Bellows, Ben W; Conlon, Claudia M; Higgs, Elizabeth S; Townsend, John W; Nahed, Matta G; Cavanaugh, Karen; Grainger, Corinne G; Okal, Jerry; Gorter, Anna C
-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.
Conlon, Claudia M.; Higgs, Elizabeth S.; Townsend, John W.; Nahed, Matta G.; Cavanaugh, Karen; Grainger, Corinne G.; Okal, Jerry; Gorter, Anna C.
-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.
Obare, Francis; Warren, Charlotte; Njuki, Rebecca; Abuya, Timothy; Sunday, Joseph; Askew, Ian; Bellows, Ben
This paper examines community-level association between exposure to the reproductive health vouchers programme in Kenya and utilization of services. The data are from a household survey conducted among 2527 women (15-49 years) from voucher and comparable non-voucher sites. Analysis entails cross-tabulations with Chi-square tests and significant tests of proportions as well as estimation of multi-level logit models to predict service utilization by exposure to the programme. The results show that for births occurring after the voucher programme began, women from communities that had been exposed to the programme since 2006 were significantly more likely to have delivered at a health facility and to have received skilled care during delivery compared with those from communities that had not been exposed to the programme at all. There were, however, no significant differences in the timing of first trimester utilization of antenatal care (ANC) and making four or more ANC visits by exposure to the programme. In addition, poor women were significantly less likely to have used safe motherhood services (health facility delivery, skilled delivery care and postnatal care) compared with their non-poor counterparts regardless of exposure to the programme. Nonetheless, a significantly higher proportion of poor women from communities that had been exposed to the programme since 2006 used the services compared with their poor counterparts from communities that had not been exposed to the programme at all. The findings suggest that the programme is associated with increased health facility deliveries and skilled delivery care especially among poor women. However, it has had limited community-level impact on the first trimester timing of antenatal care use and making four or more visits, which remain a challenge despite the high proportion of women in the country that make at least one antenatal care visit during pregnancy.
Mulligan, Jo-Ann; Yukich, Joshua; Hanson, Kara
Background The cost-effectiveness of insecticide-treated nets (ITNs) in reducing morbidity and mortality is well established. International focus has now moved on to how best to scale up coverage and what financing mechanisms might be used to achieve this. The approach in Tanzania has been to deliver a targeted subsidy for those most vulnerable to the effects of malaria while at the same time providing support to the development of the commercial ITN distribution system. In October 2004, with funds from the Global Fund to Fight AIDS Tuberculosis and Malaria, the government launched the Tanzania National Voucher Scheme (TNVS), a nationwide discounted voucher scheme for ITNs for pregnant women and their infants. This paper analyses the costs and effects of the scheme and compares it with other approaches to distribution. Methods Economic costs were estimated using the ingredients approach whereby all resources required in the delivery of the intervention (including the user contribution) are quantified and valued. Effects were measured in terms of number of vouchers used (and therefore nets delivered) and treated nets years. Estimates were also made for the cost per malaria case and death averted. Results and Conclusion The total financial cost of the programme represents around 5% of the Ministry of Health's total budget. The average economic cost of delivering an ITN using the voucher scheme, including the user contribution, was $7.57. The cost-effectiveness results are within the benchmarks set by other malaria prevention studies. The Government of Tanzania's approach to scaling up ITNs uses both the public and private sectors in order to achieve and sustain the level of coverage required to meet the Abuja targets. The results presented here suggest that the TNVS is a cost-effective strategy for delivering subsidized ITNs to targeted vulnerable groups. PMID:18279509
Pickard, Brent W.; Richards, Donald M.
Summarizes the rationale for educational voucher systems, outlines model voucher systems, discusses implications of voucher systems, and suggests a generalized plan for applying voucher systems in continuing education. (Available from the Department of Educational Administration, The University of Alberta, Edmonton, Alberta, Canada, T6G 2G5;…
Zehr, Mary Ann
State-level momentum in support of vouchers and tax credits that help students go to private schools highlights what has been a largely theoretical issue: private school capacity to support voucher-financed enrollment. Academics say the national supply of seats in secular and religious private schools is sufficient to meet short-term demand from…
Witte, John F.; Wolf, Patrick J.; Cowen, Joshua M.; Carlson, Deven E.; Fleming, David J.
This article considers the impact of a high-stakes testing and reporting requirement on students using publicly funded vouchers to attend private schools. We describe how such a policy was implemented during the course of a previously authorized multi-year evaluation of the Milwaukee Parental Choice Program, which provided us with data on voucher…
Macauley, Molly K.
Recent national space policy proposes the use of space transportation vouchers to increase opportunities for space-based science research and to support the U.S. space transportation industry. Vouchers issued and financially backed by the government would be given to researchers for redemption on any mode of space transportation. This paper examines the economic costs and benefits of vouchers; incentive-based strategies for effective program design; and areas where the voucher scheme is weak. It is concluded that, under plausible assumptions, vouchers may well be a cost-effective way to achieve near-term space transportation for space research payloads.
The collaborative efforts of healthcare providers, governmental policy and law makers and the public are often needed to provide the pressure necessary to establish a national universal vaccination programme. Key initiatives for those beginning to establish such a programme are the following: secure a scientific consensus or base of support; clarify relevance of the subject to all concerned; increase awareness of everyone (providers and consumers); recruit and involve influential people (angels) for support; seek out agendas within which to review the topic; generate cost-benefit data; encourage a consensus to be reached; identify legislative pathways to be used; convince politicians of the value of such a programme; request budgeting and funding; and, finally, follow up with surveillance studies to demonstrate the benefits of the programme.
United Nations Environment Programme, Nairobi (Kenya).
This edition of the United Nations Environment Programme (UNEP) annual report is structured in three parts. Part 1 focuses on three contemporary problems (ground water, toxic chemicals and human food chains and environmental economics) and attempts to solve them. Also included is a modified extract of "The Annual State of the Environment…
Kikuchi, M.; Tamai, H.; Matsukawa, M.; Fujita, T.; Takase, Y.; Sakurai, S.; Kizu, K.; Tsuchiya, K.; Kurita, G.; Morioka, A.; Hayashi, N.; Miura, Y.; Itoh, S.; Bialek, J.; Navratil, G.; Ikeda, Y.; Fujii, T.; Kurihara, K.; Kubo, H.; Kamada, Y.; Miya, N.; Suzuki, T.; Hamamatsu, K.; Kawashima, H.; Kudo, Y.; Masaki, K.; Takahashi, H.; Takechi, M.; Akiba, M.; Okuno, K.; Ishida, S.; Ichimura, M.; Imai, T.; Hashizume; Miura, Y. M.; Horiike, H.; Kimura, A.; Tsutsui, H.; Matsuoka, M.; Uesugi, Y.; Sagara, A.; Nishimura, A.; Shimizu, A.; Sakamoto, M.; Nakamura, K.; Sato, K.; Okano, K.; Ida, K.; Shimada, H. R.; Kishimoto, Y.; Azechi, H.; Tanaka, S.; Yatsu, K.; Yoshida, N.; Inutake, M.; Fujiwara, M.; Inoue, N.; Hosogane, N.; Kuriyama, M.; Ninomiya, H.
An overview is given of the National Centralized Tokamak (NCT) programme as a research programme for advanced tokamak research to succeed JT-60U. The mission of NCT is to establish high beta steady-state operation for DEMO and to contribute to ITER. The machine flexibility is pursued in aspect ratio and shape controllability for the demonstration of the high-β steady-state, feedback control of resistive wall modes, wide current and pressure profile control capability and also very long pulse steady-state operation. Existing JT-60 infrastructure such as the heating and current drive system, power supplies and cooling systems will be best utilized for this modification.
Can food vouchers improve nutrition and reduce health inequalities in low-income mothers and young children: a multi-method evaluation of the experiences of beneficiaries and practitioners of the Healthy Start programme in England
Background Good nutrition is important during pregnancy, breastfeeding and early life to optimise the health of women and children. It is difficult for low-income families to prioritise spending on healthy food. Healthy Start is a targeted United Kingdom (UK) food subsidy programme that gives vouchers for fruit, vegetables, milk, and vitamins to low-income families. This paper reports an evaluation of Healthy Start from the perspectives of women and health practitioners. Methods The multi-method study conducted in England in 2011/2012 included focus group discussions with 49 health practitioners, an online consultation with 620 health and social care practitioners, service managers, commissioners, and user and advocacy groups, and qualitative participatory workshops with 85 low-income women. Additional focus group discussions and telephone interviews included the views of 25 women who did not speak English and three women from Traveller communities. Results Women reported that Healthy Start vouchers increased the quantity and range of fruit and vegetables they used and improved the quality of family diets, and established good habits for the future. Barriers to registration included complex eligibility criteria, inappropriate targeting of information about the programme by health practitioners and a general low level of awareness among families. Access to the programme was particularly challenging for women who did not speak English, had low literacy levels, were in low paid work or had fluctuating incomes. The potential impact was undermined by the rising price of food relative to voucher value. Access to registered retailers was problematic in rural areas, and there was low registration among smaller shops and market stalls, especially those serving culturally diverse communities. Conclusions Our evaluation of the Healthy Start programme in England suggests that a food subsidy programme can provide an important nutritional safety net and potentially improve
Background As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. Methods This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. Results 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4%) and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Conclusions Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not
Prather, J. C.; Smith, S. K.; Watson, C. R.
The National Radiobiology Archives is a comprehensive effort to gather, organize, and catalog original data, representative specimens, and supporting materials related to significant radiobiology studies. This provides researchers with information for analyses which compare or combine results of these and other studies and with materials for analysis by advanced molecular biology techniques. This Programmer's Guide document describes the database access software, NRADEMO, and the subset loading script NRADEMO/MAINT/MAINTAIN, which comprise the National Laboratory Archives Distributed Access Package. The guide is intended for use by an experienced database management specialist. It contains information about the physical and logical organization of the software and data files. It also contains printouts of all the scripts and associated batch processing files. It is part of a suite of documents published by the National Radiobiology Archives.
Caire, Kaleem M. S.
Based on data from five educational voucher programs in the United States, argues that voucher schools do not "cream" the best students, do serve special-needs students, can improve academic achievement, do not increase racial segregation, and do not harm public schools. Explains why African Americans support educational vouchers. (Contains 18…
A widely accepted result in the literature is that the majority of voters are against the introduction of universal vouchers. Chen and West (2000) predict that voters' attitudes towards selective vouchers (SV) may be different. They claim that voters are indifferent between the no-voucher and SV regimes, unless competition leads to a reduction in…
Bryce, J.; Roungou, J. B.; Nguyen-Dinh, P.; Naimoli, J. F.; Breman, J. G.
Evaluation is an essential management tool for the improvement of public health programmes or projects. As malaria morbidity and mortality continue to increase in most countries in Africa, international agencies and malaria control programme managers have identified the strengthening of programme evaluation as an important strategy for improving the efficiency and effectiveness of malaria control programmes. Managers can develop an evaluation strategy only after they have defined programme objectives and planned specific programme activities. Indicators should be directly related to programme objectives and should be selected on the basis of the following criteria: their validity; reliability; ability to detect change within a reasonable time period and as a result of successful programme implementation; ability to be interpreted; and usefulness in guiding programme change. Only those indicators that can be measured with available programme resources should be selected. Managers will also need to identify the sources of indicator data and to determine how often each indicator will be measured. Programme managers should develop criteria or indicators for the following: programme policies and plans; the process of programme implementation; the outcomes of malaria control interventions in disease management and prevention; and programme impact in terms of reductions in malaria-related mortality and morbidity. Key issues related to the management of evaluation activities within a national programme include the need to begin with available resources and build incrementally; to explore options for administering evaluation activities; to select, train and supervise staff who carry out evaluation activities; to develop quality control strategies; and to ensure that data are managed and communicated in ways that support effective programme decision-making. For evaluation to lead to improvements in malaria control programmes it must be clearly defined as a part of the
Janisch, C P; Albrecht, M; Wolfschuetz, A; Kundu, F; Klein, S
Reaching the United Nation's Millennium Development Goals has been a focus for many countries and development partners. In Kenya, as in many other countries with low levels of development, access to and equity of basic quality health services is limited, especially for the very poor. Among poor populations, maternal mortality is high as access to medical care and financial means are lacking. In 2005, the Governments of Kenya and Germany in cooperation with KfW Banking Group made funds available for the Reproductive Health OBA Voucher Programme offering vouchers for Safe Motherhood, Family Planning and Gender Violence Recovery Services. This programme, herein referred to as Vouchers for Health, was launched in June of 2006 in five Kenyan districts with the aim of providing health services for safe deliveries, long-term family planning methods and victims of gender violence. The way that the programme is being implemented in Kenya demonstrates that the voucher-based approach comprises a variety of key structural elements of a national health insurance scheme: accreditation; quality assurance; reimbursement system; claims processing; integrating the private sector; client choice; provider competition; and access to and equity of services provided.
The magic of the marketplace is insufficient to guarantee a school voucher system's success or a public-school turnaround. Educators and policymakers must address practical issues such as accountability and instructional space needs. Vouchers may provide a life preserver for a few poor students, but open-market competition does nothing for…
Young, David G.
The idea of educational vouchers goes back to Adam Smith in 1778, according to this examination of past and present discussions about vouchers. The author begins by defining educational vouchers and summarizing the idea's history, especially since its revival in 1955 by economist Milton Friedman. Seven models of voucher systems are briefly…
Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo
Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.
Background Developing countries face challenges in financing healthcare; often the poor do not receive the most basic services. The past decade has seen a sharp increase in the number of voucher programs, which target output-based subsidies for specific services to poor and underserved groups. The dearth of literature that examines lessons learned risks the wheel being endlessly reinvented. This paper examines commonalities and differences in voucher design and implementation, highlighting lessons learned for the design of new voucher programmes. Methodology The methodology comprised: discussion among key experts to develop inclusion/exclusion criteria; up-dating the literature database used by the DFID systematic review of voucher programs; and networking with key contacts to identify new programs and obtain additional program documents. We identified 40 programs for review and extracted a dataset of more than 120 program characteristics for detailed analysis. Results All programs aimed to increase utilisation of healthcare, particularly maternal health services, overwhelmingly among low-income populations. The majority contract(ed) private providers, or public and private providers, and all facilitate(d) access to services that are well defined, time-limited and reflect the country’s stated health priorities. All voucher programs incorporate a governing body, management agency, contracted providers and target population, and all share the same incentive structure: the transfer of subsidies from consumers to service providers, resulting in a strong effect on both consumer and provider behaviour. Vouchers deliver subsidies to individuals, who in the absence of the subsidy would likely not have sought care, and in all programs a positive behavioural response is observed, with providers investing voucher revenue to attract more clients. A large majority of programs studied used targeting mechanisms. Conclusions While many programs remain too small to address
A recent Pioneer Institute report written by Ken Ardon and Cara Stilling Candal, "Modeling Urban Scholarship Vouchers in Massachusetts," explores the viability of a school choice voucher program in the Commonwealth. Nationally, school choice has been shown to improve parent satisfaction and student achievement, reduce racial segregation,…
Muller, Eve; Ahearn, Eileen
The National Association of State Directors of Special Education has published documents on home schooling and various aspects of the charter school movement, but not on other types of school choice such as vouchers. This Project Forum document focuses on voucher programs that are specifically designed to provide public funds for parental…
The Third United Nations Conference on the Exploration and Peaceful Uses of Outer Space (UNISPACE III) was held in 1999 with efforts to identify world wide benefits of developing space science and technology, particularly in the developing nations. One of the main vehicles to implement recommendations of UNISPACE III is the United Nations Programme on Space Applications of the Office for Outer Space Affairs at UN Headquarters in Vienna. Following a process of prioritization by Member States, the Programme focus its activities on (i) knowledge-based themes as space law and basic space science, (ii) application-based themes as disaster management, natural resources management, environmental monitoring, tele-health, and (iii) enabling technologies such as remote sensing satellites, communications satellites, global navigation satellite systems, and small satellites. Current activities of the Programme will be reviewed. Further information available at http://www.oosa.unvienna.org/sapidx.html
Sarsfield, Mairuth, Ed.; Emes, John, Ed.
The 1978 Annual State of the Environment Report of the United Nations Environment Program (UNEP) focused on four selected environmental problems of international significance: (1) chemicals and the environment; (2) malaria; (3) the use of agricultural and agro-industrial residues to increase the base for food production; and (4) the conservation…
India has formulated a nationally applicable, socially acceptable, and epidemiologically effective National Tuberculosis Program (NTP), which served as an example for many other countries. In the 1940s, the New Delhi Tuberculosis Center pioneered organized domiciliary treatment of TB cases; the Union Mission Tuberculosis Sanatorium, Madanapalle, had started conducting epidemiological surveys in the late 1930s; the 1954-56 national sample survey of TB is still considered a classic; and this was followed by outstanding longitudinal surveys and epidemiological studies demonstrating that BCG does not provide protection to adults against TB. Halfdan Mahler joined P.V. Benjamin in launching the National BCG Campaign in the 1950s. India demonstrated in the 1950s that home treatment of patients is as efficacious as sanatorium treatment. The National Tuberculosis Institute was set up in 1959 with the specific mandate of making TB services available to larger masses of people. Social science data were also collected to show that TB patients were seeking help from health institutions; they helped diagnose patients in remote rural areas, they proved that the TB program had to be part of the general health services, and they demonstrated the epidemiological potential of a felt-need oriented TB program. The NTP diagnosed TB cases in rural institutions by sputum examination and treated them with chemotherapy. The Tuberculosis Center at district headquarters (DTC) was responsible for providing training to health workers, keeping track of all TB cases and referring them. By 1983-84, the NTP program had been implemented in 353 districts and during that year 1,308,880 cases were treated. Nevertheless, hundreds of thousands of infectious patients are not treated because health authorities put priority on child immunization and are preoccupied with malaria and family planning. The indifference of the bureaucracy and public health leadership is to be blamed for thousands of TB deaths
Armour, Kathleen M.; Makopoulou, Kyriaki
This paper reports findings from an evaluation of a national continuing professional development (CPD) programme for teachers in England. Data showed that the localised implementation, opportunities for interactive learning, and "collective participation" were positive factors. Research participants reported difficulties, however, in…
de Savigny, Don; Webster, Jayne; Agyepong, Irene Akua; Mwita, Alex; Bart-Plange, Constance; Baffoe-Wilmot, Aba; Koenker, Hannah; Kramer, Karen; Brown, Nick; Lengeler, Christian
There are striking similarities in health system and other contexts between Tanzania and Ghana that are relevant to the scaling up of continuous delivery of insecticide treated nets (ITNs) for malaria prevention. However, specific contextual factors of relevance to ITN delivery have led implementation down very different pathways in the two countries. Both countries have made major efforts and investments to address this intervention through integrating consumer discount vouchers into the health system. Discount vouchers require arrangements among the public, private and non-governmental sectors and constitute a complex intervention in both health systems and business systems. In Tanzania, vouchers have moved beyond the planning agenda, had policies and programmes formulated, been sustained in implementation at national scale for many years and have become as of 2012 the main and only publicly supported continuous delivery system for ITNs. In Ghana national-scale implementation of vouchers never progressed beyond consideration on the agenda and piloting towards formulation of policy; and the approach was replaced by mass distribution campaigns with less dependency on or integration with the health system. By 2011, Ghana entered a phase with no publicly supported continuous delivery system for ITNs. To understand the different outcomes, we compared the voucher programme timelines, phases, processes and contexts in both countries in reference to the main health system building blocks (governance, human resources, financing, informatics, technologies and service delivery). Contextual factors which provided an enabling environment for the voucher scheme in Tanzania did not do so in Ghana. The voucher scheme was never seen as an appropriate national strategy, other delivery systems were not complementary and the private sector was under-developed. The extensive time devoted to engagement and consensus building among all stakeholders in Tanzania was an important and
Katti, A P
India's joint conference of the Central Councils of Health and Family Welfare, meeting during April 1979, scaled down the national family planning target for 1979-80 due to the poor performance by some states during 1978-79. The target is now 9.65 million rather than 10.7 million people. The conference also recommended a country wide campaign to explain the concept of the small family and its benefits and a system of incentives and appropriate community awards. Focusing on specific issues, the conference called for initiating a gigantic effort to reduce infant and child mortality by at least 50%. At this time the infant mortality rate is 122/1000. The conference called for family welfare to be integrated with the national adult education program, approved the goal of primary health care for all by the year 2000, and recommended that a higher percentage of the plan budget be allocated to the minimum needs program in the health sector. Another topic considered was the National Development Council (NDC) decision to transfer most of the centrally sponsored health schemes to the state sector. One of the most closely monitored programs in the country, the Family Welfare Program, is being evaluated periodically by the Ministry of Health and Family Welfare to assess how far the objectives and operational goals have been realized. Some interesting facts emerged from the most recent studies conducted by the Population Research Center on the impact of the Family Welfare Program on marriage age, sterilization, IUD, fertility, abortion and the role of trade unions, Panchayats, and voluntary organizations. There has been a rise in the age of marriage for both male and females in urban and rural areas, but it is small and slow. A vast majority of acceptors were within the reproductive age group, but a substantial percentage of acceptors belong to the low fertility age group with a large number of living children. A majority of acceptors of sterilization or other permanent methods
This news insert relays information on the Second National Conference on China's Urban Family Planning Program held in Nanjing, Jiangsu province, during December 1996. Conference participants included Mme. Peng Peiyun as Minister of the State Family Planning Commission and 200 participants from 30 provinces and State Council departments. The conference aimed to discuss the family planning system in relation to the socialist market economy, improvements in delivery of more and better services to reproductive age couples, and more scientific and reasonable family planning management. The conference was sponsored by the State Family Planning Commission. The program offered the opportunity to exchange experiences in implementing urban family planning programs. The first conference was held in Shanghai in 1992. Significant changes have taken place over the past 10 years. There is now a low birth rate, a low rate of natural increase, and changes in attitudes toward fertility. Family planning is a voluntary practice. The urban population has experienced improvements in the quality of life. People demand more and better services and services for maternal and child health and reproductive health. The process of urbanization is accelerating as more people move to cities and towns and new towns are formed. An increasing number of workers are engaged in joint-venture businesses and in the private sector.
