trainings report some form of mentoring, supervision or coaching following the training. Drawing on the literature, it is likely that more purposeful planning is required in terms of the selection of trainees, local adaptation and development of materials, participatory training approaches, and techniques to develop and sustain skills as well as knowledge. Demonstration and mentorship in the field together with quality assurance procedures, pre-and post-assessment to evaluate training, processes to transfer learning into subsequent practice, as well as certification, are all fundamental steps to ensure that training plays a supportive role in the behavior changes necessary to support young children affected by HIV and AIDS and their families. PMID:26430466
Richter, Linda; Louw, Julia; Naicker, Sara
Many programs to support young children and families affected by HIV and AIDS depend substantially on a model of cascaded training from international nongovernmental organizations, through in-country groups and organizations to services on the ground. In this paper, we describe the training and capacity building - as described in proposals, progress reports, and individualized questionnaires - offered by 10 international organizations funded by the Conrad N. Hilton Foundation to provide supportive services for young children and their families in five southern and eastern African countries. We related the findings to effective features of training described in the literature. Training and capacity development were found to be the most substantial activities in rendering services to children and families, both in terms of effort and human and financial resources. A total of 67 trainings were conducted over a period of 18 months. Almost all trainings combine lecture-based instruction, group work/discussions, and role play, but only half of the trainings report some form of mentoring, supervision or coaching following the training. Drawing on the literature, it is likely that more purposeful planning is required in terms of the selection of trainees, local adaptation and development of materials, participatory training approaches, and techniques to develop and sustain skills as well as knowledge. Demonstration and mentorship in the field together with quality assurance procedures, pre-and post-assessment to evaluate training, processes to transfer learning into subsequent practice, as well as certification, are all fundamental steps to ensure that training plays a supportive role in the behavior changes necessary to support young children affected by HIV and AIDS and their families.
Casey, Meghan M; Payne, Warren R; Eime, Rochelle M; Brown, Sue J
The involvement of the sport and recreation sector as a setting for health promotion is a new strategy implemented by health policy makers and strategic planners. Strategies to promote and sustain health promotion activities are important considering the risk that programs may cease after initial funding ends. This study explored the factors affecting the sustainability of a sport- and recreation-based health promotion program. A stratified sampling method was used to select four of the nine Regional Sports Assemblies (RSAs) that delivered a state-wide health promotion program funded by the Victorian Health Promotion Foundation in Australia. Data were collected from in-depth interviews with four Executive Officers (EOs) and focus group discussions with their Boards of Management. A sustainability checklist with pre-specified dimensions (e.g. organisational setting, broader community environment, and program design and implementation) guided data collection and analysis. The results showed that the organisational setting and the broader community environment supported program institutionalisation; whilst the design and implementation of the program worked against institutionalisation. The capacity of the organisations to generate new funds for the program was limited; the relationship between the central funding organisation and the Boards of Management was weak; and the program did not support the retention of staff. The engagement of sport and recreation organisations has potential to facilitate health promotion and public health. To enhance organisational capacity and achieve program sustainability, it is important that organisational processes, structures, and resources that support long-term health promotion practice are effectively and efficiently planned and managed.
Mulcahy, Maurice; Evans, David S; Lahiffe, Blaithin; Goggin, Deirdre; Smyth, Colm; Hastings, Gerard; Byrne, Miriam
Implementing the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) relies heavily on enforcement. Little is known of the way different enforcement agencies operate, prioritise or network. A questionnaire was sent to representatives of the International Federation of Environmental Health (IFEH) in 36 countries. Tobacco control was given low priority. Almost two thirds did not have any tobacco control policy. A third reported their organisation had worked with other agencies on tobacco control. Obstacles to addressing tobacco control included a lack of resources (61%) and absence of a coherent strategy (39%).
Edited by: Oliver Roberts Lorraine Hanlon Sheila McBreen Local Organising Committee: Oliver Roberts (Chair) Antonio Martin-Carrillo Lorraine Hanlon Sheila McBreen Alexey Uliyanov David Murphy Sinéad Hales Scientific Organising Committee:: Sheila McBreen, (UCD, Ireland) (Chair) Franco Camera (INFN-Milano, Italy) Nerine Cherepy (LLNL, USA) Jarek Glodo (RMD, USA) Lorraine Hanlon (UCD, Ireland) Paul Lecoq (CERN, Switzerland) Julie McEnery (NASA, USA) Oliver Roberts (UCD, Ireland) Anant Setlur, (GE, USA) Brian Shortt, (ESA, the Netherlands) Kenneth Stanton (UCD, Ireland)
Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; D'Amico, Fiora; Sasanelli, Giovanni; De Vanna, Floriana; Signorino, Mario
Three studies were conducted to assess technology-aided programs to promote leisure engagement and mild physical activity in persons with Alzheimer's disease. Specifically, Study I assessed a program aimed at enabling three patients with mild or moderate Alzheimer's disease to choose among different music options and activate the preferred ones. Studies II and III were directed at patients in the low moderate or severe stages of the Alzheimer's disease who were no longer capable of ambulating and spent their time generally inactive, sitting in their wheelchairs. In particular, Study II used a program to help three patients exercise an arm-raising movement. Study III used a program to help three patients exercise a leg-foot movement. Each study was carried out according to a nonconcurrent multiple baseline design across patients. Results were very encouraging. The patients of Study I learned to choose and activate their preferred music pieces. The patients of Studies II and III enhanced their performance of the target movements and increased their indices of positive participation (e.g., smiles and verbalizations) during the sessions. The applicability of the programs in daily contexts and their implications for the patients involved are discussed.
Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Alberti, Gloria; Perilli, Viviana; Laporta, Dominga; Campodonico, Francesca; Oliva, Doretta; Groeneweg, Jop
These two studies were aimed at assessing technology-aided programs to help persons with multiple disabilities engage in basic occupation or work activities. Specifically, Study I focused on teaching two participants (an adolescent and an adult) with low vision or total blindness, severe/profound intellectual disabilities, and minimal object interaction to engage in constructive object-manipulation responses. The technology monitored their responses and followed them with brief stimulation periods automatically. Study II focused on teaching three adults with deafness, severe visual impairment, and profound intellectual disabilities to perform a complex activity, that is, to assemble a five-component water pipe. The technology regulated (a) light cues to guide the participants through the workstations containing single pipe components and the carton for completed pipes and (b) stimulation events. The results of both studies were positive. The participants of Study I showed consistent and independent engagement in object-manipulation responses. The participants of Study II showed consistent and independent pipe assembling performance. General implications of the two programs and the related technology packages for intervention with persons with multiple disabilities are discussed.
... facebook share with twitter share with linkedin HIV/AIDS HIV, or human immunodeficiency virus, is the virus ... HIV/AIDS. Why Is the Study of HIV/AIDS a Priority for NIAID? Nearly 37 million people ...
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Casale, Marisa; Cluver, Lucie; Crankshaw, Tamaryn; Kuo, Caroline; Lachman, Jamie M.; Wild, Lauren G.
Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV-endemic, resource-scarce Southern African communities. A cross-sectional household survey was conducted over 2009-2010 with 2477 South African adolescents aged 10-17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu-Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (p<.001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network. PMID:25623784
Casale, Marisa; Cluver, Lucie; Crankshaw, Tamaryn; Kuo, Caroline; Lachman, Jamie M; Wild, Lauren G
Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV-endemic, resource-scarce Southern African communities. A cross-sectional household survey was conducted over 2009-2010 with 2,477 South African adolescents aged 10-17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa's KwaZulu-Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: (a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and (b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (p < .001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network.
This paper examines knowledge creation in relation to improvements on the production line in the manufacturing department of Nissan Motor Company and aims to clarify embodied knowledge observed in the actions of organisational members who enable knowledge creation will be clarified. For that purpose, this study adopts an approach that adds a first, second, and third-person's viewpoint to the theory of knowledge creation. Embodied knowledge, observed in the actions of organisational members who enable knowledge creation, is the continued practice of 'ethos' (in Greek) founded in Nissan Production Way as an ethical basis. Ethos is knowledge (intangible) assets for knowledge creating companies. Substantiated analysis classifies ethos into three categories: the individual, team and organisation. This indicates the precise actions of the organisational members in each category during the knowledge creation process. This research will be successful in its role of showing the indispensability of ethos - the new concept of knowledge assets, which enables knowledge creation -for future knowledge-based management in the knowledge society.
PEB Exchange, 2001
Discusses the past and current organizational structure of Greece's School Building Organisation, a body established to work with government agencies in the design and construction of new buildings and the provisioning of educational equipment. Future planning to incorporate culture and creativity, sports, and laboratory learning in modern school…
Collin, Camille; Mbizvo, Michael
Abstract Objective To assess the sexual and reproductive health interventions included by countries in HIV-related proposals approved by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). Methods We examined the Global Fund database for elements and indicators of sexual and reproductive health in all approved HIV-related proposals (214) submitted by 134 countries, from rounds 1 to 7, and in an illustrative sample of 35 grant agreements. Findings At least 70% of the HIV-related proposals included one or more of the four broad elements: sexual and reproductive health information, education and communication; condom promotion/distribution; diagnosis and treatment of sexually transmitted infections; and prevention of mother-to-child transmission of HIV. Between 20% and 30% included sexual health counselling, gender-based violence, and the linking of voluntary counselling and testing for HIV with sexual and reproductive health services. Less than 20% focused on adolescent sexual and reproductive health, the rights and needs of people living with HIV, or safe abortion services. All these elements were rarely featured, if at all, in the grant agreements reviewed. Overall, however, sexual and reproductive health indicators did appear in most HIV-related proposals and in more than 80% of the grant agreements. Conclusion Country coordinating mechanisms and national-level stakeholders see in funding for sexual and reproductive health a means to address the problem of HIV infection in their respective national settings. However, we highlight some missed opportunities for linking HIV and sexual and reproductive health services. PMID:20072766
Richter, Linda M.; Lönnroth, Knut; Desmond, Chris; Jackson, Robin; Jaramillo, Ernesto; Weil, Diana
People with TB and/or HIV frequently experience severe economic barriers to health care, including out-of-pocket expenses related to diagnosis and treatment, as well as indirect costs due to loss of income. These barriers can both aggravate economic hardship and prevent or delay diagnosis, treatment and successful outcome, leading to increased transmission, morbidity and mortality. WHO, UNAIDS and the ILO argue that economic support of various kinds is essential to enable vulnerable people to protect themselves from infection, avoid delayed diagnosis and treatment, overcome barriers to adherence, and avert destitution. This paper analyses successful country proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria that include economic support in Rounds 7 and 10; 36 and 20 HIV and TB grants in Round 7 and 32 and 26, respectively, in Round 10. Of these, up to 84 percent included direct or indirect economic support for beneficiaries, although the amount constituted a very small proportion of the total grant. In TB grants, the objectives of economic support were generally clearly stated, and focused on mechanisms to improve treatment uptake and adherence, and the case was most clearly made for MDR-TB patients. In HIV grants, the objectives were much broader in scope, including mitigation of adverse economic and social effects of HIV and its treatment on both patients and families. The analysis shows that economic support is on the radar for countries developing Global Fund proposals, and a wide range of economic support activities are in place. In order to move forward in this area, the wealth of country experience that exists needs to be collated, assessed and disseminated. In addition to trials, operational research and programme evaluations, more precise guidance to countries is needed to inform evidence-based decision about activities that are cost-effective, affordable and feasible. PMID:24489702
Ciocca, Leonardo; Tarsitano, Achille; Marchetti, Claudio; Scotti, Roberto
This study was undertaken to design an updated connection system for an eyeglass-supported nasal prosthesis using rapid prototyping techniques. The substructure was developed with two main endpoints in mind: the connection to the silicone and the connection to the eyeglasses. The mold design was also updated; the mold was composed of various parts, each carefully designed to allow for easy release after silicone processing and to facilitate extraction of the prosthesis without any strain. The approach used in this study enabled perfect transfer of the reciprocal position of the prosthesis with respect to the eyeglasses, from the virtual to the clinical environment. Moreover, the reduction in thickness improved the flexibility of the prosthesis and promoted adaptation to the contours of the skin, even during functional movements. The method described here is a simplified and viable alternative to standard construction techniques for nasal prostheses and offers improved esthetic and functional results when no bone is available for implant-supported prostheses.
features , computer optimization will be applied to maintenance tasks (via modeling of maintenance scenarios resulting from defined battle scenarios...34illities" engineers’ own experience, with little or no tradeoff between performance-related and support-related design features . This is due to the lack...implementable but will also be translated to design features to ensure compliance. (5). Accurate and Timely Analyses. The many reliability
Arnold, Emily A; Bailey, Marlon M
This article focuses on the construction of homes and families within the ballroom community, a prominent feature of urban GLBTQ communities of color in cities across the United States. Based on two ethnographic studies with ballroom communities in the San Francisco Bay Area, California, and Detroit, Michigan, we explore the importance of gender and sexual identity in informing community practice around HIV prevention and treatment. As a community, the ballroom scene provides African American queer youth with support for same-sex desire and identity, along with multiple forms of support for HIV prevention. Our study of the ballroom community documents current forms of "intravention" occurring within the community and the importance of the gender-sex system in organizing these practices. We also offer recommendations for community-based organizations to partner with the ballroom community, making use of existing social structures within the community and the salient concepts of home and family, to provide HIV-related services and support. We argue for HIV-prevention interventions to take a more culturally appropriate, nuanced approach to reaching African American youth at risk, utilizing community and family structures, in whatever forms these may take.
Nguyen, V. D.; Nguyen, D. T.; Nguyen, T. D.; Phan, V. A.; Truong, Q. D.
In this paper, a method for reducing false positive in computer-aided mass detection in screening mammograms is proposed. A set of 32 features, including First Order Statistics (FOS) features, Gray-Level Occurrence Matrix (GLCM) features, Block Difference Inverse Probability (BDIP) features, and Block Variation of Local Correlation coefficients (BVLC) are extracted from detected Regions-Of-Interest (ROIs). An optimal subset of 8 features is selected from the full feature set by mean of a filter-based Sequential Backward Selection (SBS). Then, Support Vector Machine (SVM) is utilized to classify the ROIs into massive regions or normal regions. The method's performance is evaluated using the area under the Receiver Operating Characteristic (ROC) curve (AUC or AZ). On a dataset consisting about 2700 ROIs detected from mini-MIAS database of mammograms, the proposed method achieves AZ=0.938.
NYAMATHI, ADELINE M.; WILLIAM, RAVI RAJ; GANGULY, KALYAN K.; SINHA, SANJEEV; HERAVIAN, ANISA; ALBARRÁN, CYNTHIA R.; THOMAS, ALEXANDRA; GREENGOLD, BARBARA; EKSTRAND, MARIA; RAMAKRISHNA, PADMA; RAO, PANTANGI RAMA
A community-based participatory research study was conducted using focus groups with 39 women living with AIDS (WLA) in the rural setting of Andhra Pradesh, India. In addition, three nurses, two physicians, and five reproductive health accredited social health activists (ASHAs) took part in focus groups. The WLA offered insight into the benefits of HIV-trained ASHAs including emotional support, assistance with travel to health care providers and antiretroviral therapy medication adherence. Health care providers also identified benefits of using HIV-trained ASHAs and suggested modalities for how to train these individuals. These findings will contribute to the design of a future program of care involving HIV-trained ASHAs. PMID:21331322
Greenberg, Alan E; Purcell, David W; Gordon, Christopher M; Flores, Stephen; Grossman, Cynthia; Fisher, Holly H; Barasky, Rebecca J
The contributions reported in this supplemental issue highlight the relevance of NIH-funded CEWG research to health department–supported HIV prevention and care activities in the 9 US cities with the highest numbers of AIDS cases. The project findings have the potential to enhance ongoing HIV treatment and care services and to advance the wider scientific agenda. The HIV testing to care continuum, while providing a framework to help track progress on national goals, also can reflect the heterogeneities of local epidemics. The collaborative research that is highlighted in this issue not only reflects a locally driven research agenda but also demonstrates research methods, data collection tools, and collaborative processes that could be encouraged across jurisdictions. Projects such as these, capitalizing on the integrated efforts of NIH, CDC, DOH, and academic institutions, have the potential to contribute to improvements in the HIV care continuum in these communities, bringing us closer to realizing the HIV prevention and treatment goals of the NHAS.
Janet, J.; Natesan, T. R.; Santhosh, Ramamurthy; Ibramsha, Mohideen
An intelligent decision support tool to the Radiologist in telemedicine is described. Medical prescriptions are given based on the images of cyst that has been transmitted over computer networks to the remote medical center. The digital image, acquired by sonography, is converted into an intensity image. This image is then subjected to image preprocessing which involves correction methods to eliminate specific artifacts. The image is resized into a 256 x 256 matrix by using bilinear interpolation method. The background area is detected using distinct block operation. The area of the cyst is calculated by removing the background area from the original image. Boundary enhancement and morphological operations are done to remove unrelated pixels. This gives us the cyst volume. This segmented image of the cyst is sent to the remote medical center for analysis by Knowledge based artificial Intelligent Decision Support System (KIDSS). The type of cyst is detected and reported to the control mechanism of KIDSS. Then the inference engine compares this with the knowledge base and gives appropriate medical prescriptions or treatment recommendations by applying reasoning mechanisms at the remote medical center.
Bain, Alan; Walker, Allan; Chan, Anissa
Purpose: The paper aims to describe the application of theoretical principles derived from a study of self-organisation and complex systems theory and their application to school-based capacity building to support planned change. Design/methodology/approach: The paper employs a case example in a Hong Kong School to illustrate the application of…
Higher education institutions are evolving and technology often plays a central role in their transformations. Educational changes benefit from a supportive environment. The study examines the relationship between organisational culture and teachers' perceptions of and responses to technology-enhanced innovation among Chinese universities. A…
Thoenig, Jean-Claude; Paradeise, Catherine
Are universities able to operate as strategic actors? An organisational sociology based approach supported by a comparative field research project identifies three types of social, cultural and cognitive processes that play a decisive role in building and implementing local capabilities required to mobilise a strategic capacity. The paper…
Schuurman, Nadine; Randall, Ellen; Berube, Myriam
There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote areas. Using this tool, health-care planners can model multiple scenarios to determine the optimal location for health services, as well as the number of people served in each instance.
Hemminki, Elina; Toiviainen, Hanna K; Vuorenkoski, Lauri
The aim of the study was to investigate the co-operation between patient organizations and the drug industry in Finland prior to critical discussions on the topic. The data were gathered by a questionnaire survey of 85 patient organisations (response rate 65%, n = 55) and 20 drug firms (response rate 100%) in 2003, and by interviewing 13 organisations and surveying their web-pages and other documents in 2004. In the surveys, half of the patient organisations and 80% of the drug firms considered co-operation important. Most (71%) organisations reported financial support from the drug industry. Most organisations and drug firms had experienced problems. Common problems for organisations were too little or too unpredictable support from industry, and threats to independence and objectivity. Drug firms frequently mentioned unclear rules of co-operation. The patient organisation interviews exhibited similar themes and findings to those found in the surveys, revealing the complexity and importance of co-operation in organisation activities, and the variation between organisations. This case study from Finland showed that co-operation between patient organizations and the drug industry was common, many-sided and not usually transparent. The close connections between patient organizations and commercial companies, particularly drug firms, raise several policy issues and the need for action.
Bullying is a pervasive problem in healthcare organisations. Inquiries and reports on patient care and poor practice in the NHS have emphasised the substantial negative effects this behaviour may have on patient care. If bullying is to be addressed, it is crucial we develop clarity about what behaviours constitute bullying and how these behaviours differ from other negative behaviours in the workplace. It is important that we recognise the extent of the problem; statistics on the prevalence of bullying are likely to be an underestimate because of under-reporting of bullying. Effective interventions may only be designed and implemented if there is knowledge about what precipitates bullying and the magnitude of the changes required in organisations to tackle bullying. Individuals should also be aware of the options that are available to them should they be the target of bullying behaviour and what they should do if they witness bullying in their workplace.
Knipfer, Kristin; Kump, Barbara; Wessel, Daniel; Cress, Ulrike
This article takes a psychological perspective on organisational learning, putting "reflection" into the centre of attention. We argue that (1) organisational learning is based on individual and team learning at work, (2) reflection is the driving force that leads to organisational learning and (3) cumulation of the staff's reflection outcomes…
Background Since 2003, the Global Fund has supported the scale-up of HIV/AIDS, tuberculosis and malaria control in low- and middle-income countries. This paper presents and discusses a methodology for estimating the lives saved through selected service deliveries reported to the Global Fund. Methods Global Fund-supported programs reported, by end-2007, 1.4 million HIV-infected persons on antiretroviral treatment (ARV), 3.3 million new smear-positive tuberculosis cases detected in DOTS (directly observed TB treatment, short course) programs, and 46 million insecticide-treated mosquito nets (ITNs) delivered. We estimated the corresponding lives saved using adaptations of existing epidemiological estimation models. Results By end-2007, an estimated 681,000 lives (95% uncertainty range 619,000-774,000) were saved and 1,097,000 (993,000-1,249,000) life-years gained by ARV. DOTS treatment would have saved 1.63 million lives (1.09 - 2.17 million) when compared against no treatment, or 408,000 lives (265,000-551,000) when compared against non-DOTS treatment. ITN distributions in countries with stable endemic falciparum malaria were estimated to have achieved protection from malaria for 26 million of child-years at risk cumulatively, resulting in 130,000 (27,000-232,000) under-5 deaths prevented. Conclusions These results illustrate the scale of mortality effects that supported programs may have achieved in recent years, despite margins of uncertainty and covering only selected intervention components. Evidence-based evaluation of disease impact of the programs supported by the Global Fund with international and in-country partners must be strengthened using population-level data on intervention coverage and demographic outcomes, information on quality of services, and trends in disease burdens recorded in national health information systems. PMID:20433714
The success of biotechnological research, development and marketing depends to a large extent on the international transfer of information and on the ability to organise biotechnology information into knowledge. To increase the efficiency of information-based approaches, an information strategy has been developed and consists of the following stages: definition of the problem, its structure and sub-problems; acquisition of data by targeted processing of computer-supported bibliographic, numeric, textual and graphic databases; analysis of data and building of specialized in-house information systems; information processing for structuring data into systems, recognition of trends and patterns of knowledge, particularly by information synthesis using the concept of information density; design of research hypotheses; testing hypotheses in the laboratory and/or pilot plant; repeated evaluation and optimization of hypotheses by information methods and testing them by further laboratory work. The information approaches are illustrated by examples from the university-industry joint projects in biotechnology, biochemistry and agriculture.
Adams Tucker, Leigh; George, Gavin; Reardon, Candice; Panday, Saadhna
Objective: Drawing on the perceptions of various key stakeholders, the paper explores the strengths and limitations of involving civil society organisations in the delivery of HIV and AIDS and sexuality education in South African schools. Design: Qualitative study with a cross-sectional design. Setting: Research was conducted at 16 public…
... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...
AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. ...
Radermacher, Harriet; Karunarathna, Yoshitha; Grace, Nicci; Feldman, Susan
Given an Australian national and state policy agenda that continues to promote collaborative work, many community organisations are attempting to engage in partnerships with mixed results. This paper reports on a qualitative study conducted to explore the experiences of existing partnerships between organisations and small community groups who deliver community based support services to older people from culturally diverse backgrounds. In particular, this study sought to identify the key factors that facilitate and hinder the formation, maintenance and effectiveness of partnerships within the ethnic and multicultural community aged care (EMCAC) sector. Fourteen participants representing nine community and health service organisations located in the Melbourne metropolitan area took part in semi-structured interviews. Participants reported that partnerships between organisations are necessary and beneficial within the EMCAC sector. Organisational capacity, access to information and guidelines, and the inequality experienced by smaller organisations were key issues identified by participants. Increasing organisational capacity and reducing the inequalities experienced in partnerships may be addressed via training and education about the nature of partnerships, as well as by advocating for increased resources to smaller ethno-specific organisations. Further investigation is required to examine whether not engaging in partnerships will deem an organisation unsustainable in the longer term.
Lancioni, Giulio E; Singh, Nirbhay N; O'reilly, Mark F; Sigafoos, Jeff; Buonocunto, Francesca; D'amico, Fiora; Quaranta, Sara; Navarro, Jorge; Lanzilotti, Crocifissa; Colonna, Fabio
Intervention programs for people with acquired brain injury and extensive motor and communication impairment need to be diversified according to their characteristics and environment. These two studies assessed two technology-aided programs for supporting leisure (i.e., access to songs and videos) and communication (i.e., expressing needs and feelings and making requests) in six of those people. The three people participating in Study 1 did not possess speech but were able to understand spoken and written sentences. Their program presented leisure and communication options through written phrases appearing on the computer screen. The three people participating in Study 2 did not possess any speech and were unable to understand spoken or written language. Their program presented leisure and communication options through pictorial images. All participants relied on a simple microswitch response to enter the options and activate songs, videos, and communication messages. The data showed that the participants of both studies learned to use the program available to them and to engage in leisure and communication independently. The importance of using programs adapted to the participants and their environment was discussed.
Williams, Lindy; McMurray, Adela J
This exploratory study reports on two surveys conducted in metropolitan and rural health organisations. Two questionnaires consisting of open and closed questions were distributed to a total of 340 respondents resulting in 176 usable responses, yielding a response rate of 53%. The findings revealed that nurse managers require fairness, trust, recognition, supervisory encouragement, organisational support, and reward for efforts. These are key aspects of organisational climate, which support innovative practice. Experience and innovation were significantly related and other factors such as, management structures and management styles, also had an impact on nurse managers' ability to exhibit innovative behaviour in the 21st Century workplace.
The Order of Malta France is organising, through an innovative partnership with the French Army, the training of first aid instructors aimed at former soldiers injured in combat. One soldier, who received multiple wounds in Lebanon in 2011, describes his training experience.
McFarlane, K; Judd, J; Devine, S; Watt, K
Issue addressed: Primary healthcare settings are important providers of health promotion approaches. However, organisational challenges can affect their capacity to deliver these approaches. This review identified the common enablers and barriers health organisations faced and it aimed to explore the experiences health organisations, in particular Aboriginal organisations, had when increasing their health promotion capacity.Methods: A systematic search of peer-reviewed literature was conducted. Articles published between 1990-2014 that focused on a health care-settings approach and discussed factors that facilitated or hindered an organisation's ability to increase health promotion capacity were included.Results: Twenty-five articles met the inclusion criteria. Qualitative (n = 18) and quantitative (n = 7) study designs were included. Only one article described the experiences of an Aboriginal health organisation. Enablers included: management support, skilled staff, provision of external support to the organisation, committed staffing and financial resources, leadership and the availability of external partners to work with. Barriers included: lack of management support, lack of dedicated health promotion staff, staff lacking skills or confidence, competing priorities and a lack of time and resources allocated to health promotion activities.Conclusions: While the literature highlighted the importance of health promotion work, barriers can limit the delivery of health promotion approaches within primary healthcare organisations. A gap in the literature exists about how Aboriginal health organisations face these challenges.So what?: Primary healthcare organisations wanting to increase their health promotion capacity can pre-empt the common barriers and strengthen identified enablers through the shared learnings outlined in this review.
In the area of business continuity management, a preliminary review of the literature reveals extensive knowledge, expertise and experience concerning organisations in the private and public sectors. It is interesting to note, however, that there is little literature about business continuity management in international organisations, although these entities are complex and particularly prone to threats. This apparent absence of literature suggests that business continuity management has not yet hit the agenda of international organisations. In recent years, member states have encouraged senior management to design and implement business continuity strategies to minimise the mishandling of an internal crisis and build organisational resilience, but very few of them have actually been able to design and implement comprehensive business continuity programmes. Based on actual experience working in international organisations, this paper outlines some of the challenges faced by international organisations in developing and implementing business continuity activities and attempts to make suggestions for further improvement.
Kalanda, Boniface; Mamimine, Patrick; Taela, Katia; Chingandu, Louis; Musuka, Godfrey
The governments across the world have endorsed numerous international Conventions and Declarations (C&Ds) that enhance interventions to reduce the impact of HIV and AIDS. The objective of this study was to assess the extent to which the governments of Lesotho, Malawi and Mozambique have implemented HIV and AIDS international and regional…
Introduction Lesotho has the third highest HIV prevalence in the world (an adult prevalence of 23.2%). Despite a lack of resources for health, the country has implemented state-of-the-art antiretroviral treatment guidelines, including early initiation of treatment (<350 cells/mm3), tenofovir in first line, and nurse-initiated and managed HIV care, including antiretroviral therapy (ART), at primary health care level. Programme approach We describe two-year outcomes of a decentralized HIV/AIDS care programme run by Doctors Without Borders/Médecins Sans Frontières, the Ministry of Health and Social Welfare, and the Christian Health Association of Lesotho in Scott catchment area, a rural health zone covering 14 clinics and one district hospital. Outcome data are described through a retrospective cohort analysis of adults and children initiated on ART between 2006 and 2008. Discussion and Evaluation Overall, 13,243 people have been enrolled in HIV care (5% children), and 5376 initiated on ART (6.5% children), 80% at primary care level. Between 2006 and 2008, annual enrolment more than doubled for adults and children, with no major external increase in human resources. The proportion of adults arriving sick (CD4 <50 cells/mm3) decreased from 22.2% in 2006 to 11.9% in 2008. Twelve-month outcomes are satisfactory in terms of mortality (11% for adults; 9% for children) and loss to follow up (8.8%). At 12 months, 80% of adults and 89% of children were alive and in care, meaning they were still taking their treatment; at 24 months, 77% of adults remained in care. Conclusion Despite major resource constraints, Lesotho is comparing favourably with its better resourced neighbour, using the latest international ART recommendations. The successful two-year outcomes are further evidence that HIV/AIDS care and treatment can be provided effectively at the primary care level. The programme highlights how improving HIV care strengthened the primary health care system, and validates
organisational effectiveness of coalition HQs conducting Non-article 5 crisis response operations. The paper will present intermediate results of the work of...PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Swiss Military Academy at ETH Zurich...their organisational effectiveness. It is the result of the work of NATO Research and Technology Organisation (RTO) Task Group HFM-163 “Improving
Mitchell, Mary M; Knowlton, Amy
While informal caregivers play an important role in improving the health of disadvantaged persons living with HIV/AIDS (PLHAs) in the United States, caregiver role overload has the potential for distress. We used latent profile analysis (LPA) to classify caregivers based on their perceived level of support and structural equation modeling (SEM) to examine the relationships among role overload, perceived support, caregiver demographic characteristics, and social network members' characteristics in a sample of 215 predominantly low-income, African-American informal caregivers. The LPA resulted in two classes of caregivers with higher and lower perceived support. The SEM results indicated that caregiver role overload was associated with being in the less supported class, younger age, and limited physical functioning, while social support class was associated with being female and being HIV seropositive in addition to support network characteristics. Interventions should address the support needs of HIV caregivers to reduce their potential for distress.
Zimmerman, G; Savage, L; Chandler, D; Maccarone, B
All the psoriatic arthritis and psoriasis patient advocacy organisations are devoted to promoting public awareness and patient education; supporting access to effective treatments and physicians committed to the welfare of patients; working with physicians and other organisations to facilitate development of new treatments; and supporting research for more effective treatments and a cure for psoriasis and psoriatic arthritis. They have participated in the remaking of health politics in the late twentieth century. This was an era in which small patient support and advocacy groups were transformed into sophisticated national health organisations integral to the formation of national health policy and research, treatment, and education funding by working with physicians, legislators, pharmaceutical companies, third party payors, and the media. As we enter the twenty first century, some of these groups have done critical surveys of patients and physicians to discern needs that are redirecting their programming and reshaping directions in the field. Many national leagues have united to form international organisations. Although differences in their national healthcare systems, the age of their organisations, and the diseases they cover are reflected in the focus of their individual activities, much unites them. Whatever their size, as their roles have come to be recognised in the healthcare community, the patient advocacy organisations welcome being invited to the decision making table. This report describes a sampling of these organisations. PMID:15708949
Newlands, David; Simkhada, Padam
Thousands of people are infected with HIV/AIDS in Nepal and most of them are adults of working age. Therefore, HIV/AIDS is a big burden in Nepal. This review was conducted to find the existing knowledge gap about the economic burden of HIV/AIDS at the household level in Nepal, the extent of economic burden exerted by the disease, and to provide policy recommendations. It is concluded that there was a considerable knowledge gap about the issue, and the economic burden exerted by HIV/AIDS was big enough to push the affected households into poverty. It is suggested that more studies need to be conducted to fill the knowledge gap. Similarly, Government of Nepal and other organisations working in the field of HIV/AIDS need to provide economic supports (e.g.- support for travel costs) to the HIV positive people and need to increase the awareness level among general population for reducing stigma and discrimination, and reducing economic burden on them. PMID:26913211
As health services face increasing pressure to meet the expectations of different stakeholders, they must continuously improve and learn from their experience. Many fail in attempts at continuous improvement programs because managers have not understood the complexity of making changes in organisations with multiple subcultures and interests. This article examines the related concepts of organisational culture, organisational learning and total quality management and shows how a synthesis of this knowledge can assist in developing continuous organisational learning and improvement.
The cognitive psychological processes related to learning and change behaviour are factors that impact on organisational strategy development. Strategy development is dependent on strategic thinking that is reciprocally influenced by shared mental models, organisational learning and organisational change. Although strategy development, shared…
Remedios, Richard; Boreham, Nick
This study examined the effects of organisational learning initiatives on employee motivation. Four initiatives consistent with theories of organisational learning were a priori ranked in terms of concepts that underpin intrinsic-motivation theory. Eighteen employees in a UK petrochemical company were interviewed to ascertain their experiences of…
This paper focuses on the existing and potential role of electronic learning in small and medium-sized organisations (SMEs). Innovations in information and communication technologies (ICTs) could create new forms of learning, particularly appealing to small organisations, to overcome traditional barriers such as lack of financial resources, time,…
Boreham, Nick; Morgan, Colin
The concept of organisational learning has been widely debated and frequently contested by educationalists, but the specific processes and actions which constitute this form of learning have received relatively little research attention. This paper reports a three-year empirical investigation into organisational learning in a large industrial…
This paper focuses on the World Bank/IMF (International Monetary Fund), the OECD (Organisation for Economic Cooperation and Development) and the WTO (World Trade Organisation) as institutions of transnational policy making. They are all at present making education policies which are decisively shaping current directions and developments in…
Branson, Christopher M.
Purpose: The purpose of this paper is to, first, establish the interdependency between the successful achievement of organisational change and the attainment of values alignment within an organisation's culture and then, second, to describe an effective means for attaining such values alignment. Design/methodology/approach: Literature from the…
Highly innovative organisations demonstrate six key characteristics. They create learning cultures which promote innovation as a core organisational capability; employ leaders who are "failure-tolerant"; identify innovators; reward people who propose innovative ideas; use partnerships; and, promote innovation through teams. This report…
The development of comprehensive accurate and well-organised technical documentation that demonstrates compliance with regulatory requirements is a resource-intensive, but critically important activity for medical device manufacturers. This article discusses guidance documents and method of organising technical documentation that may help avoid costly and time-consuming duplication.
organisational learning, and accompanying processes and mechanisms designed to facilitate learning across these levels. For example, there is a tendency by...and leaders would need to relinquish control over the learning process . The reliance on employee’s initiative and creativity may challenge...organisational processes .................................................................................................................... 29 5.3
Purpose: The aim of this research was to determine whether leadership practices vary between German and UK organisations. Design/methodology/approach: The author used self-assessment documents submitted by German and UK organisations to the European Foundation for Quality Management (EFQM), to identify leadership practices in both countries. A…
This study investigates the effectiveness of a solution-focused approach to organisational change. Planning Alternative Tomorrows with Hope (PATH) is an intervention more commonly applied to individuals. In this study the intervention is used with groups of people working in educational organisations to help manage the change process. The approach…
Baxter, Gavin J.; Connolly, Thomas M.
Purpose: The aim of this paper is to provide an overview of the "state of art" of organisational blogging. It also aims to provide a critical review of the literature on organisational blogging and propose recommendations on how to advance the subject area in terms of academic research. Design/methodology/approach: A systematic literature review…
McMurray, Adela; Scott, Don
Being aware of the factors that develop a positive organisational climate is especially important in universities, where the academic members of staff are, in large measure, self-motivated. To identify the determinants of organisational climate for university academia, the validity and reliability of the first-order constructs of autonomy,…
Baxter, Gavin J.; Connolly, Thomas M.; Stansfield, Mark H.
Purpose: The purpose of this paper is to identify the theoretical link between blogs and organisational learning. It aims to provide a set of practical guidelines on how to overcome the challenges of implementing an organisational blog. Design/methodology/approach: A literature review will be used to examine blogs and their association towards…
Lawler, Alan; Sillitoe, James
The term "organisational learning" was popularised by Peter Senge in "The Fifth Discipline", his seminal book from 1990. Since then, the term has become widely accepted among those interested in organisational learning and change management. However, partly due to the somewhat ambiguous situation which arises in a university…
The Institute for the Achievement of Human Potential developed a device known as the Vehicle for Initial Crawling (VIC); the acronym is a tribute to the crawler's inventor, Hubert "Vic" Vykukal; is an effective crawling aid. The VIC is used by brain injured children who are unable to crawl due to the problems of weight-bearing and friction, caused by gravity. It is a rounded plywood frame large enough to support the child's torso, leaving arms and legs free to move. On its underside are three aluminum discs through which air is pumped to create an air-bearing surface that has less friction than a film of oil. Upper side contains the connection to the air supply and a pair of straps which restrain the child and cause the device to move with him. VIC is used with the intent to recreate the normal neurological connection between brain and muscles. Over repetitive use of the device the child develops his arm and leg muscles as well as coordination. Children are given alternating therapy, with and without the VIC until eventually the device is no longer needed.
Cleveland, Peggy H.
A diagnosis of Acquired Immune Deficiency Syndrome (AIDS) has both a physical and psychosocial impact that require substantial support. Relating to the families of origin concerning an AIDS diagnosis is a difficult task which sometimes results in rejection and sometimes results in support. In this study subjects (N=32) with AIDS described their…
Liu, Zhimin; Lian, Zhi; Zhao, Chengzheng
This paper on drug use and HIV/AIDS in China follows on from the column's May 2005 article on the description of the first methadone maintenance clinic in Beijing. Methadone maintenance clinics and needle exchange programmes are now being implemented in China as a response to the rapid increase in prevalence of HIV/AIDS over the last 10-15 years. It is worth noting that in prior years methadone was available only as for short-term detoxification from opioids and for research purposes. Accordingly, the Department of Health Education and Behavioural Intervention at the National Center for AIDS Prevention and Control in China plans to establish 1,000 methadone replacement clinics within the next 5 years to treat 200,000 heroin-dependent users who are at increased risk of HIV/AIDS. Robert Ali & Rachel HumeniukEditors, Asia Pacific ColumnThe cumulative number of registered drug users in mainland China increased from 70,000 in 1990 to 1.14 million in 2004. Heroin continues to be the most commonly used drug in China; however, polydrug use is popular among heroin users. Sedatives/hypnotics (e.g. triazolam) and other uncontrolled prescription opioids (e.g. pethidine and tramadol) are used commonly in combination with heroin. The majority of drug users (79%) are young people aged between 17 and 35 years and comprise predominantly farmers (30%) and unemployed people (45%). The HIV/AIDS epidemic in China has reached expansion phase (1995-present). It is estimated that the actual number of HIV/AIDS cases reached 840,000, including 80,000 actual AIDS patients, in 2003, with injecting drug users (IDUs) making up the largest proportion of these cases. Although the prevalence rate of HIV/AIDS is only 0.065% in the Chinese population overall, there is potential for an explosive spread of HIV/AIDS if preventative measures are not employed. Supported by the Chinese government and other related international organisations, harm reduction strategies such as methadone maintenance
laboratories inl Soot h 1,lplc ie ull Australia. Victoria. NSW. ACT. Tasmania and Q I ii il sli iiifd land. The C hief IDefence S ciettist. Professor I’. F...Shlepipard. Aerodvttatits research group it I.1t’ tttt’rttt t hd Australian ntiljtarY p~rtoblemts. and tot contduct R&D on t heotretical aerodtiatttics...Adcian’d rngin s i g tirulate contamnation in Il., is shown t 7), aid hbeli X -roy dtlroitiun Laboratori to produce the successful Mullika hip noonted
Woo, David James
An international school may make organisational choices that divide the school by curriculum, grade-level, language and location. This article explores how a school's organisational stratification impacts how the school supports changing teaching and learning practices through technology. The article draws from case data of technology integration…
Donors that provide aid to the Wanni region of Sri Lanka, which is controlled by the Liberation Tigers of Tamil Eelam (LTTE), are promoting initiatives that seek to advance the national peace process. Under the rubric of post-conflict reconstruction, the actions of political forces and structural factors have led to the prioritisation of two different approaches to peace-building: community capacity-building projects; and support for the 'peace dividend'. Both of these approaches face challenges. Cooperation with civil society actors is extremely difficult due to intimidation by the LTTE political authority and the authoritarian nature of its control. Peace-building successes with respect to the peace dividend are difficult to measure, and must be balanced against the negative effects of misdirected funds. Aid organisations must be careful not to consider the tasks of peacebuilding, humanitarian relief and community empowerment as either interchangeable or as mutually reinforcing endeavours.
Thomson, Richard G; Eccles, Martin P; Steen, I Nick; Greenaway, Jane; Stobbart, Lynne; Murtagh, Madeleine J; May, Carl R
Objective To determine the efficacy of a computerised decision aid in patients with atrial fibrillation making decisions on whether to take warfarin or aspirin therapy. Design Two‐armed open exploratory randomised controlled trial. Setting Two research clinics deriving participants from general practices in Northeast England. Participants 109 patients with atrial fibrillation aged over 60. Interventions Computerised decision aid applied in shared decision‐making clinic compared to evidence‐based paper guidelines applied as direct advice. Main outcome measures Primary outcome measure was the decision conflict scale. Secondary outcome measures included anxiety, knowledge, decision‐making preference, treatment decision, use of primary and secondary care services and health outcomes. Results Decision conflict was lower in the computerised decision aid group immediately after the clinic; mean difference −0.18 (95% CI −0.34 to −0.01). Participants in this group not already on warfarin were much less likely to start warfarin than those in the guidelines arm (4/16, 25% compared to the guidelines group 15/16, 93.8%, RR 0.27, 95% CI 0.11 to 0.63). Conclusions Decision conflict was lower immediately following the use of a computerised decision aid in a shared decision‐making consultation than immediately following direct doctor‐led advice based on paper guidelines. Furthermore, participants in the computerised decision aid group were significantly much less likely to start warfarin than those in the guidelines arm. The results show that such an approach has a positive impact on decision conflict comparable to other studies of decision aids, but also reduces the uptake of a clinically effective treatment that may have important implications for health outcomes. PMID:17545350
Santos, Suong; Murphy, Gregory; Baxter, Kathryn; Robinson, Kerin M
The influence of organisational factors on the quality of hospital coding using the International Statistical Classification of Diseases and Health Related Problems, 10th Revision, Australian Modification (ICD-10-AM) was investigated using a mixed quantitative-qualitative approach. The organisational variables studied were: hospital specialty; geographical locality; structural characteristics of the coding unit; education, training and resource supports for Clinical Coders; and quality control mechanisms. Baseline data on the hospitals' coding quality, measured by the Performance Indicators for Coding Quality tool, were used as an independent index measure. No differences were found in error rates between rural and metropolitan hospitals, or general and specialist hospitals. Clinical Coder allocation to "general" rather than "specialist" unit coding resulted in fewer errors. Coding Managers reported that coding quality can be improved by: Coders engaging in a variety of role behaviours; improved Coder career opportunities; higher staffing levels; reduced throughput; fewer time constraints on coding outputs and associated work; and increased Coder interactions with medical staff.
Humanitarian and development agencies have confronted growing insecurity in some of the regions in which they work over the course of the past decade. Consequently, aid agencies are changing their approach to security issues. Compared to aid agencies from other countries, especially the United Kingdom and the United States, German aid agencies have been relatively slow to adopt security measures. In addition, the security measures they have selected differ from one agency to another, even in comparable security contexts. The literature on organisational learning helps to explain these differences. The findings show that external and internal organisational factors influence an aid agency's choice of a particular security measure. The different responses of German aid agencies to the changing security environment demonstrate that security measures are not only influenced by an organisation's identity but also can be a way for them to demonstrate their identity and thereby distinguish themselves from other actors that deliver aid.
Civil society in contemporary Vietnam has been recognised as an important force in public health. Based on qualitative interviews and observations of 30 organisations and networks in Hanoi and Ho Chi Minh City, this paper argues that civil society organisations (CSOs) focus almost exclusively on providing information and services, including care and treatment, in line with a state-sanctioned 'implementer' role for civil society, and that these organisations therefore miss an opportunity to act as agents for change. It was observed that the CSOs taking on roles involving advocacy and the monitoring of policy implementation were those that focus exclusively on HIV/AIDS prevention and control. However, the sustainability of these efforts is unclear.
Müller, Wilmuth; Marques, Hugo; Pereira, Luis; Rodriguez, Jonathan; Brouwer, Frank; Bouwers, Bert; Politis, Ilias; Lykourgiotis, Asimakis; Ladas, Alexandros; Adigun, Olayinka; Jelenc, David
The growing number of events affecting public safety and security (PS&S) on a regional scale with potential to grow up to large scale cross border disasters puts an increased pressure on agencies and organisation responsible for PS&S. In order to respond timely and in an adequate manner to such events, Public Protection and Disaster Relief (PPDR) organisations need to cooperate, align their procedures and activities, share the needed information and be interoperable. Existing PPDR/PMR technologies such as TETRA, TETRAPOL or P25, do not currently provide broadband capability nor is expected such technologies to be upgraded in the future. This presents a major limitation in supporting new services and information flows. Furthermore, there is no known standard that addresses interoperability of these technologies. In this contribution the design of a next generation communication infrastructure for PPDR organisations which fulfills the requirements of secure and seamless end-to-end communication and interoperable information exchange within the deployed communication networks is presented. Based on Enterprise Architecture of PPDR organisations, a next generation PPDR network that is backward compatible with legacy communication technologies is designed and implemented, capable of providing security, privacy, seamless mobility, QoS and reliability support for mission-critical Private Mobile Radio (PMR) voice and broadband data services. The designed solution provides a robust, reliable, and secure mobile broadband communications system for a wide variety of PMR applications and services on PPDR broadband networks, including the ability of inter-system, interagency and cross-border operations with emphasis on interoperability between users in PMR and LTE.
... hair cells (outer and inner rows). When the vibrations move through this fluid, the tiny outer hair ... ear to the brain. Hearing aids intensify sound vibrations that the damaged outer hair cells have trouble ...
Barnard, W. Robert, Ed.
Provides evaluations of several aids for teaching chemistry. Included are The Use of Chemical Abstracts, Practical Technical Writing, Infrared Spectroscopy Programs, and a film titled "You Can't Go Back." (RH)
Vallat, B; Wilson, D W
The authors discuss the mission, organisation and resources of Veterinary Services in the new international trading environment and examine how the standards for Veterinary Services, contained in the OIE (World Organisation for Animal Health) International Animal Health Code (the Code), help provide the necessary support for Veterinary Services to meet their rights and obligations under the provisions of the Sanitary and Phytosanitary (SPS) Agreement of the World Trade Organization (WTO). The authors describe the challenges of gaining access to international trading markets through surveillance and control of OIE listed diseases. Finally, the approach in the Code to the principles underpinning the quality of Veterinary Services and to guidelines for evaluating Veterinary Services, is discussed.
... therapists. See How to Become One $54,520 Personal Care Aides Personal care aides help clients with self-care and everyday tasks. They also provide social supports and assistance that enable clients to participate in ... tab describes the typical duties and responsibilities of workers in the occupation, including what tools ...
Feng, Nan; Wu, Harris; Li, Minqiang; Wu, Desheng; Chen, Fuzan; Tian, Jin
Information sharing across organisations is critical to effectively managing the security risks of inter-organisational information systems. Nevertheless, few previous studies on information systems security have focused on inter-organisational information sharing, and none have studied the sharing of inferred beliefs versus factual observations. In this article, a multiagent collaborative model (MACM) is proposed as a practical solution to assess the risk level of each allied organisation's information system and support proactive security treatment by sharing beliefs on event probabilities as well as factual observations. In MACM, for each allied organisation's information system, we design four types of agents: inspection agent, analysis agent, control agent, and communication agent. By sharing soft findings (beliefs) in addition to hard findings (factual observations) among the organisations, each organisation's analysis agent is capable of dynamically predicting its security risk level using a Bayesian network. A real-world implementation illustrates how our model can be used to manage security risks in distributed information systems and that sharing soft findings leads to lower expected loss from security risks.