Hadaya, Karine; Fehr, Thomas; Rüsi, Barbara; Ferrari-Lacraz, Sylvie; Jean, Villard; Ferrari, Paolo
Growing incidence of end-stage renal disease, shortage of kidneys from deceased donors and a better outcome for recipients of kidneys from living donor have led many centres worldwide to favour living donor kidney transplantation programmes. Although criteria for living donation have greatly evolved in recent years with acceptance of related and unrelated donors, an immunological incompatibility, either due to ABO incompatibility and/or to positive cross-match, between a living donor and the intended recipient, could impede up to 40% of such procedures. To avoid refusal of willing and healthy living donors, a number of strategies have emerged to overcome immunological incompatibilities. Kidney paired donation is the safest way for such patients to undergo kidney transplantation. Implemented with success in many countries either as national or multiple regional independent programmes, it could include simple exchanges between any number of incompatible pairs, incorporate compatible pairs and non-directed donors (NDDs) to start a chain of compatible transplantations, lead to acceptance of ABO-incompatible matching, and integrate desensitising protocols. Incorporating all variations of kidney paired donation, the Australian programme has been able to facilitate kidney transplantation in 49% of registered incompatible pairs. This review is a plea for implementing a national kidney paired donation programme in Switzerland.
Kirtava, A; Soucie, M; Evatt, B; Mdivinishvili, M; Abashidze, M; Iosava, G
After the dissolution of Soviet Union in 1991, haemophilia care in the Republic of Georgia was negatively affected because of the expense of treatment products, lack of clinical and diagnostic facilities, and the need for trained personnel throughout the country. In 2001, the Georgian Government, working through the Ministry of Health, in collaboration with Georgian Association of Haemophilia and Donors, the Institute of Haematology and Transfusion, and the World Federation of Haemophilia, initiated a National Haemophilia Programme. As part of this programme the first Georgian Haemophilia Treatment Centre (HTC) was established. In this paper, we will describe (i) our outreach efforts to identify patients with haemophilia (PWH), (ii) the diagnostic and clinical services provided to patients by the HTC, and (iii) the results of a patient survey designed to assess patient satisfaction with the care provided. Total of 216 PWH were diagnosed, mean age was 25 years (range 4 months to 75 years); 43% had severe, 33% had moderate and 24% had mild haemophilia A or B. Overall, 183 (85%) had haemophilia A and 33 (15%) had haemophilia B, giving a ratio of 5.6. During the 2-year period, 77% of the expected number of PWH was identified by our outreach programme. Vast majority had comprehensive evaluation including joint assessment and over 60% were tested for blood-borne infections within a year and half period. Our findings showed that haemophilia care was considerably improved since the beginning of the National Haemophilia Programme and the survey of PWH showed a high degree of satisfaction with services provided in the HTC. In conclusion, close collaboration of the government, non-government entities and medical professionals in a Georgian national haemophilia care model; resulted in the successful delivery of the much needed services and care to the people living in Georgia with haemophilia.
White, F.; Nanan, D.
Reported are the responses in the latter half of 1997 of all ministries of health in the Region of the Americas to the Declaration of the Americas on Diabetes, which was adopted by the Directing Council of the Pan American Health Organization (PAHO) in 1996 as a basis for national programme development in diabetes. The short-term targets were the designation of national focal points, the preparation of national estimates of the disease burden, and the development and implementation of national strategies and plans to deal with diabetes. The survey found that most countries recognized diabetes as a significant public health problem. In terms of global relevance, a number of lessons have been learned from this exercise: the role of broadly based participation in gaining recognition at the national health policy level; the wide acceptance of an integrated programme model; the relevance of process-related targets to achieve short-term success; and the critical role of having a designated focal point within the managerial approach. PMID:10680245
Bochicchio, F; Hulka, J; Ringer, W; Rovenská, K; Fojtikova, I; Venoso, G; Bradley, E J; Fenton, D; Gruson, M; Arvela, H; Holmgren, O; Quindos, L; McLaughlin, J; Collignan, B; Gray, A; Grosche, B; Jiranek, M; Kalimeri, K; Kephalopoulos, S; Kreuzer, M; Schlesinger, D; Zeeb, H; Bartzis, J
Results from epidemiological studies on lung cancer and radon exposure in dwellings and mines led to a significant revision of recommendations and regulations of international organisations, such as WHO, IAEA, Nordic Countries, European Commission. Within the European project RADPAR, scientists from 18 institutions of 14 European countries worked together for 3 y (2009-12). Among other reports, a comprehensive booklet of recommendations was produced with the aim that they should be useful both for countries with a well-developed radon programme and for countries with little experience on radon issues. In this paper, the main RADPAR recommendations on radon programmes and policies are described and discussed. These recommendations should be very useful in preparing a national action plan, required by the recent Council Directive 2013/59/Euratom.
Brody, Carinne Meyer; Bellows, Nicole; Campbell, Martha; Potts, Malcom
One approach to delivering healthcare in developing countries is through voucher programmes, where vouchers are distributed to a targeted population for free or subsidised health care. Using inclusion/exclusion criteria, a search of databases, key journals and websites review was conducted in October 2010. A narrative synthesis approach was taken to summarise and analyse five outcome categories: targeting, utilisation, cost efficiency, quality and health outcomes. Sub-group and sensitivity analyses were also performed. A total of 24 studies evaluating 16 health voucher programmes were identified. The findings from 64 outcome variables indicates: modest evidence that vouchers effectively target specific populations; insufficient evidence to determine whether vouchers deliver healthcare efficiently; robust evidence that vouchers increase utilisation; modest evidence that vouchers improve quality; no evidence that vouchers have an impact on health outcomes; however, this last conclusion was found to be unstable in a sensitivity analysis. The results in the areas of targeting, utilisation and quality indicate that vouchers have a positive effect on health service delivery. The subsequent link that they improve health was found to be unstable from the data analysed; another finding of a positive effect would result in robust evidence. Vouchers are still new and the number of published studies is limiting.
Borroffice, Robert; Chizea, Francis; Sun, Wei; Sweeting, Martin, , Sir
Space technology and access to space have been elusive to most developing countries over the last half of the 21st century, which is attributed to very low par capital income and the lack of awareness of policy/decision makers about the role of space technology in national development. Space technology was seen as very expensive and prestigious, meant only for the major industrialized countries, while the developing countries should focus on building their national economy and providing food, shelter and other social amenities for their ever-growing populations. In the last decade, the trend has changed with many developing countries embracing spaced technology as one of the major ways of achieving sustainable development. The present trend towards the use of small satellites in meeting national needs has aided this transition because, apart from the small size, they are cheaper to build and to launch, with shorter development time, lower complexity, improved effectiveness and reduced operating costs. This in turn has made them more affordable and has opened up new avenues for the acquisition of satellite technology. The collaborative work between National Space Research and Development Agency of Nigeria (NASRDA) and Surrey Satellite and Technology Limited (SSTL) is a programme aimed at building two small satellites as a way of kick- starting the national space programme. The first project, NigeriaSAT-1, is an enhanced microsatellite carrying Earth observation payloads able to provide 32 metre GSD 3 band multispectral images with a 600km swath width. NigeriaSAT-1 is one of six microsatellites forming the Disaster Monitoring Constellation (DMC) alongside microsatellites contributed by Algeria, China, Turkey, Thailand and UK. Through participation in this international constellation, Nigeria will be able to receive images with a daily revisit worldwide. The EO images generated by NigeriaSAT-1 and the partner microsatellites will be used for providing rapid coverage
Supporting performance objectives 49 and 50 of the V-TECS (Vocational-Technical Education Consortium of States) Secretarial Catalog, both a set of student materials and an instructor's manual on preparing vouchers and pay vouchers are included in this packet, which is one of a series. The student materials include five business transactions…
Sangaré, Mohamed; Tanner, Lydia; Voss, Sarah; Laureys, Francois; Hollow, David; Touré, Mahamadou
We reviewed the national teleradiology programme in Mali to establish whether it improved diagnosis for patients and improved the referring doctor's ability to give an accurate diagnosis. The teleradiology programme connected the University Hospital in Bamako to all seven regional hospitals in Mali and one private health clinic. The pilot phase began in 2005 in three hospitals. Initially the implementation involved connections via broadband, but subsequently satellite antennae were provided at three remote hospitals in the north. Between 2005 and 2013, X-ray and mammogram images from 5628 patients were read by teleradiology. Radiologists provided the sole diagnosis for 29% of cases (i.e. the referrer did not make a diagnosis) and altered the regional doctor's diagnosis in 12% of cases. The proportion of cases for which the regional doctor gave no diagnosis decreased from 93% to 24% over the same period, indicating an increase in the doctors' confidence and incentive to test their own diagnosis. The percentage of cases for which regional doctors made an inaccurate diagnosis decreased to 3% in 2013. Use of the teleradiology service varied widely between hospitals. Successful implementation depended on local ownership of a network, which was developed in close collaboration with hospital leadership, national radiologists and other healthcare personnel.
Russo, Charles J.; Mawdsley, Ralph D.
Describes the facts and state and federal constitutional law related to "Zelman v. Simons-Harris," a Cleveland school-voucher case before the United States Supreme Court. Argues that the Court will likely uphold the constitutionality of the Cleveland voucher program, finding that it does not advance religion in violation of the First…
Simkins, Tim; Garrick, Ros
This paper explores the factors which influence the effectiveness of formal development programmes targeted at multi-agency teams in children's services. It draws on two studies of the National College for School Leadership's Multi-Agency Teams Development programme, reporting key characteristics of the programme, short-term outcomes in terms of…
Cassim, Naseem; Coetzee, Lindi; Motlonye, Bahule; Mpele, Nobantu; Glencross, Deborah K
The NHLS performs close to 4 million CD4 tests per annum for the public sector in South Africa through a network of 60 CD4 testing laboratories. CD4 laboratory data provides an assessment of the number of patients on ART and HIV-positive patients in the pre-ART wellness programs. This study aims to develop a laboratory based Comprehensive Care, Management and Treatment of HIV and AIDS (CCMT) programme status reporting system for CD4 testing at three health facilities in the Ekurhuleni health district using a newly developed CCMT request form, the Laboratory Information System (LIMS) and Corporate Data Warehouse (CDW). The study will generate monitoring and evaluation data to assist in the management of health facilities through a national electronic corporate data warehouse.
Mahendradhata, Yodi; Probandari, Ari; Widjanarko, Bagoes; Riono, Pandu; Mustikawati, Dyah; Tiemersma, Edine W.; Alisjahbana, Bachti
There is growing recognition that operational research (OR) should be embedded into national disease control programmes. However, much of the current OR capacity building schemes are still predominantly driven by international agencies with limited integration into national disease control programmes. We demonstrated that it is possible to achieve a more sustainable capacity building effort across the country by establishing an OR group within the national tuberculosis (TB) control programme in Indonesia. Key challenges identified include long-term financial support, limited number of scientific publications, and difficulties in documenting impact on programmatic performance. External evaluation has expressed concerns in regard to utilisation of OR in policy making. Efforts to address this concern have been introduced recently and led to indications of increased utilisation of research evidence in policy making by the national TB control programme. Embedding OR in national disease control programmes is key in establishing an evidence-based disease control programme. PMID:25361728
Ford, Michael R.
This article uses originally collected survey data to determine how leaders of private schools in the nation's oldest school-voucher program define accountability and perceive the state agency charged with holding them accountable. The results indicate voucher-school administrators' views on accountability are influenced by their school's level of…
Watts, Jennifer J; Segal, Leonie
This paper explores the economic implications of vouchers for chronic disease management with respect to achieving objectives of equity and efficiency. Vouchers as a payment policy instrument for health care services have a set of properties that suggest they may address both demand-side and supply-side issues, and contribute to equity and efficiency. They provide a means whereby health care services can be targeted at selected groups, enabling consumer choice of provider, and encouraging competition in the supply of health services. This analysis suggests that, when structured appropriately, vouchers can support consumers to choose services that will meet their health care needs and encourage competition among providers. Although they may not be appropriate across the entire health care system, there are features of vouchers that make them a potentially attractive option, especially for the management of chronic disease.
The paper examines the recent national programme of English language instruction in the Mexican public primary schools, called the "Programa Nacional de Inglés en Educación Básica" (PNIEB). The programme, initiated in 2009 by the Ministry of Education as part of the national curriculum, represents the largest expansion of English…
Heebner, John; Borden, Michael; Miller, Phil; Hunter, Steve; Christensen, Kim; Scanlan, Michael; Haynam, Chris; Wegner, Paul; Hermann, Mark; Brunton, Gordon; Tse, Eddy; Awwal, Abdul; Wong, Nan; Seppala, Lynn; Franks, Mark; Marley, Ed; Williams, Kevin; Budge, Tracy; Henesian, Mark; Stolz, Christopher; Suratwala, Tayyab; Monticelli, Marcus; Walmer, Dan; Dixit, Sham; Widmayer, Clay; Wolfe, Justin; Bude, Jeff; McCarty, Kelly; DiNicola, Jean-Michel
A system of customized spatial light modulators has been installed onto the front end of the laser system at the National Ignition Facility (NIF). The devices are capable of shaping the beam profile at a low-fluence relay plane upstream of the amplifier chain. Their primary function is to introduce "blocker" obscurations at programmed locations within the beam profile. These obscurations are positioned to shadow small, isolated flaws on downstream optical components that might otherwise limit the system operating energy. The modulators were designed to enable a drop-in retrofit of each of the 48 existing Pre Amplifier Modules (PAMs) without compromising their original performance specifications. This was accomplished by use of transmissive Optically Addressable Light Valves (OALV) based on a Bismuth Silicon Oxide photoconductive layer in series with a twisted nematic liquid crystal (LC) layer. These Programmable Spatial Shaper packages in combination with a flaw inspection system and optic registration strategy have provided a robust approach for extending the operational lifetime of high fluence laser optics on NIF.
Heebner, J; Borden, M; Miller, P; Hunter, S; Christensen, K; Scanlan, M; Haynam, C; Wegner, P; Hermann, M; Brunton, G; Tse, E; Awwal, A; Wong, N; Seppala, L; Franks, M; Marley, E; Wong, N; Seppala, L; Franks, M; Marley, E; Williams, K; Budge, T; Henesian, M; Stolz, C; Suratwala, T; Monticelli, M; Walmer, D; Dixit, S; Widmayer, C; Wolfe, J; Bude, J; McCarty, K; DiNicola, J M
A system of customized spatial light modulators has been installed onto the front end of the laser system at the National Ignition Facility (NIF). The devices are capable of shaping the beam profile at a low-fluence relay plane upstream of the amplifier chain. Their primary function is to introduce 'blocker' obscurations at programmed locations within the beam profile. These obscurations are positioned to shadow small, isolated flaws on downstream optical components that might otherwise limit the system operating energy. The modulators were designed to enable a drop-in retrofit of each of the 48 existing Pre Amplifier Modules (PAMs) without compromising their original performance specifications. This was accomplished by use of transmissive Optically Addressable Light Valves (OALV) based on a Bismuth Silicon Oxide photoconductive layer in series with a twisted nematic liquid crystal (LC) layer. These Programmable Spatial Shaper packages in combination with a flaw inspection system and optic registration strategy have provided a robust approach for extending the operational lifetime of high fluence laser optics on NIF.
Kirby, K C; Marlowe, D B; Festinger, D S; Lamb, R J; Platt, J J
This study examined whether voucher delivery arrangements affect treatment outcome. First, 90 cocaine-dependent adults were randomly assigned to behavioral counseling or counseling plus vouchers for cocaine-free urine samples. The value of each voucher was low at the beginning but increased as the patient progressed (Voucher Schedule 1). Voucher Schedule 1 produced no improvements relative to counseling only. Next, 23 patients received vouchers on either Voucher Schedule 1 or Voucher Schedule 2. Voucher Schedule 2 began with high voucher values, but requirements for earning vouchers increased as the patient progressed. Average durations of cocaine abstinence were 6.9 weeks on Voucher Schedule 2 versus 2.0 weeks on Voucher Schedule 1 (p = .02). This confirms that vouchers can assist in initiating abstinence and that voucher delivery arrangements are critical.
Hurley, Peter M.
Book vouchers serve as one component of need-based financial aid packages at the College of Southern Nevada (CSN), one of the nation's largest community colleges. This study compared the academic performance of Free Application for Federal Student Aid (FAFSA) applicants in attendance at CSN during the 2008-09 and 2009-10 academic years. A basic…
Grimesey, Robert P., Jr.
In September 2010, the U.S. Senate's Armed Services Committee approved an amendment to the proposed National Defense Authorization Act. The amendment, known as Section 583, authorized a Defense Department pilot voucher program to mitigate the cost of private school tuition for special-needs children of military parents. Sen. Jim Webb, a member of…
Rehman, Sajjad ur
This paper investigates the accreditation possibilities and prospects for the library and information science education programmes located in the six member nations of the Gulf Cooperation Council. This paper has been based on the findings of a study focused on the evaluation practices of these programmes and the perceptions of the leading…
Mishra, Arundhati; Vijayshri; Garg, Suresh
The undergraduate science programme was launched at the Indira Gandhi National Open University (IGNOU) in 1991-92 with an enrolment of 1,210 students. The programme was well received, and enrolments increased over the years. However, the success rates have not kept pace with enrolment. In this paper, the authors report the results of an evaluation…
Zhou, Xiao-Nong; Li, Shi-Zhu
Based on theoretic management and quality control of the project, this paper summarizes the 3 major management modes in the national schistosomiasis control programme of China, and the health system management mechanisms under the guidance of national legislation, national programme and national standard and regulation. It is revealed that scientific assessment and assurance of the quality of each control programme is one of the highlighted concerns in the management mode of schistosomiasis control in China after a case study on mollusciciding project. Therefore, it is recommended that the actions, including management of every step in the project management of schistosomiasis control, formulation of operation procedure for each control programme and standardization of the working flow for professional staff, are not only a prerequistite to achievment-based evaluation, but also the key to ensure the quality of every control intervention and present the actual control effect.
Language teacher education programmes can be viewed as "change" programmes, particularly in their endeavours to re-shape cognition. However, often such programmes are found to be relatively ineffective in this regard. As a means of facilitating the desired change, trans-national language teacher education programmes, in which students…
Ridley, David B.
The U.S. Congress created the priority review voucher program in 2007 to encourage development of drugs for neglected diseases. Under the voucher program, the developer of a drug for a neglected or rare pediatric disease that is approved by the U.S. Food and Drug Administration receives a bonus priority review voucher for another drug. As of 2016, four vouchers have sold for an average price of $200 million. Recent experience with the voucher program indicates strengths and weaknesses of the program, as well as a need for legislative changes. PMID:27573624
Peterson, Paul E., Ed.; Campbell, David E., Ed.
This book presents 15 papers on charters, vouchers, and public education: (1) "Introduction: A New Direction in Public Education?" (Paul E. Peterson and David E. Campbell); (2) "Charter Schools: Taking Stock" (Chester E. Finn, Jr, Bruno V. Manno, and Gregg Vanourek); (3) "School Choice in Michigan" (Michael Mintrom…
Museums Collaborative, Inc., New York, NY.
A description of the Museums Collaborative Voucher Program, a system through which cultural institutions conduct programs with large, heterogeneous, adult populations in New York City is provided in this paper. The program began with two goals: to broaden the audience served by New York City's cultural institutions and to provide the institutions…
Farkas, Steve; Johnson, Jean; Foleno, Anthony
This study explored public opinion with regard to educational vouchers and charter schools. It summarizes findings from an in-depth national survey conducted in 1999 of 1,200 members of the public, including 394 parents of school-age children. The study also examined parents' attitudes in several areas where vouchers and charter schools are now…
Burkhalter, B. R.; Abel, E.; Aguayo, V.; Diene, S. M.; Parlato, M. B.; Ross, J. S.