Marynissen, H M F
Both researchers and managers search for the most appropriate form of organisational communication. The aim of such an organisational communication is to influence the receivers' perception to confirm, adapt or change behaviour according to the sender's intention. This paper argues that to influence the receivers' perception, a specific form of communication that is embedded in a specific organisational culture is required. It also demands prior knowledge of the existing organisational schemata and the current perception concerning the topic that has to be communicated. The rationale is that three obstacles hinder the objectives of traditional communication strategies to influence perception according to the sender's objectives. The first challenge is that a receiver of a certain message never garners one single, clearly pronounced message conveyed by one single person. Yet, few studies are based on multiple messages from various sources. This makes most of the communication strategies in use obsolete. The second strain is the dual mode of thinking that forms organisational members' perceptions: the heuristic and the cogitative (Taleb, 2010). Most organisational communication theories are based on the paradigm in which receivers of information process this information in a rational way, while research in the field of neurobiology (Lehrer, 2009) indicates that rationality is dominated by emotions. The third difficulty is that organisational members constrain to well-established, ingrained schemas (Labianca et al., 2000; Balogun and Johnson, 2004). Based on these existing schemas, the scattered information from multiple sources, and the inability to process that information through cognitive reasoning, organisational members construct perceptions that are not in line with the objectives of the sender's communication. This article reviews different communication theories, points out key concepts in the literature on individual and collective perceptions, and suggests
Carroll, J S; Edmondson, A C
As healthcare organisations seek to enhance safety and quality in a changing environment, organisational learning practices can help to improve existing skills and knowledge and provide opportunities to discover better ways of working together. Leadership at executive, middle management, and local levels is needed to create a sense of shared purpose. This shared vision should help to build effective relationships, facilitate connections between action and reflection, and strengthen the desirable elements of the healthcare culture while modifying outdated assumptions, procedures, and structures.
In recent years, landscape and its management has become a focus of policies and academic conceptualisation. Landscape is understood as a concept of interconnected natural and human systems. Its management must take into account the dynamic interdependencies and diverging interests of various stakeholders at different levels. Bridging organisations can provide an arena for trust-building, conflict resolution, learning and collaboration between relevant stakeholders. This paper draws on two strands of literature - landscape governance and co-management of social-ecological systems - to investigate the contributions of agri-environmental collaboratives (AEC) to sustainable landscape management. Based on data from 41 interviews with key informants and AEC members in Germany and the Netherlands, six fields of contributions were identified: policy implementation and service provision; coordination and mediation; awareness raising and behaviour change; care for 'everyday' landscapes; maintenance and protection of landscapes (including species and habitats); and income generation and economic benefits. Some of the contributions evolve around the specific role of AEC as bridging organisations, but other contributions such as economic benefits emerge beyond this analytical lens. The paper therefore emphasises holistic, bottom up assessment of AEC contributions and argues that governments should support such organisations through i) funding for facilitators and ii) funding for impact monitoring and data management.
Rondina, Renante; Curtiss, Kaitlin; Meltzer, Jed A; Barense, Morgan D; Ryan, Jennifer D
Episodic memories are comprised of details of "where" and "when"; spatial and temporal relations, respectively. However, evidence from behavioural, neuropsychological, and neuroimaging studies has provided mixed interpretations about how memories for spatial and temporal relations are organised-they may be hierarchical, fully interactive, or independent. In the current study, we examined the interaction of memory for spatial and temporal relations. Using explicit reports and eye-tracking, we assessed younger and older adults' memory for spatial and temporal relations of objects that were presented singly across time in unique spatial locations. Explicit change detection of spatial relations was affected by a change in temporal relations, but explicit change detection of temporal relations was not affected by a change in spatial relations. Younger and older adults showed eye movement evidence of incidental memory for temporal relations, but only younger adults showed eye movement evidence of incidental memory for spatial relations. Together, these findings point towards a hierarchical organisation of relational memory. The implications of these findings are discussed in the context of the neural mechanisms that may support such a hierarchical organisation of memory.
Resources - HIV/AIDS ... The following organizations are good resources for information on AIDS : AIDS.gov -- www.aids.gov AIDS Info -- aidsinfo.nih.gov The Henry J. Kaiser Family Foundation -- www. ...
... Devices Consumer Products Hearing Aids Types of Hearing Aids Share Tweet Linkedin Pin it More sharing options ... some features for hearing aids? What are hearing aids? Hearing aids are sound-amplifying devices designed to ...
This ethnographic study in Dzivaresekwa district, Harare, Zimbabwe, examines the issue of sexuality among the elderly and their challenges in accessing information, education, and communication (IEC) campaigns in the face of HIV and AIDS. The research depended heavily on collecting life histories through key informant interviews. The theory of structuration (as proposed by Anthony Giddens) was adopted as a framework to analyse the findings. The findings reveal that although the sample of elderly people in Dzivaresekwa district were sexually active, HIV/ AIDS-related interventions in the form of IEC campaigns mainly focus on the age group of 14-49-year-olds, and otherwise consider the elderly only as a group indirectly affected by the epidemic and less at risk of HIV infection. This is mainly a result of society's presumption that people withdraw from sexual life with advanced age. Thus, the elderly are incorrectly regarded as sexually inactive and not susceptible to contracting sexually transmitted infections. A fuller understanding of the sexuality of the elderly is important to increase the usefulness HIV/AIDS efforts, while IEC campaigns that target them are still needed.
During the First World War the British Red Cross Society (BRCS) served as the coordinating body for voluntary medical aid giving in Britain. Among the many units which came within its purview was the Friends’ Ambulance Unit (FAU), formed by a group of young men whose desire to serve their nation in wartime conflicted with their pacifist principles. Both the BRCS and the FAU were wracked by ideological conflicts in the years which preceded and throughout the war. These struggles over voluntarist identity highlight the contested meanings of service and conscience in wartime. Through a critical examination of the language of official histories and biographies, this article will argue that the war formed a key moment in the relationship between the British state and voluntary medical aid, with the state’s increasing role in the work of such organizations raising questions about the voluntarist principles to which aid organizations laid claim. The struggles that both organizations and individuals within them faced in reconciling the competing pressures that this new relationship created form a legacy of the war which continues to have important implications for the place of medical voluntarism in wartime today. PMID:26213442
During the First World War the British Red Cross Society (BRCS) served as the coordinating body for voluntary medical aid giving in Britain. Among the many units which came within its purview was the Friends' Ambulance Unit (FAU), formed by a group of young men whose desire to serve their nation in wartime conflicted with their pacifist principles. Both the BRCS and the FAU were wracked by ideological conflicts in the years which preceded and throughout the war. These struggles over voluntarist identity highlight the contested meanings of service and conscience in wartime. Through a critical examination of the language of official histories and biographies, this article will argue that the war formed a key moment in the relationship between the British state and voluntary medical aid, with the state's increasing role in the work of such organizations raising questions about the voluntarist principles to which aid organizations laid claim. The struggles that both organizations and individuals within them faced in reconciling the competing pressures that this new relationship created form a legacy of the war which continues to have important implications for the place of medical voluntarism in wartime today.
Branchard, Delphine; Tentillier, Éric; Gillet, Stéphane; Naud, Julien
In France, the organisation of aid involves the intervention of the emergency medical services (Samu), which coordinate the medical regulation platforms for site 15 and the mobile emergency and intensive care services (Smur). Since they were created, the Samu have been tirelessly adapting their response to the various characteristics of pre-hospital assignments. Pre- and inter-hospital paediatrics has seen the development of specialised teams with the aim of providing effective aid which is adapted to the youngest and most vulnerable patients.
Tam, Steven; Gray, David E.
Purpose: The purpose of this study is to relate the practice of organisational learning in small- and medium-sized enterprises (SMEs) to the organisational life cycle (OLC), contextualising the differential aspects of an integrated relationship between them. Design/methodology/approach: It is a mixed-method study with two consecutive phases. In…
Boyd, Emily; Osbahr, Henny
Drawing from the organisational learning and governance literature, this paper assesses four internationally networked governmental and non-governmental organisations in the UK addressing climate change. We analyse how those concerned understand the climate change crisis, what mechanisms are put in place to address information flows, and what…
The purpose of this article is to present a specific approach to the practice of action research "in complex organisations". Clearly, there are many approaches to the challenge of doing action research in organisations; approaches that are, and also must be, quite context dependent and specific. But my purpose is neither to give an…
Bipath, Keshni; Adeyemo, Kolawole Samuel
One of the more frequently cited cultural dimensions within the field of cultural research is that of cultural strength (Cameron & Ettington, 1998). Early published works on organisational culture argue that there is an absolute need for a "strong" culture for organisations to be effective. This study has examined the contradiction…
Paturas, James L; Smith, Stewart R; Albanese, Joseph; Waite, Geraldine
Inter-organisational communication failures during times of real-world disasters impede the collaborative response of agencies responsible for ensuring the public's health and safety. In the best of circumstances, communications across jurisdictional boundaries are ineffective. In times of crisis, when communities are grappling with the impact of a disaster, communications become critically important and more complex. Important factors for improving inter-organisational communications are critical thinking and problem-solving skills; inter-organisational relationships; as well as strategic, tactical and operational communications. Improving communication, critical thinking, problem-solving and decision-making requires a review of leadership skills. This discussion begins with an analysis of the existing disaster management research and moves to an examination of the importance of inter-organisational working relationships. Before a successful resolution of a disaster by multiple levels of first responders, the group of organisations must have a foundation of trust, collegiality, flexibility, expertise, openness, relational networking and effective communications. Leaders must also be prepared to improve leadership skills through continual development in each of these foundational areas.
Perceived social support, hopefulness, and emotional regulations as mediators of the relationship between enacted stigma and post-traumatic growth among children affected by parental HIV/AIDS in rural China.
Wei, Wei; Li, Xiaoming; Tu, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang
Some previous studies have revealed a negative impact of enacted stigma on post-traumatic growth (PTG) of children affected by HIV/AIDS, but little is known about protective psychological factors that can mitigate the effect of enacted stigma on children's PTG. This study aims to examine the mediating effects of perceived social support, hopefulness, and emotional regulation on the relationship between enacted stigma and PTG among HIV-affected children. Cross-sectional data were collected from 790 children affected by parental HIV (382 girls, 408 boys) aged 6-17 years in 2012 in rural central China. Multiple regression was conducted to test the mediation model. The study found that the experience of enacted stigma had a negative effect on PTG among children affected by HIV/AIDS. Emotional regulation together with hopefulness and perceived social support mediated the impact of enacted stigma on PTG. Perceived social support, hopefulness, and emotional regulation offer multiple levels of protection that can mitigate the impact of enacted stigma on PTG. Results suggest that future psychological intervention programs should seek strategies to reduce the stigmatizing experience of these children and promote children's level of PTG, and health professionals should also emphasize the development of these protective psychological factors.
Perceived social support, hopefulness, and emotional regulations as mediators of the relationship between enacted stigma and post-traumatic growth among children affected by parental HIV/AIDS in rural China
Wei, Wei; Li, Xiaoming; Tu, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang
ABSTRACT Some previous studies have revealed a negative impact of enacted stigma on post-traumatic growth (PTG) of children affected by HIV/AIDS, but little is known about protective psychological factors that can mitigate the effect of enacted stigma on children's PTG. This study aims to examine the mediating effects of perceived social support, hopefulness, and emotional regulation on the relationship between enacted stigma and PTG among HIV-affected children. Cross-sectional data were collected from 790 children affected by parental HIV (382 girls, 408 boys) aged 6–17 years in 2012 in rural central China. Multiple regression was conducted to test the mediation model. The study found that the experience of enacted stigma had a negative effect on PTG among children affected by HIV/AIDS. Emotional regulation together with hopefulness and perceived social support mediated the impact of enacted stigma on PTG. Perceived social support, hopefulness, and emotional regulation offer multiple levels of protection that can mitigate the impact of enacted stigma on PTG. Results suggest that future psychological intervention programs should seek strategies to reduce the stigmatizing experience of these children and promote children's level of PTG, and health professionals should also emphasize the development of these protective psychological factors. PMID:26899475
Rooksby, J; Kay, S
Radiology reports, as a form of clinical narrative, are more than a repository of patient information but are active in patient care. They are not unique and individual to each patient but have structured content suitable for supporting the activities of care. We consider these activities of care and how they manifest in the report. This recognition of the infusion of clinical organisation in clinical narrative leads to the recognition of seven properties of radiology reports: labels, concepts, genre, structure, author, subject, reader. These properties exist across two relationships: the intertextual relationship between radiology reports and the interpersonal relationship between a radiology report and people.
Science Activities: Classroom Projects and Curriculum Ideas, 2007
This article describes 6 aids for science instruction, including (1) the use of fudge to represent lava; (2) the "Living by Chemistry" program, designed to make high school chemistry more accessible to a diverse pool of students without sacrificing content; (3) NOAA and NSTA's online coral reef teaching tool, a new web-based "science toolbox" for…
Martin, Joyce; Looney, Era
Designed for use in a self-paced, open-entry/open-exit vocational training program for a floriculture aide, this program guide is one of six for teachers of adult women offenders from a correctional institution. Module topic outlines and sample lesson plans are presented on eleven topics: occupational opportunities in the retail florist industry;…
Hoyte, Tamika; Purcell, David W.; Van Handel, Michelle; Williams, Weston; Krueger, Amy; Dietz, Patricia; Stratford, Dale; Heitgerd, Janet; Dunbar, Erica; Wan, Choi; Linley, Laurie A.; Flores, Stephen A.
Objective The Enhanced Comprehensive HIV Prevention Planning project was the first initiative of the Centers for Disease Control and Prevention (CDC) to address the goals of the National HIV/AIDS Strategy (NHAS). Health departments in 12 U.S. cities with a high prevalence of AIDS conducted comprehensive program planning and implemented cost-effective, scalable HIV prevention interventions that targeted high-risk populations. We examined trends in health department HIV prevention programs in these cities during the project. Methods We analyzed the number of people who received partner services, condoms distributed, and people tested for HIV, as well as funding allocations for selected HIV prevention programs by year and by site from October 2010 through September 2013. We assessed trends in the proportional change in services and allocations during the project period using generalized estimating equations. We also conducted thematic coding of program activities that targeted people living with HIV infection (PLWH). Results We found significant increases in funding allocations for HIV testing and condom distribution. All HIV partner services indicators, condom distribution, and HIV testing of African American and Hispanic/Latino populations significantly increased. HIV tests associated with a new diagnosis increased significantly among those self-identifying as Hispanic/Latino but significantly decreased among African Americans. For programs targeting PLWH, health department activities included implementing new program models, improving local data use, and building local capacity to enhance linkage to HIV medical care, retention in care, and treatment adherence. Conclusions Overall, these findings indicate that health departments in areas with a high burden of AIDS successfully shifted their HIV prevention resources to scale up important HIV programs and make progress toward NHAS goals. PMID:26843685
Woolcock, Katrina J; Bühler, Marc
Over the last decade, the fission yeast Schizosaccharomyces pombe has been used extensively for investigating RNA interference (RNAi)-mediated heterochromatin assembly. However, only recently have studies begun to shed light on the 3D organisation of chromatin and the RNAi machinery in the fission yeast nucleus. These studies indicate association of repressive and active chromatin with different regions of the nuclear periphery, similar to other model organisms, and clustering of functionally related genomic features. Unexpectedly, RNAi factors were shown to associate with nuclear pores and were implicated in the regulation of genomic features outside of the well-studied heterochromatic regions. Nuclear organisation is likely to contribute to substrate specificity of the RNAi pathway. However, further studies are required to elucidate the exact mechanisms and functional importance of this nuclear organisation.
The objective of this paper is to highlight the dimensions characterising the socialisation process in a crisis context. Based on the definition of organisational socialisation advanced by Van Maanen and Schein (1979) and employed later by Jones (1986), a crisis is presented as a passage from a 'normal' situation to an 'exceptional' situation. A crisis represents a socialisation context in the sense that it is a novel state in which actors must develop a different way of mobilising their knowledge, utilising their skills, and practicing their trade or profession. The paper discusses certain findings that have emerged from the literature on organisational socialisation, as well as from the testimony of actors who participated in efforts to manage the Quebec ice-storm crisis of early 1998. It is hoped that this exploratory study's data will give rise to fruitful interaction between the field of organisational socialisation and that of crisis management.
McNeil, Ryan; Dilley, Laura B; Guirguis-Younger, Manal; Hwang, Stephen W; Small, Will
Introduction Improvements in the availability and effectiveness of highly active antiretroviral therapy (HAART) have prolonged the lives of people living with HIV/AIDS. However, mortality rates have remained high among populations that encounter barriers to accessing and adhering to HAART, notably people who use drugs. This population consequently has a high burden of illness and complex palliative and supportive care needs, but is often unable to access these services due to anti-drug policies and discrimination. In Vancouver, Canada, the Dr. Peter Centre (DPC), which operates a 24-bed residential HIV/AIDS care facility, has sought to improve access to palliative and supportive care services by adopting a comprehensive harm reduction strategy, including supervised injection services. We undertook this study to explore how the integration of comprehensive harm reduction services into this setting shapes access to and engagement with care. Methods Qualitative interviews were conducted with 13 DPC residents between November 2010 and August 2011. Interviews made use of a semistructured interview guide which facilitated discussion regarding how the DPC Residence's model of care (a) shaped healthcare access, (b) influenced healthcare interactions and (c) impacted drug use practices and overall health. Interview transcripts were analysed thematically. Results Participant accounts highlight how the harm reduction policy altered the structural-environmental context of healthcare services and thus mediated access to palliative and supportive care services. Furthermore, this approach fostered an atmosphere in which drug use could be discussed without the risk of punitive action, and thus increased openness between residents and staff. Finally, participants reported that the environmental supports provided by the DPC Residence decreased drug-related risks and improved health outcomes, including HAART adherence and survival. Conclusions This study highlights how adopting
In the field of business continuity management, organisations commit sums of money (often very large sums) to develop and maintain their continuity capability. Despite this, there is almost no measurement of whether this expense offers value for money, or whether it is targeted in the right areas. This paper will explain some methods of measuring components of a business continuity programme. The important outputs from this measurement activity are to demonstrate that an organisation's continuity capability is improving over time, and to identify areas of weakness that should be targeted during future work.
therapy, pain medication, nutritional and psychological support, thoracocentesis and/or tube thorascopy.”44 Three studies described supportive care... gestalt survival expectation is presented without loss of contradictory information. This increases the transparency and traceability of the...and/ or psychological damages to the patient. Specifically, a patient may suffer harms due to a treatment strategy (e. g. adverse effects) or
Brown, Charlotte; Seville, Erica; Vargo, John
Insurance is widely acknowledged to be an important component of an organisation's disaster preparedness and resilience. Yet, little analysis exists of how well current commercial insurance policies and practices support organisational recovery in the wake of a major disaster. This exploratory qualitative research, supported by some quantitative survey data, evaluated the efficacy of commercial insurance following the sequence of earthquakes in Canterbury, New Zealand, in 2010 and 2011. The study found that, generally, the commercial insurance sector performed adequately, given the complexity of the events. However, there are a number of ways in which insurers could improve their operations to increase the efficacy of commercial insurance cover and to assist organisational recovery following a disaster. The most notable of these are: (i) better wording of policies; (ii) the availability of sector-specific policies; (iii) the enhancement of claims assessment systems; and (iv) risk-based policy pricing to incentivise risk reduction measures.
Nafukho, Fredrick Muyia; Wawire, Nelson H. W.; Lam, Penina Mungania
Adult education is now considered a mainstream academic discipline in several African countries, and its importance in today's knowledge and "ideas" economies is growing steadily. It is provided by organisations such as public universities, training colleges, corporate universities and employers. The successful operation of educational…
Corney, Tim; Broadbent, Robyn; Darmanin, Lisa
Recent attempts at professionalising the youth sector have focused on "codes of ethics" and left pay and conditions issues to community sector unions. The authors suggest that the history of nursing in Victoria provides a case example of the benefits of combining professional aspirations with industrial organisation.
Swan, Peter; Atkinson, Sarah
Background Arts and health organisations must increasingly provide measurable evidence of impact to stakeholders, which can pose both logistical and ideological challenges. This paper examines the relationship between the ethos of an arts and health organisation with external demands for evaluation. Methods Research involved an ethnographic engagement where the first author worked closely with the organisation for a year. In addition to informal discussions, twenty semi-structured interviews were conducted with core staff and participants. Transcribed interviews were coded and emerging themes were identified. Results Staff considered evaluation to be necessary and useful, yet also to be time consuming and a potential threat to their ethos. Nevertheless, they were able to negotiate the terms of evaluation to enable them to meet their own needs as well as those of funders and other stakeholders. Conclusions While not completely resisting outside demands for evaluation, the organisation was seen to intentionally rework demands for evidence into processes they felt they could work with, thus enabling their ethos to be maintained. PMID:25429306
Lagrosen, Yvonne; Lagrosen, Stefan
Purpose: The purpose of this paper is to shed light upon the connections between quality management, employee health and organisational learning in a school setting. Design/methodology/approach: The study is based on a quantitative survey. Items measuring health status and values of quality management were included in a questionnaire addressed to…
This paper portrays the inferences that employers in Greece draw from particular aspects of study programmes, as recorded on educational qualifications. Based on semi-structured interviews with human resource managers in 37 industrial and service organisations and general directors of careers offices in eight higher education institutions, and…
The steadily increasing degree of globalisation of enterprises implies development of many skills, among which the skills to learn are among the most important. Learning takes place at the individual level, but collective learning and organisational learning are also important. Learning styles of individuals are different and learning styles are…
Akkerman, Sanne; Petter, Christian; de Laat, Maarten
Purpose: The notion of communities of practice (CoP) has received great attention in educational and organisational practice and research. Although the concept originally refers to collaborative practices that emerge naturally, educational and HRD practitioners are increasingly searching for ways to create these practices intentionally in order to…
National Centre for Vocational Education Research (NCVER), 2006
Organisational capability is rapidly becoming recognized as the key to organizational success. However, the lack of research on it has been well documented in the literature, and organizational capability remains an elusive concept. Yet an understanding of organizational capability can offer insights into how RTOs might work most effectively,…
Young, Charlotte E; Mutch, Allyson J; Boyle, Frances M; Dean, Julie H
While chronic disease places an increasing burden on Australia's primary care system it is unrealistic to expect GPs to meet the range of support needs experienced by patients managing chronic conditions. Consumer health organisations (CHO) have the potential to augment clinical care by providing a variety of supportive services; however, they are underutilised by patients and GPs. This qualitative study investigates GPs' knowledge and perceptions of CHO and their contributions to chronic disease care. The study involved semi-structured interviews with 10 GPs. Overall, participants demonstrated clear understanding of the role of CHO in chronic disease management, but a critical finding was the way GPs' view of their own chronic care role appears to influence referral practices. GPs operating in a traditional role were less likely to refer to CHO than those who had adopted a chronic care approach. A second key finding related to GPs' views of Diabetes Australia. All GPs identified this organisation as an important referral point, providing some reassurance that CHO can be integrated into the primary care sector. Further research is needed to determine how the 'definite advantages' associated with Diabetes Australia can be used to extend GP referral and enhance the health system's integration of other CHO.
Scott, Betsy; Rapson, Terri; Allibone, Liz; Hamilton, Rozi; Mambanje, Constance S; Pisaneschi, Laura
The role of the practice education facilitator (PEF) was introduced to support the management of large student nurse numbers in clinical areas and to monitor and enhance the quality of placements. While much has been written about the activities and roles undertaken by PEFs, less is known about the value of this type of role to the NHS organisations that employ them. This article explores some of the views of PEFs working in a variety of trusts and organisations in London and surrounding counties. There is no consistent job definition and often insufficient support, leading to some PEFs feeling overwhelmed by the work and isolated within the role. Since its introduction, the role has required post holders to work more strategically within their trusts' education remits. However, it was felt by most post holders that the role remains undervalued and the perception is that these posts are vulnerable to budget cuts. The article considers what effect this could have on pre-registration nurse education. The profile of the role needs to be strengthened through consistent job descriptions and streamlining the number of job titles attached to the role.