Investment in nutritional programmes can contribute to economic growth and is cost-effective in improving child survival and development. In order to communicate this to decision-makers, the PROFILES nutrition advocacy and policy development programme was applied in certain developing countries. Effective advocacy is necessary to generate financial and political support for scaling up from small pilot projects and maintaining successful national programmes. The programme uses scientific knowledge to estimate development indicators such as mortality, morbidity, fertility, school performance and labour productivity from the size and nutritional condition of populations. Changes in nutritional condition are estimated from the costs, coverage and effectiveness of proposed programmes. In Bangladesh this approach helped to gain approval and funding for a major nutrition programme. PROFILES helped to promote the nutrition component of an early childhood development programme in the Philippines, and to make nutrition a top priority in Ghana's new national child survival strategy. The application of PROFILES in these and other countries has been supported by the United States Agency for International Development, the United Nations Children's Fund, the World Bank, the Asian Development Bank, the Micronutrient Initiative and other bodies. PMID:10361758
Pio, A.; Luelmo, F.; Kumaresan, J.; Spinaci, S.
Since 1990 the WHO Global Tuberculosis Programme (GTB) has promoted the revision of national tuberculosis programmes to strengthen the focus on directly observed treatment, short-course (DOTS) and close monitoring of treatment outcomes. GTB has encouraged in-depth evaluation of activities through a comprehensive programme review. Over the period 1990-95, WHO supported 12 such programme reviews. The criteria for selection were as follows: large population (Bangladesh, Brazil, China, Ethiopia, India, Indonesia, Mexico, and Thailand); good prospects of developing a model programme for a region (Nepal, Zimbabwe); or at advanced stage of implementation of a model programme for a region (Guinea, Peru). The estimated combined incidence of smear-positive pulmonary tuberculosis was 82 per 100,000 population, about 43% of the global incidence. The prevalence of infection with human immunodeficiency virus (HIV) was variable, being very high in Ethiopia and Zimbabwe, but negligible in Bangladesh, China, Nepal and Peru. The programme reviews were conducted by teams of 15-35 experts representing a wide range of national and external institutions. After a 2-3-month preparatory period, the conduct of the review usually lasted 2-3 weeks, including a first phase of meetings with authorities and review of documents, a second phase for field visits, and a third phase of discussion of findings and recommendations. The main lessons learned from the programme reviews were as follows: programme review is a useful tool to secure government commitment, reorient the tuberculosis control policies and replan the activities on solid grounds; the involvement of public health and academic institutions, cooperating agencies, and nongovernmental organizations secured a broad support to the new policies; programme success is linked to a centralized direction which supports a decentralized implementation through the primary health care services; monitoring and evaluation of case management functions
Ajisafe, Olatunbosun Emmanuel; Bolarinwa, Kayode Omotayo; Tuke, Edeh
Transformation engenders change, and change denotes a departure from the old order to a new one. National transformation therefore implies fundamental change in the building block of a nation; change in the social, economic, infrastructural and political landscape of a nation. For transformation to be achieved, it must encompass all levels of…
McCracken, Wendy; Young, Alys; Tattersall, Helen; Uus, Kai; Bamford, John
This article presents results related to the impact on educational support services of the introduction of the first phase of the national Newborn Hearing Screening Programme (NHSP) in England. This study was funded by the Department of Health and undertaken as one element of a national evaluation of NHSP across a range of domains. It presents…
Nhung, N. V.; Kumar, A. M. V.; Harries, A. D.
In April 2009, an operational research fellow was placed within the Viet Nam National Tuberculosis Control Programme (NTP). Over the 6 years from 2010 to 2015, the OR fellow co-authored 21 tuberculosis research papers (as principal author in 15 [71%]). This constituted 23% of the 91 tuberculosis papers published in Viet Nam during this period. Of the 21 published papers, 16 (76%) contributed to changes in policy (n = 8) and practice (n = 8), and these in turn improved programme performance. Many papers also contributed important evidence for better programme planning. Highly motivated OR fellows embedded within NTPs can facilitate high-quality research and research uptake. PMID:28123967
Hoa, N B; Nhung, N V; Kumar, A M V; Harries, A D
In April 2009, an operational research fellow was placed within the Viet Nam National Tuberculosis Control Programme (NTP). Over the 6 years from 2010 to 2015, the OR fellow co-authored 21 tuberculosis research papers (as principal author in 15 [71%]). This constituted 23% of the 91 tuberculosis papers published in Viet Nam during this period. Of the 21 published papers, 16 (76%) contributed to changes in policy (n = 8) and practice (n = 8), and these in turn improved programme performance. Many papers also contributed important evidence for better programme planning. Highly motivated OR fellows embedded within NTPs can facilitate high-quality research and research uptake.
The voucher model of financing schooling is becoming increasingly common throughout Latin America, with at least 12 countries using vouchers or voucher-like schemes. The present study focuses on the voucher models of Colombia and Chile, which have the most extensive programs of this type and those of the longest standing in the region. Using empirical evidence, the author compares the two models along four evaluative dimensions: educational quality, segregation, choice and socialization. After weighing the successes and weaknesses of each system, he concludes that, among other characteristics, the most effective and equitable voucher model features: (a) a flexible interpretation of educational quality; (b) financial grants which target solely the poor; (c) vouchers which cover the entire cost of tuition; (d) open enrolment at participating schools; (e) the participation of both secular and religious private schools; (f) accessible and meaningful information to parents; and (g) strong systems of accountability.
Friedman Foundation for Educational Choice, 2014
In 2011, Indiana enacted the broadest school voucher program in the country. In the program's first year, almost 4,000 families used vouchers to attend participating private schools, with the number of students applying for vouchers more than doubling in each of the following two years, to 9,324 students in 2012-13, and 19,809 in 2013-14. The…
UNEP News, 1988
Lists titles of 31 environmental programs over 13 broad categories including terrestrial ecosystems, oceans, health and welfare, and energy, industry and transportation. Describes the general objectives, implementing agencies, and the role of UNEP (United Nations Environment Programme). (YP)
Hill, Peter S; Tan Eang, Mao
Following the destruction of Cambodia's health infrastructure during the Khmer Rouge period (1975-1979) and the subsequent decade of United Nations sanctions, international development assistance has focused on reconstructing the country's health system. The recognition of Cambodia's heavy burden of tuberculosis (TB) and the lapse of TB control strategies during the transition to democracy prompted the national tuberculosis programme's relaunch in the mid-1990s as WHO-backed health sector reforms were introduced. This paper examines the conflicts that arose between health reforms and TB control programmes due to their different operating paradigms. It also discusses how these tensions were resolved during introduction of the DOTS strategy for TB treatment.
Secades-Villa, Roberto; García-Rodríguez, Olaya; Alvarez Rodríguez, Helí; Río Rodríguez, Arcadio; Fernández-Hermida, José R; Luis Carballo, José
Cocaine use is an increasingly serious problem in Spain. The absence of effective drugs for the treatment of cocaine addiction and of empirically validated therapy programmes makes it necessary to resort to programmes that have shown their effectiveness in other countries. The aim of the present study was to explore the effectiveness of one of the programmes that has obtained the best results in the United States: the Community Reinforcement Approach (CRA) Plus Vouchers for the treatment of cocaine addiction. We assessed treatment retention and dropout rates and cocaine use during the first three months of intervention. The sample was made up of 37 patients addicted to cocaine who were assigned at random to one of two conditions: experimental (CRA Plus Vouchers) or control (Standard Treatment), both in the outpatient context. The results showed that 85.7% of the experimental group patients completed 12 weeks of treatment, compared to 69.6% of the control group. In the experimental group, 57.1% of the patients maintained continuous abstinence, compared to 39.1% of the control group. These results coincide with those of previous studies, all from outside Spain. Nevertheless, longer-term studies with larger samples are necessary in order to confirm the effectiveness of this program.
Stanners, Greig; Lang, Jaroslaw; Brewster, David H; Carey, Francis A; Fraser, Callum G
Background Little is known about interval cancers (ICs) in colorectal cancer (CRC) screening. Objective The purpose of this study was to identify IC characteristics and compare these with screen-detected cancers (SCs) and cancers in non-participants (NPCs) over the same time period. Design This was an observational study done in the first round of the Scottish Bowel Screening Programme. All individuals (772,790), aged 50–74 years, invited to participate between 1 January 2007 and 31 May 2009 were studied by linking their screening records with confirmed CRC records in the Scottish Cancer Registry (SCR). Characteristics of SC, IC and NPC were determined. Results There were 555 SCs, 502 ICs and 922 NPCs. SCs were at an earlier stage than ICs and NPCs (33.9% Dukes’ A as against 18.7% in IC and 11.3% in NPC), screening preferentially detected cancers in males (64.7% as against 52.8% in IC and 59.7% in NPC): this was independent of a different cancer site distribution in males and females. SC in the colon were less advanced than IC, but not in the rectum. Conclusion ICs account for 47.5% of the CRCs in the screened population, indicating approximately 50% screening test sensitivity: guaiac faecal occult blood testing (gFOBT) sensitivity is less for women than for men and gFOBT screening may not be effective for rectal cancer. PMID:27536369
Weinbrenner, Susanne; Lelgemann, Monika; Ollenschäger, Günter; Kleudgen, Susanne; Niederstadt, Christina; Thole, Henning; Sänger, Sylvia; Zorn, Ulrich; Selbmann, Hans-Konrad; Kopp, Ina
The Programme for National Disease Management Guidelines (German DM-CPG Programme) was established in 2002 by the German Medical Association (umbrella organisation of the German Chambers of Physicians) and joined by the Association of the Scientific Medical Societies (AWMF)--umbrella organisation of more than 150 professional societies--and by the National Association of Statutory Health Insurance Physicians (NASHIP) in 2003. The programme provides a conceptual basis for disease management, focussing on high priority healthcare topics and aiming at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. It is organised by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network G-I-N. The main objective of the German DM-CPG Programme is to establish consensus among the medical professions on evidence-based key recommendations covering all sectors of healthcare provision and facilitating the coordination of care for the individual patient through time and across interfaces. Within the last year DM-CPGs have been published for asthma, COPD, type 2 diabetes and coronary heart disease. In addition, experts from national patient self-help groups have been developing patient guidance based upon the recommendations for healthcare providers. The article describes background, methods and tools of the DM-CPG programme using the DM-CPG Method Report 2007.
Ollenschläger, G; Kopp, I; Lelgemann, M; Sänger, S; Klakow-Franck, R; Gibis, B; Gramsch, E; Jonitz, G
The Programme for National Disease Management Guidelines (German DM-CPG Programme) aims at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. The programme, focussing on high priority healthcare topics, has been sponsored since 2003 by the German Medical Association (BAEK), the Association of the Scientific Medical Societies (AWMF), and by the National Association of Statutory Health Insurance Physicians (KBV). It is organised by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the programme is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health care provision and facilitating the coordination of care for the individual patient through time and across disciplines. Within this framework experts from national patient self-help groups have been developing patient guidance based upon the recommendations for healthcare providers. The article describes goals, topics and selected contents of the DM-CPG programme - using asthma as an example.
United Nations Educational, Scientific, and Cultural Organization, Paris (France). Population Education Section.
Population education has been introduced into school curricula in a large number of countries in most regions of the world. The purpose of this document is to help various national population education program leaders to share information and learn from each other. The publication is the result of a cooperative effort involving the participation…
Castleman, John L.
Advantages and disadvantages of educational voucher systems are discussed, and three approaches--only one of which became operational--are described. Difficulties such as parent and educator opposition, the public-private school issue, and probable high costs of voucher systems, are explored. (PP)
In 2002 the U.S. Supreme Court ruled that state-supported vouchers, which parents can redeem in private schools, do not offend the Establishment Clause of the First Amendment. Thus, the legality of government vouchers to fund education will be determined primarily on the basis of state law. Specifically, programs are being challenged under state…
This report presents the case for competition in education, tenders the voucher plan as a means of fostering competition and providing choice in education, and discusses some problems associated with education voucher proposals. Two primary problems -- segregation and church-state conflict -- are given particular attention. The author also…
Gittins, Naomi E., Ed.
This issue deals with the Supreme Court's recent decision in "Mitchell v. Helms" that is viewed by many as additional legal fire power for voucher proponents in the battle over the constitutionality of such programs. The discussion attempts to sort out how the High Court's decision may affect the future of voucher programs. Specifically, the Court…
Steuerle, C. Eugene, Ed.; Ooms, Van Doorn, Ed.; Peterson, George E., Ed.; Reischauer, Robert D., Ed.
Studies in this volume provide a comprehensive examination of the use of vouchers. The contributions to this book examine a variety of applications in such areas as education, child care, employment training, housing, food, and health care, and they discuss the dimensions along which vouchers should be compared to alternative delivery mechanisms.…
Hill, Paul T.
This paper focuses on the administrative costs of vouchers programs. It considers the tasks that public and private agencies must undertake and estimates the administrative burdens and cash flow that local programs create. It assumes that all voucher programs, including those meant in part to reduce overcrowding, will be voluntary. The paper…
Mushi, Adiel K; Schellenberg, Joanna R M Armstrong; Mponda, Haji; Lengeler, Christian
During the last decade insecticide-treated nets have become a key strategy for malaria control. Social marketing is an appealing tool for getting such nets to poor rural African communities who are most afflicted by malaria. This approach usually involves subsidized prices to make nets and insecticide more affordable and help establish a commercial market. We evaluated a voucher system for targeted subsidy of treated nets in young children and pregnant women in two rural districts of southern Tanzania. Qualitative work involved focus group discussions with community leaders, male and female parents of children under 5 years. In-depth interviews were held with maternal and child health clinic staff and retail agents. Quantitative data were collected through interviewing more than 750 mothers of children under 5 years during a cluster sample survey of child health. The voucher return rate was extremely high at 97% (7720/8000). However, 2 years after the start of the scheme awareness among target groups was only 43% (45/104), and only 12% of women (12/103; 95% CI 4-48%) had used a voucher towards the cost of a net. We found some evidence of increased voucher use among least poor households, compared with the poorest households. On the basis of these results we renewed our information, education and communication (IEC) campaign about vouchers. Discount vouchers are a feasible system for targeted subsidies, although a substantial amount of time and effort may be needed to achieve high awareness and uptake - by which we mean the proportion of eligible women who used the vouchers - among those targeted. Within a poor society, vouchers may not necessarily increase health equity unless they cover a high proportion of the total cost: since some cash is needed when using a voucher as part-payment, poorer women among the target group are likely to have lower uptake than richer women. The vouchers have two important additional functions: strengthening the role of public health
Schechter, Chen; Sykes, Israel; Rosenfeld, Jona
Collective learning from past school experiences (retrospective learning) has traditionally focused on failures and difficulties, depriving school personnel of learning opportunities embedded in their own past professional successes. In this article we present a national programme in Israel that aimed at fostering collective learning, stimulated…
Taut, Sandy; Valencia, Edgar; Palacios, Diego; Santelices, Maria V.; Jiménez, Daniela; Manzi, Jorge
This paper investigates the validity of a national, standards-based teacher evaluation programme by examining the relationship between teachers' evaluation results and their students' learning progress. We used census achievement data that assessed the same cohort of students at the end of 8th and 10th grade. We applied multilevel modelling and…
United Nations Environment Programme, Nairobi (Kenya).
One of the main activities assigned to the Governing Council of the United Nations Environment Programme (UNEP) is to review the world environmental situation to insure that emerging environmental problems of wide international significance receive appropriate and adequate consideration by governments. Accordingly, UNEP has assessed the state of…
United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.
This study examines the work of the Asia-Pacific Programme of Education for All (APPEAL) since its 1987 inception. Efforts to assess educational achievement at the local, regional, and national levels in Malaysia are examined with a view to achieving universal primary education; eradicating illiteracy; and providing continuing education in support…
van Els, Theo. J. M.; van Hest, Erna W. C. M.
Describes and reviews the Dutch National Action Programme (NAP) on Foreign Languages, instituted in anticipation of the demands of the 1992 Single European Market. The increasing demand for foreign languages is confirmed, some shortcomings of the current program regarding French and German language learning are identified, and recommendations for…
This article examines an increasingly popular alternative to government-funded voucher plans: private voucher and scholarship plans. Through the 1998-99 school year, spending on privately funded voucher programs totalled $61 million. Private vouchers began with the Golden Rule Program in Indianapolis in 1991 and was inspired by insurance CEO J.…
After describing the history of the educational voucher movement, this paper briefly discusses the various voucher models that have been proposed and considers some of the issues for and against the establishment of voucher systems. Tracing the voucher concept back to Adam Smith, Thomas Paine, and John Stuart Mill, the author notes that after the…
Energy is central to current concerns about sustainable human development, affecting economic and social development; economic growth, the local, national, regional, and global environment; the global climate; a host of social concerns, including poverty, population, and health, the balance of payments, and the prospects for peace. Energy is not an end in itself, but rather the means to achieve the goals of sustainable human development. The energy systems of most developing countries are in serious crisis involving insufficient levels of energy services, environmental degradation, inequity, poor technical and financial performance, and capital scarcity. Approximately 2.5 billion people in the developing countries have little access to commercial energy supplies. Yet the global demand for energy continues to grow: total primary energy is projected to grow from 378 exajoules (EJ) per year in 1990 to 571 EJ in 2020, and 832 EJ in 2050. If this increase occurs using conventional approaches and energy sources, already serious local (e.g., indoor and urban air pollution), regional (eg., acidification and land degradation), and global (e.g., climate change) environmental problems will be critically aggravated. There is likely to be inadequate capital available for the needed investments in conventional energy sources. Current approaches to energy are thus not sustainable and will, in fact, make energy a barrier to socio-economic development. What is needed now is a new approach in which energy becomes an instrument for sustainable development. The two major components of a sustainable energy strategy are (1) more efficient energy use, especially at the point of end-use, and (2) increased use of renewable sources of energy. The UNDP Initiative for Sustainable Energy (UNISE) is designed to harness opportunities in these areas to build upon UNDP`s existing energy activities to help move the world toward a more sustainable energy strategy by helping program countries.
Boateng, Cyril D.; Cudjoe Bensah, Edem; Ahiekpor, Julius C.
Chemical engineers have played key roles in the growth of the chemical and allied industries in Ghana but indigenous industries that have traditionally been the domain of the informal sector need to be migrated to the formal sector through the entrepreneurship and innovation of chemical engineers. The Higher National Diploma Chemical Engineering programme is being migrated from a subject-based to a competency-based curriculum. This paper evaluates the programme from the point of view of students. Data were drawn from a survey conducted in the department and were analysed using SPSS. The survey involved administering questionnaires to students at all levels in the department. Analysis of the responses indicated that the majority of the students had decided to pursue chemical engineering due to the career opportunities available. Their knowledge of the programme learning outcomes was, however, poor. The study revealed that none of the students was interested in developing indigenous industries.
Gingrich, Chris D; Hanson, Kara; Marchant, Tanya; Mulligan, Jo-Ann; Mponda, Hadji
This study uses a partial equilibrium simulation model to explore how price subsidies for insecticide-treated mosquito nets (ITNs) affect households' purchases of ITNs. The model describes the ITN market in a typical developing country and is applied to the situation in Tanzania, where the Tanzania National Voucher Scheme (TNVS) provides a targeted subsidy to vulnerable population groups by means of a discount voucher. The data for this study come from a nationally-representative household survey completed July-August 2006 covering over 4300 households in 21 districts. The simulation results show the impact of the voucher program on ITN coverage among target households, namely those that experienced the birth of a child. More specifically, the share of target households purchasing an ITN increased from 18 to 62 percent because of the discount voucher. The model also suggests that the voucher program could cause the retail ITN price to rise due to an overall increase in demand. As a result, ITN purchases by households without a voucher may actually decline. The simulation model suggests that additional increases toward the stated goal of 80 percent ITN coverage for pregnant women and children could best be achieved through a combination of "catch up" mass distribution programs and expanding the target group for the voucher program to cover additional households. The model can be employed in other countries considering use of a targeted price subsidy for ITNs, and could be adapted to assess the impact of subsidies for other public health commodities.
Fiske, Edward B.; Ladd, Helen F.
The decision of the U.S. Supreme Court in "Zelman v. Simmons-Harris" will significantly alter debate over national education policy in the U.S., mainly because vouchers have suddenly become a more realistic political option. Until June 27, 2002, the day the high court issued its ruling, it was possible in to dismiss voucher proposals out…
El-Akel, W; El-Sayed, M H; El Kassas, M; El-Serafy, M; Khairy, M; Elsaeed, K; Kabil, K; Hassany, M; Shawky, A; Yosry, A; Shaker, M K; ElShazly, Y; Waked, I; Esmat, G; Doss, W
Hepatitis C virus (HCV) infection is a major health problem in Egypt as the nation bears the highest prevalence rate worldwide. This necessitated establishing a novel model of care (MOC) to contain the epidemic, deliver patient care and ensure global treatment access. In this review, we describe the process of development of the Egyptian model and future strategies for sustainability. Although the magnitude of the HCV problem was known for many years, the HCV MOC only came into being in 2006 with the establishment of the National Committee for Control of Viral Hepatitis (NCCVH) to set up and implement a national control strategy for the disease and other causes of viral hepatitis. The strategy outlines best practices for patient care delivery by applying a set of service principles through identified clinical streams and patient flow continuums. The Egyptian national viral hepatitis treatment programme is considered one of the most successful and effective public health programmes. To date, more than one million patients were evaluated and more than 850 000 received treatment under the umbrella of the programme since 2006. The NCCVH has been successful in establishing a strong infrastructure for controlling viral hepatitis in Egypt. It established a nationwide network of digitally connected viral hepatitis-specialized treatment centres covering the country map to enhance treatment access. Practice guidelines suiting local circumstances were issued and regularly updated and are applied in all affiliated centres. This review illustrates the model and the successful Egyptian experience. It sets an exemplar for states, organizations and policy-makers setting up programmes for care and management of people with hepatitis C.
Hunter, Benjamin M.; Harrison, Sean; Portela, Anayda; Bick, Debra
Background Cash transfers and vouchers are forms of ‘demand-side financing’ that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years. Methods This systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute approach for systematic reviewing. The review protocol for this update was registered with PROSPERO (CRD42015020637). Results Data from 51 studies (15 more than previous reviews) and 22 cash transfer and voucher programmes suggest that approaches tied to service use (either via payment conditionalities or vouchers for selected services) can increase use of antenatal care, use of a skilled attendant at birth and in the case of vouchers, postnatal care too. The strongest evidence of positive effect was for conditional cash transfers and uptake of antenatal care, and for vouchers for maternity care services and birth with a skilled birth attendant. However, effects appear to be shaped by a complex set of social and healthcare system barriers and facilitators. Studies have typically focused on an initial programme period, usually two or three years after initiation, and many lack a counterfactual comparison with supply-side investment. There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes. Conclusion Future research should use multiple intervention arms to compare cost-effectiveness with similar investment in public services, and should look beyond short- to medium-term service utilisation by examining programme costs, longer-term effects on service utilisation and health outcomes, and the equity of those effects. PMID:28328940
... Fee Study Data Collection for Full National Study AGENCY: Office of the Chief Information Officer, HUD... Housing Choice Voucher (HCV) Program Administrative Fee Study. The purpose of the study is to collect... this study and is for data collection for the full national study. The prior OMB requests have...
Baltazar, Jane C.; Nadera, Dinah P.; Victora, Cesar G.
OBJECTIVE: To evaluate the impact of the National Control of Diarrhoeal Disease Programme (NCDDP) in the Philippines over the period 1980-93, describing levels and trends in programme activities, and relating them to severe diarrhoea morbidity and mortality among under-5-year-olds. METHODS: Routinely collected data on morbidity and mortality trends were obtained from health statistics reports of the Health Intelligence Service and the NCDDP. Socioeconomic indicators, including annual average family income and expenditures, gross national product, and unemployment rates, were derived from the Philippine population census data collected by the National Statistics Office. FINDINGS: In relation to baseline levels, diarrhoea mortality among infants and young children fell by about 5% annually over the 18-year period under review. The decline was faster than those related to acute respiratory infections (ARIs) among children of similar age and to perinatal causes. Diarrhoea hospital admission rates registered an annual decline of 2.4% relative to the baseline level. CONCLUSION:These findings suggest that the programme had a substantial impact; the period under review also witnessed some degree of improvement in other factors with positive influences on health, such as exclusive breastfeeding, nutrition and environmental sanitation. The quality, particularly completeness and reliability, of the existing data did not allow further analysis, thus, making it difficult to conclude beyond doubt that the observed trends indicate that they were solely due to NCDDP. PMID:12219155
Cutter, J.; Tan, B. Y.; Chew, S. K.
OBJECTIVE: To evaluate the impact of the National Healthy Lifestyle Programme, a noncommunicable disease intervention programme for major cardiovascular disease risk factors in Singapore, implemented in 1992. METHODS: The evaluation was carried out in 1998 by the Singapore National Health Survey (NHS). The reference population was 2.2 million multiracial Singapore residents, 18-69 years of age. A population-based survey sample (n = 4723) was selected by disproportionate stratified and systematic sampling. Anthropometric and blood pressure measurements were carried out on all subjects and blood samples were taken for biochemical analysis. FINDINGS: The 1998 results suggest that the National Healthy Lifestyle Programme significantly decreased regular smoking and increased regular exercise over 1992 levels and stabilized the prevalence of obesity and diabetes mellitus. However, the prevalence of high total blood cholesterol and hypertension increased. Ethnic differences in the prevalence of diabetes mellitus, hypertension, and smoking; and in lipid profile and exercise levels were also observed. CONCLUSION: The intervention had mixed results after six years. Successful strategies have been continued and strengthened. PMID:11693972
Horsley, Tanya; Lockyer, Jocelyn; Cogo, Elise; Zeiter, Jeanie; Bursey, Ford; Campbell, Craig
Objective To explore and categorise the state of existing literature for national programmes designed to affirm or establish the continuing competence of physicians. Design Scoping review. Data sources MEDLINE, ERIC, Sociological Abstracts, web/grey literature (2000–2014). Selection Included when a record described a (1) national-level physician validation system, (2) recognised as a system for affirming competence and (3) reported relevant data. Data extraction Using bibliographic software, title and abstracts were reviewed using an assessment matrix to ensure duplicate, paired screening. Dyads included both a methodologist and content expert on each assessment, reflective of evidence-informed best practices to decrease errors. Results 45 reports were included. Publication dates ranged from 2002 to 2014 with the majority of publications occurring in the previous six years (n=35). Country of origin—defined as that of the primary author—included the USA (N=32), the UK (N=8), Canada (N=3), Kuwait (N=1) and Australia (N=1). Three broad themes emerged from this heterogeneous data set: contemporary national programmes, contextual factors and terminological consistency. Four national physician validation systems emerged from the data: the American Board of Medical Specialties Maintenance of Certification Program, the Federation of State Medical Boards Maintenance of Licensure Program, the Canadian Revalidation Program and the UK Revalidation Program. Three contextual factors emerged as stimuli for the implementation of national validation systems: medical regulation, quality of care and professional competence. Finally, great variation among the definitions of key terms was identified. Conclusions There is an emerging literature focusing on national physician validation systems. Four major systems have been implemented in recent years and it is anticipated that more will follow. Much of this work is descriptive, and gaps exist for the extent to which systems build
Charli-Joseph, Lakshmi; Escalante, Ana E.; Eakin, Hallie; Solares, Ma. José; Mazari-Hiriart, Marisa; Nation, Marcia; Gómez-Priego, Paola; Pérez-Tejada, César A. Domínguez; Bojórquez-Tapia, Luis A.
Purpose: The authors describe the challenges and opportunities associated with developing an interdisciplinary sustainability programme in an emerging economy and illustrate how these are addressed through the approach taken for the development of the first postgraduate programme (MSc and PhD) in sustainability science at the National Autonomous…
The Kuwait National Programme for Healthy Living is an initiative to promote the health and well-being for individuals residing in the country. The plan has been created based on current data and available information pertaining to the various lifestyles of the populations living in Kuwait and their impact on health in general and chronic diseases in particular. Leading a healthy lifestyle is important because it means living in an environment, such as the Kuwaiti society, where chronic conditions such as obesity, diabetes, hypertension and coronary heart diseases are significantly reduced. Several factors regarding lifestyles among the various ethnic groups residing in Kuwait have been identified, including inactivity resulting from the lack of need for physical exertion in daily-life activities and social rituals involving the serving of food amongst the various ethnic groups residing in Kuwait. For Kuwaitis and other ethnicities as well, traditional social gatherings include serving food as an integral element of the social ritual. The environments of school and work also contribute to an individual's lifestyle. The goal of the programme is to address the contribution of lifestyle choices and the social environment to health with the goal of creating a healthy environment that will sustain good health and social well-being. This can be accomplished by involving the various stakeholders in promoting the aim of the programme. Finally, addressing the research needs for healthy lifestyle issues can have a huge impact on the outcome of the programmes designed and would aid in creating a healthy living environment.
Peat, Marwick, Mitchell and Co., New York, NY.
Part 1 of this report outlines the concept of vouchers and the nature and objectives of the New Rochelle study. The more pertinent work tasks undertaken to accomplish the objectives are contained in the appendix. The authors describe their position regarding the voucher plan, highlight its major elements, and outline the steps the district should…
This paper analyzes the impact of voucher design on student sorting in the application and enrollment phases of parental choice. Much of the existing literature investigates the question of sorting where private schools can screen students. However, the publicly funded U.S. voucher programs require private schools to accept all students unless…
Sjolander, K.; Karlsson, T.; Lockowandt, C.
Initiated in 2012 by the Swedish National Space Board (SNSB), a new programme dedicated for Swedish scientists to gain access to space using balloons and sounding rockets was started. This programme promotes the possibility to ensure continuity in both the science and the technology used. The sounding rocket part of this national programme started with three possible missions. SPIDER (Small Payloads for Investigation of Disturbances in Electrojet by Rockets) from the Space and Plasma physics department of KTH, 0-STATES (Oxygen Species and Thermospheric Airglow in The Earth's Sky) from the Department of Meteorology Stockholm University (MISU) and LEEWAVES (Local Excitation and Effects of Waves on Atmospheric VErtical Structure) that is collaboration between KTH and MISU. These three missions were planned for launches in 2015 and 2016. SSc has been contracted on a launch ticket basis to provide the launch and service to the scientific instrumentation. This paper presents the SPIDER, 0-STATES and LEEWAVES missions focussing on a mission related technical solutions perspective.
There are various kinds of good laboratory practice (GLP) monitoring authorities (MAs) in the world. Some countries have only one MA, while others, including Japan, have more than one MA. In addition, each MA has its own relationship with regulatory authorities (RAs), receiving authorities (RcAs) and industry based on the internal regulatory systems. There are eight GLP MAs in Japan. This number is probably the largest in the world. Efforts have been made to establish a close link among MAs and to apply and implement GLP programmes in an efficient, effective and consistent way, namely: i) interministerial meeting on GLP. It is essential to establish a system for information exchange and decision making when there are a number of MAs such as in Japan. To this end, the interministerial meeting on GLP has been set up as a means for MAs, RAs, and RcAs to share information on Organization for Economic Co-operation and Development (OECD) and foreign countries and make national decisions as a whole country; ii) joint training programme. With the goal of training inspectors and minimizing differences in inspections among MAs, a joint training programme has been started including joint visits to test facilities (TFs) and participation in evaluation committees at other MAs. One of the purposes of this training programme is to get ready for the on-site evaluation visit (OEV) of the OECD by simulating it at MAs in Japan; iii) joint translation programme of the OECD documents. To avoid unnecessary confusion due to differences of interpretation and translation of OECD documents among MAs, these have been translated into Japanese in cooperation with industry. This has also other substantial merits such as cost reduction and time saving for all stakeholders in Japan. Some countries, both members and non-members of the OECD, have also established more than one GLP MA. It is hoped that the Japanese experience can be useful to them.
Anopa, Yulia; McMahon, Alex D.; Conway, David I.; Ball, Graham E.; McIntosh, Emma; Macpherson, Lorna M. D.
Dental caries is one of the most common diseases of childhood. The aim of this study was to compare the cost of providing the Scotland-wide nursery toothbrushing programme with associated National Health Service (NHS) cost savings from improvements in the dental health of five-year-old children: through avoided dental extractions, fillings and potential treatments for decay. Methods Estimated costs of the nursery toothbrushing programme in 2011/12 were requested from all Scottish Health Boards. Unit costs of a filled, extracted and decayed primary tooth were calculated using verifiable sources of information. Total costs associated with dental treatments were estimated for the period from 1999/00 to 2009/10. These costs were based on the unit costs above and using the data of the National Dental Inspection Programme and then extrapolated to the population level. Expected cost savings were calculated for each of the subsequent years in comparison with the 2001/02 dental treatment costs. Population standardised analysis of hypothetical cohorts of 1000 children per deprivation category was performed. Results The estimated cost of the nursery toothbrushing programme in Scotland was £1,762,621 per year. The estimated cost of dental treatments in the baseline year 2001/02 was £8,766,297, while in 2009/10 it was £4,035,200. In 2002/03 the costs of dental treatments increased by £213,380 (2.4%). In the following years the costs decreased dramatically with the estimated annual savings ranging from £1,217,255 in 2003/04 (13.9% of costs in 2001/02) to £4,731,097 in 2009/10 (54.0%). Population standardised analysis by deprivation groups showed that the largest decrease in modelled costs was for the most deprived cohort of children. Conclusions The NHS costs associated with the dental treatments for five-year-old children decreased over time. In the eighth year of the toothbrushing programme the expected savings were more than two and a half times the costs of the
Morlot, J C; Schwengels, P; Lurding, S
This paper summarises key results of the Joint IPCC/OECD Programme, in particular the draft IPCC Guidelines for National GHG Inventories to be released in January 1994. The focus is on how these results are likely to improve the availability and the quality of national inventories of anthropogenic GHG emission sources and removals by sinks. The IPCC/OECD has already received nearly 50 inventories from 35 countries. Most of the data are for 1988, but some reports cover 1989 and 1990. In addition to CO2, many of these inventories include CH4, N2O, NOx, CO, and NMVOC. Detailed analyses of these inventories have provided valuable insights about the strengths and weaknesses of the national inventories, differences in approach to estimation, reporting, available methods and data. These results in turn, have facilitated the development of the draft Guidelines, most notably the proposed reporting system, and also on estimation methods for the different anthropogenic sources and sinks of GHG. The paper previews key aspects of the draft Guidelines for non-CO2 GHG. Experts are urged to actively participate in the IPCC/OECD Programme to continue to improve inventory methods and overall the Guidelines.
Stärk, K D C; Miserez, R; Siegmann, S; Ochs, H; Infanger, P; Schmidt, J
Before the start of systematic disease control, respiratory diseases in swine in Switzerland caused estimated losses of several million euros per year. In 1993, a national programme to control enzootic respiratory diseases in pigs was proposed, with the aim of reducing the incidence of clinical cases to less than 1%. Enzootic pneumonia (EP) caused by Mycoplasma hyopneumoniae and clinical cases of pleuropneumonia caused by any serotype of Actinobacillus pleuropneumoniae (APP) would be targeted, in addition to any cases with serological evidence of APP serotype 2. This control programme was initiated in 1996, region by region, and fully implemented by 2004. Clinical, epidemiological and laboratory test results were used to identify the appropriate disease control measures. Partial depopulation was used to control EP on breeding and breeding-finishing farms. Total depopulation was implemented on all farms affected with APP and finishing farms affected with EP Animal trade was strictly regulated during the programme and all suspected cases of respiratory disease in pigs were made notifiable. Continued monitoring is based on clinical suspicion of infection and/or the detection of gross pathological lesions at slaughter, followed by laboratory confirmation. In 2005, the incidence of clinical cases was less than 1%. Regulations have been introduced to control the international trade in live pigs and prevent the re-introduction of respiratory diseases into Switzerland.
Prozesky, V. M.; Pineda, C. A.; Mesjasz-Przybylowicz, J.; Przybylowicz, W. J.; Churms, C. L.; Springhorn, K. A.; Moretto, Ph; Michelet, C.; Chikte, U.; Wenzl, P.
The nuclear microprobe (NMP) unit of the National Accelerator Centre (NAC) has initiated a focused research programme on studies of biological material, ranging from applications in medicine to agriculture and botany. During this period a state-of-the-art cryo-preparation laboratory was also developed. This research programme has resulted in a wide range of projects, and has shown how well suited the NMP is for studies of biological material in general. This paper reports on some of the problems and demands in this field, as well as some of the results obtained using particle induced X-ray spectroscopy (PIXE) and Rutherford backscattering (RBS). True elemental imaging is routinely performed using the dynamic analysis (DA) method, which forms part of the GeoPIXE suite of programmes. A collaborative project, together with the CENBG group of Bordeaux-Gradignan in France, on the development of a facility with the aim of studying effects of single-events of radiation in living cells was recently established and is discussed.
Rossi, Isabelle A; Zuber, Patrick L F; Dumolard, Laure; Walker, Damian G; Watt, James
Despite the demonstration of effectiveness and public health impact of Hib conjugate vaccines, the majority of infants from poorest countries do not yet have access to this safe and effective preventive intervention. This paper provides a descriptive analysis of the main characteristics of countries that have included Hib vaccine in their national immunization programmes before 2006. It highlights the importance of regularly analyzing the process of decision-making involved in implementation of public health interventions, in order to learn from cumulative experience and expedite the introduction of future interventions.
Hacsi, Timothy A.
In the last half-decade Florida has been in tune with, or on the cutting edge of, several national trends in education. Florida has a comprehensive testing program, and has created a range of options for students who seem to be poorly served by traditional public schools. Three Florida programs provide scholarships or vouchers to children from…
The USDA-ARS, National Center for Genetic Resources Preservation maintains the voucher germplasm of Plant Variety Protection (PVP) potato (S. tuberosum) cultivars registered with the U.S. Plant Variety Protection Office. The potato cultivars are deposited at the Center as tissue culture and are main...
Hillman, Nicholas W.; Tandberg, David A.; Gross, Jacob P. K.
In 2004, Colorado introduced the nation's first voucher model for financing public higher education. With state appropriations now allocated to students, rather than institutions, state officials expect this model to create cost efficiencies while also expanding college access. Using difference-in-difference regression analysis, we find limited…
Gooden, Mark A.; Jabbar, Huriya; Torres, Mario S., Jr.
This article investigates legal and political issues as they relate to school vouchers serving students of color. Specifically, we draw on the empirical, historical, and legal research to examine whether school vouchers will create a more equitable system of education for poor students of color. First, we present a history of vouchers, including…
... PLANT VARIETY AND PROTECTION The Application § 97.7 Deposit of Voucher Specimen. (a) Voucher specimen types. As regards the deposit of voucher specimen material for purposes of plant variety protection... self-replication either directly or indirectly. Representative examples include seeds, plant...
... PLANT VARIETY AND PROTECTION The Application § 97.7 Deposit of Voucher Specimen. (a) Voucher specimen types. As regards the deposit of voucher specimen material for purposes of plant variety protection... self-replication either directly or indirectly. Representative examples include seeds, plant...
Wolf, Patrick J.; Kisida, Brian; Gutmann, Babette; Puma, Michael; Eissa, Nada; Rizzo, Lou
School vouchers are the most contentious form of parental school choice. Vouchers provide government funds that parents can use to send their children to private schools of their choice. Here we examine the empirical question of whether or not a school voucher program in Washington, DC, affected achievement or the rate of high school graduation…
Nathwani, Dilip; Sneddon, Jacqueline; Malcolm, William; Wiuff, Camilla; Patton, Andrea; Hurding, Simon; Eastaway, Anne; Seaton, R Andrew; Watson, Emma; Gillies, Elizabeth; Davey, Peter; Bennie, Marion
In 2008, the Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP) was published by the Scottish Government. One of the key actions was initiation of the Scottish Antimicrobial Prescribing Group (SAPG), hosted within the Scottish Medicines Consortium, to take forward national implementation of the key recommendations of this action plan. The primary objective of SAPG is to co-ordinate and deliver a national framework or programme of work for antimicrobial stewardship. This programme, led by SAPG, is delivered by NHS National Services Scotland (Health Protection Scotland and Information Services Division), NHS Quality Improvement Scotland, and NHS National Education Scotland as well as NHS board Antimicrobial Management Teams. Between 2008 and 2010, SAPG has achieved a number of early successes, which are the subject of this review: (i) through measures to optimise prescribing in hospital and primary care, combined with infection prevention measures, SAPG has contributed significantly to reducing Clostridium difficile infection rates in Scotland; (ii) there has been engagement of all key stakeholders at local and national levels to ensure an integrated approach to antimicrobial stewardship within the wider healthcare-associated infection agenda; (iii) development and implementation of data management systems to support quality improvement; (iv) development of training materials on antimicrobial stewardship for healthcare professionals; and (v) improving clinical management of infections (e.g. community-acquired pneumonia) through quality improvement methodology. The early successes achieved by SAPG demonstrate that this delivery model is effective and provides the leadership and focus required to implement antimicrobial stewardship to improve antimicrobial prescribing and infection management across NHS Scotland.