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Lane, Riki; Halcomb, Elizabeth; McKenna, Lisa; Zwar, Nicholas; Naccarella, Lucio; Davies, Gawaine Powell; Russell, Grant
Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce.Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territoriesResults Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies.Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices.What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally
Taylor, Stephanie JC; Bestall, Janine C; Cotter, Sarah; Falshaw, Margaret; Hood, Sonja G; Parsons, Suzanne; Wood, Lesley; Underwood, Martin
Background Chronic heart failure (CHF) is a serious, common condition associated with frequent hospitalisation. Several different disease management interventions (clinical service organisation interventions) for patients with CHF have been proposed. Objectives To assess the effectiveness of disease management interventions for patients with CHF. Search methods We searched: Cochrane CENTRAL Register of Controlled Trials (to June 2003); MEDLINE (January 1966 to July 2003); EMBASE (January 1980 to July 2003); CINAHL (January 1982 to July 2003); AMED (January 1985 to July 2003); Science Citation Index Expanded (searched January 1981 to March 2001); SIGLE (January 1980 to July 2003); DARE (July 2003); National Research Register (July 2003); NHS Economic Evaluations Database (March 2001); reference lists of articles and asked experts in the field. Selection criteria Randomised controlled trials comparing disease management interventions specifically directed at patients with CHF to usual care. Data collection and analysis At least two reviewers independently extracted data information and assessed study quality. Study authors were contacted for further information where necessary. Main results Sixteen trials involving 1,627 people were included. We classified the interventions into three models: multidisciplinary interventions (a holistic approach bridging the gap between hospital admission and discharge home delivered by a team); case management interventions (intense monitoring of patients following discharge often involving telephone follow up and home visits); and clinic interventions (follow up in a CHF clinic). There was considerable overlap within these categories, however the components, intensity and duration of the interventions varied. Case management interventions tended to be associated with reduced all cause mortality but these findings were not statistically significant (odds ratio 0.86, 95% confidence interval 0.67 to 1.10, P = 0.23), although the
Short, R V
This article reviews a peer group Acquired Immunodeficiency Syndrome (AIDS) educational program at a university in Australia. Studies in the US have shown that most adolescents, although sexually active, do not believe they are likely to become infected with the Human Immunodeficiency Virus, and therefore do not attempt to modify their sexual behavior. A 1st step in educating students is to introduce them to condoms and impress upon them the fact that condoms should be used at the beginning of all sexual relationships, whether homosexual or heterosexual. In this program 3rd year medical students were targeted, as they are effective communicators and disseminators of information to the rest of the student body. After class members blow up condoms, giving them a chance to handle various brands and observe the varying degrees of strength, statistical evidence about the contraceptive failure rate of condoms (0.6-14.7 per 100 women-years) is discussed. Spermicides, such as nonoxynol-9 used in conjunction with condoms, are also discussed, as are condoms for women, packaging and marketing of condoms, including those made from latex and from the caecum of sheep, the latter condoms being of questionable effectiveness in preventing transmission of the virus. The care of terminal AIDS cases and current global and national statistics on AIDS are presented. The program also includes cash prizes for the best student essays on condom use, the distribution of condoms, condom key rings and T-shirts, and a student-run safe sex stand during orientation week. All of these activities are intended to involve students and attract the interest of the undergraduate community. Questionnaires administered to students at the end of the course revealed that the lectures were received favorably. Questionnaires administered to new medical and English students attending orientation week revealed that 72% of students thought the stand was a good idea and 81% and 83%, respectively found it
Cornish, Flora; Shukla, Anuprita; Banerji, Riddhi
Given that the communities which are most vulnerable to HIV often have little control over their own lives and their health-related behaviour, HIV prevention policies increasingly recommend that HIV prevention projects work to build relationships with powerful external groups (i.e., build "bridging social capital"). To aid conceptualisation of how community organisations may build such social capital, this paper outlines a typology of strategies for influencing local stakeholders. We present a study of two successful Indian sex workers' organisations, VAMP and DMSC, focusing on how the organisations have influenced three groups of stakeholders, namely police, politicians and local social organisations. Interviews with project employees (45), with representatives of the three groups of stakeholders (12) and fieldwork diaries recording 6 months of observation in each site provide the data. Three approaches emerged. "Persuading" refers to the practice of holding information-giving meetings with stakeholders and requesting their support. It appears to build "weak social ties". "Protesting" entails a collective confrontation with stakeholders, and appears to be useful when the stakeholder has a public image to protect that would be tarnished by protest, and when the protestors can stake a legitimate claim that their rights are being denied. In "exchanging favours", the sex workers' organisations find creative ways to position themselves as offering valued resources to their stakeholders (such as useful information on criminal activities for the police, a stage and audience for politicians or a celebration for local social organisations) as incentives for their support. In conclusion, we discuss the strengths and weaknesses of each approach, the implications for social capital theorising and implications for community HIV prevention.
Peterson, Curtis W; Rose, Donny; Mink, Jonah; Levitz, David
In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal. In this paper, a new app feature that documents clinical decisions using an integrated job aid was deployed in a cervical cancer screening camp in Kenya. Six organizations conducting VIA used the EVA System to screen 824 patients over the course of a week, and providers recorded their diagnoses and treatments in the application. Real-time aggregated statistics were broadcast on a public website. Screening organizations were able to assess the number of patients screened, alongside treatment rates, and the patients who tested positive and required treatment in real time, which allowed them to make adjustments as needed. The real-time M&E enabled by "smart" diagnostic medical devices holds promise for broader use in screening programs in low-resource settings.
Lancioni, Giulio E.; Singh, Nirbhay N.; O’Reilly, Mark F.; Sigafoos, Jeff; D’Amico, Fiora; Renna, Caterina; Pinto, Katia
Pilot studies using technology-aided programs to promote verbal reminiscence and mild physical activity (i.e., positive forms of engagement) in persons with moderate or severe Alzheimer’s disease have provided promising results (Lancioni et al., 2015a,b). The present two studies were aimed at upgrading and/or extending the assessment of those programs. Specifically, Study 1 upgraded the program for verbal reminiscence and assessed it with eight new participants. The upgraded version automatically monitored the participants’ verbal behavior during the sessions, in which photos and brief videos were used to foster verbal reminiscence. Monitoring allowed computer approval and reminders to be consistent with the participants’ behavior. Study 2 extended the assessment of the program for promoting mild physical activity with 10 new participants for whom arm-raising responses were targeted. The results of Study 1 showed that the participants’ mean percentages of intervals with verbal engagement/reminiscence were below 10 during baseline and control sessions and between above 50 and nearly 80 during the intervention. The results of Study 2 showed that the mean frequencies of arm-raising responses were about or below four and between about 10 and 19 per session during the baseline and the intervention, respectively. The general implications of the aforementioned results and the need for new research in the area were discussed. PMID:27148050
Peterson, Curtis W.; Rose, Donny; Mink, Jonah; Levitz, David
In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal. In this paper, a new app feature that documents clinical decisions using an integrated job aid was deployed in a cervical cancer screening camp in Kenya. Six organizations conducting VIA used the EVA System to screen 824 patients over the course of a week, and providers recorded their diagnoses and treatments in the application. Real-time aggregated statistics were broadcast on a public website. Screening organizations were able to assess the number of patients screened, alongside treatment rates, and the patients who tested positive and required treatment in real time, which allowed them to make adjustments as needed. The real-time M&E enabled by “smart” diagnostic medical devices holds promise for broader use in screening programs in low-resource settings. PMID:27196932
Doyle, William R.
The advent of merit-based state financial aid programs has had several first order effects, such as changes in enrollment. However, these programs may also have second order effects, such as declining state support for need-based state financial aid programs. I hypothesize that the advent of merit-based state financial aid may be an example of…
Jolivet, Anne; Caroly, Sandrine; Ehlinger, Virgine; Kelly-Irving, Michelle; Delpierre, Cyrille; Balducci, Franck; Sobaszek, Annie; De Gaudemaris, Régis; Lang, Thierry
Few studies have analysed the association between the organisational work environment and depression in hospital workers and we still have little understanding of how processes in the practice environment are related to depressive disorders. However, individual perception of an imbalance between efforts made and expected rewards has been associated with incident depression. The main goal of this study was to test the hypothesis that some organisational constraints at the work-unit level may be related to depressive symptoms in hospital workers, either directly or through individual perceptions of effort-reward imbalance (ERI). In 2006, 3316 female registered nurses and nursing aids working in 190 work units in seven French university hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded in 2006 to valid self-report questionnaires (CES-D, ERI). The organisational work environment was assessed with the self-rated Nursing Work Index - Extended Organisation (NWI-EO) aggregated at the work unit level. Multilevel models were used. We found that poor relations between workers within work units were associated with higher CES-D score, independently of perceived ERI. Low level of communication between workers in the unit was associated with individual perceptions of ERI and indirectly associated with depressive symptoms. Understaffing and non-respect of planned days off and vacations were associated with perceived ERI but these organisational constraints were not associated with depressive symptoms. Our study allowed us to identify and quantify organisational factors that have a direct effect on hospital workers' depressive symptoms, or an indirect effect through perceived ERI. Better understanding of the effect of organisational factors on health through perceived ERI would provide targets for successful interventions. Organisational approaches may be more effective in improving mental health at work and may also
Sanz-Medel, Alfredo; Fernandez de la Campa, Maria del Rosario; Gonzalez, Elisa Blanco; Fernandez-Sanchez, Maria Luisa
The use of surfactant-based organised assemblies in analytical atomic spectroscopy is extensively and critically reviewed along three main lines: first, the ability of organised media to enhance detection of atomic spectroscopic methods by favourable manipulation of physical and chemical properties of the sample solution second, the extension of separation mechanisms by resorting to organised media and third a discussion of synergistic combinations of liquid chromatography separations and atomic detectors via the use of vesicular mobile phases. Changes in physical properties of sample solutions aspirated in atomic spectrometry by addition of surfactants can be advantageously used in at least four different ways: (i) to improve nebulisation efficiency; (ii) to enhance wettability of solid surfaces used for atomisation; (iii) to improve compatibility between aqueous and organic phases; and (iv) to achieve good dispersion of small particles in "slurry" techniques. Controversial results and statements published so far are critically discussed. The ability of surfactant-based organised assemblies, such as micelles and vesicles, to organise reactants at the molecular level has also been applied to enhance the characteristics of chemical generation of volalite species of metals and semi-metals (e.g., hydride or ethylide generation of As, Pb, Cd, Se, Sn, and cold vapour Hg generation) used in atomic methods. Enhancements in efficiency/transport of volatile species, increases in the reaction kinetics, stabilisation of some unstable species and changes in the selectivity of the reactions by surfactants are dealt with. Non-chromatographic cloud-point separations to design pre-concentration procedures with subsequent metal determination by atomic methods are addressed along with chromatographic separations of expanded scope by addition of surfactants to the conventional aqueous mobile phases of reversed-phase high-performance liquid chromatography. Finally, the synergistic
... 34 Education 2 2011-07-01 2010-07-01 true Supplementary aids and services. 300.42 Section 300.42... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.42 Supplementary aids and services. Supplementary aids and services means aids, services, and other supports that are provided in regular...
... 34 Education 2 2010-07-01 2010-07-01 false Supplementary aids and services. 300.42 Section 300.42... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.42 Supplementary aids and services. Supplementary aids and services means aids, services, and other supports that are provided in regular...
... 34 Education 2 2014-07-01 2013-07-01 true Supplementary aids and services. 300.42 Section 300.42... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.42 Supplementary aids and services. Supplementary aids and services means aids, services, and other supports that are provided in regular...
... 34 Education 2 2013-07-01 2013-07-01 false Supplementary aids and services. 300.42 Section 300.42... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.42 Supplementary aids and services. Supplementary aids and services means aids, services, and other supports that are provided in regular...
... 34 Education 2 2012-07-01 2012-07-01 false Supplementary aids and services. 300.42 Section 300.42... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.42 Supplementary aids and services. Supplementary aids and services means aids, services, and other supports that are provided in regular...
Khaola, Peter P.
As one of the most important dependent variables in education and work research, performance has been operationalised either as the proficiency with which core tasks are performed (task performance), or as extra-role behaviours that support core activities (organisational citizenship behaviours). Relative to academic performance (core academic…
Sun, Hongyi; Ho, Kario; Ni, Wenbin
There are still many questions remain unanswered about the relationship between Organisational Learning (OL) and Continuous Improvement (CI). For example, how do OL and CI contribute to business performance? Are OL and CI equal? Do OL and CI support each other? Should OL and CI be implemented separately or together? If together, how to integrate…
Sheridan, Sonja; Williams, Pia; Pramling Samuelsson, Ingrid
Background: There is a limited amount of research about group size in preschool, and how it impacts on teachers' working conditions and their ability to support children's learning and knowledge development in line with curriculum intentions. Purpose: From a perspective on quality, this article examines the organisational conditions for children's…
The aim of this article is to explore how international donors influence civil society organisations (CSOs) in Mozambique through funding mechanisms, the creation of partnerships, or inclusion in targeted programmes. The main focus is the relationship between donors and AIDS non-governmental organisations (NGOs). The main questions the paper aims to answer are: Who is setting the agenda? What power mechanisms are in place to fulfil planned projects and programmes? Are there any forms of resistance from civil society AIDS-organisations in the face of the donor interventions? The actions will be analysed through the lens of governmentality theory. The study concluded that donors have the power to set the agenda through predetermined programmes and using various technologies. Their strongest weapons are audit mechanisms such as the result based management model used as a control mechanism, and there is still a long way to go to achieve a situation with multiple forms of local resistance to the conditions set by economically powerful donors. The standardisation imposed through clustering donors into like-minded groups and other constellations gives them power to govern the politics of AIDS.
Organisational representative response is an important factor to consider when counselling employees who have experienced bullying and are considering approaching their organisation for assistance. The author argues that not all responses are supportive and that some responses can further harm an employee. The author presents a review of…
Bassaneze, Vinicius; Sacramento, Chester Bittencourt; Freire, Rodolfo; De Alencar, Patrícia Fernandes; Ortega, Neli Regina Siqueira; Krieger, Jose Eduardo
The a priori identification of induced pluripotent stem cells remains a challenge. Being able to quickly identify the most embryonic stem cell-similar induced pluripotent stem cells when validating results could help to reduce costs and save time. In this context, tools based on non-classic logic can be useful in creating aid-systems based on visual criteria. True colonies when viewed at 100x magnification have been found to have the following 3 characteristics: a high degree of border delineation, a more uniform texture, and the absence of a cracked texture. These visual criteria were used for fuzzy logic modeling. We investigated the possibility of predicting the presence of alkaline phosphatase activity, typical of true induced pluripotent stem cell colonies, after 25 individuals, with varying degrees of experience in working with murine iPS cells, categorized the images of 136 colonies based on visual criteria. Intriguingly, the performance evaluation by area under the ROC curve (16 individuals with satisfactory performance), Spearman correlation (all statistically significant), and Cohen's Kappa agreement analysis (all statistically significant) demonstrates that the discriminatory capacity of different evaluators are similar, even those who have never cultivated cells. Thus, we report on a new system to facilitate visual identification of murine- induced pluripotent stem cell colonies that can be useful for staff training and opens the possibility of exploring visual characteristics of induced pluripotent stem cell colonies with their functional peculiarities. The fuzzy model has been integrated as a web-based tool named "2see-iPS" which is freely accessed at http://genetica.incor.usp.br/2seeips/.
Tawileh, Anas; Hilton, Jeremy; McIntosh, Stephen
This paper presents the results of the latest survey on information security management and pracitces in organisations. The study is based on a holistic approach to information security that does not confine itself to technical measures and technology implementations, but encompasses other equally important aspects such as human, social, motiviational and trust. In order to achieve this purpose, a comprehensive intellectual framework of the concepts of information security using Soft Systems Methodology (SSM) was utilised. The survey questions were drived from this conceptual model to ensure their coherence, completeness and relevance to the topic being addressed. The paper concludes with a discussion of the survey results and draws significant insight into the existing status of informaiton assurance in organisations that could be useful for security practitioners, researchers and managers.
Purpose: The purpose of this paper is to investigate and characterise the knowledge creation process in construction organisations and explore to what extent organisations facilitate the process. Design/methodology/approach: A case study approach is adopted using four construction organisations; a knowledge creation model is also used as the…
Campbell, Timothy T.; Armstrong, Steven J.
Purpose: The purpose of this paper is to empirically examine organisational learning (OL) and individual managerial learning and provide a comparative evaluation of the ability of each to generate organisational benefits. Design/methodology/approach: A theoretical model of organisational learning is developed which was then longitudinally tested…
Harms, Sheila; Kizza, Ruth; Sebunnya, Joshua; Jack, Susan
The AIDS epidemic has disproportionately affected developing or low-income sub-Saharan African countries. Within the context of the epidemic, children and youth are at risk of losing their parents at an early age. The experience of orphanhood due to AIDS has the potential to negatively impact on a child's mental health. A qualitative study was conducted to comprehensively describe the experience of orphanhood and its impact on mental health from the culturally specific perspective of Ugandan youths. We conducted interviews with a purposeful sample of 13 youths (ages 12 to 18) who had lost one or both parents to AIDS illness and who were also affiliated with a non-governmental organisation providing support to orphans. The orphaned youths experienced significant ongoing emotional difficulties following the death of their parent(s). The youths in this study were unfamiliar with the term 'mental health,' however they easily identified factors associated with good or poor mental health. In general, good mental health was associated with social conduct that is culturally appropriate. Poor mental health was perceived as a form of madness or insanity and it was associated with a loss of basic life necessities, such as access to food, education or shelter. The youths also identified factors that promote more successful orphans. The findings of this study suggest that Western terminologies and symptom constellations in the Diagnostic and Statistical Manual IV may not be applicable in an African cultural context. There are several clinical implications, including the development of a mental health intervention paradigm that emphasises resilience.
Elwyn, Glyn; Hocking, Paul
Background Improving the quality and effectiveness of clinical practice is becoming a key task within all health services. Primary medical care, as organised in the UK is composed of clinicians who work in independent partnerships (general practices) that collaborate with other health care professionals. Although many practices have successfully introduced innovations, there are no organisational development structures in place that support the evolution of primary medical care towards integrated care processes. Providing incentives for attendance at passive educational events and promoting 'teamwork' without first identifying organisational priorities are interventions that have proved to be ineffective at changing clinical processes. A practice and professional development plan feasibility study was evaluated in Wales and provided the experiential basis for a summary of the lessons learnt on how best to guide organisational development systems for primary medical care. Results Practice and professional development plans are hybrids produced by the combination of ideas from management (the applied behavioural science of organisational development) and education (self-directed adult learning theories) and, in conceptual terms, address the lack of effectiveness of passive educational strategies by making interventions relevant to identified system wide needs. In the intervention, each practice participated in a series of multidisciplinary workshops (minimum 4) where the process outcome was the production of a practice development plan and a set of personal portfolios, and the final outcome was a realised organisational change. It was apparent during the project that organisational admission to a process of developmental planning needed to be a stepwise process, where initial interest can lead to a fuller understanding, which subsequently develops into motivation and ownership, sufficient to complete the exercise. The advantages of introducing expert external
RTO-MP-IST-055 1 - 1 Intelligence Base: Strategic Instrument of an Organisation Major Marc Rabaey and Colonel Jean-Marie Leclercq, Ir...in the fight against international terrorism a nation has to share intelligence and exchange information with other nations. This requires a secure...and performing communication system. This paper introduces the concept of the Intelligence Base, which meets the needs of an efficient and effective
Spinelli, D; Antonucci, G; Daini, R; Martelli, M L; Zoccolotti, P
According to Rock [1990, in The Legacy of Solomon Asch (Hillsdale, NJ: Lawrence Erlbaum Associates)], hierarchical organisation of perception describes cases in which the orientation of an object is affected by the immediately surrounding elements in the visual field. Various experiments were performed to study the hierarchical organisation of orientation perception. In most of them the rod-and-frame-illusion (RFI: change of the apparent vertical measured on a central rod surrounded by a tilted frame) was measured in the presence/absence of a second inner frame. The first three experiments showed that, when the inner frame is vertical, the direction and size of the illusion are consistent with expectancies based on the hierarchical organisation hypothesis. An analysis of published and unpublished data collected on a large number of subjects showed that orientational hierarchical effects are independent from the absolute size of the RFI. In experiments 4 to 7 we examined the perceptual conditions of the inner stimulus (enclosure, orientation, and presence of luminance borders) critical for obtaining a hierarchical organisation effect. Although an inner vertical square was effective in reducing the illusion (experiment 3), an inner circle enclosing the rod was ineffective (experiment 4). This indicates that definite orientation is necessary to modulate the illusion. However, orientational information provided by a vertical or horizontal rectangle presented near the rod, but not enclosing it, did not modulate the RFI (experiment 5). This suggests that the presence of a figure with oriented contours enclosing the rod is critical. In experiments 6 and 7 we studied whether the presence of luminance borders is important or whether the inner upright square might be effective also if made of subjective contours. When the subjective contour figure was salient and the observers perceived it clearly, its effectiveness in modulating the RFI was comparable to that observed with
regarding continuation of life-sustaining vs. palliative care . Finally, using regret DCA, the optimal decision for the specific patient is suggested...is to develop an Evidence-based Clinical Decision Support (CDSS-EBM) system and make it available at the point of care to improve prognostication of...Analysis and Regret theory to compare multiple decision strategies based on the decision maker’s personal attitudes towards each strategy
Lenau, T. A.; Hesselberg, T.
Self-organisation appeals to humans because difficult and repeated actions can be avoided through automation via bottom-up nonhierarchical processes. This is in contrast to the top-level controlled action strategy normally applied in automated products and in manufacturing. There are many situations where it is required that objects perform an action dependent on external stimuli. An example is automatic window blinds that open or closes in response to sunlight level. However, simpler and more robust designs could be made using the self-organising principles for movement found in many plants. Plants move to adapt to external conditions, e.g. sun-flower buds tracking the sun, touch-me-not Mimosa and Venus fly trap responding to mechanical stimuli by closing leaves to protect them and capture insects respectively. This paper describes 3 of the basic biomimetic principles used by plants to track the sun; i) light causing an inhibiting effect on the illuminated side causing it to bend, ii) light inducing a signal from the illuminated side that causes an action on the darker side and iii) light illuminating a number of sensing plates pointing upwards at an angle activate an expansion on the same side. A concept for mimicking the second principle is presented. It is a very simple and possible reliable self-organising structure that aligns a plate perpendicular to the source of illumination.
Mavris, M.; Le Cam, Y.
Patients’ representatives have an increasingly present voice in all aspects of drug development from fundamental research through regulatory processes to health technology assessment. Although major advances have been made in raising awareness and increasing funding for rare diseases, important challenges remain in terms of best use of resources, coordinating efforts and improving policy. This article describes actions taken by rare disease patients’ organisations as well as initiatives at the national and European levels to promote research into rare diseases. A survey conducted by EURORDIS (European Organisation for Rare Diseases) on the support (financial and non-financial) provided by patients’ organisations in rare disease research is described as well as the involvement of patients’ representatives in regulatory processes for medicinal products at the European Medicines Agency. The importance of including patients’ groups in fundamental and clinical research as equal partners has become a fact that clearly contributes to the success of an application and the research conducted. PMID:23293582
Ndjaboué, Ruth; Brisson, Chantal; Vézina, Michel
The models most commonly used, to study the effects of psychosocial work factors on workers' health, are the demand-control-support (DCS) model and Effort-Reward Imbalance (ERI) model. An emerging body of research has identified Organisational Justice as another model that can help to explain deleterious health effects. This review aimed: (1) to identify prospective studies of the associations between organisational justice and mental health in industrialised countries from 1990 to 2010; (2) to evaluate the extent to which organisational justice has an effect on mental health independently of the DCS and ERI models; and (3) to discuss theoretical and empirical overlap and differences with previous models. The studies had to present associations between organisational justice and a mental health outcome, be prospective, and be entirely available in English or in French. Duplicated papers were excluded. Eleven prospective studies were selected for this review. They provide evidence that procedural justice and relational justice are associated with mental health. These associations remained significant even after controlling for the DCS and ERI models. There is a lack of prospective studies on distributive and informational justice. In conclusion, procedural and relational justice can be considered a different and complementary model to the DCS and ERI models. Future studies should evaluate the effect of change in exposure to organisational justice on employees' mental health over time.
Didymus, Faye F; Fletcher, David
We explored sport performers' cognitive appraisals of organisational stressors. The relevant demands and transactional alternatives that athletes experience in relation to the situational properties were identified. Thirteen national standard swimmers completed semi-structured, interval-contingent daily diaries for a 28-day period. A combination of inductive and deductive content analysis was used to organise and analyse the diary entries with a focus on the following areas: organisational stressors, their underlying situational properties, and the swimmers' transactional alternatives. One hundred and thirty-one of the organisational stressors were appraised as threat, 41 as challenge, and 83 as harm/loss. Support was found for the majority of Lazarus and Folkman's (1984) situational properties with the only exception being temporal uncertainty. Imminence was associated with the greatest number of threat appraisals (47), novelty was associated with the greatest number of challenge appraisals (17), and duration was associated with the greatest number of harm/loss appraisals (22). It is concluded that appraisal plays a pivotal role in sport performers' experiences of their organisational environment. Swimmers' transactional alternatives are influenced by the situational properties of the stressors encountered.
Warne, T; McAndrew, S; King, M; Holland, K
The sustained modernisation of the UK primary health care service has resulted in individuals and organisations having to develop more integrated ways of working. This has resulted in changes to the structure and functioning of primary care organisations, changes to the traditional workforce, and an increase in scope of primary care practice. These changes have contributed to what for many staff has become a constantly turbulent organisational and practice environment. Data from a three-year project, commissioned by the North West Development Agency is used to explore how staff involved in these changes dealt with this turbulence. Three hundred and fifty staff working within primary care participated in the study. A multimethods approach was used which facilitated an iterative analysis and data collection process. Thematic analysis revealed a high degree of congruence between the perceptions of all staff groups with evidence of a generally well-articulated, but often rhetorical view of the organisational and professional factors involved in how these changes were experienced. This rhetoric was used by individuals as a way of containing both the good and bad elements of their experience. This paper discusses how these defense mechanisms need to be recognised and understood by managers so that a more supportive organisational culture is developed.