Bhattacharjee, Parinita; McClarty, Leigh M; Musyoki, Helgar; Anthony, John; Kioko, Japheth; Kaosa, Shem; Ogwang, Bernard E; Githuka, George; Sirengo, Martin; Birir, Sarah; Blanchard, James F; Muraguri, Nicholas; Isac, Shajy; Moses, Stephen
In preparation for the implementation of the Kenya AIDS Strategic Framework 2014/15-2018/19, the Kenya National AIDS and STI Control Programme facilitated a national polling booth survey as part of a baseline assessment of HIV-related risk behaviours among FSWs, MSM, and PWID, and their utilization of existing preventive interventions, as well as structural factors that may influence KPs' vulnerability to HIV. The survey was conducted among "key populations" (female sex workers, men who have sex with men, and people who inject drugs) to understand current HIV risk and prevention behaviours, utilization of existing programmes and services, and experiences of violence. In total, 3,448 female sex workers, 1,308 men who have sex with men, and 690 people who inject drugs were randomly selected to participate in polling booth survey sessions from seven priority sites. Survey responses were aggregated and descriptive statistics derived. In general, reported condom use among all key populations was quite high with paying clients, and lower with regular, non-paying partners. Many participants reported unavailability of condoms or clean injecting equipment within the past month. Exposure to, and utilization of, existing HIV prevention services varied significantly among the groups, and was reported least commonly by female sex workers. Encouragingly, approximately three-quarters of all key population members reported receiving an HIV test in the past three months. All key population groups reported experiencing high levels of physical and sexual violence from partners/clients, and/or arrest and violence by law enforcement officials. Although some of the findings are encouraging, there is room for improvement in HIV prevention programmes and services for key populations across Kenya.
Ngo, Diana K L; Sherry, Tisamarie B; Bauhoff, Sebastian
Pay-for-performance (P4P) programmes have been introduced in numerous developing countries with the goal of increasing the provision and quality of health services through financial incentives. Despite the popularity of P4P, there is limited evidence on how providers achieve performance gains and how P4P affects health system quality by changing structural inputs. We explore these two questions in the context of Rwanda's 2006 national P4P programme by examining the programme's impact on structural quality measures drawn from international and national guidelines. Given the programme's previously documented success at increasing institutional delivery rates, we focus on a set of delivery-specific and more general structural inputs. Using the programme's quasi-randomized roll-out, we apply multivariate regression analysis to short-run facility data from the 2007 Service Provision Assessment. We find positive programme effects on the presence of maternity-related staff, the presence of covered waiting areas and a management indicator and a negative programme effect on delivery statistics monitoring. We find no effects on a set of other delivery-specific physical resources, delivery-specific human resources, delivery-specific operations, general physical resources and general human resources. Using mediation analysis, we find that the positive input differences explain a small and insignificant fraction of P4P's impact on institutional delivery rates. The results suggest that P4P increases provider availability and facility operations but is only weakly linked with short-run structural health system improvements overall.
Jha, N.; Pokhrel, S.; Sehgal, R.
The initiative to eradicate poliomyelitis globally by the year 2000 was launched at the Forty-first World Health Assembly in May 1988, when all WHO Member States were challenged to help eradicate poliomyelitis from the world, a gift to the children of the twenty-first century. In Nepal, 100-250 children per year become disabled due to poliomyelitis. The government of Nepal is determined to eradicate the disease from the country by the year 2000 through the National Immunization Day (NID) Programme. Since 1996, about 3.3 million children under 5 years of age have been immunized each year in Nepal. In the present study, we analysed the impact of the campaign in the Sunsari district of Nepal. The study was carried out during the first NID (6 December 1996) to evaluate the local population's awareness of the programme and the impact of the media on such awareness. A total of 843 respondents were interviewed, 39% of whom were illiterate. Two important aspects of the mass campaign (whether a child previously immunized should be immunized again in the NID, and whether children should be brought to the next NID) were clearly understood by the majority of the people (93.1% and 98.8% of the respondents, respectively), although only a small proportion (24.4%) of individuals understood the purpose of the programme. Radio was the single most effective means of providing information, education, and communication about NIDs. The encouraging response, especially from a poor, illiterate rural population, augurs well for the goal of eradicating poliomyelitis from the world. PMID:10444884
Drain, Paul K.; Ralaivao, Josoa S.; Rakotonandrasana, Alexander; Carnell, Mary A.
OBJECTIVE: To evaluate the safety and coverage benefits of auto-disable (AD) syringes, weighed against the financial and logis- tical costs, and to create appropriate health policies in Madagascar. METHODS: Fifteen clinics in Madagascar, trained to use AD syringes, were randomized to implement an AD syringe only, mixed (AD syringes used only on non-routine immunization days), or sterilizable syringe only (control) programme. During a five-week period, data on administered vaccinations were collected, interviews were conducted, and observations were recorded. FINDINGS: The use of AD syringes improved coverage rates by significantly increasing the percentage of vaccines administered on non-routine immunization days (AD-only 4.3%, mixed 5.7%, control 1.1% (P<0.05)). AD-only clinics eliminated sterilization sessions for vaccinations, whereas mixed clinics reduced the number of sterilization sessions by 64%. AD syringes were five times more expensive than sterilizable syringes, which increased AD-only and mixed clinics' projected annual injection costs by 365% and 22%, respectively. However, introducing AD syringes for all vaccinations would only increase the national immunization budget by 2%. CONCLUSION: The use of AD syringes improved vaccination coverage rates by providing ready-to-use sterile syringes on non-routine immunization days and decreasing the number of sterilization sessions, thereby improving injection safety. The mixed programme was the most beneficial approach to phasing in AD syringes and diminishing logistical complications, and it had minimal costs. AD syringes, although more expensive, can feasibly be introduced into a developing country's immunization programme to improve vaccination safety and coverage. PMID:14576886
Public Policy Forum, 2010
This brochure provides charted reference information for Milwaukee Voucher Schools for the 2009-2010 school year. Schools are grouped by grade level. The following is included: Name, Address, Telephone, Grades; Religion/Denomination; Enrollment; Choice Student Enrollment; Number of Teachers; School Hours; Before/After School Programs;…
Epple, Dennis; Romano, Richard
The analysis of educational vouchers has evolved from market-based analogies to models that incorporate distinctive features of the educational environment. These distinctive features include peer effects, scope for private school pricing and admissions based on student characteristics, the linkage of household residential and school choices in…
Robelen, Erik W.
Washington is a safe distance from the powerful winds that have wreaked havoc on the Gulf Coast, but a political storm continued to brew in the capital over President Bush's plan to help pay the costs of private school tuition for students displaced by Hurricane Katrina. As voucher opponents decried the president's plan, Louisiana's two U.S.…
Stern, Jonathan M. B.
The achievement gap in many developing countries is defined in terms of rich/poor and public/private. The prevailing explanation for the "developing" achievement gap is an underfunded, inefficient, and/or inadequately supplied public school sector. Via an analysis of a Colombian voucher experiment, this article examines the extent to…
Highlights some of the major findings of the December 2001 RAND report on charter schools and vouchers prepared by Brain P. Gill, P. Michael Timpane, Karen E. Ross, and Dominic J. Brewer. The report can be ordered from RAND at www.rand.org/publications. (PKP)
Levin, Henry M.; Schwartz, Heather L.
This article considers two issues regarding preschool education. First, it provides a brief set of arguments for government funding of universal, pre-school education. Second, it explores the applicability of a voucher plan using a regulated market approach for the funding of universal, pre-school education. Four criteria are used to assess the…
Bryson, Maria; Tidy, Natalie; Smith, Michael; Levy, Sharon
We conducted an online survey to investigate nurses' perceptions, knowledge and expectations of the National Health Service (NHS) modernization programme in the UK. The questionnaire was available for 28 days via the Website of the Royal College of Nursing. The questionnaire was completed by 2020 nurses, midwives and health visitors working in all sectors of the health service in a wide range of specialties and environments of care. Less than one-quarter of respondents felt that they had adequate information about NHS information technology (IT) developments. In all, 528 (26%) said this was the first they had heard of the initiatives. Only 383 respondents (19%) felt adequately informed about the development of electronic health records; 470 (23%) felt inadequately informed and 456 (23%) had only heard something about it. The findings of this survey suggest that nursing staff are not widely aware of current IT plans and programmes in the NHS. They suggest that nurses also lack confidence in using advanced IT, which is compounded by lack of training.
Al Hosani, H; Salah, M; Osman, H M; Farag, H M; El-Assiouty, L; Saade, D; Hertecant, J
The national neonatal screening programme in the United Arab Emirates currently includes 16 disorders: congenital hypothyroidism, sickle-cell diseases, congenital adrenal hyperplasia, biotinidase deficiency and 12 amino acid, organic acid and fatty acid disorders. This paper reports data since the programme started in January 1995 up to December 2011 on the incidence of screened disorders and the molecular basis of positive screened cases. Screening used a combination of tandem mass spectrometry, molecular technologies and biochemical analysis. A total of 750 365 infants were screened and 717 babies saved from associated morbidity and/or mortality. The incidence of screened disorders were 1:1 873 for congenital hypothyroidism, 1:14 544 for phenylketonuria, 1:3 526 for amino acid, organic acid and fatty acid disorders, 1:9 030 for classical congenital adrenal hyperplasia, 1:8 300 for biotinidase deficiency, 1:2 384 for sickle-cell disease and 1:121 for sickle-cell traits. Coverage of neonatal screening in the population reached 95% in 2010.
Tabah, Earnest Njih; Nsagha, Dickson Shey; Bissek, Anne-Cécile Zoung-Kanyi; Njamnshi, Alfred Kongnyu; Bratschi, Martin W.; Pluschke, Gerd; Um Boock, Alphonse
Background Cameroon is endemic for Buruli ulcer (BU) and organised institutional BU control began in 2002. The objective was to describe the evolution, achievements and challenges of the national BU control programme (NBUCP) and to make suggestions for scaling up the programme. Methods We analysed collated data on BU from 2001 to 2014 and reviewed activity reports NBUCP in Cameroon. Case-detection rates and key BU control indicators were calculated and plotted on a time scale to determine trends in performance. A linear regression analysis of BU detection rate from 2005–2014 was done. The regression coefficient was tested statistically for the significance in variation of BU detection rate. Principal findings In 14 years of BU control, 3700 cases were notified. The BU detection rate dropped significantly from 3.89 to 1.45 per 100 000 inhabitants. The number of BU endemic health districts rose from two to 64. Five BU diagnostic and treatment centres are functional and two more are planned for 2015. The health system has been strengthened and BU research and education has gained more interest in Cameroon. Conclusion/Significance Although institutional BU control Cameroon only began 30 years after the first cases were reported in 1969, a number of milestones have been attained. These would serve as stepping stones for charting the way forward and improving upon control activities in the country if the major challenge of resource allocation is dealt with. PMID:26760499
Gutierrez, Felix; Chacon, Gloria
The 2 essays on educational vouchers given in this publication are: (1) "The Economics of Educational Vouchers: Schools and Parents", and (2) "The Alum Rock Voucher Program". "The Economics of Educational Vouchers: Schools and Parents" traces the roots of the voucher concept from Adam Smith to the conservative…
Van Damme, P.; Kane, M.; Meheus, A.
Hepatitis B is a major public health problem even though safe and effective vaccines have been available for over 10 years. Because hepatitis B infection is largely asymptomatic with long term complications occurring after many years it has not received the attention it deserves. Strategies to immunise those at high risk have failed to control the disease. Delegates to the World Health Assembly of the World Health Organisation recommended in May 1992 that all countries should integrate hepatitis B vaccination into their national immunisation programmes by 1997. Some western European countries remain unconvinced that the burden of disease warrants the expense of universal vaccination. However, epidemiological data and economic evaluation show that universal hepatitis B vaccination is cost effective in countries with low endemicity and that it will control hepatitis B, reinforcing the necessity for action. PMID:9112852
Xu, J; Steinman, P; Maybe, D; Zhou, X-N; Lv, S; Li, S-Z; Peeling, R
Schistosomiasis japonica is caused by the parasitic trematode Schistosoma japonicum. It is endemic in The People's Republic of China and has significant impact on human health and socioeconomic development in certain regions. Over the last six decades, the national control programmes evolved in remarkable ways and brought schistosomiasis japonica largely under control. We describe the history and evolution of schistosomiasis control in The People's Republic of China, with an emphasis on shifts in control strategies that evolved with new insights into the biology of the parasite and its intermediate hosts, and the epidemiology of the disease in the country. We also highlight the achievements in controlling the disease in different socioecological settings, and identify persisting challenges to fully eliminate schistosomiasis japonica from the country. To reach the goal of schistosomiasis elimination, further integration of interventions, multisector collaboration, sensitive and effective surveillance are needed to strengthen.
Depleted Uranium (DU) is used in ammunition designed for armour-piercing. DU was used in the Gulf war 1991, wars in Bosnia 1994-1995, Kosovo 1999 and Iraq 2003. The United Nations Environmental Programme (UNEP) Post-Conflict Branch investigated sites where DU was used and evaluated health and environmental risks during missions to Kosovo, Serbia and Bosnia. During a mission to Lebanon in 2006, UNEP also sampled areas where DU was supposed to have been used but did not find any DU. Due to the grave risks to the lives of UN personnel, no UNEP mission was carried out in Iraq. UNEP has provided training for personnel engaged in decontamination of DU in Bosnia and Iraq.
Vashist, Praveen; Senjam, Suraj Singh; Gupta, Vivek; Gupta, Noopur; Kumar, Atul
A review appropriateness of the current definition of blindness under National Programme for Control of Blindness (NPCB), Government of India. Online search of peer-reviewed scientific published literature and guidelines using PubMed, the World Health Organization (WHO) IRIS, and Google Scholar with keywords, namely blindness and visual impairment, along with offline examination of reports of national and international organizations, as well as their cross-references was done until December 2016, to identify relevant documents on the definition of blindness. The evidence for the historical and currently adopted definition of blindness under the NPCB, the WHO, and other countries was reviewed. Differences in the NPCB and WHO definitions were analyzed to assess the impact on the epidemiological status of blindness and visual impairment in India. The differences in the criteria for blindness under the NPCB and the WHO definitions cause an overestimation of the prevalence of blindness in India. These variations are also associated with an over-representation of refractive errors as a cause of blindness and an under-representation of other causes under the NPCB definition. The targets for achieving elimination of blindness also become much more difficult to achieve under the NPCB definition. Ignoring differences in definitions when comparing the global and Indian prevalence of blindness will cause erroneous interpretations. We recommend that the appropriate modifications should be made in the NPCB definition of blindness to make it consistent with the WHO definition.
This case study examines the policies formulated by the Indira Gandhi National Open University (IGNOU), an open and distance learning university of India for regulating the practices related to the assignments of its Bachelor of Education programme. Following the examination it argues that some policies are formulated in the context of the…
Some bilingual secondary schools in the Netherlands have introduced or are introducing the International Baccalaureate (IB) Middle Years Programme (MYP).The implementation of this international scheme at (semi-) public national Dutch schools proves anything but unproblematic. Based on a series of questionnaires filled out by school managers and…
The new National Curriculum Programme of Study for primary science in England includes most of the topics with which primary teachers are familiar. However, when looking at the science enquiry section, the changes are much more far-reaching. Science enquiry has been renamed as "working scientifically" and is integrated with developing…
Wright, Caradee Y.; Reeder, Anthony I.; Albers, Patricia N.
Interventions in primary schools that increase sun-protective behaviours and decrease ultraviolet radiation exposure, sunburn incidence and skin cancer risk can be effective. SunSmart School Accreditation Programmes (SSAP) are recommended. Prior to SSAP implementation in South Africa, we explored the feasibility of obtaining national baseline…
Osborne, Aoife; Carroll, Paula; Richardson, Noel; Doheny, Martin; Brennan, Lorcan; Lambe, Barry
Ireland's National Men's Health Policy recommended developing training programmes tailored to the needs of those working in health and allied health professionals and ENGAGE was developed to meet that recommendation. This study evaluated the impact of ENGAGE on frontline service providers' self-reported knowledge, skills, capacity and practice up to 5-months post training. Between 2012 and 2015, ENGAGE Trainers (n = 57) delivered 62 1-day training programmes to 810 participants. This study was conducted on a subset of those training days (n = 26) and participants. Quantitative methodologies were used to collect pre (n = 295), post (n = 295) and 5-month post (n = 128) training questionnaire data. Overall, participants were highly satisfied with the training immediately post training (8.60 ± 1.60 out of 10) and at 5-month follow up (8.06 ± 1.43 out of 10). Participants' self-reported level of knowledge, skill and capacity in identifying priorities, engaging men and influencing practice beyond their own organisation increased immediately following training (P < 0.001) and, with the exception of improving capacity to engage men and influencing practice beyond their organisation, these improvements were sustained at 5-month post training (P < 0.001). The vast majority of service providers (93.4%) reported that ENGAGE had impacted their work practice up to 5-month post training. The findings suggest that ENGAGE has succeeded in improving service providers' capacity to engage and work with men; improving gender competency in the delivery of health and health related services may increase the utilisation of such services by men and thereby improve health outcomes for men.
Faal, H.; Minassian, D.; Dolin, P.; Mohamed, A.; Ajewole, J.; Johnson, G.
AIM—To re-survey the Gambia after an interval of 10 years to assess the impact of a national eye care programme (NECP) on the prevalence of blindness and low vision. METHOD—Comparison of two multistage cluster random sample surveys taking into account the marked increase in population in the Gambia, west Africa. Samples of the whole population in 1986 and 1996 were taken. The definition of blindness is presenting vision less than 3/60 in the better eye, or visual fields constricted to less than 10° from fixation. Low vision is less than 6/18 but 3/60 or better. Causes of blindness were determined clinically by three ophthalmologists. RESULTS—The crude prevalence of blindness fell from 0.70% to 0.42%, a relative reduction of 40%. During the same 10 year period, the population increased by 51% from 775 000 to 1 169 000. When the results were standardised for age, a west to east gradient was found for changes in risk of blindness over the 10 year period. This matched the phased west to east introduction of the NECP interventions. There was a modest but significant increase in the risk of low vision across the whole country. CONCLUSIONS—The overall reduction in risk of blindness, in those areas where the NECP has been active, appears to justify the programme and the support of donor organisations. The low vision cases due to cataract must now be addressed. PMID:10966942
ter Maat, Judith; Haasnoot, Marjolijn; van der Vat, Marnix; Hunink, Joachim; Prinsen, Geert; Visser, Martijn
Keywords: uncertainty, policymaking, adaptive policies, fresh water management, droughts, Netherlands, Dutch Deltaprogramme, physically-based complex model, theory-motivated meta-model To prepare the Dutch Delta for future droughts and water scarcity, a nation-wide 4-year project, called Delta Programme, is established to assess impacts of climate scenarios and socio-economic developments and to explore policy options. The results should contribute to a national adaptive plan that is able to adapt to future uncertain conditions, if necessary. For this purpose, we followed a model-based step-wise approach, wherein both physically-based complex models and theory-motivated meta-models were used. First step (2010-2011) was to make a quantitative problem description. This involved a sensitivity analysis of the water system for drought situations under current and future conditions. The comprehensive Dutch national hydrological instrument was used for this purpose and further developed. Secondly (2011-2012) our main focus was on making an inventory of potential actions together with stakeholders. We assessed efficacy, sell-by date of actions, and reassessed vulnerabilities and opportunities for the future water supply system if actions were (not) taken. A rapid assessment meta-model was made based on the complex model. The effects of all potential measures were included in the tool. Thirdly (2012-2013), with support of the rapid assessment model, we assessed the efficacy of policy actions over time for an ensemble of possible futures including sea level rise and climate and land use change. Last step (2013-2014) involves the selection of preferred actions from a set of promising actions that meet the defined objectives. These actions are all modeled and evaluated using the complex model. The outcome of the process will be an adaptive management plan. The adaptive plan describes a set of preferred policy pathways - sequences of policy actions - to achieve targets under
Jehan, Kate; Sidney, Kristi; Smith, Helen; de Costa, Ayesha
In Nepal, India, Bangladesh and Pakistan, policy focused on improving access to maternity services has led to measures to reduce cost barriers impeding women's access to care. Specifically, these include cash transfer or voucher schemes designed to stimulate demand for services, including antenatal, delivery and post-partum care. In spite of their popularity, however, little is known about the impact or effectiveness of these schemes. This paper provides an overview of five major interventions: the Aama (Mothers') Programme (cash transfer element) in Nepal; the Janani Suraksha Yojana (Safe Motherhood Scheme) in India; the Chiranjeevi Yojana (Scheme for Long Life) in India; the Maternal Health Voucher Scheme in Bangladesh and the Sehat (Health) Voucher Scheme in Pakistan. It reviews the aims, rationale, implementation challenges, known outcomes, potential and limitations of each scheme based on current available data. Increased use of maternal health services has been reported since the schemes began, though evidence of improvements in maternal health outcomes has not been established due to a lack of controlled studies. Areas for improvement in these schemes, identified in this review, include the need for more efficient operational management, clear guidelines, financial transparency, plans for sustainability, evidence of equity and, above all, proven impact on quality of care and maternal mortality and morbidity.
The value of theory in programmes to implement clinical guidelines: Insights from a retrospective mixed-methods evaluation of a programme to increase adherence to national guidelines for chronic disease in primary care
Sheringham, Jessica; Solmi, Francesca; Ariti, Cono; Baim-Lance, Abigail; Morris, Steve; Fulop, Naomi J.
Background Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in ‘real-world’ rather than research settings. Materials and methods This mixed-methods study tested a retrospective theory-based approach to evaluate a ‘real-world’ programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care. Quantitative analyses comprised controlled before-and-after analyses to test ‘early’ and evolved’ programme theories with comparators grounded in each theory. ‘Early’ theory predicted the programme would reduce emergency hospital admissions (EHA). It was tested using national analysis of standardized borough-level EHA rates between programme and comparator boroughs. ‘Evolved’ theory predicted practices with higher programme participation would increase guideline adherence and reduce EHA and costs. It was tested using a difference-in-differences analysis with linked primary and secondary care data to compare changes in diagnosis, management, EHA and costs, over time and by programme participation. Results Contrary to programme planners’ predictions in ‘early’ and ‘evolved’ programme theories, admissions did not change following the programme. However, consistent with ‘evolved’ theory, higher guideline adoption occurred in practices with greater programme participation. Conclusions Retrospectively constructing theories based on the ideas of programme planners can enable evaluators to
Cham, M K; Olaleye, B; D'Alessandro, U; Aikins, M; Cham, B; Maine, N; Williams, L A; Mills, A; Greenwood, B M
During the second year of the Gambian National Impregnated Bednet Programme (NIBP) charges for insecticide ($0.50 per net) were introduced into the half of the primary health care villages in the country where insecticide have been provided free of charge the previous year. Free insecticide was provided in the remaining villages that had acted as controls during the previous year. In villages where insecticide was provided free, 77% of nets were treated with insecticide. In contrast, in villages where charges were made coverage was only 14%. During the first year of the NIBP, mortality in children was significantly lower in villages where insecticide was provided free than in the control villages. Introduction of a charge for insecticide into the first group of villages and the provision of free insecticide in the latter abolished this difference. The cash income of rural Gambians is very limited and payment of even $2-3 for insecticide treatment for all the bednets in a household represents a substantial outlay. Further education on the benefits of treatment of nets and/or the provision of cheaper insecticide will be required before the full benefits of this powerful new malaria control measure can be fully realised in the Gambia.
Johnson, Claire; Mohan, Sailesh; Praveen, Deversetty; Woodward, Mark; Maulik, Pallab K; Shivashankar, Roopa; Amarchand, Ritvik; Webster, Jacqui; Dunford, Elizabeth; Thout, Sudhir Raj; MacGregor, Graham; He, Feng; Reddy, K Srinath; Krishnan, Anand; Prabhakaran, Dorairaj; Neal, Bruce
Introduction The scientific evidence base in support of salt reduction is strong but the data required to translate these insights into reduced population salt intake are mostly absent. The aim of this research project is to develop the evidence base required to formulate and implement a national salt reduction programme for India. Methods and analysis The research will comprise three components: a stakeholder analysis involving government, industry, consumers and civil society organisations; a population survey using an age-stratified and sex-stratified random samples drawn from urban (slum and non-slum) and rural areas of North and South India; and a systematic quantitative evaluation of the nutritional components of processed and restaurant foods. The stakeholder interviews will be analysed using qualitative methods to summarise the main themes and define the broad range of factors influencing the food environment in India. The population survey will estimate the mean daily salt consumption through the collection of 24 h urine samples with concurrent dietary surveys identifying the main sources of dietary sodium/salt. The survey of foods will record the nutritional composition of the chief elements of food supply. The findings from this research will be synthesised and proposals for a national salt reduction strategy for India will be developed in collaboration with key stakeholders. Ethics and dissemination This study has been approved by the Human Research Ethics Committees of the University of Sydney and the Centre for Chronic Disease Control in New Delhi, and also by the Indian Health Ministry's Screening Committee. The project began fieldwork in February 2014 and will report the main results in 2016. The ﬁndings will be targeted primarily at public health policymakers and advocates, but will be disseminated widely through other mechanisms including conference presentations and peer-reviewed publications, as well as to the participating communities. PMID
Background Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Methods Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. Results The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and
Efforts to prevent and curb school bullying have resulted in a proliferation of anti-school-bullying programmes, many based on intuitive appeal rather than systematic evidence. This article presents a comparative analysis of two Norwegian programmes whose developers have demonstrated the effectiveness of their interventions: the Olweus Programme…
Abrantes, Pedro; Roldao, Cristina; Amaral, Patricia; Mauritti, Rosario
The article analyses the main benefits of a Portuguese programme, launched in 1996, which was designed to support schools in segregated districts (TEIPs). The first part of the article presents a theoretical framework, before moving on to the main features of the TEIP programme in contemporary Portuguese society and education. An explanation of…
Shafiq, M. Najeeb; Myers, John P.
This study examines the Swedish national educational voucher scheme and changes in social cohesion. We conduct a statistical analysis using data from the 1999 and 2009 rounds of the International Association for the Evaluation of Educational Achievement's civic education study of 14-year-old students and their attitudes toward the rights of ethnic…
Good, Thomas L.; Braden, Jennifer S.
This book examines reform in American education over the past 50 years, analyzing why contemporary voucher plans and charter schools have yet to fulfill the expectations of their advocates. The book discusses: a historical perspective, insight into student achievement, voucher plans and charter schools, and policy recommendations. The eight…
Witte, John F.
This paper is the first summary of two studies and 10 years of evaluating the Milwaukee Parental Choice (voucher) Program (MPCP). This paper discusses school voucher evaluations in general terms and how these studies are carried out. The paper outlines the types of studies completed in "Study I" and "Study II" and the results…
Public funding of private K-12 schooling through vouchers continues to be a contentious issue across the U.S., even though a solid majority of Americans continues to oppose them. The voucher plans run the risk of legal challenge for how they handle the rights of students with disabilities and whether they violate state constitutional provisions…
Bast, Joseph L.; And Others
Advocates of educational freedom disagree about whether school vouchers would liberate schools and families and lead to greater freedom of choice or trap private schools in a web of subsidy and regulation that would destroy their independence and quality. In this exchange of opinions, Joseph L. Bast and David Harmer argue that voucher plans would…
Figlio, David N.; Hart, Cassandra M. D.
School choice options--including both voucher and neo-voucher options like tuition tax credit funded scholarship programs--have become increasingly prevalent in recent years (Howell, Peterson, Wolf and Campbell, 2006). One popular argument for school choice policies, drawing from economic theory, is that public schools will improve the education…
The impact of voucher schools on the further education (FE) curriculum in Britain was examined in a study of the 22 FE colleges and 3 training and enterprise councils (TECs) involved in the initial pilot testing of the 5 voucher schemes: Youth Credits; Gateway to Learning; Skill Choice; Open Learning Credits; and Adult Training Credits. It was…
Sutton, Lenford C.; King, Richard A.
Legal scrutiny of school voucher policies initially focused on the establishment clause concerning with allocating public dollars to schools sponsored by religious organizations. In recent years, advocates asserted that the exclusion of faith-based organizations from voucher plans that permit expenditures in secular private organizations violates…
Bon, Susan C.; Decker, Janet R.; Strassfeld, Natasha
As of 2015, 17 special education voucher programs (SVPs) existed in 13 states and proposals continue to emerge. Eligible parents utilize these vouchers to enroll their children in private schools and thereby relinquish special education services and protections provided under the Individuals with Disabilities Education Act (IDEA). Using a…
... family one or more extensions of the initial voucher term in accordance with PHA policy as described in... that purpose. (c) Suspension of term. The PHA policy may or may not provide for suspension of the initial or any extended term of the voucher. At its discretion, and in accordance with PHA policy...
This report examines research on education vouchers. It discusses how most studies have focused on the systems in place in Milwaukee, Cleveland, and New York City. Although researchers have accused each other of specious findings, some generally consistent results have arisen: families that are served by vouchers are generally low income, parents…
Peterson, Paul E.; Howell, William G.
The voucher intervention sponsored by New York City's School Choice Scholarships Foundation (SCSF) has been a valuable source of information about such programs. It began in 1997, when K-4 public school students were invited to apply to SCSF for a voucher to help defray costs of private school tuition. Over 1,200 of 20,000 applicants were offered…
Cutress, Anna L; Muncer, Steven J
Parent training interventions are recommended for parents soon after their child's autism spectrum condition diagnosis with the aim of improving parents' psychological well-being and coping, as well as the child's behaviour. This report explores parents' views of the EarlyBird Plus Programme through data collected routinely in the post-programme questionnaire. Participants' reported increased understanding of autism and improvements in their communication with their child and their ability to manage their child's behaviour. Parents appeared to value the opportunity to meet with other parents, and the programme seemed acceptable to the majority of parents who attended.
Harris, Douglas N.; Herrington, Carolyn D.; Albee, Amy
This study considers why Florida has been the most aggressive state in adopting school vouchers. Vouchers are consistent with Florida's tradition of aggressive educational accountability policies, arising from the state's moderate social conservatism, openness to privatization, and state demographic characteristics. Even with this fertile…
Doyle, Denis P.
This monograph analyzes trends in American educational philosophy and history in its proposal to implement an all-public statewide school voucher system. Following an introduction, section 1, "Alternative Voucher Systems," discusses three concepts: universal unregulated vouchers, favored by Milton Friedman; regulated compensatory vouchers,…
Wolf, Patrick J.; Hoople, Daniel S.
Several evaluations of private school voucher programs in the United States have reported achievement gains for voucher users, particularly African Americans. These studies tend to be structured as Randomized Field Trials (RFTs) in which participants are assigned to treatment (offered a voucher) and control (not offered a voucher) groups by…
Khurram Azmat, Syed; Tasneem Shaikh, Babar; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Asghar, Jamshaid; Ishaque, Muhammad; Ahmed, Aftab; Bilgrami, Mohsina
Background Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society – a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan. Methodology We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA) in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11. Results Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1%) was recorded in the uptake of IUCDs, which were being promoted with vouchers. Conclusion Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training
Kobayashi, S; Yano, M; Hirakawa, T; Horii, K; Watanabe, T; Tsutsui, A; Sakai, O; Kani, M; Horowitz, A M
The purpose of this investigation was to determine the current status of fluoride mouthrinse programmes throughout Japan. Data collection and analysis took place in 1992. The focus of this study was on schools that were participating in the rinse programme at the time of the survey. Questionnaires were sent by mail to 49 dentist-members of the Association for the Promotion of Fluoride Use in Japan. These members gathered information from the schools and, when necessary, also from local government offices. Starting with a single prefecture in 1970, the rinse programme increased to 32 out of 47 prefectures by 1992. The total number of schools using fluoride mouthrinse was 1,183 (nursery schools and kindergartens 48 per cent, primary schools 46 per cent, and secondary schools 6 per cent). In nursery schools and kindergartens, 60 per cent of the participating schools adopted the daily method using 0.05 per cent NaF solution. In primary and secondary schools, 78 per cent adopted the weekly method using 0.2 per cent NaF solution. The costs for the rinse regimen were paid for by public funds of the prefectural and municipal governments in 71 per cent of the schools. Fifty-four per cent of the schools which first initiated the rinse programmes in their districts identified dentists and dental associations as the most influential in programme acceptance and implementation. Although the number of fluoride rinse programmes is increasing, it is still modest. These results suggest that cooperation between dental organisations, dental schools and prefectural governments can play very important roles in implementing school based rinse programmes.
Silverman, K; Wong, C J; Higgins, S T; Brooner, R K; Montoya, I D; Contoreggi, C; Umbricht-Schneiter, A; Schuster, C R; Preston, K L
Heroin dependence remains a serious and costly public health problem, even in patients receiving methadone maintenance treatment. This study used a within-subject reversal design to assess the effectiveness of voucher-based abstinence reinforcement in reducing opiate use in patients receiving methadone maintenance treatment in an inner-city program. Throughout the study subjects received standard methadone maintenance treatment involving methadone, counseling, and urine monitoring (three times per week). Thirteen patients who continued to use opiates regularly during a 5-week baseline period were exposed to a 12-week program in which they received a voucher for each opiate-free urine sample provided: the vouchers had monetary values that increased as the number of consecutive opiate-free urines increased. Subjects continued receiving standard methadone maintenance for 8 weeks after discontinuation of the voucher program (return-to-baseline). Tukey's posthoc contrasts showed that the percentage of urine specimens that were positive for opiates decreased significantly when the voucher program was instituted. (P < or = 0.01) and then increased significantly when the voucher program was discontinued during the return-to-baseline condition (P < or = 0.01). Rates of opiate positive urines in the return-to-baseline condition remained significantly below the rates observed in the initial baseline period (P < or = 0.01). Overall, the study shows that voucher-based reinforcement contingencies can decrease opiate use in heroin dependent patients receiving methadone maintenance treatment.
Watson, Tara Marie; Strike, Carol; Challacombe, Laurel; Demel, Geoff; Heywood, Diana; Zurba, Nadia
Through promotion of consistent, evidence-based policy and practice, best practice recommendations can improve service delivery. Nationally relevant best practice recommendations, including guidance for programmes that provide service to people who use drugs, are often created and disseminated by government departments or other national organisations. However, funding priorities do not always align with stakeholder- and community-identified needs for such recommendations, particularly in the case of harm reduction. We achieved success in developing and widely disseminating best practice documents for Canadian harm reduction programmes by bringing together a multi-stakeholder, cross-regional team of people with relevant and diverse experience and expertise. In this commentary, we summarise key elements of our experience to contribute to the literature more detailed and transparent dialogue about team processes that hold much promise for developing best practice resources. We describe our project's community-based principles and process of working together (e.g., regularly scheduled teleconferences to overcome geographic distance and facilitate engagement), and integrate post-project insights shared by our team members. Although we missed some opportunities for power-sharing with our community partners, overall team members expressed that the project offered them valuable opportunities to learn from each other. We aim to provide practical considerations for researchers, other stakeholders, and community members who are planning or already engaged in a process of developing best practice recommendations for programmes and interventions that address drug use.
This research seeks to look at the effect of the new Swedish training programme for head teachers by comparing it with the previous national training programme and does so primarily through an analysis of documents and texts that served to underpin the two different programmes. To put the Swedish teacher-training programme in an international…
Handa, Sudhanshu; Palermo, Tia; Rosenberg, Molly; Pettifor, Audrey; Halpern, Carolyn Tucker; Thirumurthy, Harsha
Cash transfer programmes have recently emerged as promising interventions for HIV prevention among adolescents in Africa. However, the pathways through which risk reduction occurs are not well understood. We examine data on 1429 adolescents and youth from the Kenya Cash Transfer for Orphans and Vulnerable Children, which has been shown to result in delayed sexual debut among adolescents. We explored three potential mediating pathways: schooling, socio-economic status and psycho-social status. None of these hypothesised mediators greatly altered the main effect. However, school attendance had a larger protective effect on sexual debut among females but was only increased by the programme among males. This gendered pattern of effects may explain why we did not see a mediating effect of the cash transfer through schooling, despite schooling's protective effects against early sexual debut. Results also suggest that cash transfer programmes in Africa can contribute to the reduction of HIV related risk behaviours.
Lubienski, Christopher; Brewer, T. Jameson
Voucher proponents have increasingly pursued empirical evidence on the effectiveness of vouchers as a form of education improvement, in addition to advocating for vouchers on moral or ethical grounds. Voucher proponents contend that randomized assignment studies of students in voucher programs have consistently confirmed the effectiveness of…
Yusuf, Mudasiru Olalere; Falade, Ayotunde Atanda
This study investigated the use of media by distance learners enrolled in the NTI distance education programme. Two hundred and fifty five distance learners drawn from Oyo State, Nigeria, completed a questionnaire to determine the use of media, and factors militating against their effective use by distance learners. Research data were analyzed…
Wang, Kai; Gimbel, Sarah; Malik, Elfatih; Hassen, Sara; Hagopian, Amy
Chinese Medical Teams have been working in developing countries since 1963 as a health diplomacy strategy. In 2010, 1252 Chinese medical personnel were assigned to 48 countries. We conducted a review of Chinese literature and governmental websites to describe the history and current distribution of Chinese Medical Teams around the world. In addition, we interviewed members of a 36-member Chinese Medical Team deployed to Sudan (primarily about their motivations to join the programme and the challenges and benefits they face), along with their Sudanese hosts. The most significant challenge health workers described was homesickness. Most members said they were able to maintain motivation through their curiosity and the doctor-friendly environment. All but two rated their own working performance as 'good' or 'very good', while their Sudanese colleagues consistently rated them even higher. Participants reported conflicting beliefs regarding the perceived responsibilities of the team and challenges around communication. Three pillars support the Chinese Medical Team programme in Sudan: bilateral government commitment, the professionalism of the Medical Teams, and the welcoming medical environment. Future success of this or similar Chinese programmes depend on the willingness of both governments to participate, the ongoing commitment of younger Chinese doctors, and the hospitality of physicians in the host country. There are also some threats to the programme, including a potentially diminishing need for Chinese doctors to support increasingly well-trained host country physicians.
Cutress, Anna L.; Muncer, Steven J.
Parent training interventions are recommended for parents soon after their child's autism spectrum condition diagnosis with the aim of improving parents' psychological well-being and coping, as well as the child's behaviour. This report explores parents' views of the EarlyBird Plus Programme through data collected routinely in the post-programme…
This article explores the ability of the training and work experience offered under public works programmes to promote employment in South Africa. Public works are a key component of South African labour market policy and are ascribed considerable potential in terms of addressing the core challenge of unemployment. However, despite this policy…
This paper analyzes the impact of voucher design on student sorting, and more specifically investigates whether there are feasible ways of designing vouchers that can reduce or eliminate student sorting. It studies these questions in the context of the first five years of the Milwaukee voucher program. Much of the existing literature investigates…
Mousaid, Sarah; Huegaerts, Kelly; Bosmans, Kim; Julià, Mireia; Benach, Joan; Vanroelen, Christophe
Several European countries implemented initiatives to boost the growth of the domestic cleaning sector. Few studies investigated the quality of work in these initiatives, although effects on workers' health and on social health inequalities can be expected. This study contributes to the scant research on this subject, by investigating the quality of work in the Belgian service voucher system - a subsidized system for domestic work. The applied research methodology includes a qualitative content analysis of parliamentary debates, legislation and previous research about the service voucher system and of 40 in-depth interviews with service voucher workers. The study shows that the legal framework that regulates the system must be further enhanced in order to improve the quality of work in the service voucher system. In addition, the actors involved must be better controlled, and sanctioned in case of non-compliance with legislation.
Young, Stacy L.; Gacic-Dobo, Marta; Brown, David W.
Background Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. Methods During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether records were provided free-of-charge or required by schools, whether there was a stock-out and the duration of any stock-outs that occurred, as well as the total expenditure for printing HBRs during 2013. Results A total of 140 countries returned a completed HBR questionnaire. Two countries were excluded from analysis because they did not use a HBR during 2013. HBR types varied across countries (vaccination only cards, 32/138 [23.1%]; vaccination plus growth monitoring records, 31/138 [22.4%]; child health books, 48/138 [34.7%]; combination of these, 27/138 [19.5%] countries). HBRs were provided free-of-charge in 124/138 (89.8%) respondent countries. HBRs were required for school entry in 62/138 (44.9%) countries. Nearly a quarter of countries reported HBR stock-outs during 2013. Computed printing cost per record was
In 2006, the Kenyan state joined the international commitment to make antiretroviral treatment free in public health institutions to people infected with HIV. Less than a decade later, treatment has reached over 60% of those who need it in Kenya. This paper, which is based on an in-depth ethnographic case study of the HIV treatment programme at Kenyatta National Hospital, conducted intermittently between 2008 and 2014, examines how HIV-positive peer mentors encourage and track adherence to treatment regimens within and beyond the clinic walls using mobile phones and computer technology. This research into the everyday practices of patient monitoring demonstrates that both surveillance and adherence are collective activities. Peer mentors provide counselling services, follow up people who stray from treatment regimens, and perform a range of other tasks related to patient management and treatment adherence. Despite peer mentors’ involvement in many tasks key to encouraging optimal adherence, their role is rarely acknowledged by co-workers, hospital administrators, or public health officials. Following a biomedical paradigm, adherence at Kenyatta and in Kenya is framed by programme administrators as something individual clients must do and for which they must be held accountable. This framing simultaneously conceals the sociality of adherence and undervalues the work of peer mentors in treatment programmes. PMID:25175291
In 2006, the Kenyan state joined the international commitment to make antiretroviral treatment free in public health institutions to people infected with HIV. Less than a decade later, treatment has reached over 60% of those who need it in Kenya. This paper, which is based on an in-depth ethnographic case study of the HIV treatment programme at Kenyatta National Hospital, conducted intermittently between 2008 and 2014, examines how HIV-positive peer mentors encourage and track adherence to treatment regimens within and beyond the clinic walls using mobile phones and computer technology. This research into the everyday practices of patient monitoring demonstrates that both surveillance and adherence are collective activities. Peer mentors provide counselling services, follow up people who stray from treatment regimens, and perform a range of other tasks related to patient management and treatment adherence. Despite peer mentors' involvement in many tasks key to encouraging optimal adherence, their role is rarely acknowledged by co-workers, hospital administrators, or public health officials. Following a biomedical paradigm, adherence at Kenyatta and in Kenya is framed by programme administrators as something individual clients must do and for which they must be held accountable. This framing simultaneously conceals the sociality of adherence and undervalues the work of peer mentors in treatment programmes.