Jude, S R; Drew, G H; Pollard, S J T; Rocks, S A; Jenkinson, K; Lamb, R
There is increasing recognition that organisations, particularly in key infrastructure sectors, are potentially vulnerable to climate change and extreme weather events, and require organisational responses to ensure they are resilient and adaptive. However, detailed evidence of how adaptation is facilitated, implemented and reported, particularly through legislative mechanisms is lacking. The United Kingdom Climate Change Act (2008), introduced the Adaptation Reporting Power, enabling the Government to direct so-called reporting authorities to report their climate change risks and adaptation plans. We describe the authors' unique role and experience supporting the Department for Environment, Food and Rural Affairs (Defra) during the Adaptation Reporting Power's first round. An evaluation framework, used to review the adaptation reports, is presented alongside evidence on how the process provides new insights into adaptation activities and triggered organisational change in 78% of reporting authorities, including the embedding of climate risk and adaptation issues. The role of legislative mechanisms and risk-based approaches in driving and delivering adaptation is discussed alongside future research needs, including the development of organisational maturity models to determine resilient and well adapting organisations. The Adaptation Reporting Power process provides a basis for similar initiatives in other countries, although a clear engagement strategy to ensure buy-in to the process and research on its long-term legacy, including the potential merits of voluntary approaches, is required.
This brief article identifies new levels of government funding for health and more specifically AIDS programs in South Africa. Health allocations were increased from R23 billion in 1998 to R24 billion during 1999. Health funding will increase in 2 years to R28 in 2001. AIDS programs will receive R110 million (US$17.7 million) in 1999, of which R58 million will be directed to the government's AIDS Awareness Action Plan. South Africa has one of the fastest growing epidemics in the world. The government is responding to its needs and the pressure from activists for its failure to sufficiently address the spread of HIV/AIDS. AIDS activists have criticized the government decision not to fund pilot projects that would give HIV-positive pregnant women free access to zidovudine. General elections are scheduled for April 1999 and the ruling African National Congress could be attacked for failing to support AIDS awareness. The Western Cape province's AIDS program director was pleased with the level of support, since international donors had previously funded AIDS programs. The Democratic Party was pleased with the government's funding of nongovernmental organizations (NGOs) with HIV/AIDS programs. A party spokesperson thought that the government's inefficiencies in preventing the spread of HIV/AIDS indicated that it is now up to NGOs to show their strengths in combating HIV/AIDS.
Tang, AM; Quick, T; Chung, M; Wanke, CA
Background While numerous studies have shown that severe to moderate wasting at the time of antiretroviral therapy (ART) initiation is strongly predictive of mortality, it remains unclear whether nutritional interventions at or prior to ART initiation will improve outcomes. This review examines data on nutrition assessment, counseling, and support (NACS) interventions in resource-limited settings. Methods We identified articles published between 2005 and 2014 on the effectiveness of NACS interventions, particularly its impact on five outcomes: mortality, morbidity, retention in care, quality of life, and/or prevention of ongoing HIV transmission. We rated the overall quality of individual articles and summarized the body of evidence and expected impact for each outcome. Results Twenty-one articles met all inclusion criteria. The overall quality of evidence was weak, predominantly due to few studies being designed to directly address the question of interest. Only two studies were randomized trials with proper control groups. The remainder were randomized studies of one type of food support versus another, cohort (non-randomized) studies, or single-arm studies. Ratings of individual study quality ranged from “medium” to “weak,” and the quality of the overall body of evidence ranged from “fair” to “poor.” We rated the expected impact on all outcomes as “uncertain.” Conclusion Rigorous, better designed studies in resource-limited settings are urgently needed to understand the effectiveness of nutrition assessment and counseling alone, as well as studies to understand better modalities of food support (targeting, timing, composition, form, and duration) to improve both short- and long-term patient retention in care and treatment, and clinical outcomes. PMID:25768873
Gong, Wenjie; Caine, Eric D; Xiao, Shuiyuan; Hughes, James P; Ng, Marie; Simoni, Jane; He, Hua; Smith, Kirk L; Brown, Henry Shelton; Gloyd, Stephen
Introduction Schizophrenia is a severe, chronic and disabling mental illness. Non-adherence to medication and relapse may lead to poorer patient function. This randomised controlled study, under the acronym LEAN (Lay health supporter, e-platform, award, and iNtegration), is designed to improve medication adherence and high relapse among people with schizophrenia in resource poor settings. Methods/analysis The community-based LEAN has four parts: (1) Lay health supporters (LHSs), mostly family members who will help supervise patient medication, monitor relapse and side effects, and facilitate access to care, (2) an E-platform to support two-way mobile text and voice messaging to remind patients to take medication; and alert LHSs when patients are non-adherent, (3) an Award system to motivate patients and strengthen LHS support, and (4) iNtegration of the efforts of patients and LHSs with those of village doctors, township mental health administrators and psychiatrists via the e-platform. A random sample of 258 villagers with schizophrenia will be drawn from the schizophrenic ‘686’ Program registry for the 9 Xiang dialect towns of the Liuyang municipality in China. The sample will be further randomised into a control group and a treatment group of equal sizes, and each group will be followed for 6 months after launch of the intervention. The primary outcome will be medication adherence as measured by pill counts and supplemented by pharmacy records. Other outcomes include symptoms and level of function. Outcomes will be assessed primarily when patients present for medication refill visits scheduled every 2 months over the 6-month follow-up period. Data from the study will be analysed using analysis of covariance for the programme effect and an intent-to-treat approach. Ethics and dissemination University of Washington: 49464 G; Central South University: CTXY-150002-6. Results will be published in peer-reviewed journals with deidentified data made available on
Gutknecht, N.; Van Betteray, C.; Ozturan, S.; Vanweersch, L.; Franzen, R.
Objective. The aim of this study was to evaluate the effectiveness of a radial firing tip of an Er,Cr:YSGG laser as an adjunct to a nonsurgical periodontal treatment. Methods. Twelve patients with chronic or aggressive periodontitis were treated by conventional periodontal treatment using ultrasonic devices and hand instruments and, additionally, in two quadrants with an Er,Cr:YSGG laser. A new radial firing tip (RFPT 14-5, Biolase) was used with 1.5 W, 30 Hz, 11% air, 20% water, and pulse duration 140 μs. Microbiological smears were taken before treatment, one day after lasing, and three and six months after lasing. Pocket depths of all periodontal sites were measured before and six months after treatment. Results. The total bacterial load of Prevotella intermedia, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans inside the pocket was reduced significantly throughout the whole examination time. Greater pocket depth reductions were observed in all groups. There was a slight higher reduction of pocket depth in the lased group after six months. Conclusions. These results support the thesis that Er,Cr:YSGG laser supported periodontal treatment leads to a significant reduction of periopathogenes and thereby helps the maintenance of periodontal health. PMID:25879057
Walker, Rae; Blacker, Vivian; Pandita, Linda; Close, Jacky; Mason, Wendy; Watson, Julie
In Victoria, despite strong policy support, e-care planning and coordination is poorly developed. The action research project discussed here was developed to overcome organisational and worker-level barriers to change. The project outcomes highlighted the need for work on the building blocks of e-care coordination that enhance workers' knowledge and skills, and provide permission and support for appropriate collaborative system and services coordination practices.
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The successful experiences of Tamil Nadu (TN) in the control and prevention of HIV/AIDS provides vital clues for the second phase of the Rs. 1,150-crore World Bank-funded national AIDS control program which will begin in July. The National AIDS Control Organization (NACO) is looking at TN for concrete answers in several areas before it composes its guidelines for the second phase. Key areas of focus in the second phase will be high-risk groups, control of STDs, people living with AIDS, communication structures and blood safety. NACO and the funding agency has been impressed by TN¿s method of mobilizing NGOs in the massive anti-HIV/AIDS campaign and its handling of the cost of the care. In addition to the Tamil Nadu State AIDS Control Society (TNSACS), the AIDS Prevention and Control Project of the Voluntary Health Services (supported by USAID) also contributed to the impressive performance of this State.
Benito Gonzélez López, José; Ferreira, José Pedro; Baron, Thomas
While the remote collaboration services at CERN slowly aggregate around the Indico event management software, its new version which is the result of a careful maturation process includes improvements which will set a new reference in its domain. The presentation will focus on the description of the new features of the tool, the user feedback process which resulted in a new record of usability. We will also describe the interactions with the worldwide community of users and server administrators and the impact this has had on our development process, as well as the tools set in place to streamline the work between the different collaborating sites. A last part will be dedicated to the use of Indico as a central hub for operating other local services around the event organisation (registration epayment, audiovisual recording, webcast, room booking, and videoconference support)
While Asia was the last region to be exposed to the global spread of HIV and AIDS, the incidence of HIV infection there is increasing fastest. The Asian Development Bank predicts mortality from AIDS will cause some town and village populations to begin declining by the year 2000. With an estimated 1 million people infected in India, and 400,000 in Thailand, these 2 countries are particularly exposed to the risk of epidemic HIV spread. In 5 years, more people may be affected by AIDS in India than anywhere else in the world. Concern over a growing presence of HIV is also merited for the Philippines, Indonesia, China, and the drug trade's Golden Triangle. The Second International Conference on AIDS in Asia and the Pacific in November 1992 stressed that AIDS no longer affects only homosexual and IV drug using populations. 50% of new infections worldwide in the first half of 1992 were among women, 65% of Thailand's AIDS cases are among heterosexuals, and 3-5% of Thailand's long-haul truck drivers have tested positive for HIV infection. HIV and AIDS robs economies and societies of their best workers. The immediate costs of caring for AIDS patients will pale next to the far greater losses to be realized in private sector economic productivity. Asia's more developed economies will probably be able to survive the epidemic, but small, poor countries like Laos will wilt. Prompt action must be taken to overcome public and religious ignorance and objections to promoting and using condoms throughout the region. For the first time, Beijing has organized an AIDS awareness conference for male homosexuals. Further, Singapore has implemented compulsory testing for lower-income foreign workers. Pakistan has even solicited educational assistance and support from Islamic religious leaders; similar action is being considered in Bangladesh.
Migration is very often a family affair, and often involves children, directly or indirectly. It may give rise to better quality of life for an entire family, or to bitter disappointment, and may also increase vulnerability to HIV and AIDS. This review, carried out for the Joint Learning Initiative on Children and AIDS, links the literature on "migration", on "HIV and AIDS" and on "families". Three themes are sketched: (1) As both HIV prevalence and circular migration increase, former migrant workers affected by AIDS may return to their families for care and support, especially at the end of life, often under crisis conditions. Families thus lose promising members, as well as sources of support. However, very little is known about the children of such migrants. (2) Following patterns of migration established for far different reasons, children may have to relocate to different places, sometimes over long distances, if their AIDS-affected parents can no longer care for them. They face the same adaptation challenges as other children who move, but complicated by loss of parent(s), AIDS stigma, and often poverty. (3) The issue of migrant families living with HIV has been studied to some extent, but mainly in developed countries with a long history of migration, and with little attention paid to the children in such families. Difficulties include involuntary separation from family members, isolation and lack of support, disclosure and planning for children's care should the parent(s) die and differences in treatment access within the same family. Numerous research and policy gaps are defined regarding the three themes, and a call is made for thinking about migration, families and AIDS to go beyond description to include resilience theory, and to go beyond prevention to include care.
Prakash, Ravi; Isac, Shajy; Washington, Reynold; Halli, Shiva S.
Background In Indian context, limited attempts have been made to estimate the mortality risks among people living with HIV (PLHIV). We estimated the rates of mortality among PLHIV covered under an integrated HIV-prevention cum care and support programme implemented in Karnataka state, India, and attempted to identify the key programme components associated with the higher likelihood of their survival. Methods Retrospective programme data of 55,801 PLHIV registered with the Samastha programme implemented in Karnataka state during 2006–11 was used. Kaplan-Meier survival methods were used to estimate the ten years expected survival probabilities and Cox-proportional hazard model was used to examine the factors associated with risk of mortality among PLHIV. We also calculated mortality rates (per 1000 person-year) across selected demographic and clinical parameters. Results Of the total PLHIV registered with the programme, about nine percent died within the 5-years of programme period with an overall death rate of 38 per 1000 person-years. The mortality rate was higher among males, aged 18 and above, among illiterates, and those residing in rural areas. While the presence of co-infections such as Tuberculosis leads to higher mortality rate, adherence to ART was significantly associated with reduction in overall death rate. Cox proportional hazard model revealed that increase in CD4 cell counts and exposure to intensive care and support programme for at least two years can bring significant reduction in risk of death among PLHIV [(hazard ratio: 0.234; CI: 0.211–0.260) & (hazard ratio: 0.062; CI: 0.054–0.071), respectively] even after adjusting the effect of other socio-demographic, economic and health related confounders. Conclusion Study confirms that while residing in rural areas and presence of co-infection significantly increases the mortality risk among PLHIV, adherence to ART and improvement in CD4 counts led to significant reduction in their mortality risk
Afsarmanesh, Hamideh; Sargolzaei, Mahdi; Shadi, Mahdieh
To enhance their business opportunities, organisations involved in many service industries are increasingly active in pursuit of both online provision of their business services (BSs) and collaborating with others. Collaborative Networks (CNs) in service industry sector, however, face many challenges related to sharing and integration of their collection of provided BSs and their corresponding software services. Therefore, the topic of service interoperability for which this article introduces a framework is gaining momentum in research for supporting CNs. It contributes to generation of formal machine readable specification for business processes, aimed at providing their unambiguous definitions, as needed for developing their equivalent software services. The framework provides a model and implementation architecture for discovery and composition of shared services, to support the semi-automated development of integrated value-added services. In support of service discovery, a main contribution of this research is the formal representation of services' behaviour and applying desired service behaviour specified by users for automated matchmaking with other existing services. Furthermore, to support service integration, mechanisms are developed for automated selection of the most suitable service(s) according to a number of service quality aspects. Two scenario cases are presented, which exemplify several specific features related to service discovery and service integration aspects.
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Pitman, John P.; Bocking, Adele; Wilkinson, Robert; Postma, Maarten J.; Basavaraju, Sridhar V.; von Finckenstein, Bjorn; Mataranyika, Mary; Marfin, Anthony A.; Lowrance, David W.; Sibinga, Cees Th. Smit
Background External assistance can rapidly strengthen health programmes in developing countries, but such funding can also create sustainability challenges. From 2004–2011, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) provided more than $ 8 million to the Blood Transfusion Service of Namibia (NAMBTS) for supplies, equipment, and staff salaries. This analysis describes the impact that support had on actual production costs and the unit prices charged for red cell concentrate (RCC) units issued to public sector hospitals. Material and methods A costing system developed by NAMBTS to set public sector RCC unit prices was used to describe production costs and unit prices during the period of PEPFAR scale-up (2004–2009) and the 2 years in which PEPFAR support began to decline (2010–2011). Hypothetical production costs were estimated to illustrate differences had PEPFAR support not been available. Results Between 2004–2006, NAMBTS sold 22,575 RCC units to public sector facilities. During this time, RCC unit prices exceeded per unit cost-recovery targets by between 40.3% (US$ 16.75 or N$ 109.86) and 168.3% (US$ 48.72 or N$ 333.28) per year. However, revenue surpluses dwindled between 2007 and 2011, the final year of the study period, when NAMBTS sold 20,382 RCC units to public facilities but lost US$23.31 (N$ 170.43) on each unit. Discussion PEPFAR support allowed NAMBTS to leverage domestic cost-recovery revenue to rapidly increase blood collections and the distribution of RCC. However, external support kept production costs lower than they would have been without PEPFAR. If PEPFAR funds had not been available, RCC prices would have needed to increase by 20% per year to have met annual cost-recovery targets and funded the same level of investments as were made with PEPFAR support. Tracking the subsidising influence of external support can help blood services make strategic investments and plan for unit price increases as external funds are
Oliveira, Francisco P. M.; Castelo-Branco, Miguel
Objective. The aim of the present study was to develop a fully-automated computational solution for computer-aided diagnosis in Parkinson syndrome based on [123I]FP-CIT single photon emission computed tomography (SPECT) images. Approach. A dataset of 654 [123I]FP-CIT SPECT brain images from the Parkinson’s Progression Markers Initiative were used. Of these, 445 images were of patients with Parkinson’s disease at an early stage and the remainder formed a control group. The images were pre-processed using automated template-based registration followed by the computation of the binding potential at a voxel level. Then, the binding potential images were used for classification, based on the voxel-as-feature approach and using the support vector machines paradigm. Main results. The obtained estimated classification accuracy was 97.86%, the sensitivity was 97.75% and the specificity 98.09%. Significance. The achieved classification accuracy was very high and, in fact, higher than accuracies found in previous studies reported in the literature. In addition, results were obtained on a large dataset of early Parkinson’s disease subjects. In summation, the information provided by the developed computational solution potentially supports clinical decision-making in nuclear medicine, using important additional information beyond the commonly used uptake ratios and respective statistical comparisons. (ClinicalTrials.gov Identifier: NCT01141023)
Zhao, Qun; Li, Xiaoming; Kaljee, Linda M; Fang, Xiaoyi; Stanton, Bonita; Zhang, Liying
With the increasing number of AIDS orphans in China, the government has been building AIDS orphanages since 2004 to accommodate some of those children who have lost both parents to AIDS. However, no data are available regarding the quality of this model of institutional care of AIDS orphans in China. This study, based on qualitative data from children and workers in AIDS orphanages, examines the daily lives, needs, and feelings of orphans and explores the advantages and disadvantages of institutionalized care of AIDS orphans in China. The current study was conducted in 2006-2007 in two rural counties of central China. Data in the current study included individual in-depth interviews with 23 children who lost both of their parents to HIV/AIDS (ages 8 to 17 years) living in AIDS orphanages and 5 AIDS orphanage workers. Findings in this study reveal that children living in orphanages mostly felt that the living conditions were better than the families they lived with after the death of their parents. However, according to the children and orphanage workers, the institutional care has some disadvantages, such as administrative restraints, limited psychological guidance, stigma, lack of education on AIDS, and financial burdens of the operation. Implications for intervention programs include continuing support from the government and nongovernmental organizations, improvements in administrative styles, and the need of incorporating psychological support within the institutions.
Coyle, E F
The catabolism of bodily fuels provides the energy for muscular work. Work output can be limited by the size of fuel reserves, the rate of their catabolism, the build-up of by-products, or the neurologic activation of muscle. A substance that favorably affects a step that is normally limiting, and thus increases work output, can be considered an ergogenic aid. The maximal amount of muscular force generated during brief contractions can be acutely increased during hypnosis and with the ingestion of a placebo or psychomotor stimulant. This effect is most obvious in subjects under laboratory conditions and is less evident in athletes who are highly motivated prior to competition. Fatigue is associated with acidosis in the working musculature when attempts are made to maximize work output during a 4 to 15-minute period. Sodium bicarbonate ingestion may act to buffer the acid produced, provided that blood flow to the muscle is adequate. Prolonged intense exercise can be maintained for approximately two hours before carbohydrate stores become depleted. Carbohydrate feedings delay fatigue during prolonged exercise, especially in subjects who display a decline in blood glucose during exercise in the fasting state. Caffeine ingestion prior to an endurance bout has been reported to allow an individual to exercise somewhat more intensely than he or she would otherwise. Its effect may be mediated by augmenting fat metabolism or by altering the perception of effort. Amphetamines may act in a similar manner. Water ingestion during prolonged exercise that results in dehydration and hyperthermia can offset fluid losses and allow an individual to better maintain work output while substantially reducing the risk of heat-related injuries.
Wenzel, Suzanne L; Rhoades, Harmony; Harris, Taylor; Winetrobe, Hailey; Rice, Eric; Henwood, Ben
Homeless persons suffer disproportionately high rates of HIV infection, and moving into permanent supportive housing (PSH) can provide a stable base from which to access needed prevention services. However, little is known about HIV risk or prevention behavior during this critical time of transition. The current study investigated STI and HIV risk and prevention behavior and recent use of prevention and treatment services (i.e., education, testing, medication) among homeless persons preparing to move into PSH. Data come from interviews with 421 homeless adults before they moved into PSH. Thirty-seven percent of the respondents were sexually active; of those, 75.7% reported unprotected sex. Nearly two-thirds (64%) reported past year HIV testing and 40% reported testing for another STI. Fewer than one-third (31%) of respondents reported receiving posttest counseling at their last HIV test. HIV seropositivity was self-reported by 10%. Among those persons who were HIV-positive, 57.1% reported less than 100% antiretroviral (ARV) adherence. Among HIV-negative respondents, less than 1% had been prescribed preexposure prophylaxis (PrEP). Less than half (46.4%) of the sample reported any HIV prevention education in the past year. This population of homeless adults about to move into PSH report high rates of HIV risk behavior, but low rates of HIV prevention education and very little PrEP utilization. Further, low rates of ARV adherence among HIV-positive respondents indicate significant risk for HIV transmission and acquisition. Entering PSH is a period of transition for homeless persons when integrated care is critically important to ensure positive health outcomes, but these data suggest that PrEP and other HIV prevention services are poorly accessed among this population. As such, multipronged services that integrate PrEP and other HIV prevention services are needed to prevent transmission and acquisition of HIV in this high-risk, vulnerable population and ensure the
Woodcock, Paul; Edwards, David P.; Newton, Rob J.; Vun Khen, Chey; Bottrell, Simon H.; Hamer, Keith C.
Trophic organisation defines the flow of energy through ecosystems and is a key component of community structure. Widespread and intensifying anthropogenic disturbance threatens to disrupt trophic organisation by altering species composition and relative abundances and by driving shifts in the trophic ecology of species that persist in disturbed ecosystems. We examined how intensive disturbance caused by selective logging affects trophic organisation in the biodiversity hotspot of Sabah, Borneo. Using stable nitrogen isotopes, we quantified the positions in the food web of 159 leaf-litter ant species in unlogged and logged rainforest and tested four predictions: (i) there is a negative relationship between the trophic position of a species in unlogged forest and its change in abundance following logging, (ii) the trophic positions of species are altered by logging, (iii) disturbance alters the frequency distribution of trophic positions within the ant assemblage, and (iv) disturbance reduces food chain length. We found that ant abundance was 30% lower in logged forest than in unlogged forest but changes in abundance of individual species were not related to trophic position, providing no support for prediction (i). However, trophic positions of individual species were significantly higher in logged forest, supporting prediction (ii). Consequently, the frequency distribution of trophic positions differed significantly between unlogged and logged forest, supporting prediction (iii), and food chains were 0.2 trophic levels longer in logged forest, the opposite of prediction (iv). Our results demonstrate that disturbance can alter trophic organisation even without trophically-biased changes in community composition. Nonetheless, the absence of any reduction in food chain length in logged forest suggests that species-rich arthropod food webs do not experience trophic downgrading or a related collapse in trophic organisation despite the disturbance caused by logging
Woodcock, Paul; Edwards, David P; Newton, Rob J; Vun Khen, Chey; Bottrell, Simon H; Hamer, Keith C
Trophic organisation defines the flow of energy through ecosystems and is a key component of community structure. Widespread and intensifying anthropogenic disturbance threatens to disrupt trophic organisation by altering species composition and relative abundances and by driving shifts in the trophic ecology of species that persist in disturbed ecosystems. We examined how intensive disturbance caused by selective logging affects trophic organisation in the biodiversity hotspot of Sabah, Borneo. Using stable nitrogen isotopes, we quantified the positions in the food web of 159 leaf-litter ant species in unlogged and logged rainforest and tested four predictions: (i) there is a negative relationship between the trophic position of a species in unlogged forest and its change in abundance following logging, (ii) the trophic positions of species are altered by logging, (iii) disturbance alters the frequency distribution of trophic positions within the ant assemblage, and (iv) disturbance reduces food chain length. We found that ant abundance was 30% lower in logged forest than in unlogged forest but changes in abundance of individual species were not related to trophic position, providing no support for prediction (i). However, trophic positions of individual species were significantly higher in logged forest, supporting prediction (ii). Consequently, the frequency distribution of trophic positions differed significantly between unlogged and logged forest, supporting prediction (iii), and food chains were 0.2 trophic levels longer in logged forest, the opposite of prediction (iv). Our results demonstrate that disturbance can alter trophic organisation even without trophically-biased changes in community composition. Nonetheless, the absence of any reduction in food chain length in logged forest suggests that species-rich arthropod food webs do not experience trophic downgrading or a related collapse in trophic organisation despite the disturbance caused by logging
New York State Education Dept., Albany. Div. of Library Development.
This booklet presents information about the financial support authorized for libraries and library systems in Chapter 917 of the "Laws of 1990" and advocated by the Regents of the State University of New York for the state's library systems. It is noted that, although Chapter 917 provides for modest increases in library aid each year for…
Infection with HIV is serious. But the outlook for people with HIV/AIDS is improving. If you are infected with HIV, there are many things you can do to ... health care provider who knows how to treat HIV. You may want to join a support group. ...
Brehony, Kevin J.; Deem, Rosemary
This paper examines claims that recent reforms to UK education have led to significant organisational changes in primary school and higher education. It also examines two main theoretical explanations for these, namely post-Fordism and New Managerialism. Examples of changes in both schools and universities, including flexibility and teamwork, are…
Bentley, Tim; Tappin, David
This paper conceptualises organisational safety culture and considers its relevance to ergonomics practice. Issues discussed in the paper include the modest contribution that ergonomists and ergonomics as a discipline have made to this burgeoning field of study and the significance of safety culture to a systems approach. The relevance of safety culture to ergonomics work with regard to the analysis, design, implementation and evaluation process, and implications for participatory ergonomics approaches, are also discussed. A potential user-friendly, qualitative approach to assessing safety culture as part of ergonomics work is presented, based on a recently published conceptual framework that recognises the dynamic and multi-dimensional nature of safety culture. The paper concludes by considering the use of such an approach, where an understanding of different aspects of safety culture within an organisation is seen as important to the success of ergonomics projects. STATEMENT OF RELEVANCE: The relevance of safety culture to ergonomics practice is a key focus of this paper, including its relationship with the systems approach, participatory ergonomics and the ergonomics analysis, design, implementation and evaluation process. An approach to assessing safety culture as part of ergonomics work is presented.
Rocha, L. E. C.; Holme, P.
Interaction between consumers and companies can create conflict. When a consensus is unreachable there are legal authorities to resolve the case. This letter is a study of data from the Brazilian Department of Justice from which we build a bipartite network of categories of complaints linked to the companies receiving those complaints. We find the complaint categories organised in an hierarchical way where companies only get complaints of lower degree if they already got complaints of higher degree. The fraction of resolved complaints for a company appears to be nearly independent of the equity of the company but is positively correlated with the total number of complaints received. We construct feature vectors based on the edge-weight —the weight of an edge represents the times complaints of a category have been filed against that company— and use these vectors to study the similarity between the categories of complaints. From this analysis, we obtain trees mapping the hierarchical organisation of the complaints. We also apply principal component analysis to the set of feature vectors concluding that a reduction of the dimensionality of these from 8827 to 27 gives an optimal hierarchical representation.
Schoorl, J. M.; Temme, A. J. A. M.; Veldkamp, A.
Rivers tend to develop towards an equilibrium length profile, independently of exogenous factors. In general, although still under debate, this so-called self-organisation is assumed to be caused by simple feedbacks between sedimentation and erosion. Erosion correlates positively with gradient and discharge and sedimentation negatively. With the LAPSUS model, which was run for the catchment of the Sabinal, a small river in the South of Spain, this interplay of erosion and sedimentation results in sediment pulses (sequences of incision and sedimentation through time). These pulses are visualised in a short movie ( see http://www.youtube.com/watch?v=V5LDUMvYZxU). In this case the LAPSUS model run did not take climate, base level nor tectonics into account. Therefore, these pulses can be considered independent of them. Furthermore, different scenarios show that the existence of the pulses is independent of precipitation, erodibility and sedimentation rate, although they control the number and shape of the pulses. A fieldwork check showed the plausibility of the occurrence of these sediment pulses. We conclude that the pulses as modelled with LAPSUS are indeed the consequence of the feedbacks between erosion and sedimentation and are not depending on exogenous factors. Keywords: Landscape self-organisation, Erosion, Deposition, LAPSUS, Modelling
Dickinson, Dena; And Others
Individuals with Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related conditions (ARC) need continual care and support, at a level which can severely tax the health resources of a community. Public health nursing should have a central role in the effective and efficient response to this devastating problem. Since the early stages of the AIDS…
Fraser, Katherine; Mitchell, Patricia
This guide provides information to support state and local efforts to fight the Acquired Immune Deficiency Syndrome (AIDS) epidemic. The guide is divided into three sections: (1) the need; (2) the challenge: providing effective AIDS prevention education; and (3) developing a comprehensive state leadership role. An extensive bibliography of 66…
SAMTER, EUGENE C.
THE EFFECTS OF A 1962 NEW YORK STATE AID TO EDUCATION ACT WERE INVESTIGATED IN RELATION TO AN OLD FOUNDATION PROGRAM. THIS STATE AID TO EDUCATION ACT WAS BASED ON THE CONCEPT OF SHARED COST. BOTH NEW AND OLD PROGRAMS WERE APPRAISED WITH RESPECT TO THE OBJECTIVES OF SCHOOL FISCAL POLICY--EQUITY OF SUPPORT (EQUAL TREATMENT OF EQUALS), EQUALIZATION…
Fuller, Matthew B.
Colleges, universities, and the communities they serve have always been concerned about students' abilities to pay and the systems of aid to support students' learning. This article reviews the history of aiding student in higher education. Early student- and institutionally-led programs are discussed along with initial philanthropic and…
Kidman, Rachel; Heymann, Jody
In the wake of the HIV/AIDS epidemic, caregivers are struggling to support HIV-affected children. For reasons of equity and efficiency, their needs can be best met through strong social protections and policies. This paper presents a conceptual framework to help address the needs of HIV-affected caregivers and to prioritize policies. We describe the needs that are common across diverse caregiving populations (e.g., economic security); the needs which are intensified (e.g., leave to care for sick children) or unique to providing care to HIV-affected children (e.g., ARV treatment). The paper then explores the types of social policies that would facilitate families meeting these needs. We outline a basic package of policies that would support HIV-affected families, and would meet goals agreed to by national governments. We examine the availability of these policies in 25 highly affected countries in sub-Saharan Africa. The majority of countries guarantee short-term income protection during illness, free primary school, and educational inclusion of children with special needs. However, there are significant gaps in areas critical to family economic security and healthy child development. Fewer than half of the countries we analyzed guarantee a minimum wage that will enable families to escape poverty; only six have eliminated tuition fees for secondary school; and only three offer paid leave to care for sick children. Filling these policy gaps, as well as making mental health and social services more widely available, is essential to support caregiving by families for HIV-affected children. As part of the HIV agenda, the global community can help national governments advance towards their policy targets. This would provide meaningful protection for families affected by HIV, as well as for millions of other vulnerable families and children across the region.
Kidman, Rachel; Heymann, Jody
ABSTRACT In the wake of the HIV/AIDS epidemic, caregivers are struggling to support HIV-affected children. For reasons of equity and efficiency, their needs can be best met through strong social protections and policies. This paper presents a conceptual framework to help address the needs of HIV-affected caregivers and to prioritize policies. We describe the needs that are common across diverse caregiving populations (e.g., economic security); the needs which are intensified (e.g., leave to care for sick children) or unique to providing care to HIV-affected children (e.g., ARV treatment). The paper then explores the types of social policies that would facilitate families meeting these needs. We outline a basic package of policies that would support HIV-affected families, and would meet goals agreed to by national governments. We examine the availability of these policies in 25 highly affected countries in sub-Saharan Africa. The majority of countries guarantee short-term income protection during illness, free primary school, and educational inclusion of children with special needs. However, there are significant gaps in areas critical to family economic security and healthy child development. Fewer than half of the countries we analyzed guarantee a minimum wage that will enable families to escape poverty; only six have eliminated tuition fees for secondary school; and only three offer paid leave to care for sick children. Filling these policy gaps, as well as making mental health and social services more widely available, is essential to support caregiving by families for HIV-affected children. As part of the HIV agenda, the global community can help national governments advance towards their policy targets. This would provide meaningful protection for families affected by HIV, as well as for millions of other vulnerable families and children across the region. PMID:27392009
Report and policy brief from the 4th Africa Conference on Social Aspects of HIV/AIDS Research: innovations in access to prevention, treatment and care in HIV/AIDS, Kisumu, Kenya, 29 April - 3 May 2007.
Setswe, G; Peltzer, K; Banyini, M; Skinner, D; Seager, J; Maile, S; Sedumedi, S; Gomis, D; van der Linde, I
About 520 delegates from all over Africa and 21 countries attended the conference. This report and policy brief summarises the key findings and suggested policy options that emerged from rapporteur reports of conference proceedings including the following themes: (1) Orphans and vulnerable children, (2) Treatment, (3) Prevention, (4) Gender and male involvement, (5) Male circumcision, (6) People living with HIV/AIDS, (7) Food and nutrition, (8) Socioeconomics, and (9) Politics/policy. Two (11.8%) of the 17 OVC projects from the three countries were classified as best practice interventions. Of the 83 abstracts that were accepted at the conference, only 7 (8.4%) were dealing with antiretroviral therapy (ART). There has been tremendous effort by various organisations to provide information about prevention of HIV/AIDS. Information received by adolescents has been effective in increasing their knowledge, but without positive sexual behaviour change. The conference noted the contribution of gender discrimination and violence to the HIV epidemic and the different risks that men and women face in relation to the epidemic. Social scientists need to study the deep cultural meanings attached to male circumcision among different ethnic groups to be able to guide the debate on the latest biomedical findings on the protective effect of circumcision against HIV. Palliative care and support is crucial for coping among people living with HIV/AIDS (PLWHA) in order to deal with medical and psychological issues. Results from several countries have helped researchers to explore alternative ways of examining poverty in the context of HIV and AIDS. Policy frameworks which are likely to succeed in combating HIV/AIDS need to be updated to cover issues of access, testing, disclosure and stigma. In general, the conference was successful in identifying innovations in access to prevention, treatment and care in HIV/AIDS.
Scahill, Shane; Harrison, Jeff; Carswell, Peter; Babar, Zaheer-Ud-Din
Throughout the developed world, community pharmacy is under considerable pressure to play a greater part in delivering effective primary health care. The requirement to adopt new roles continues to challenge community pharmacy and drive change. The factors that determine the ability of community pharmacy to effectively deliver services for health gain are complex and include; policy, professional, financial and structural elements. There is also evidence to suggest that organisational culture may influence the effectiveness of an organisation. In order to address this there is a need to understand the dimensions of organisational culture that lead to successful implementation of the change necessary for community pharmacy to become a more effective primary health care organisation. In this commentary, we introduce the concept of organisational culture, outline two frameworks for studying culture, and argue the benefits of pursuing an organisational culture research agenda for the evolution of pharmacy practice and research.
Sanahuja-Gavaldà, Josep M.; Olmos-Rueda, Patricia; Morón-Velasco, Mar
Nowadays, in Catalonia, students with autism spectrum disorders (ASD) are increasingly in regular schools although their presence, participation, learning and success are unequal. Barriers towards inclusion often depend on how to organise supporting at regular schools and the teachers' collaboration during this process. In this paper, the support…
Elwyn, Glyn; Dannenberg, Michelle; Blaine, Arianna; Poddar, Urbashi; Durand, Marie-Anne
Objective Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. Design Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing interest policies and disclosure forms. Results We contacted 25 organisations likely to meet the inclusion criteria. 12 eligible organisations provided data. 11 organisations did not reply and 2 declined to participate. Most patient decision aid developers recognise the need to consider the issue of competing interests. Assessment processes vary widely and, for the most part, are insufficiently robust to minimise the risk of competing interests. Only half of the 12 organisations had competing interest policies. Some considered disclosure to be sufficient, while others imposed differing levels of exclusion. Conclusions Patient decision aid developers do not have a consistent approach to managing competing interests. Some have developed policies and procedures, while others pay no attention to the issue. As is the case for clinical practice guidelines, increasing attention will need to be given to how the competing interests of contributors of evidence-based publications may influence materials, especially if they are designed for patient use. PMID:27612542
LIFEbeat is a not-for-profit AIDS resource and awareness organization supported primarily by people in the music industry. It was founded in 1982 and provides grants to many community-based organizations and to members of the music industry who are living with HIV/AIDS. Among its programs is Hearts and Voices, a program that eases the suffering and isolation of patients by providing live musical entertainment at hospitals and health care facilities. The group also sets up information booths at concerts and sponsors events such as SkateAID and BoardAID, fundraisers designed to appeal to in-line skaters and snowboarders.
Apart from a multidimensional quality definition and the understanding of quality as a company-wide challenge, a third essential element of quality management is prevention. Thus, company quality policy has to be prevention-oriented and requires both customer and process orientation as important prerequisites. Process orientation especially focuses on the critical analyses of work flows as a condition for identifying early intervention options which, in turn, may influence the result. Developing a business organisation requires the definition of criteria for space planning, room assignment and room integration in consideration of both medical and economic aspects and the architectural concept. Specific experiences will be demonstrated as a case study using the example of a new building in the midst of the Carl Gustav Carus University Hospital in Dresden, the Diagnostic Centre for Internal Medicine and Neurology. The hospital management placed an order to develop a sustainable as well as feasible business organisation for all the different departments. The idea was to create a medical centre where maximum use was made of all planned spaces and resources on the basis of target processes which had to be defined and agreed upon with all the persons concerned. In a next step all the personal, space and operational resources required were assigned. The success of management in all industries, including the health care sector, crucially depends on the translation of ideas into practice, among them the critical factor of sustainability. In this context, the support by the management as a role model, a formal frame for the respective project group and the definition of controlling via defined indicators have special importance. The example of the Diagnostic Centre for Internal Medicine and Neurology demonstrates that the result of changed processes may release a cultural change where competition can be replaced by cooperation step by step.
Hartl, H K; Ahonen, M; Eidher, U; Kunze, M
Prevention campaigns and new antiretroviral therapies caused a decline in HIV-infections as well as mortality from HIV/AIDS in industrialised countries. Despite this development AIDS is one of the ten mean causes of death worldwide, with 3,1 million deaths in 2002. Hence there is an urgent need for prevention and information campaigns, which ideally should start in early childhood or at school age. It is well known that preventive strategies start at a time when the risk or the possibility of a risky behaviour does not yet exist. A WHO-report in 1993 showed, that sex education often comes too late, as sexual activity of adolescents is already on its way. Persons who are already sexually active can be influenced to have fewer sexual partners and to increase safer sex methods. There is no evidence for causing a higher risk by sex education of adolescents. In Austrian schools numerous experts and organisations cooperate in the sphere of sex education and STD-prevention. School children in Vienna are confronted with this topic by the schools they attend according to the Sex Education-Act of 1970 on a voluntary basis. Various examples of effective teaching models prove intensive efforts and successful interdisciplinary cooperation. This study analyses common risk-reduction-methods and describes the Austrian way of HIV/AIDS/STD prevention in school children, although there is no obligation for sex education in schools, according to the School Teaching-Act of 1986, which leads to better knowledge and subsequent risk behaviour of adolescents in the same geographical area.
Laursen, Brett; Bukowski, William M.
A developmental guide to close relationships is presented. Parent-child, sibling, friend, and romantic relationships are described along dimensions that address permanence, power, and gender. These dimensions describe relationship differences in organisational principles that encompass internal representations, social understanding, and interpersonal experiences. The concept of domain specificity is borrowed from cognitive development to address the shifting developmental dynamics of close relationships. Distinct relationships are organised around distinct socialisation tasks, so each relationship requires its own organisational system. As a consequence, different principles guide different relationships, and these organisational principles change with development. PMID:20090927
This article critically investigates state-civil society relations in the Ugandan AIDS response by tracing the history of Uganda's 'multisectoral' and 'partnership' approaches, particularly as it pertains to The AIDS Support Organisation (TASO). It finds that the Ugandan government's reputation for good leadership on AIDS is more ambiguous than commonly supposed and that the much-vaunted 'partnership' approach has not enabled strong critical civil society voices to emerge or prevented the harmful impact of a socially conservative agenda. By the 1990s, TASO had become the most important provider of medical and psychosocial support services to HIV/AIDS patients, but was less effective in influencing policy or holding the state accountable (because the political context prevented a more activist stance). The effectiveness of civil society has been constrained by an authoritarian political culture and institutions that discourage vocal criticism. Despite these limitations, however, state-civil society partnership did contribute to the emergence of a relatively effective coalition for action against HIV/AIDS. Donors were essential in encouraging the emergence of this coalition.
Curran, James R.
As early as the 1930s the term Master Hearing Aid (MHA) described a device used in the fitting of hearing aids. In their original form, the MHA was a desktop system that allowed for simulated or actual adjustment of hearing aid components that resulted in a changed hearing aid response. Over the years the MHA saw many embodiments and contributed to a number of rationales for the fitting of hearing aids. During these same years, the MHA was viewed by many as an inappropriate means of demonstrating hearing aids; the audio quality of the desktop systems was often superior to the hearing aids themselves. These opinions and the evolution of the MHA have molded the modern perception of hearing aids and the techniques used in the fitting of hearing aids. This article reports on a history of the MHA and its influence on the fitting of hearing aids. PMID:23686682
Rowe, M J; Ryan, C C
The State AIDS Policy Center at the Inter-governmental Health Policy Project (IHPP) at George Washington University surveyed all 50 states to determine state AIDS (acquired immunodeficiency syndrome) expenditures, without Medicaid or federal funds, for fiscal 1984-88. During this period, state-only expenditures increased 15-fold, to $156.3 million. Between fiscal 1986-1988, the distribution of state funding for AIDS patient care and support services doubled from 16 to 35 per cent and the number of states supplementing federal funds for testing and counseling increased from eight to 20. Five states continue to account for the largest AIDS appropriations. Of these, California leads in funding research; New York, Florida, and New Jersey have directed funds to provide care and services to IV (intravenous) drug users, prisoners, and children. The average state expenditure per diagnosed AIDS case is $3,323 and an increasing number of states with relatively low case loads are appropriating funds beyond this level. Across states, AIDS expenditures per person average $.65 and $.21 for education, testing and counseling--below the level recommended by the Institute of Medicine for AIDS prevention activities. Some jurisdictions support AIDS activities indirectly by shifting resources, often from their STD (sexually transmitted disease) programs--this trend deserves continuing review given the rise in STD cases and their relationship to diagnosed AIDS. PMID:3126674
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Stevens, Paul A; Batty, William J; Longhurst, Phil J; Drew, Gillian H
The need and ability of an organisation to manage and control its impact on the environment has been hotly debated in recent times. However, the uptake of certificated environmental management systems (EMS), specifically BS EN ISO 14001 (ISO 14001) (British Standards Institution, 2004), is becoming more prevalent, even though evidence of the individual benefits is less clear. Furthermore, reports are often limited and anecdotal in their discussion of the true barriers that organisations experience during the certification and management of their EMS. Presently organisations are commonly classified simply according to size and the barriers they experience when implementing an EMS successfully. This system of classification is not sufficient to understand the multifaceted environments within which modern organisations operate. This paper reviews existing classification methodologies relevant to environmental management so as to determine whether opportunities exist for their practical application in this sector. It begins with an introduction to EMS and existing discussions regarding implementation is provided before a more detailed consideration of organisational size, the integration and development of environmental management within an organisation, then cladistics and quality management systems (QMS) are reviewed as potential opportunities for classification. This shows that whilst numerous methods are available, none function beyond the theoretical, or that the classes provided restrain the description of the complex tasks. Central to differences faced by organisations are insights to the true hurdles that each experience when implementing an EMS. It is shown here how the manipulation of techniques from the more mature field of Energy Management may offer a direction for the development of robust classes. A valuable outcome is that these methods produce classifications that are fit for purpose to better support organisations through the implementation and
Watson, Richard A; Mills, Rob; Buckley, C L; Kouvaris, Kostas; Jackson, Adam; Powers, Simon T; Cox, Chris; Tudge, Simon; Davies, Adam; Kounios, Loizos; Power, Daniel
systems and modify the adaptive capabilities of natural selection over time. We review the evidence supporting the functional equivalences between the domains of learning and of evolution, and discuss the potential for this to resolve conceptual problems in our understanding of the evolution of developmental, ecological and reproductive organisations and, in particular, the major evolutionary transitions.
Fong, Y T; Anantharaman, V; Lim, S H; Leong, K F; Pokkan, G
Mass cardiopulmonary resuscitation (CPR) 99 in Singapore was a large-scale multi-organisational effort to increase awareness and impart basic cardiac life support skills to the lay public. Mass CPR demonstrations followed by small group manikin practice with instructor guidance was conducted simultaneously in three centres, four times a day. The exercise enlisted 15 community organisations and received the support of 19 other organisations. Three hundred and ninety-eight manikins and 500 instructors ('I's) were mobilised to teach an audience of 6000 participants ('P's). Two surveys, for 'I's and 'P's were conducted with respondent rates of 65.8% and 50%, respectively. 73.6% of the P-respondents ('P-R's) indicated that they attended the event to increase their knowledge. 66.9% were willing to attend a more comprehensive CPR course. Concerns and perceptions in performing bystander CPR were assessed.
The purpose of this research activity is to understand further how large and small registered training organisations (RTOs) make decisions about the allocation of resources for developing their workforces. Six registered training organisations--four technical and further education (TAFE) institutes and two private providers--were selected for…
Rimmington, Glyn M.; Alagic, Mara
Learning organisations face new challenges in the 21st century. Increased flow of trade in commodities, manufactured goods and information as well as mobility of people have led to increased global interdependence, interconnectedness and cultural diversity. People and teams within learning organisations have become globally distributed with the…
Yau, Hon Keung; Cheng, Alison Lai Fong
Purpose: The purpose of this paper is to investigate whether the IT professionals in a Hong Kong public transport company have a general perception of influence of the organisational defensive patterns on learning of ICT; and whether skilled incompetence, organisational defensive routines and fancy footwork are positively associated with each…
Purpose: This research paper is a distinctive element of an empirical study on learning organisations carried out between 1999 and 2002. It seeks to examine a whole range of issues that seem to permeate higher-performing organisations. Design/methodology/approach: The study design utilised both quantitative and qualitative research methodologies.…
Zhang, Li-Fang; Jing, Li-Zhen
This research pioneered the investigation of the predictive power of organisational commitments for academics' teaching styles. Participants were 370 faculty members from 15 higher educational institutions in Beijing, the People's Republic of China. Results showed that academics' organisational commitments as measured by the Organisational…
Background: Quality faculty members is a must for any higher education institution aspiring for Quality. Organisational stress one of the most important factors influencing the quality and efficiency of the faculty. Hence, the Organisational stress has to be managed in such a way that it should contribute to the quality of higher education. Hence…
Casteleyn, Jordi; Mottart, André; Valcke, Martin
There is abundant educational research indicating that graphic organisers (knowledge maps, concept maps, or mind maps) have a beneficial impact on learning, but hardly any research has examined this in the context of presentations. This study therefore investigated how graphic organisers -- as delivered via presentation software -- affect learning…
Turker, Duygu; Altuntas, Ceren
Purpose: The purpose of this paper is to analyse how newcomers' perceptions of organisational culture can change over time. The study tries to address whether initial working experience changes newcomers' perceptions about the ideal organisational culture, and whether these perceptions converge with those of their supervisors.…
Rungruang, Parisa; Donohue, Ross
Few studies have examined the links between perceived transferability of education or perceived transferability of skills and organisational commitment. This paper reports on a study examining the relationships between transferability of education and transferability of skills, and the three components of organisational commitment (affective,…
Elstad, Eyvind; Christophersen, Knut-Andreas; Turmo, Are
Purpose: Organisational citizenship behaviour (OCB) involves discretionary behaviour advantageous to the organisation that goes beyond existing role expectations. The purpose of this paper is to explore the link between the strength of accountability and teachers' OCB within three different management systems in which teachers are working: a…
Kansikas, Juha; Murphy, Linda
The aim of this qualitative study is to understand the prerequisites for learning organisations (LO) as perceived by university students. Intrapreneurship education offers possibilities to increase student's adaptation of learning organisation's climate and behaviour. By analysing students' perceptions, more information about learning organisation…
Olsson, Annika; Wadell, Carl; Odenrick, Per; Norell Bergendahl, Margareta
Product innovation in highly complex and technological areas, such as medical technology, puts high requirements on the innovation capability of an organisation. Previous research and publications have highlighted organisational issues and learning matters as important and necessary for the development of innovation capability. Action learning…
Bobe, Belete J.; Kober, Ralph
Purpose: Drawing on the resource-based view (RBV), the purpose of this paper is to develop a framework and instrument to measure the organisational capabilities of university schools/departments. In doing so, this study provides evidence of the way competitive resources are bundled to generate organisational capabilities that give university…
Fearon, Colm; McLaughlin, Heather; Morris, Lynn
Purpose: The purpose of this paper is to explore the role of multi-level forms of efficacy and organisational interactions necessary for promoting effective work engagement. Design/methodology/approach: Work engagement is explored from a multi-level efficacy perspective (self, collective and organisational). Based on the ideas of Bandura,…
Hoyle, Eric; Wallace, Mike
One social science base for educational administration proposed in the Baron and Taylor collection was organisation theory. In the event this expectation turned out to be over-optimistic. Organisation theory was much too contested and insufficiently pragmatic for the British taste. Major developments in this field occurred mainly in the USA.…
Organisations worldwide have acknowledged the connection between corporate learning, development and business sustainability. Emphasis is being laid on creating and designing a learning organisation "that is skilled at creating, acquiring, interpreting, transferring and retaining knowledge" [Garvin, (2000), p.32]. Extensive literature…
Bello, Muhammad Ibrahim; Ibrahim, Burhan Muhammad Bn; Bularafa, Mohammed Waziri
The study examines the influence of leadership roles related to organisational capability consisting of directing setting, strategic and organisational process, alignment, intervention and strategic capability on depending variable internalising quality culture in IIUM. The study used 100 samples consisting of lecturers, non-academic staff and…
Uddin, Mohammed Shahadat; Hossain, Liaquat
In this paper, we introduce a network enabled coordination model to examine the coordination preparedness of soft-target organisations such as common public access areas including transit hubs, schools, parks, and sports areas. It is apparent that little attention is given in recent research focusing on the use of network analysis as a way to explore coordination preparedness for this type of organisation. In this study, we emphasise this type of soft-target organisation and propose a model to examine the coordination preparedness to any disasters by testing hypothesis related to network relationship and coordination preparedness. We analyse the dataset entitled Preparedness of Large Retail Malls to Prevent and Respond to Terrorist Attack, 2004, which contains a total of 120 completed surveys of security directors of retail malls. The following questions form the basis of this study: What do soft-target organisations need to be better prepared to respond to disaster? How does network relationship between soft-target organisation and emergency agencies affect the coordination preparedness of soft-target organisation for disaster recovery? Which degree of centrality measure needs to be followed to measure network variables in order to analyse the coordination preparedness? Result shows that soft-target organisation with high level of network relationship with other emergency agencies are better prepared to disaster response. Using this result, the preparedness of a soft-target organisation might be judged for successfully participation in an actual emergency.