Koduah, Augustina; Agyepong, Irene Akua; van Dijk, Han
This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. Understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries (LMIC).
Gottvall, Maria; Stenhammar, Christina; Grandahl, Maria
Objective To explore parents' views of extending the human papillomavirus (HPV) vaccination programme to also include boys. Design Explorative qualitative design using individual, face-to-face, interviews and inductive thematic analysis. Setting 11 strategically chosen municipalities in central Sweden. Participants Parents (n=42) who were offered HPV vaccination for their 11–12 years old daughter in the national school-based vaccination programme. Results The key themes were: equality from a public health perspective and perception of risk for disease. Parents expressed low knowledge and awareness about the health benefits of male HPV vaccination, and they perceived low risk for boys to get HPV. Some parents could not see any reason for vaccinating boys. However, many parents preferred gender-neutral vaccination, and some of the parents who had not accepted HPV vaccination for their daughter expressed that they would be willing to accept vaccination for their son, if it was offered. It was evident that there was both trust and distrust in authorities' decision to only vaccinate girls. Parents expressed a preference for increased sexual and reproductive health promotion such as more information about condom use. Some parents shared that it was more important to vaccinate girls than boys since they believed girls face a higher risk of deadly diseases associated with HPV, but some also believed girls might be more vulnerable to side effects of the vaccine. Conclusions A vaccine offered only to girls may cause parents to be hesitant to vaccinate, while also including boys in the national vaccination programme might improve parents' trust in the vaccine. More information about the health benefits of HPV vaccination for males is necessary to increase HPV vaccination among boys. This may eventually lead to increased HPV vaccine coverage among both girls and boys. PMID:28246143
Ekerete, P P
The National Programme on Immunization (NPI), which was formerly known as the Expanded Program on Immunization (EPI), and Oral Rehydration Therapy (ORT) were relaunched in 1984 after the problems of vaccine supply had been corrected. The aim of the NPI was to protect children against six childhood killer diseases and ORT to rehydrate the dehydrated child caused by diarrhoea. In order to achieve these objectives, a Partner-in-Health strategy was set up to educate, convince and motivate mothers, pregnant women and the community to accept the programme. To assess the effect of the promotional strategy, the government decided to conduct a National Immunization Coverage survey. The results showed that some states were able to reach the target while some were not. The survey also reported that 32% of the reason for immunization failure was due to lack of information and that 9% was lack of motivation. It therefore became necessary to design a promotional model for effective and rapid implementation of the programme. After an evaluation of the promotional strategy set up by the government, a pilot survey was conducted from which nine promotional elements were selected. These promotional elements were regarded as sources of information and motivation. Based on these, a promotional model was set up which stated that promotion depends on consumer information which in turn depends on the extent of interaction between the consumer and the promotional elements. The implication of the model is the need for the formation of a Public Health Organisation with a Public Health Committee at all levels of government.
Alvarez, Inés; Del Carmen Saldías, Ma; Wodowoz, Olga; Pérez Campos, Héctor; Machin, Daniel; Silva, Walter; Sueta, Patricia; Pérez, Natalia; Acosta Md, Ma del Carmen
The transplant law of 1971 based on informed consent, allows people to register their willingness to be a donor upon death. Since 1978 the governmental Institution, the National Bank of Organs and Tissues (BNOT), have been regulated the organ and tissue donation. Important progress was implemented in the BNOT and specially in the National Multi-tissue Bank (NMTB). Since 2001 with the participation in the IAEA Tissue Banking Programme, Quality System Management has been implemented in the NMTB. New bio-production for radiosterilized tissues for the first time and improved procedures were carried out. As a result an increased production of high-quality tissues was obtained and distributed for clinical use.
Swietliński, Janusz; Zejda, Jan E; Piróg, Maciej; Dobrzańska, Anna; Helwich, Ewa; Ksiazyk, Janusz; Migdał, Marek; Szczapa, Jerzy; Brozek, Grzegorz; Musialik-Swietlińska, Ewa
In this paper we outline the aims and methods of the Polish National Programme for Standardisation of Clinical Practice in Neonatology and Paediatric Intensive Care, with special reference to infants with low and extremely low birth weight. The aim of this Programme is to adjust the diagnostic and therapeutic procedures to the latest guide lines and recommendations. The first stage consisted of a national level survey in order to identify the diversity of procedures implemented in Medical University Clinical Departments, Neonatology Units and Paediatric Intensive Care Units. The survey also served to confront the legitimacy of the used procedures with the current clinical knowledge and research. It is planned to repeat the survey 24 months after the implementation of the latest recommendations with the aim to assess the impact of the Programme on clinical practice. Partial stages of the Programme were started since 2006. The survey is coordinated by an independent statistics unit. The recommendations are developed on published standards.
Walt, G; Ross, D; Gilson, L; Owuor-Omondi, L; Knudsen, T
Community health worker programmes have become a prominent feature of many primary health care schemes in developing countries. This paper, which is based on a larger collaborative study undertaken in 3 countries, focuses on the experiences with such workers in Botswana, and concludes that many of the key issues that were highlighted in the Botswana study are similar to those in other countries. These can be summarized under four headings: unrealistic expectations, poor initial planning, problems of sustainability, and the difficulty of maintaining quality of care. The future success of these workers will depend on their being integrated more systematically into local services, with concomitant strengthening of management support and supervision.
The study set out to examine the private cost of a National Certificate in Education, through the distance learning mode as organized by the National Teachers Institute (NTI) Ekiti State branch in Nigeria. This was to open the eyes of the prospective students to know what on the average he has to spend, and also to provide data for the state…
Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz
Objective To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. Design A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Participants National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Setting National and provincial tuberculosis programmes in Pakistan Main outcome measures 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. Results The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. Conclusion This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB
... Voucher (HCV) Family Self-Sufficiency (FSS) Program AGENCY: Office of the Assistant Secretary for Public... also lists the following information: Title of Proposal: Housing Choice Voucher (HCV) Family...
Background Nigeria has included a regulated community-based health insurance (CBHI) model within its National Health Insurance Scheme (NHIS). Uptake to date has been disappointing, however. The aim of this study is to review the present status of CBHI in SSA in general to highlight the issues that affect its successful integration within the NHIS of Nigeria and more widely in developing countries. Methods A literature survey using PubMed and EconLit was carried out to identify and review studies that report factors affecting implementation of CBHI in SSA with a focus on Nigeria. Results CBHI schemes with a variety of designs have been introduced across SSA but with generally disappointing results so far. Two exceptions are Ghana and Rwanda, both of which have introduced schemes with effective government control and support coupled with intensive implementation programmes. Poor support for CBHI is repeatedly linked elsewhere with failure to engage and account for the ‘real world’ needs of beneficiaries, lack of clear legislative and regulatory frameworks, inadequate financial support, and unrealistic enrolment requirements. Nigeria’s CBHI-type schemes for the informal sectors of its NHIS have been set up under an appropriate legislative framework, but work is needed to eliminate regressive financing, to involve scheme members in the setting up and management of programmes, to inform and educate more effectively, to eliminate lack of confidence in the schemes, and to address inequity in provision. Targeted subsidies should also be considered. Conclusions Disappointing uptake of CBHI-type NHIS elements in Nigeria can be addressed through closer integration of informal and formal programmes under the NHIS umbrella, with increasing involvement of beneficiaries in scheme design and management, improved communication and education, and targeted financial assistance. PMID:24559409
Low, David C
NHS Connecting for Health set up a Child Health Programme in 2007 to map out and make the case for a common core content for electronic child health records. Because of the relatively low level of integration of existing systems, sharing is technically difficult, and a consistent community-based detailed care record does not yet exist. However, Government policy and good clinical care, emphasised by Lord Laming in 2003 and again this year, stress the importance of information sharing and a common record. A record with a common core content, readily available for every child and parent or carer and for each professional delivering their health care, would be an advantage. The basis of one already exists as the Personal Child Health Record. Systems are developing and are in operation in different parts of the country which are beginning to share information between different health organisations as well as integrating different systems.
Singapore has a long way to go to becoming a 'heartsafe' society. Given our small size and culture of hard work in our country, we can achieve a state of good first response by our community citizens through public cardiopulmonary resuscitation and automated external defibrillators training programmes at various key sectors and through the implementation of public access defibrillation in a committed manner. For our second-line responders, investing in technology to improve response times and quality of chest compressions with earlier interventions will go a long way toward strengthening the chain of survival in the community. Building on this strong foundation and having a strong hospital-based cardiac arrest management system will ensure that those who achieve return of spontaneous circulation will more likely remain alive and be discharged from hospital in a neurologically optimal state.
Wilkins, S; Best, R L; Evans, S M
Clinical quality registries are an overlooked and under-funded arm of clinical research in Australia. Registries are databases for patients with a particular disease, or who undergo a procedure, or use a health resource. Registries, where properly funded and universally adopted, have provided substantial benefits to the quality of healthcare and, in some cases, have had demonstrable effect in reducing costs. There is a lack of a coordinated programme for both funding and development of registries in Australia. A coordinated effort is required to address key gaps in registry coverage and ensure registries comply with appropriate technical and operating principles, and target areas where registries can add value to the health system. This will ensure that Australia is competitive with its international peers in this dynamic environment.
Deuñas, L; Alcantud, V; Alvarez, F; Arteaga, J; Benítez, A; Bopuza, M; Carniege, L; Cartaya, B; Comas, C; Cotayo, R; Escobar, H; Fernández, H; Fernández, M; Fernández, R; García, M; Iznaga, N; la O, F; Márquez, J; Nordet, D; Pérez, J; Quintero, J; Redonavich, A; Robeleco, M; Rodríguez, H; Strander, H
Laryngeal papillomatosis is one of the first diseases where interferon (IFN) was found to be effective. In 1983, a programme for the treatment of all such cases started in Cuba. Up to December 1991, 125 patients (92 children, 33 adults) have been treated: 102 with leucocyte IFN-alpha, 12 with recombinant IFN-alpha-2b, and 11 have received both preparations. Case management consisted of surgical removal of the lesions followed by an IFN schedule starting with 10(5) IU/kg of weight in children or 6 x 10(6) IU in adults, i.m. daily. The dose was progressively reduced, as long as no relapses occurred. At the end of the one-year schedule the doses were reduced to 5 x 10(4) IU/kg in children or 3 x 10(6) IU in adults, weekly. If there was a relapse, it was removed surgically and the patient returned to a higher dose level. Most cases (89; 71 per cent) have not relapsed after the treatment; 60 of them have been followed for more than three years. In those with relapses, the frequency of recurrence decreased in all but four patients. The treatment seemed to be more effective if initiated less than three months after the disease onset. The tracheostomy could be removed in five out of seven patients who needed it before the IFN treatment and was necessary in only three new cases during IFN treatment. In two of these, decannulation was possible later on. In a total of 14 patients relapses persisted after several cycles of IFN treatment. They were considered resistant to such treatment. No severe side effects were reported. The most frequent ones were fever, drowsiness, increased bronchial secretion, chills and headache. The establishment of this programme has maintained the disease under control in Cuba.
Stark, D; Bielack, S; Brugieres, L; Dirksen, U; Duarte, X; Dunn, S; Erdelyi, D J; Grew, T; Hjorth, L; Jazbec, J; Kabickova, E; Konsoulova, A; Kowalczyk, J R; Lassaletta, A; Laurence, V; Lewis, I; Monrabal, A; Morgan, S; Mountzios, G; Olsen, P R; Renard, M; Saeter, G; van der Graaf, W T; Ferrari, A
Over 14 000 patients aged 15-24 are estimated to be diagnosed with cancer in the European Union (EU) each year. Teenagers and young adults (TYA) often fall down gaps between children's and adults cancer services. The specific challenges of providing optimal care to them are described, but we present a summary of recent progress. Progress to overcome these challenges is happening at different rates across Europe. We summarise the European national projects in this field but more recently we have seen the beginnings of European coordination. Within the EU 7th Funding Programme (FP7) European Network for Cancer Research in Children and Adolescents programme (ENCCA), a specific European Network for Teenagers and Young Adults with Cancer has held a series of scientific meetings, including professionals, patients and caregivers. This group has proposed unanswered research questions and agreed key features of a high-quality service that can improve outcomes for TYA with cancer, including the primacy of collaboration between adult and paediatric services to eliminate the gap in the management of TYA with cancer.
Then Administrator Jackson signed the first Memorandum of Understanding (MOU) between EPA and United Nations Environment Program (UNEP) during the 26th Session of the UNEP Governing Council Meeting/Global Ministerial Environment Forum in 2011.
Epple, Dennis N.; Romano, Richard
Two significant challenges hamper analyses of collective choice of educational vouchers. One is the multi-dimensional choice set arising from the interdependence of the voucher, public education spending, and taxation. The other is that household preferences between public and private schooling vary with the policy chosen. Even absent a voucher,…
... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Voucher submission (cost-reimbursement). 2452.232-71 Section 2452.232-71 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... costs to date. All vouchers shall be distributed as follows, except for the final voucher, which...
This report collects the results of all available empirical studies using the best available scientific methods to measure how school vouchers affect academic outcomes for participants, and all available studies on how vouchers affect outcomes in public schools. Contrary to the widespread claim that vouchers do not benefit participants and hurt…
Mendes-Victor, L.; Vieira, G.; Xavier, J.; Canario, A.
Before the International Polar Year, in Portugal polar research was conducted by a very small group of scientists integrated in foreign projects or research institutions. Portugal was not member of the Scientific Committee for Antarctic Research (SCAR), the European Polar Board (EPB), neither a subscriber of the Antarctic Treaty. In 2004 Portuguese Polar researchers considered the IPY as an opportunity to change this situation and organized the national Committee for the IPY. The objectives were ambitious: to answer the aforementioned issues in defining and proposing a National Polar Programme. In late 2008, close to the end of the IPY, the objectives were attained, except the Antarctic Treaty signature that is, however, in an advanced stage, having been approved by consensus at the National Parliament in early 2007. Portugal joined SCAR in July 2006, the EPB in 2007 and a set of 5 Antarctic research projects forming the roots of the National Polar Programme (ProPolar) have been approved by the Foundation for Science and Technology (FCT-MCTES). Scientifically, the IPY can already be considered a major success in Portugal with an improvement in polar scientific research, in the number of scientists performing field work in the Antarctic, organizing polar science meetings and producing an expected increase in the number of polar science peer- reviewed papers. The Portuguese IPY scientific activities were accompanied by a major education and outreach project funded by the Agencia Ciência Viva (MCTES): LATITUDE60! Education for the Planet in the IPY. This project lead by the universities of Algarve, Lisbon and by the Portuguese Association of Geography Teachers is heavily interdisciplinary, programmed for all ages, from kindergarten to adults, and hoped to bring together scientists and society. LATITUDE60! was a major success and focussed on showing the importance of the polar regions for Earth's environment, emphasising on the implications of polar change for
Stucki, Virpi; Smith, Mark
The relationship of forests in water quantity and quality has been debated during the past years. At the same time, focus on climate change has increased interest in ecosystem restoration as a means for adaptation. Climate change might become one of the key drivers pushing integrated approaches for natural resources management into practice. The National Adaptation Programme of Action (NAPA) is an initiative agreed under the UN Framework Convention on Climate Change. An analysis was done to find out how widely ecosystem restoration and integrated approaches have been incorporated into NAPA priority adaptation projects. The data show that that the NAPAs can be seen as potentially important channel for operationalizing various integrated concepts. Key challenge is to implement the NAPA projects. The amount needed to implement the NAPA projects aiming at ecosystem restoration using integrated approaches presents only 0.7% of the money pledged in Copenhagen for climate change adaptation.
This paper explores the origins of the Diet, Nutrition and Cancer Programme (DNCP) of the National Cancer Institute (NCI) and its fate under its first director, Gio Batta Gori. The DNCP is used to explore the emergence of federal support for research on diet, nutrition and cancer following the 1971 Cancer Act, the complex relations between cancer prevention and therapeutics in the NCI during the 1970s, the broader politics around diet, nutrition and cancer during that decade, and their relations to Senator George McGovern's select committee on Nutrition and Human Needs. It also provides a window onto the debates and struggles over whether NCI research should be funded by contracts or grants, the nature of the patronage system within the federal cancer research agency, how a director, Gio Gori, lost patronage within that system and how a tightening of the budget for cancer research in the mid-to-late 1970s affected the DNCP.
Liu, Z.; Milich, L.; Teng, W.; Rui, H.; Kempler, S.
This presentation will describe our collaborative work with the World Food Programme of the United Nations, including web-based information services and tools to address global and regional water related issues, such as, floods and droughts. Set-up in 1963, the World Food Programme (WFP) is the United Nations frontline agency in the fight against global hunger. WFP depends on donors worldwide. The United States of America has been the largest donor. Natural disasters, such as, floods and droughts, occur every year in third world countries and often require emergency food aid. Moving large quantities of foods is not an easy task. Time and planning are required. Accurate and timely environmental information will facilitate decision-making and food distribution and maximize the use of contributions. Few observational data are available for disaster monitoring in remote and poor countries. Satellite observations provide a unique way in providing such data from space. The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) and Dr. Lenard Milich of WFP have been collaborating for the past three years on ways to integrate Tropical Rainfall Measuring Mission (TRMM) data into forward planning exercises for establishing geographic areas (e.g., sub-equatorial Africa, Indonesia, and North Korea) in need of food assistance. To monitor and assess current conditions, the GES DISC has developed a number of rainfall products derived from TRMM and online based tools to facilitate data and information access. These tools will not only benefit the WFP decision-making activities, but also other local agencies and the general public. All data and services are web-based to minimize the cost for data accessing and maximize the use of global rainfall data products.
van Lier, A; Oomen, P; de Hoogh, P; Drijfhout, I; Elsinghorst, B; Kemmeren, J; Conyn-van Spaendonck, M; de Melker, H
Vaccination coverage is an important performance indicator of any national immunisation programme (NIP). To monitor the vaccination coverage in the Netherlands, an electronic national immunisation register called ‘Præventis’ was implemented in 2005. Præventis has a link with the population register and can produce letters of invitation for the NIP, register and validate administered vaccinations. The database is used to monitor the vaccination process, produce reminder letters, control the stock of vaccines and provides information used for paying the fees to the different executive organisations involved. Præventis provides a crucial tool for the evaluation of the NIP by producing (sub)national vaccination coverage estimates with high accuracy and allowing additional research: identifying populations at high risk for low coverage based on existing data, conducting specific studies where individuals included in the immunisation register are approached for further research, using vaccination coverage data for the interpretation of (sero)surveillance data, and linking the immunisation register with disease registers to address vaccine safety or vaccine effectiveness. The ability to combine Præventis data with data from other databases or disease registers and the ability to approach individuals with additional research questions offers opportunities to identify areas of priority for improving the Dutch NIP.
Jacob, Anil G; Lal, Pranay G; Buragohain, Anita
The United Nations Development Programme's (UNDP) position on non-communicable diseases (NCDs) is undermined by a key issue at the global institutional level. Fundamentally, the nature of the relationship between international development agencies and the tobacco industry is at odds with the professed public health priorities of the former. At its core, the business model of the tobacco industry is premised on the sale of addictive and disease-causing substances that fuel NCDs in the first place. The role of the United Nations system and, in particular, UNDP is to 'build nations that can withstand crisis', not to collaborate with entities that profit from crises. This simple and well-established fact cannot be overlooked. We outline an array of conflict of interests. If the effects of NCDs are ever to be reversed, then international agencies such as the UNDP ought to adhere to ethical standards in choosing partners and avoid conflict of interests. In the absence of this, the UNDP may well compromise its own agenda and proliferate NCDs rather than containing them.
Wazir, Mohammad Salim; Iqbal, Shahid
Rubella is a mild infection of childhood and young adults with 75% of cases occurring in age group 15-45 years. In unvaccinated populations, rubella usually occurs in spring with epidemics in 6-9 years cycles. Rubella has devastating effects on growing foetus if contracted by women in the first trimester of pregnancy. Perinatal infection of Rubella contributes to 2-3% of all congenital anomalies. Over the past three decades many resource risk countries have introduced universal or selective immunization programs against rubella with evidence that such interventions reduce the incidence of congenital rubella syndrome. In Pakistan the schedules of the Expanded Program on Immunization (EPI) do not include immunization against rubella and evidence is needed to estimate the risk of congenital rubella with a view to start immunization programmes to combat the menace of Congenital Rubella Syndrome (CRS). Logistically it is easy to add rubella vaccine to the already existing EPI schedules as measles is given on 9th and 15 month with little implications for cost, resulting in great reduction in CRS.
Internationalisation processes have accelerated the implementation of English-medium programmes (EMPs) across European higher education institutions. The field of business and management studies has been particularly affected by this trend (Wachter & Maiworm 2008: 46) with numerous new EMPs introduced each year. This paper presents key…
Boateng, Cyril D.; Bensah, Edem Cudjoe; Ahiekpor, Julius C.