Creusere, Marlena; Fletcher, Carla; Klepfer, Kasey; Norman, Patricia
TG provides critical support to schools, students, and borrowers at every stage of the federal student aid process--from providing information on how to pay for a higher education including financial aid options, to facilitating successful loan repayment after graduation. This issue of "State of Student Aid and Higher Education in Texas"…
Carlton, Sally; Mills, Colleen E
This paper seeks to contribute to understanding of the factors associated with an effective emergent emergency response organisation and to provide new insights into this understudied area. It examines, through an analysis of a range of textual resources, the emergence and re-emergence of the Student Volunteer Army (SVA) during the devastating earthquakes in Canterbury, New Zealand, in 2010-11. This evaluation is conducted in relation to the four key features of an effective emergency response organisation: adaptability; direction; leadership; and communication. In addition, the paper aims to further understanding of 'emergency entrepreneurship' and thus of the values and strategies that underpin social entrepreneur organisations in times of normalcy. The paper concludes that the unique position of the SVA as a 'repeat emergent' emergency response organisation enabled it to innovate continually and to improve repeatedly its systems, relationships, and image, such that it exhibited features common to emergent and established emergency response organisations.
Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind
Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.
This paper analyses the role of local social, cultural, and political institutions in post-disaster reconstruction projects. It contends that such institutions are important considerations within community-driven reconstruction initiatives, but are often viewed with ambivalence by external aid organisations. This paper draws upon in-depth qualitative interviews with aid workers involved in the post-tsunami reconstruction in Aceh, Indonesia, to establish: (i) what roles community institutions were suited to play in the reconstruction; (ii) what were the limitations of community institutions when engaging with external aid agencies; (iii) how did external aid agencies engage with local community institutions; and (iv) how did external aid agencies perceive community institutions.
Shultz, James M; Forbes, David
Psychological first aid (PFA) has become the flagship early intervention for disaster survivors, with recent adaptations for disaster responders, in the post-9/11 era. PFA is broadly endorsed by expert consensus and integrated into guidelines for mental health and psychosocial support in disasters and extreme events. PFA frameworks are proliferating, with increasing numbers of models developed for delivery by a range of providers for use with an expanding array of target populations. Despite popularity and promotion there remains a dearth of evidence for effectiveness and recent independent reviews of PFA have highlighted this important gap. This commentary juxtaposes the current propagation of PFA against the compelling need to produce evidence for effectiveness and suggests a series of actions to prioritize and expedite real-time, real-event field evaluation of PFA.
Milicić-Juhas, Valerija; Loncar, Branka; Mahovlić, Vesna; Kardum-Skelin, Ika; Pajtler, Marija
Current cytological service in Croatia is organised in 46 cytological organisational units in 23 towns with total of 350 employees: 101 specialists of clinical cytology, 20 residents in clinical cytology, 141 cytotechnologists (cytoscreeners), 45 health technicians, and 25 administrators and 18 auxiliary personnel. In spite of employment of significant number of cytotechnologists in the last ten years, there is still an unacceptable ratio of number of cytologists and cytotechnologists (1:1.4) which is the result of unresolved education of cytotechnologists which should be permanent, complete and acknowledged. Education and scientific promotion of cytologists is continuous and today our profession has 31 masters of science and 9 doctors of science, one of which is the assistant professor, and four of them are associate or full professors at medical schools in Zagreb and Osijek. Croatian cytology, in average, is in its "best years", i.e. an average cytologist is 46-years-old and cytotechnologist is averagely 43-years-old, but "suffers" from personnel deficit. With regard to the type of activity, the most numerous are units dealing the entire diagnostic cytology (72%), 13% general cytology without gynaecological cytology, while 15% are engaged in one diagnostic field (gynaecological, pulmological or thyroid cytology). According to accessible data, total of 770996 cytological examinations were done in Croatia in 2008. The increasing application of additional methods (cytochemical, immunocytochemical, molecular, cytogenetics and computer-assisted image analysis) has become a trend in numerous cytological units. Exclusively morphological analysis of standard stained samples is performed in 37% of units, morphological and cytochemical staining methods are used in 17% of units, and additional immunocytochemical methods in 30% of units. According to the long tradition of cytology in Croatia, that has progressed thanks to the enthusiasm and great effort of our teachers, we
BOLAM, J. P.; HANLEY, J. J.; BOOTH, P. A. C.; BEVAN, M. D.
The basal ganglia are a group of subcortical nuclei involved in a variety of processes including motor, cognitive and mnemonic functions. One of their major roles is to integrate sensorimotor, associative and limbic information in the production of context-dependent behaviours. These roles are exemplified by the clinical manifestations of neurological disorders of the basal ganglia. Recent advances in many fields, including pharmacology, anatomy, physiology and pathophysiology have provided converging data that have led to unifying hypotheses concerning the functional organisation of the basal ganglia in health and disease. The major input to the basal ganglia is derived from the cerebral cortex. Virtually the whole of the cortical mantle projects in a topographic manner onto the striatum, this cortical information is ‘processed’ within the striatum and passed via the so-called direct and indirect pathways to the output nuclei of the basal ganglia, the internal segment of the globus pallidus and the substantia nigra pars reticulata. The basal ganglia influence behaviour by the projections of these output nuclei to the thalamus and thence back to the cortex, or to subcortical ‘premotor’ regions. Recent studies have demonstrated that the organisation of these pathways is more complex than previously suggested. Thus the cortical input to the basal ganglia, in addition to innervating the spiny projection neurons, also innervates GABA interneurons, which in turn provide a feed-forward inhibition of the spiny output neurons. Individual neurons of the globus pallidus innervate basal ganglia output nuclei as well as the subthalamic nucleus and substantia nigra pars compacta. About one quarter of them also innervate the striatum and are in a position to control the output of the striatum powerfully as they preferentially contact GABA interneurons. Neurons of the pallidal complex also provide an anatomical substrate, within the basal ganglia, for the synaptic
Elg, Ulf; Jonnergard, Karin
A number of measures have been taken by the society to ensure gender equality in higher education. Nevertheless, women still face great difficulties when pursuing an academic career. Our aim is to increase the understanding of how the society, conceptualised as the organisational field, interacts with organisational factors and personal actions as…
Aragonés, Carlos; Campos, Jorge R; Nogueira, Oscar; Pérez, Jorge
As long as there is no cure for AIDS, the only effective means of containing its spread is prevention, primarily through public education. Cuba's AIDS Prevention Group is a community-based organization whose main purpose is to support the National HIV/AIDS Program's prevention and education efforts. The Group's Memorias Project uses the creation and display of memorial quilts to put a human face on AIDS statistics and stimulate public reflection on issues related to the disease and society.
Domingues, Ana Rita; Lozano, Rodrigo; Ceulemans, Kim; Ramos, Tomás B
Sustainability Reporting has become a key element in different organisations. Although there have been a number of academic publications discussing the adoption of sustainability reports in the public sector, their numbers have been quite low when compared to those focussing on corporate reports. Additionally, there has been little research on the link between sustainability reporting in Public Sector Organisations (PSOs) and Organisational Change Management for Sustainability (OCMS). This paper focuses on the contribution of sustainability reporting to OCMS. A survey was sent to all PSOs that have published at least one sustainability report based on the GRI guidelines. The study provides a critical analysis of the relation between sustainability reporting and OCMS in PSOs, including the drivers for reporting, the impacts on organisation change management, and the role of stakeholders in the process. Despite still lagging in sustainability reporting journey, PSOs are starting to use sustainability reporting as a communication tool, and this could drive organisational changes for sustainability.
... the neurological complications of AIDS. Some disorders require aggressive therapy while others are treated symptomatically. Medicines range ... certain bacterial infections, and penicillin to treat neurosyphilis. Aggressive antiretroviral therapy is used to treat AIDS dementia ...
Loss of consciousness - first aid; Coma - first aid; Mental status change; Altered mental status ... person is unconscious and: Does not return to consciousness quickly (within a minute) Has fallen down or ...
... NEI for Kids > First Aid Tips All About Vision About the Eye Ask a Scientist Video Series ... Eye Health and Safety First Aid Tips Healthy Vision Tips Protective Eyewear Sports and Your Eyes Fun ...
... do the following: Assist clients in their daily personal tasks, such as bathing or dressing Provide basic ... social networks and communities Home health aides, unlike personal care aides , typically work for certified home health ...
Calabrese, Leonard H.; Kelley, Dennis
This article discusses the onset and progression of AIDS, its importance as a public health issue, and reducing the risk of AIDS transmission among athletes and those who work with them, including team physicians and athletic trainers. (IAH)
... at risk for serious infections and certain cancers. AIDS stands for acquired immunodeficiency syndrome. It is the final stage of infection with HIV. Not everyone with HIV develops AIDS. HIV most often spreads through unprotected sex with ...
... yeast infection (thrush) Shingles (herpes zoster) Progression to AIDS If you receive no treatment for your HIV ... childbirth or breast-feeding. How does HIV become AIDS? HIV destroys CD4 cells — a specific type of ...
... Laotian Mongolian Spanish Turkish Vietnamese Hindi Subscribe HIV/AIDS Coinfection Approximately 10% of the HIV-infected population ... Control and Prevention website to learn about HIV/AIDS and Viral Hepatitis guidelines and resources. Home About ...
Scott, J E
Connective tissue function is defined as the formation and maintenance of shape, without which centralised physiologies (circulatory, digestive or nervous) could not have evolved. Two elements, inextensible (collagenous) fibrils and compression-resistant interfibrillar soluble polymers (proteoglycans), cope with all usual stresses. Relationships between the two are highly specific, as demonstrated by electron histochemistry based on Cupromeronic blue and critical electrolyte concentration (CEC) methodologies. Recent ideas on (1) the protofibrillar or modular structure of collagen fibrils, (2) the nature of specific binding sites for proteoglycans on fibrils, and (3) fundamental similarities in secondary and tertiary structures of the glycosaminoglycans (hyaluronan, chondroitin, keratan and dermatan sulphates) are described. They have greatly illuminated the study of extracellular matrix structure and function in normal, pathological (osteogenesis imperfecta) and ageing tissues. The small proteoglycans are proposed to be tissue organisers, orienting and ordering the collagen fibrils--thus shaping the tissue at a molecular and ultimately macro level. These interfibrillar structures are based on their bifunctional character, the protein parts binding to collagen fibrils at specific sites and the glycosaminoglycans duplexing and aggregating to hold the proteins and hence the collagen fibrils at defined distances from each other, rather like yardsticks. Examples of the way these functions work in specific tissues are drawn from the cornea and vitreous humour of the eye and developing tendon. Images Fig. 3 (cont.) Fig. 3 PMID:7591990
Information is encountered in two different appearances, in native form by arbitrary physical structures, or in symbolic form by coded sequences of letters or the like. The self-organised emergence of symbolic information from structural information is referred to as a ritualisation transition. Occurring at some stage in evolutionary history, ritualisation transitions have in common that after the crossover, arbitrary symbols are issued and recognised by information-processing devices, by transmitters and receivers in the sense of Shannon's communication theory. Symbolic information-processing systems exhibit the fundamental code symmetry whose key features, such as largely lossless copying or persistence under hostile conditions, may elucidate the reasons for the repeated successful occurrence of ritualisation phenomena in evolution history. Ritualisation examples are briefly reviewed such as the origin of life, the appearance of human languages, the establishment of emergent social categories such as money, or the development of digital computers. In addition to their role as carriers of symbolic information, symbols are physical structures which also represent structural information. For a thermodynamic description of symbols and their arrangements, it appears reasonable to distinguish between Boltzmann entropy, Clausius entropy and Pauling entropy. Thermodynamic properties of symbols imply that their lifetimes are limited by the 2nd law.
Information is encountered in two different appearances, in native form by arbitrary physical structures, or in symbolic form by coded sequences of letters or the like. The self-organised emergence of symbolic information from structural information is referred to as a ritualisation transition. Occurring at some stage in evolutionary history, ritualisation transitions have in common that after the crossover, arbitrary symbols are issued and recognised by information-processing devices, by transmitters and receivers in the sense of Shannon's communication theory. Symbolic information-processing systems exhibit the fundamental code symmetry whose key features, such as largely lossless copying or persistence under hostile conditions, may elucidate the reasons for the repeated successful occurrence of ritualisation phenomena in evolution history. Ritualisation examples are briefly reviewed such as the origin of life, the appearance of human languages, the establishment of emergent social categories such as money, or the development of digital computers. In addition to their role as carriers of symbolic information, symbols are physical structures which also represent structural information. For a thermodynamic description of symbols and their arrangements, it appears reasonable to distinguish between Boltzmann entropy, Clausius entropy and Pauling entropy. Thermodynamic properties of symbols imply that their lifetimes are limited by the 2nd law.
Antell, Sonja; Heywood, John
Action learning is often used as an element of leadership development programmes. The intention is to support classroom learning with an experiential thread which runs throughout the life of the programme. Action Learning Associates (ALA) has been working with an international organisation for three years to deliver the global "First Line…
This article explores the manner in which self-assessment in schools can play an integral role in the transformation of schools into learning organisations. The perspective adopted is based upon European experiences and describes and analyses the sociological constructs and bases supporting the process of transformation. (Contains 6 notes and 2…
Wooten, Donald B.
Examines the increase in AIDS patients in rural California, which is greater than that in urban areas, including AIDS population projections through 1991. Describes differences between AIDS populations in rural and urban areas and relates these to state expenditure patterns and differential needs. (DHP)
Describes an exhibition for the benefit of teachers of English in Arab Primary Schools, which was prepared by third-year students at the Teachers College for Arab Teachers. The exhibition included games, songs, audiovisual aids, crossword puzzles, vocabulary, spelling booklets, preposition aids, and worksheet and lesson planning aids. (SED)
Slesnick, Irwin L.
Focuses on public education about the acquired immune deficiency syndrome (AIDS) epidemic. Discusses the problems of a second epidemic of fear and anxiety. Presents several questions for classroom discussion and analysis of the public fear of AIDS. Gives some statistics highlighting misinformation about AIDS. (CW)
First aid Stroke: First aid Stroke: First aid By Mayo Clinic Staff A stroke occurs when there's bleeding into your brain or when normal blood flow to ... next several hours. Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is ...
Tilaro, Angie; Rossett, Allison
Explains how to create job aids that employees will be motivated to use, based on a review of pertinent literature and interviews with professionals. Topics addressed include linking motivation with job aids; Keller's ARCS (Attention, Relevance, Confidence, Satisfaction) model of motivation; and design strategies for job aids based on Keller's…
... A Week of Healthy Breakfasts Shyness HIV and AIDS KidsHealth > For Teens > HIV and AIDS Print A A A What's in this article? ... in human history. HIV causes a condition called acquired immunodeficiency syndrome — better known as AIDS . HIV destroys a type ...
Zhao, Bo; Bradbury, Katharine
This paper designs a new equalization-aid formula based on fiscal gaps of local communities. When states are in transition to a new local aid formula, the issue of whether and how to hold existing aid harmless poses a challenge. The authors show that some previous studies and the formulas derived from them give differential weights to existing and…
Millan, N M; Lau, P; Hann, M; Ioannou, D; Hoffman, D; Barrionuevo, M; Maxson, W; Ory, S; Tempest, H G
It is well established that chromosomes occupy distinct positions within the interphase nuclei, conferring a potential functional implication to the genome. In addition, alterations in the nuclear organisation patterns have been associated with disease phenotypes (e.g. cancer or laminopathies). The human sperm is the smallest cell in the body with specific DNA packaging and the mission of delivering the paternal genome to the oocyte during fertilisation. Studies of nuclear organisation in the sperm have postulated nonrandom chromosome position and have proposed a chromocentre model with the centromeres facing toward the interior and the telomeres toward the periphery of the nucleus. Most studies have assessed the nuclear address in the sperm longitudinally predominantly using centromeric or telomeric probes and to a lesser extent with whole chromosome paints. To date, studies investigating the radial organisation of human sperm have been limited. The purpose of this study was to utilise whole chromosome paints for six clinically important chromosomes (18, 19, 21, 22, X, and Y) to investigate nuclear address by assessing their radial and longitudinal nuclear organisation. A total of 10,800 sperm were analysed in nine normozoospermic individuals. The results have shown nonrandom chromosome position for all chromosomes using both methods of analysis. We present novel radial and polar analysis of chromosome territory localization within the human sperm nucleus. Specifically, a hierarchical organisation was observed radially with chromosomes organised from the interior to the periphery (chromosomes 22, 21, Y, X, 19, and 18 respectively) and polar organisation from the sperm head to tail (chromosomes X, 19, Y, 22, 21, and 18, respectively). We provide evidence of defined nuclear organisation in the human sperm and discuss the function of organisation and potential possible clinical ramifications of these results in regards to male infertility and early human development.
Ntaios, George; Bornstein, Natan M; Caso, Valeria; Christensen, Hanne; De Keyser, Jacques; Diener, Hans-Christoph; Diez-Tejedor, Exuperio; Ferro, Jose M; Ford, Gary A; Grau, Armin; Keller, Emanuella; Leys, Didier; Russell, David; Toni, Danilo; Turc, Guillaume; Van der Worp, Bart; Wahlgren, Nils; Steiner, Thorsten
In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations on the related module rather swiftly; with the previous approach of a single large Guideline Document, its entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines. After discussion within the European Stroke Organisation Guidelines Committee and significant input from European Stroke Organisation members as well as methodologists and analysts, this document presents the official standard operating procedure for
CPI's spinoff from miniaturized pace circuitry is the new heart-assist device, the AID implantable automatic pulse generator. AID pulse generator monitors the heart continuously, recognizes onset of fibrillation, then administers a corrective electrical shock. A mini- computer, a power source, and two electrodes which sense heart activity are included in the unit. An associated system was also developed. It includes an external recorder to be worn by AID patients and a physician's console to display the data stored by the recorder. System provides a record of fibrillation occurrences and the ensuing defibrillation.
The organisation of clinical research in French teaching hospitals has been profoundly modified over the past 15 years. The first call for clinical research projects was made by the Ministry of Health in 1993. This Hospital Program for Clinical Research was created by the public welfare system, a situation unique in Europe and the USA at the time. Every year since 1993, new clinical research projects have been supported through this program. In 2007, more than 14 million euros was provided for clinical research in oncology more than 21 million euros for clinical research in other fields, and more than 11 million euros through interregional grants. Overall, more than 50 million euros will be provided in 2008 to support clinical research with public sponsorship in French teaching hospitals. Major organisational changes were made to support this unprecedented financial effort in favor of clinical research. In each of the 29 French teaching hospitals, a Delegation for Clinical Research (DRC) was created to promote public sponsorship of clinical trials, to monitor these trials, to guarantee that Good Clinical Practices are respected, and to control the financial aspects of research projects. Clinical Research Assistants were recruited by DRC to monitor clinical trials. Clinical Investigation Centers (CIC) were organized in conjunction with teaching hospitals and with the French biomedical research council (INSERM). Today, there are 54 CICs located in 23 teaching hospitals, conducting clinical trials and other research in epidemiology and biotechnology. In May 2005, seven interregional delegations for clinical research (DIRC) were created to coordinate these activities on a regional basis. The aim was to improve scientific collaboration between teaching hospitals in a given region, to organize the training of clinical investigators and technicians, and to support the development of clinical trial monitoring, quality assurance, and pharmacovigilance. A 2006 survey of
Benoit, Cecilia; Wrede, Sirpa; Bourgeault, Ivy; Sandall, Jane; De Vries, Raymond; van Teijlingen, Edwin R
Theories of professions and healthcare organisation have difficulty in explaining variation in the organisation of maternity services across developed welfare states. Four countries - the United Kingdom, Finland, the Netherlands and Canada - serve as our case examples. While sharing several features, including political and economic systems, publicly-funded universal healthcare and favourable health outcomes, these countries nevertheless have distinct maternity care systems. We use the profession of midwifery, found in all four countries, as a 'touchstone' for exploring the sources of this diversity. Our analysis focuses on three key dimensions: (1) welfare state approaches to legalising midwifery and negotiating the role of the midwife in the division of labour; (2) professional boundaries in the maternity care domain; and (3) consumer mobilisation in support of midwifery and around maternity issues.
The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.
Thiermann, A B
The provisions of the World Trade Organisation Agreement on the Application of Sanitary and Phytosanitary Measures are designed to extend the liberalisation of trade, without increasing the risk to public, animal or plant health. The international standards set by the Office International des Epizooties (OIE) will be used as a benchmark by World Trade Organisation panels and committees when evaluating national sanitary-based regulations. For a significant liberalisation of trade to be achieved, Member Countries are faced with a dual mandate: a) each country must put these concepts into practice when making import/export decisions; and b) each country must make the commitment to support the OIE in its efforts to develop and review sanitary standards. Of equal importance to the application of standards is the cultural change that trade and regulatory communities must undergo. The author examines the role of Member Countries and the OIE in the implementation of this important agreement.
Woodhouse, Francis; Goldstein, Raymond
Cytoplasmic streaming is the ubiquitous phenomenon of deliberate, active circulation of the entire liquid contents of a plant or animal cell by the walking of motor proteins on polymer filament tracks. Its manifestation in the plant kingdom is particularly striking, where many cells exhibit highly organised patterns of flow. How these regimented flow templates develop is biologically unclear, but there is growing experimental evidence to support hydrodynamically-mediated self-organisation of the underlying microfilament tracks. Using the spirally-streaming giant internodal cells of the characean algae Chara and Nitella as our prototype, we model the developing sub-cortical streaming cytoplasm as a continuum microfilament suspension subject to hydrodynamic and geometric forcing. We show that our model successfully reproduces emergent streaming behaviour by evolving from a totally disordered initial state into a steady characean ``conveyor belt'' configuration as a consequence of the cell geometry, and discuss applicability to other classes of steadily streaming plant cells.
San Juan Guillén, César
Interventions in extreme situations, such as natural or technological disasters, terrorist attacks or emergencies in general, take place in settings of great uncertainty and are always accompanied by extraordinary circumstances. For this reason, there are various processes related to implementing intervention protocols that must be carefully examined, including an evaluation of work scenarios, personnel selection, within-group relationships in work teams, decision-making processes, or certain peculiarities of burnout among emergency personnel. In the view of this author, an ad hoc review of the role of the organisational psychologist can highlight interesting analysis and performance possibilities that could make work in emergency and disasters contexts more effective. The aim of this paper is to provide an overview of the role of the organisational psychologist pre-and post-disaster. Furthermore, it supports the idea that professional profiles must be designed that take into account specific knowledge and skills, as well as certain aptitudes and values.
The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach. PMID:26860787
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Grugel, Richard N. (Inventor)
Progress in hearing aids has come a long way. Yet despite such progress hearing aids are not the perfect answer to many hearing problems. Some adult ears cannot accommodate tightly fitting hearing aids. Mouth movements such as chewing, talking, and athletic or other active endeavors also lead to loosely fitting ear molds. It is well accepted that loosely fitting hearing aids are the cause of feedback noise. Since feedback noise is the most common complaint of hearing aid wearers it has been the subject of various patents. Herein a hearing aid assembly is provided eliminating feedback noise. The assembly includes the combination of a hearing aid with a headset developed to constrict feedback noise.
Herold, E S; Van Kerkwijk, C
Tourists traveling internationally lower their inhibitions and take greater risks than they would typically in their home cultures. Loneliness, boredom, and a sense of freedom contribute to this behavioral change. Some tourists travel internationally in search of sexual gratification. This motivation may be actively conscious or subconscious to the traveler. Billed as romantic with great natural beauty, Thailand, the Philippines, Brazil, the Dominican Republic, and Kenya are popular destinations of tourists seeking sex. The Netherlands and countries in eastern Europe are also popular. With most initial cases of HIV infection in Europe having histories of international travel, mass tourism is a major factor in the international transmission of AIDS. While abroad, tourists have sex with casual partners, sex workers, and/or other tourists. Far from all tourists, however, carry and consistently use condoms with these partners. One study found female and non white travelers to be less likely than Whites and males to carry condoms. The risk of HIV infection increases in circumstances where condoms are not readily available in the host country and/or are of poor quality. Regarding actual condom use, a study found only 34% of sex tourists from Switzerland to consistently use condoms while abroad. 28% of men in an STD clinic in Melbourne, Australia, reported consistent condom use in sexual relations while traveling in Asia; STDs were identified in 73% of men examined. The few studies of tourists suggest that a significant proportion engage in risky behavior while traveling. HIV prevalence is rapidly increasing in countries known as destinations for sex tourism. High infection rates are especially evident among teenage sex workers in Thailand. Simply documenting the prevalence of risky behavior among sex tourists will not suffice. More research is needed on travelers and AIDS with particular attention upon the motivating factors supporting persistent high-risk behavior.
Sheffer, Efrat; von Hardenberg, Jost; Yizhaq, Hezi; Shachak, Moshe; Meron, Ehud
In this article, we develop a unifying framework for the understanding of spatial vegetation patterns in heterogeneous landscapes. While much recent research has focused on self-organised vegetation the prevailing view is still that biological patchiness is mostly due to top-down control by the physical landscape template, disturbances or predators. We suggest that vegetation patchiness in real landscapes is controlled both by the physical template and by self-organisation simultaneously, and introduce a conceptual model for the relative roles of the two mechanisms. The model considers four factors that control whether vegetation patchiness is emerged or imposed: soil patch size, plant size, resource input and resource availability. The last three factors determine the plant-patch size, and the plant-to-soil patch size ratio determines the impact of self-organisation, which becomes important when this ratio is sufficiently small. A field study and numerical simulations of a mathematical model support the conceptual model and give further insight by providing examples of self-organised and template-controlled vegetation patterns co-occurring in the same landscape. We conclude that real landscapes are generally mixtures of template-induced and self-organised patchiness. Patchiness variability increases due to source-sink resource relations, and decreases for species of larger patch sizes.
Grebe, Eduard; Nattrass, Nicoli
This paper uses multivariate logistic regressions to explore: (1) potential socio-economic, cultural, psychological and political determinants of AIDS conspiracy beliefs among young adults in Cape Town; and (2) whether these beliefs matter for unsafe sex. Membership of a religious organisation reduced the odds of believing AIDS origin conspiracy theories by more than a third, whereas serious psychological distress more than doubled it and belief in witchcraft tripled the odds among Africans. Political factors mattered, but in ways that differed by gender. Tertiary education and relatively high household income reduced the odds of believing AIDS conspiracies for African women (but not men) and trust in President Mbeki's health minister (relative to her successor) increased the odds sevenfold for African men (but not women). Never having heard of the Treatment Action Campaign (TAC), the pro-science activist group that opposed Mbeki on AIDS, tripled the odds of believing AIDS conspiracies for African women (but not men). Controlling for demographic, attitudinal and relationship variables, the odds of using a condom were halved amongst female African AIDS conspiracy believers, whereas for African men, never having heard of TAC and holding AIDS denialist beliefs were the key determinants of unsafe sex.
Clarke, Charlotte Laura; Keyes, Sarah Elizabeth; Wilkinson, Heather; Alexjuk, Joanna; Wilcockson, Jane; Robinson, Louise; Corner, Lynne; Cattan, Mima
National policy initiatives are faced with challenges in their partnership development and sustainability. The National Dementia Strategy for England recommended Dementia Adviser (DA) and Peer Support Network (PSN) services and 40 demonstration sites were established. In this paper, we report on the national evaluation of these demonstration sites, with specific reference to aspects of organisational development. The research used a mixed-methods design with three main strands: (i) activity and outcome monitoring; (ii) organisational surveys and collaborative discussion; (iii) in-depth case studies in eight of the 40 sites. This paper focuses primarily on three rounds of organisational surveys distributed to all 40 demonstration sites over a period of 21 months and interviews in the case studies. Data identify the significance of infrastructure within immediate services as well as the position of services within the external infrastructure of the wider health and social care landscape. Partnership - both internally and externally - was key to establishing and sustaining services that flourished. When working well, DAs and PSNs acted as a link between services and people with dementia at the same time as filling gaps in existing support, providing information, advice and interpersonal support that was tailored to individual needs and circumstances. In conclusion, to achieve the full potential and sustainability of services requires them to be in an organisational space that allows them to work in partnership and collaboration with other services, and that values their distinct knowledge of their communities.
Trembath, David; Iacono, Teresa; Lyon, Katie; West, Denise; Johnson, Hilary
Many adults with autism spectrum disorders have complex communication needs and may benefit from the use of augmentative and alternative communication. However, there is a lack of research examining the specific communication needs of these adults, let alone the outcomes of interventions aimed at addressing them. The aim of this study was to explore the views and experiences of support workers and family members regarding the outcomes of providing low-technology communication aids to adults with autism spectrum disorders. The participants were six support workers and two family members of six men and women with autism spectrum disorders, who had received low-technology communication aids. Using semi-structured, in-depth interviews and following thematic analysis, the results revealed strong support for, and the potential benefits of, augmentative and alternative communication for both adults with autism spectrum disorders and their communication partners. The results also revealed inconsistencies in the actions taken to support the use of the prescribed augmentative and alternative communication systems, pointing to the clinical need to address common barriers to the provision of augmentative and alternative communication support. These barriers include organisational practices and limitations in the knowledge and skills of key stakeholders, as well as problematic attitudes.
Greenhalgh, Trisha; Shaw, Sara; Wherton, Joe; Hughes, Gemma; Lynch, Jenni; A'Court, Christine; Hinder, Sue; Fahy, Nick; Byrne, Emma; Finlayson, Alexander; Sorell, Tom; Procter, Rob; Stones, Rob
Introduction Research to date into assisted living technologies broadly consists of 3 generations: technical design, experimental trials and qualitative studies of the patient experience. We describe a fourth-generation paradigm: studies of assisted living technologies in their organisational, social, political and policy context. Fourth-generation studies are necessarily organic and emergent; they view technology as part of a dynamic, networked and potentially unstable system. They use co-design methods to generate and stabilise local solutions, taking account of context. Methods and analysis SCALS (Studies in Co-creating Assisted Living Solutions) consists (currently) of 5 organisational case studies, each an English health or social care organisation striving to introduce technology-supported services to support independent living in people with health and/or social care needs. Treating these cases as complex systems, we seek to explore interdependencies, emergence and conflict. We employ a co-design approach informed by the principles of action research to help participating organisations establish, refine and evaluate their service. To that end, we are conducting in-depth ethnographic studies of people's experience of assisted living technologies (micro level), embedded in evolving organisational case studies that use interviews, ethnography and document analysis (meso level), and exploring the wider national and international context for assisted living technologies and policy (macro level). Data will be analysed using a sociotechnical framework developed from structuration theory. Ethics and dissemination Research ethics approval for the first 4 case studies has been granted. An important outcome will be lessons learned from individual co-design case studies. We will document the studies’ credibility and rigour, and assess the transferability of findings to other settings while also recognising unique aspects of the contexts in which they were generated
Porter, Stephen R.
Competency-based education is increasingly popular because of the flexibility it provides for students seeking a postsecondary credential. Current federal student aid, however, is geared toward supporting students in traditional, time-based degree programs. This paper discusses why current approaches to federal student aid are not supportive of…
Oh, Soo Hee
Hearing aids are one of the most widely used treatment options for the hearing impaired and optimal outcomes of hearing aids are supported by comprehensive hearing aid fitting protocols. Currently, the term 'hearing aid fitting' is prevalently used among service and industry sectors with its comprehensive procedures not systematically explicated. In addition, a variety of non-normalized guidelines for hearing aid fitting has led to non-uniform care, outcome variability, and dissatisfaction of the use of hearing aids. The main purpose of the present study is to suggest a general framework of standardized practice for hearing aid fitting management including its pre- and post-fitting stages. The management framework centers on its fitting process with its prior steps of assessment as well as its posterior steps of follow-up, thereby eliminating diverging interpretations and non-uniform practices. Outcomes of this study are also expected to improve potential benefits such as quality of hearing aid fitting, user satisfaction, and cost effectiveness across relevant stakeholders. PMID:27144226
Holvoet, Nathalie; Dewachter, Sara
Changes in the aid architecture have provided a renewed impetus for monitoring and evaluation (M&E), while simultaneously imposing a major reform agenda on the key players involved. More specifically, since 1999, aid-dependent countries have been facing pressure to strengthen their national M&E systems, while donors have been asked to refrain from using their own parallel systems and to rely instead on country systems. Surprisingly, attempts to strengthen national M&E frameworks have thus far largely overlooked the potential of national evaluation societies (NES). Similarly, NES have also remained off the academic radar. Our study aims to fill this gap by mapping key features of NES, as well as their perceived contributions to country-led M&E. In this effort, we rely upon evidence from our survey of 23 NES in Sub-Saharan African countries with Poverty Reduction Strategy Papers (PSRP). Our findings show that there is quite some diversity among NES. Overall, NES are active organisations, whose unique membership features a wide variety of national M&E stakeholders who potentially play key roles in country-led and localised M&E development. Major obstacles faced by NES include the lack of financial resources, donor support and political influence. Survey findings also demonstrate that the increasing interest of donors and governments in NES has yet to materialise into strategic support.
Roussel, Christophe; Carbonneil, Cédric; Audry, Antoine
Health technology assessment (HTA) is a rapidly developing area and the value of taking non-clinical fields into consideration is growing. Although the health-economic aspect is commonly recognised, evaluating organisational impact has not been studied nearly as much. The goal of this work was to provide a definition of organisational impact in the sector of medical devices by defining its contours and exploring the evaluation methods specific to this field. Following an analysis of the literature concerning the impact of technologies on organisations as well as the medical literature, and also after reviewing the regulatory texts in this respect, the group of experts identified 12 types of organisational impact. A number of medical devices were carefully screened using the criteria grid, which proved to be operational and to differentiate properly. From the analysis of the practice and of the methods described, the group was then able to derive a few guidelines to successfully evaluate organisational impact. This work shows that taking organisational impact into consideration may be critical alongside of the other criteria currently in favour (clinically and economically). What remains is to confer a role in the decision-making process on this factor and one that meets the economic efficiency principle.
Meehan, S T
In its fight against the spread of AIDS, which is inextricably linked to the issues of international development, the Canadian International Development Agency (CIDA) has focused support on strengthening existing health care systems, helping vulnerable groups gain control over their lives and health, promoting AIDS prevention measures, and building links to other related health services. Funding includes 1) a grant to Hope House in Zambia (counseling and support for persons with AIDS); 2) a contribution to the Canadian Public Health Association's $11 million Southern Africa AIDS Training Programme (helps regional organizations working in AIDS prevention and support through education, training, hospital outreach, peer education for vulnerable groups, assistance to women's shelters, and networking); 3) support for Laval University's Laval Centre for International Cooperation in Health and Development (runs a $22 million program in French-speaking West Africa that operates in over 10 countries and focuses on epidemiological surveillance, information, education, and communication, control of sexually transmitted diseases [STDs], and management of national AIDS programs); 4) support for the University of Manitoba's $3 million program with the University of Nairobi to slow the spread of HIV (strengthens local health care capabilities for STD/HIV diagnosis, treatment, and counseling, with special emphasis on training and education); 5) support in the past for a study of proposed AIDS legislation and its potential impact on the human rights of PLWHIV/AIDS in Thailand; 6) a contribution to help equip the office of the National Movement for Street Children, Rio de Janeiro (focuses on preventing the spread of AIDS among child prostitutes); and 7) long-term financial support to the Interagency Coalition on AIDS and Development, a coalition of Canadian development nongovernmental organizations responding to AIDS in developing countries. An address to obtain a pamphlet giving
Chen Sheng; Suzuki, Kenji; MacMahon, Heber
Purpose: To develop a computer-aided detection (CADe) scheme for nodules in chest radiographs (CXRs) with a high sensitivity and a low false-positive (FP) rate. Methods: The authors developed a CADe scheme consisting of five major steps, which were developed for improving the overall performance of CADe schemes. First, to segment the lung fields accurately, the authors developed a multisegment active shape model. Then, a two-stage nodule-enhancement technique was developed for improving the conspicuity of nodules. Initial nodule candidates were detected and segmented by using the clustering watershed algorithm. Thirty-one shape-, gray-level-, surface-, and gradient-based features were extracted from each segmented candidate for determining the feature space, including one of the new features based on the Canny edge detector to eliminate a major FP source caused by rib crossings. Finally, a nonlinear support vector machine (SVM) with a Gaussian kernel was employed for classification of the nodule candidates. Results: To evaluate and compare the scheme to other published CADe schemes, the authors used a publicly available database containing 140 nodules in 140 CXRs and 93 normal CXRs. The CADe scheme based on the SVM classifier achieved sensitivities of 78.6% (110/140) and 71.4% (100/140) with averages of 5.0 (1165/233) FPs/image and 2.0 (466/233) FPs/image, respectively, in a leave-one-out cross-validation test, whereas the CADe scheme based on a linear discriminant analysis classifier had a sensitivity of 60.7% (85/140) at an FP rate of 5.0 FPs/image. For nodules classified as ''very subtle'' and ''extremely subtle,'' a sensitivity of 57.1% (24/42) was achieved at an FP rate of 5.0 FPs/image. When the authors used a database developed at the University of Chicago, the sensitivities was 83.3% (40/48) and 77.1% (37/48) at an FP rate of 5.0 (240/48) FPs/image and 2.0 (96/48) FPs /image, respectively. Conclusions: These results compare favorably to those described for
Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J
Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.
Ssewamala, Fred M; Nabunya, Proscovia; Mukasa, N. Miriam; Ilic, Vilma; Nattabi, Jennifer
Purpose We examine a mentorship component within a family-based economic empowerment intervention for AIDS-orphaned children in Uganda. Method Mentorship was guided by a comprehensive 9-session curriculum. We present themes developed from the mentors’ field reports and logs. Results Findings suggest that mentorship offers AIDS-orphaned children opportunities to develop and strengthen future plans. Moreover, the mentorship process was beneficial to both the mentees and their mentors. The program creates a positive life trajectory for a highly vulnerable group of youth. Conclusion The findings can be used to understand and design mentorship programs targeted at improving the psychosocial wellbeing of children and adolescents. PMID:24999449
Gilmore, N. J.; Beaulieu, R.; Steben, M.; Laverdière, M.
Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of utmost importance. PMID:6342737
Gilmore, N.J.; Beaulieu, R.; Steben, M.; Laverdière, M.
Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of the utmost importance. PMID:1544049
The insurance and medical aid industries reacted strongly in the 1980s to alarmist predictions of the likely impact of HIV upon employee benefits. Actuaries and accountants moved quickly to contain the risk, and most medical aid trustees quickly implemented a total exclusion of HIV treatment from their benefits. For more than 1 decade, it was argued that HIV/AIDS is a self-inflicted illness, often categorized with other STDs. In response, healthcare providers simply bypassed insurance restrictions and compensation limits by masking patient diagnoses to reflect pneumonia or other ambiguous, yet fully reimbursable, illnesses. Now, common sense has finally prevailed as a few managed healthcare programs are stepping forward to break the impasse. The largest such program is Aid for AIDS, run by Pharmaceutical Benefit Management Ltd. for schemes within the Medscheme Group. The Group built an entirely new, secure unit off-site from their normal branches to guarantee the confidentiality of patients' records and diagnoses, while treatment guidelines have been issued to every practicing physician in the country.
Kim, Sara; Bochatay, Naike; Relyea-Chew, Annemarie; Buttrick, Elizabeth; Amdahl, Chris; Kim, Laura; Frans, Elise; Mossanen, Matthew; Khandekar, Azhar; Fehr, Ryan; Lee, Young-Mee
Unresolved conflicts among healthcare professionals can lead to difficult patient care consequences. This scoping review examines the current healthcare literature that reported sources and consequences of conflict associated with individual, interpersonal, and organisational factors. We identified 99 articles published between 2001 and 2015 from PubMed, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medical Database. Most reviewed studies relied on healthcare professionals' perceptions and beliefs associated with conflict sources and consequences, with few studies reporting behavioural or organisational change outcomes. Individual conflict sources included personal traits, such as self-focus, self-esteem, or worldview, as well as individuals' conflict management styles. These conflicts posed threats to one's physical, mental, and emotional health and to one's ability to perform at work. Interpersonal dynamics were hampered by colleagues' uncivil behaviours, such as low degree of support, to more destructive behaviours including bullying or humiliation. Perceptions of disrespectful working environment and weakened team collaboration were the main interpersonal conflict consequences. Organisational conflict sources included ambiguity in professional roles, scope of practice, reporting structure, or workflows, negatively affecting healthcare professionals' job satisfactions and intent to stay. Future inquiries into healthcare conflict research may target the following: shifting from research involving single professions to multiple professions; dissemination of studies via journals that promote interprofessional research; inquiries into the roles of unconscious or implicit bias, or psychological capital (i.e., resilience) in healthcare conflict; and diversification of data sources to include hospital or clinic data with implications for conflict sources.
Blake, Holly; Lloyd, Scott
This article presents a discussion of the key issues in influencing organisational change in NHS settings, in the development of workplace wellness interventions to improve employee health and wellbeing. To tackle poor public health and associated rising healthcare costs, there must be a focus on the root cause of many preventable diseases - unhealthy lifestyle choices. Workplace wellness initiatives are now an important prevention strategy adopted by socially responsible organisations to target the health and wellbeing of working age adults. Lessons learned from initiatives in secondary care suggest that effective implementation requires change in organisational 'health culture', through a combination of education, behaviour change intervention, needs-based facilities, and services and strategies for developing supportive and health-promoting work environments. Most of all, employers must demonstrate a commitment to health and wellness that is fully integrated with their mission, values and long-term vision, paving the way for sustainable lifestyle changes. Evaluation systems must be in place to measure the impact and outcomes of wellness schemes.
Vicari, Stefania; Cappai, Franco
ABSTRACT This exploratory work investigates the role of digital media in expanding health discourse practices in a way to transform traditional structures of agency in public health. By focusing on a sample of rare disease patient organisations as representative of contemporary health activism, this study investigates the role of digital communication in the development of (1) bottom-up sharing and co-production of health knowledge, (2) health public engagement dynamics and (3) health information pathways. Findings show that digital media affordances for patient organisations go beyond the provision of social support for patient communities; they ease one-way, two-way and crowdsourced processes of health knowledge sharing, exchange and co-production, provide personalised routes to health public engagement and bolster the emergence of varied pathways to health information where experiential knowledge and medical authority are equally valued. These forms of organisationally enabled connective action can help the surfacing of personal narratives that strengthen patient communities, the bottom-up production of health knowledge relevant to a wider public and the development of an informational and eventually cultural context that eases patients’ political action. PMID:27499676
Ijsselmuiden, C; Evian, C; Matjilla, J; Steinberg, M; Schneider, H
The National AIDS Convention in South Africa (NACOSA) in October 1992 was the first real attempt to address HIV/AIDS. In Soweto, government, the African National Congress, nongovernmental organizations, and organized industry and labor representatives worked for 2 days to develop a national plan of action, but it did not result in a united effort to fight AIDS. The highest HIV infection rates in South Africa are among the KwaZulu in Natal, yet the Inkatha Freedom Party did not attend NACOSA. This episode exemplifies the key obstacles for South Africa to prevent and control AIDS. Inequality of access to health care may explain why health workers did not diagnose the first AIDS case in blacks until 1985. Migrant labor, Bantu education, and uprooted communities affect the epidemiology of HIV infection. Further, political and social polarization between blacks and whites contributes to a mindset that AIDS is limited to the other race which only diminishes the personal and collective sense of susceptibility and the volition and aptitude to act. The Department of National Health and Population Development's voluntary register of anonymously reported cases of AIDS specifies 1517 cumulative AIDS cases (October 1992), but this number is low. Seroprevalence studies show between 400,000-450,000 HIV positive cases. Public hospitals cannot give AIDS patients AZT and DDI. Few communities provided community-based care. Not all hospitals honor confidentiality and patients' need for autonomy. Even though HIV testing is not mandatory, it is required sometimes, e.g., HIV testing of immigrants. AIDS Training, Information and Counselling Centers are in urban areas, but not in poor areas where the need is most acute. The government just recently developed in AIDS education package for schools, but too many people consider it improper, so it is not being used. The poor quality education provided blacks would make it useless anyhow. Lifting of the academic boycott will allow South African
The French emergency medicine infrastructure (structures de médecine d'urgence) ensures patients care from the very location of the distress to the appropriate hospital department: medical care in the field, by hospital clinical teams (the services mobiles d'urgence et de réanimation [SMUR]), is a key characteristic of our medical emergency response system. Response to medical distress revolves around information about not only the location and characteristics of the medical need, but also the availability of adapted hospital services. Gathering and transmitting this information is the prerogative of the service d'aide médicale d'urgence (SAMU) and its telephone dispatch center (Centre 15). For patients coming directly to the hospital, the emergency room (ER), a former underfunded and neglected hospital service, has become a key point of access. The ER is now responsible, after providing immediate first line care, to guide the patient through the care system. As such they are equipped with short term hospitalization units designed to enable up to 24h patient observation before orientation. This ensemble, networked at the level of a health territory, ensures the quality, safety, and efficacy that the population is entitled to demand.
Murphy, T F
There are religious and philosophical versions of the thesis that AIDS is a punishment for homosexual behaviour. It is argued here that the religious version is seriously incomplete. Because of this incompleteness and because of the indeterminacies that ordinarily attend religious argumentation, it is concluded that the claim may be set aside as unconvincing. Homosexual behaviour is then judged for its morality against utilitarian, deontological, and natural law theories of ethics. It is argued that such behaviour involves no impediment to important moral goals and is not therefore immoral. Where natural law might be used to condemn homosexual behaviour, it is argued that the theory itself is not well established. Consequently there is a prima facie reason for rejecting the philosophical version of the punishment thesis. This conclusion is further supported by noting the lack of proportion between the purported immorality of homosexuality and a punishment as devastating as AIDS. PMID:3184138
Madsen, Sara M K; Moore, Brian C J
The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems.
Moore, Brian C. J.
The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. PMID:25361601
Kirkman, M B; Bell, S K
AIDS has created many challenges for those who provide care for AIDS patients. One major challenge has been the request of many public officials for healthcare professionals to abandon the traditional view of confidentiality and to reveal AIDS patients' names. This ethical dilemma is explored and some ethical theories are presented as possible resolutions. The conclusion presented is that healthcare professionals must recognize that the power of the healthcare system over an AIDS patient is immense. Therefore, healthcare professionals must make a commitment to protect the patient's right to privacy by preventing any unauthorized disclosure at all costs.
This paper reports on a case study of organised support for students who experience problems with language or academic study skills at a pharmacy faculty of an Australian university. Employing the Language Management Theory (LMT), this study exemplifies organised management and explores the various processes involved, such as the noting of…
Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater accessibility because
Crutch, Sebastian J; Warrington, Elizabeth K
We report the investigation of the organisation of proper names in two aphasic patients (NBC and FBI). The performance of both patients on spoken word to written word matching tasks was inconsistent, affected by presentation rate and semantic relatedness of the competing responses, all hallmarks of a refractory semantic access dysphasia. In a series of experiments we explored the semantic relatedness effects within their proper name vocabulary, including brand names and person names. First we demonstrated the interaction between very fine grain organisation and personal experience, with one patient with a special interest in the cinema demonstrating higher error rates when identifying the names of actors working in a similar film genre (e.g., action movies: Arnold Schwarzenegger, Bruce Willis, Sylvester Stallone, Mel Gibson) than those working in different genres (e.g., Arnold Schwarzenegger, Gregory Peck, Robin Williams, Gene Kelly). Second we compared directly two potential principles of semantic organisation - taxonomic and thematic. Furthermore we considered these principles of organisation in the context of the individuals' personal knowledge base. We selected topics matching the interests and experience of each patient, namely cinema and literature (NBC) and naval history (FBI). The stimulus items were arranged in taxonomic arrays (e.g., Jane Austen, Emily Bronte, Agatha Christie), thematic arrays (e.g., Jane Austen, Pride and Prejudice, Mr Darcy), and unrelated arrays (e.g., Jane Austen, Wuthering Heights, Hercule Poirot). We documented that different patterns of taxonomic and thematic organisation were constrained by whether the individual has limited knowledge, moderate knowledge or detailed knowledge of a particular vocabulary. It is suggested that moderate proper name knowledge is primarily organised by taxonomy whereas extensive experience results in a more detailed knowledge base in which theme is a powerful organising principle.
summarises the outcomes of the workshop hosted by the DSTO Army Learning Organisation (ALO) team. Professor Karen Watkins (University of Georgia) facilitated...the workshop (applying Action Learning principles) to generate critical reflection and questioning of Defence organisational culture. The workshop...Culture and Performance Workshop Executive Summary The Defence Science and Technology Organisation (DSTO) Army Learning Organisation (ALO