Chemical engineers have played key roles in the growth of the chemical and allied industries in Ghana but indigenous industries that have traditionally been the domain of the informal sector need to be migrated to the formal sector through the entrepreneurship and innovation of chemical engineers. The Higher National Diploma Chemical Engineering…
The United Nations University (UNU) is an international academic organization which brings together leading international scholars to tackle world problems. This article describes for South African scholars, institutions, governments, and their agencies the importance of the work being undertaken by the UNU and encourages their participation. (EV)
Braimoh, Dele; Adeola, O. A.; Lephoto, H. M.
Discussion of part-time distance education for adult learners in Africa focuses on an evaluation of an adult education degree program at the National University of Lesotho (South Africa). Topics include program management; characteristics of adult learners; program delivery; performance assessment; gender differences; and socio-metric variables.…
Daigneault, Adam J; Eppink, Florian V; Lee, William G
National scale initiatives are being attempted in New Zealand (NZ) to meet important environmental goals following land-use intensification over recent decades. Riparian restoration to filter agricultural spillover effects is currently the most widely practised mitigation measure but few studies have investigated the cumulative value of these practices at a national level. We use an applied economic land use model the benefits (GHG emissions, N leaching, P loss, sedimentation and biodiversity gain) and relevant costs (fencing, alternative stock water supplies, restoration planting and opportunity costs) of restoring riparian margins (5-50 m) on all streams in NZ flowing through current primary sector land. Extensive sensitivity analysis reveals that depending on margin width and cost assumptions, riparian margin restoration generates net benefits of between NZ$1.7 billion - $5.2 billion/yr and benefit-cost ratios ranging between 1.4 and 22.4. This suggests that even when not monetising the increase in biodiversity or components of stream ecosystem health and other benefits from planting riparian strips, the benefits to climate and freshwater are significantly greater than the implementation costs of riparian restoration.
... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Leasing units to voucher holders. 401.556 Section 401.556 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Implementation of the Restructuring Plan After Closing § 401.556 Leasing units...
... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Leasing units to voucher holders. 401.556 Section 401.556 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Implementation of the Restructuring Plan After Closing § 401.556 Leasing units...
... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Leasing units to voucher holders. 401.556 Section 401.556 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Implementation of the Restructuring Plan After Closing § 401.556 Leasing units...
Egalite, Anna J.
Studies of the competition effects from voucher or tuition tax credit scholarship programs on public school student academic outcomes have taken place in seven locations throughout the United States, with the majority of studies taking place in Florida, followed by Wisconsin. This article reviews 21 total studies of the impacts on student academic…
Fuller, Howard; Caire, Kaleem
This report suggests that organized opponents of tax-supported school vouchers purposely issue inaccurate statements about parental school choice, suggesting that their widespread efforts seriously contaminate discussion of this policy issue. Section one suggests that a "big lie" strategy is being used by organized school voucher…
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Leasing units to voucher holders. 401.556 Section 401.556 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Implementation of the Restructuring Plan After Closing § 401.556 Leasing units...
Witte, John F.
This article proposes that states create low-income targeted voucher programs for 3- and/or 4-year-olds. The basis for this proposal is considerable research demonstrating long-term effects for a number of random assignment and quasi-experimental preschool programs. Benefit-costs rates of return for these programs are between $2 and $16 for every…
Beabout, Brian R.; Cambre, Belinda M.
Set in the context of a choice-saturated public school system, this study examines the school choice process of low-income parents who participated in Louisiana's 2008 voucher program. Based on semistructured interviews with 16 parents at 1 Catholic school, we report that spirituality, small class and school size, character/values, familiarity,…
Filer, Randall K.; Munich, Daniel
The post-communist Czech Republic provides a laboratory in which to investigate possible responses to the adoption of universal education vouchers. Private schools appear to have arisen in response to distinct market incentives. They are more common in fields where public school inertia has resulted in an under-supply of available slots. They are…
Walsh, Mark; Gehring, John; Gewertz, Catherine; Zehr, Mary Ann; Robelen, Eric W.
These articles highlight reactions to the U.S. Supreme Court's landmark ruling upholding the Cleveland voucher program. "Justices Settle Case, Nettle Policy Debate" (Mark Walsh) discusses how the ruling has rejuvenated the school choice movement and reinvigorated debates over how best to improve education for all students. "Voucher…
Hart, Cassandra M. D.
This study examines public school characteristics, and public and private school market characteristics, associated with participation among elementary-aged students in a means-tested school voucher program in Florida. Participants are more likely than eligible nonparticipants to come from disadvantaged public schools on multiple dimensions. On…
Szanto, Hubert S.
Examines the impact the Coons and Sugarman voucher plan would have on both private and public schools. Expresses fear that religious schools would have to abandon their affiliations and that public schools would become dumping grounds for disorderly and low achieving students. (IRT)
Belfield, Clive; Levin, Henry M.
The economic model of education policy assumes that there is a substantial consensus on educational goals among constituencies and that the major challenge is to determine the most effective strategies for reaching those goals. Unfortunately, the debate over educational vouchers is complicated by the presence of multiple and competing goals, and…
... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Leasing units to voucher holders. 401.556 Section 401.556 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Implementation of the Restructuring Plan After Closing § 401.556 Leasing units...
Lowe, Robert, Ed.; Miner, Barbara, Ed.
A voucher system of schooling would destroy the few democratic gains made in public education in recent years, worsen inequalities that already permeate education, and block opportunities for meaningful reform. Articles included in this special issue are: (1) an introduction, "Why We Are Publishing False Choices" ("Rethinking…
Chingos, Matthew M.; Peterson, Paul E.
In 1996, Cardinal John J. O'Connor, archbishop of New York, proposed to Rudy Crew, chancellor of the New York City public school system, that the city's most troubled public-school students be sent to Catholic schools, where he would see that they were given an education. New York City's mayor at that time, Rudolph Giuliani, a voucher supporter,…
De Melker, H. E.; Conyn-van Spaendonck, M. A.
Mass vaccination can change the epidemiological dynamics of infectious diseases. It may result in a limited persistence of natural and vaccine-induced immunity and a higher mean age of infection, which may lead to a greater risk of complications. The epidemiological situation should be monitored and immunosurveillance based on the assessment of specific antibodies against vaccine-preventable diseases in human serum is one of the tools. In order to estimate the immunity of the Dutch population reliably, a large-scale, population-based, collection of serum samples was established (8359 sera in a nation-wide sampling and 1589 sera from municipalities with low vaccine coverage). In contrast to collecting residual sera from laboratories, this approach gains extensive information by means of a questionnaire regarding the determinants of the immune status and the risk factors for the transmission of infectious diseases in general. The population-based approach gives a better guarantee that the data are representative than collecting sera from laboratories does. PMID:10030714
Wright, Caradee Y; Reeder, Anthony I; Albers, Patricia N
Interventions in primary schools that increase sun-protective behaviours and decrease ultraviolet radiation exposure, sunburn incidence and skin cancer risk can be effective. SunSmart School Accreditation Programmes (SSAP) are recommended. Prior to SSAP implementation in South Africa, we explored the feasibility of obtaining national baseline information and investigated possible associations between strategies regarding sun protection in schools and students' responses to a questionnaire. Principals from randomly selected urban government schools in all nine South African provinces completed a questionnaire and 679 students were surveyed. The mean sun-related knowledge and behaviour scores of students were 4 (range: 1-7) and 3 (range-0-8) out of 9, respectively. The mean school sun protection effort score was 4 out of 14. There were no statistically significant correlations between students' knowledge or behaviour scores and their school score. The World Health Organization recommends an SSAP to address policy, practice and curriculum changes to support sun protection of students. This cross-sectional study demonstrates the feasibility of, and need for, a larger baseline study with longitudinal, multi-variable follow-up which includes other influential factors, such as parent support. Such research could quantify the impact of the SSAP and identify which key factors influence the sun-related knowledge and behaviours of students.
Nnyanzi, Lawrence Achilles
The aim of this study was to explore the reactions of children aged 10-11 years towards being weighed and measured and subsequently told their correct weight as part of the National Child Measurement Programme (NCMP). The study was undertaken in primary schools in a Primary Care Trust (PCT) in the North East of England, UK. One-to-one semi-structured interviews were conducted post-NCMP measurement (and the feedback) with a sample of 21 children, aged 10-11 years, conveniently sampled from the primary schools in the PCT. Findings from the study indicate that the NCMP, especially the weight feedback letter caused annoyance, panic and worry among children who were indicated to have weight problems and oversensitised all children about weight issues, regardless of their weight category. The NCMP is a potentially useful 'wake-up call' to the fact that something needs to be done for children identified to be overweight or obese but needs to be delivered with a sensitivity to the impact of the news on the child.
Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie
Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers.
Obembe, Taiwo A.; Osungbade, Kayode O.; Ademokun, Oluwakemi M.
Background: The awareness, knowledge, and involvement of teachers in the implementation of School Health Programme (SHP) in secondary schools are essential in ensuring the effectiveness and overall success of the School Health Policy. This study assessed the awareness and knowledge of teachers on SHP in Ibadan metropolis. Methods: A descriptive cross-sectional study was carried out using a two-stage sampling technique to select 426 secondary school teachers across all the five Urban Local Government Areas (LGAs) in Ibadan metropolis by balloting. Pretested semi-structured questionnaires were used to collect data from 426 teachers. Quantitative data were analyzed using descriptive statistics, Chi-square, and logistics regression tests at 5% level of significance. Results: About one-third of the respondents had heard of National School Health Policy (NSHP); however, few had seen the document. About half of the respondents were aware of the SHP in their schools. Many of the respondents had a good knowledge of SHP. Age and level of education of participants significantly influenced the knowledge of SHP. Above 50 years of age and postgraduate qualification were the significant predictors for the good knowledge of SHP. Conclusions: Awareness of the NSHP was low despite the good knowledge of SHP. This could be due to the tertiary education that most of the respondents had. Concerted efforts of stakeholders are required to intensify the health education awareness campaign to improve teachers’ knowledge based on NSHP. PMID:27630385
Secades-Villa, Roberto; García-Rodríguez, Olaya; García-Fernández, Gloria; Sánchez-Hervás, Emilio; Fernandez-Hermida, José R; Higgins, Stephen T
The aims of this study were to assess the effectiveness of the Community Reinforcement Approach (CRA) plus vouchers treatment in a cohort of Spanish cocaine-dependent outpatients, and to examine the maintenance of treatment effects after the voucher intervention was discontinued. Sixty-four adult outpatients were randomly assigned to one of two treatment conditions, CRA plus vouchers or standard care. The vouchers program was implemented from weeks 1 to 24. Among patients assigned to the CRA plus vouchers condition, 65.5% completed 12 months of treatment versus 28.6% of those assigned to the standard care condition (p = .003). At the 12-month assessment, 58.6% of patients assigned to the CRA plus vouchers condition were abstinent, compared with 25.7% in the standard care condition (p = .008); furthermore, 34.5% of patients assigned to the CRA plus vouchers condition achieved twelve months of continuous cocaine abstinence, versus 17.1% in the standard care condition. Those treated in the CRA plus vouchers condition also achieved greater improvements in psychosocial functioning than those treated in the standard care condition. Overall, these results reveal an extension of the effectiveness of the CRA plus vouchers treatment to a community sample of cocaine-dependent outpatients, while also supporting the maintenance of treatment effects for 6 months after completion of the voucher program.
Background Theory-based evaluation (TBE) approaches are heralded as supporting formative evaluation by facilitating increased use of evaluative findings to guide programme improvement. It is essential that learning from programme implementation is better used to improve delivery and to inform other initiatives, if interventions are to be as effective as they have the potential to be. Nonetheless, few studies describe formative feedback methods, or report direct instrumental use of findings resulting from TBE. This paper uses the case of Scotland’s, National Health Service, early years’, oral health improvement initiative (Childsmile) to describe the use of TBE as a framework for providing feedback on delivery to programme staff and to assess its impact on programmatic action. Methods In-depth, semi-structured interviews and focus groups with key stakeholders explored perceived deviations between the Childsmile programme 'as delivered’ and its Programme Theory (PT). The data was thematically analysed using constant comparative methods. Findings were shared with key programme stakeholders and discussions around likely impact and necessary actions were facilitated by the authors. Documentary review and ongoing observations of programme meetings were undertaken to assess the extent to which learning was acted upon. Results On the whole, the activities documented in Childsmile’s PT were implemented as intended. This paper purposefully focuses on those activities where variation in delivery was evident. Differences resulted from the stage of roll-out reached and the flexibility given to individual NHS boards to tailor local implementation. Some adaptations were thought to have diverged from the central features of Childsmile’s PT, to the extent that there was a risk to achieving outcomes. The methods employed prompted national service improvement action, and proposals for local action by individual NHS boards to address this. Conclusions The TBE approach
Haggart, S. A.; Furry, W. S.
This Working Note documents the first year's events and outcomes in developing the budgeting system and resource allocation rules to support the Education Voucher Demonstration. The district now has systems for per pupil resource allocation and school/minischool cost center accounting. The basic voucher of $1,041 for grades 7-8, and $788 for…
This paper analyzes the impact of voucher design on student sorting in the application and enrollment phases of parental choice. More specifically, it investigates whether there are feasible ways of designing vouchers that can reduce or eliminate student sorting in these phases. Much of the existing literature investigates the question of…
Godin, K; Leatherdale, S T; Elton-Marshall, T
First Nations, Inuit and Métis (FNIM) youth are disproportionately affected by obesity and represent known a high-risk group in Canada. School-based prevention programmes may have the potential to effectively influence obesity-related health behaviours (i.e. healthy eating and physical activity) among this population. We conducted a systematic review of nine electronic databases (2003-2014) to identify studies that describe school-based programmes that have been developed to improve obesity-related health behaviours and outcomes among FNIM youth in Canada. The objectives of this review were to identify and evaluate the effectiveness of these programmes and assess the strength of the methodologies used to evaluate them. Fifteen studies, representing seven distinct interventions, met our inclusion criteria. The majority of these programmes did not result in significant improvements in outcomes related to obesity, healthy eating, or physical activity among FNIM youth. The studies varied in design rigour and use of evaluation activities. The lack of literature on effective school-based programmes for FNIM youth in Canada that target obesity-related outcomes highlights a priority area for future intervention development, evaluation and dissemination within the peer-reviewed literature. Further research is needed on interventions involving Métis and Inuit youth, secondary school-aged FNIM youth and FNIM youth living in urban settings.
Haverkate, M; D'Ancona, F; Giambi, C; Johansen, K; Lopalco, P L; Cozza, V; Appelgren, E
This report provides an updated overview of recommended and mandatory vaccinations in the European Union (EU), Iceland and Norway, considering the differences in vaccine programme implementation between countries. In 2010, the Vaccine European New Integrated Collaboration Effort (VENICE) network, conducted a survey among the VENICE project gatekeepers to learn more about how national vaccination programmes are implemented, whether recommended or mandatory. Information was collected from all 27 EU Member States, Iceland and Norway. In total 15 countries do not have any mandatory vaccinations; the remaining 14 have at least one mandatory vaccination included in their programme. Vaccination against polio is mandatory for both children and adults in 12 countries; diphtheria and tetanus vaccination in 11 countries and hepatitis B vaccination in 10 countries. For eight of the 15 vaccines considered, some countries have a mixed strategy of recommended and mandatory vaccinations. Mandatory vaccination may be considered as a way of improving compliance to vaccination programmes. However, compliance with many programmes in Europe is high, using only recommendations. More information about the diversity in vaccine offer at European level may help countries to adapt vaccination strategies based on the experience of other countries. However, any proposal on vaccine strategies should be developed taking into consideration the local context habits.
Cronje, Johannes C.
This article tells the story of the design, development and presentation of eighteen months of coursework for a Master's degree programme in Computer-Integrated education at the Sudan University of Science and Technology in Khartoum from 2002 to 2004. The focus is on what was learnt in adapting a programme presented at the University of Pretoria…
Kivela, Jari; Haldre, Kai; Part, Kai; Ketting, Evert; Baltussen, Rob
Policy-makers making decisions on the implementation of school-based sexuality education (SE) programmes face two important questions: (1) what are the costs of implementing and scaling up SE programmes, and (2) what are the impacts? This paper responds to these questions by retrospectively assessing costs, impact and cost-effectiveness of the…
Manickam, Ponnaiah; Mehendale, Sanjay M.; Nagaraju, Bathyala; Katoch, Kiran; Jamesh, Abdul; Kutaiyan, Ramalingam; Jianping, Shen; Mugudalabetta, Shivakumar; Jadhav, Vitthal; Rajkumar, Prabu; Padma, Jayasree; Kaliaperumal, Kanagasabai; Pannikar, Vijayakumar; Krishnamurthy, Padabettu; Gupte, Mohan D.
Background & objectives: Uniform therapy for all leprosy patients will simplify leprosy treatment. In this context, we evaluated six-month multidrug therapy (MDT) currently recommended for multibacillary (MB) patients as uniform MDT (U-MDT) in a single-arm open trial under programme conditions. Primary objective was to determine efficacy to prevent five-year cumulative five per cent relapse. Secondary objectives were to assess acceptability, safety and compliance. Methods: Newly detected, treatment-naive leprosy patients were enrolled in India (six sites) and P. R. China (two sites). Primary outcome was clinically confirmed relapse of occurrence of one or more new skin patches consistent with leprosy, without evidence of reactions post-treatment. Event rates per 100 person years as well as five-year cumulative risk of relapse, were calculated. Results: A total of 2091 paucibacillary (PB) and 1298 MB leprosy patients were recruited from the 3437 patients screened. Among PB, two relapsed (rate=0.023; risk=0.11%), eight had suspected adverse drug reactions (ADRs) (rate=0.79) and rate of new lesions due toreactions was 0.24 (n=23). Rates of neuritis, type 1 and type 2 reactions were 0.39 (n=37), 0.54 (n=51) and 0.03 (n=3), respectively. Among MB, four relapsed (rate=0.07; risk=0.37%) and 16 had suspected ADR (rate=2.64). Rate of new lesions due to reactions among MB was 1.34 (n=76) and rates of neuritis, type 1 and type 2 reactions were 1.37 (n=78), 2.01 (n=114) and 0.49 (n=28), respectively. Compliance to U-MDT was 99 per cent. Skin pigmentation due to clofazimine was of short duration and acceptable. Interpretation & conclusions: We observed low relapse, minimal ADR and other adverse clinical events. Clofazimine-related pigmentation was acceptable. Evidence supports introduction of U-MDT in national leprosy programmes. [CTRI No: 2012/ 05/ 002696] PMID:28256460
Bouttell, Janet; Barnsdale, Lee; Mackay, Daniel; Lewsey, Jim; Hunter, Carole; Robinson, Mark
Abstract Background and Aims It has been suggested that distributing naloxone to people who inject drugs (PWID) will lead to fewer attendances by emergency medical services at opioid‐related overdose incidents if peer administration of naloxone was perceived to have resuscitated the overdose victim successfully. This study evaluated the impact of a national naloxone programme (NNP) on ambulance attendance at opioid‐related overdose incidents throughout Scotland. Specifically, we aimed to answer the following research questions: is there evidence of an association between ambulance call‐outs to opioid‐related overdose incidents and the cumulative number of ‘take‐home naloxone’ (THN) kits in issue; and is there evidence of an association between ambulance call‐outs to opioid‐related overdose incidents in early adopter (pilot) or later adopting (non‐pilot) regions and the cumulative number of THN kits issued in those areas? Design Controlled time–series analysis. Setting Scotland, UK, 2008–15. Participants Pre‐NNP implementation period for the evaluation was defined as 1 April 2008 to 31 March 2011 and the post‐implementation period as 1 April 2011 to 31 March 2015. In total, 3721 ambulance attendances at opioid‐related overdose were recorded for the pre‐NNP implementation period across 158 weeks (mean 23.6 attendances per week) and 5258 attendances across 212 weeks in the post‐implementation period (mean 24.8 attendances per week). Intervention Scotland's NNP; formally implemented on 1 April 2011. Measurements Primary outcome measure was weekly incidence (counts) of call‐outs to opioid‐related overdoses at national and regional Health Board level. Data were acquired from the Scottish Ambulance Service (SAS). Models were adjusted for opioid replacement therapy using data acquired from the Information Services Division on monthly sums of all dispensed methadone and buprenorphine in the study period. Models were adjusted further
Finance Travel Voucher Q-GERT Productivity Personnel Forecasts Simulation Model 20. ABSTRACT (Continue on reverse side if necessary end Jdentfly by...Finance Office (ACF) has devised a Point System for use in determining the productivity of the ACF Travel Section (ACFTT). This Point System sets values...5 to 5+) to be assigned to incoming travel vouchers based on voucher complexity. This research had set objectives of (1) building an ACFTT model that
Sharma, Surendra K.; Mohan, Alladi; Chauhan, L.S.; Narain, J.P.; Kumar, P.; Behera, D.; Sachdeva, K.S.; Kumar, Ashok
Medical college faculty, who are academicians are seldom directly involved in the implementation of national public health programmes. More than a decade ago for the first time in the global history of tuberculosis (TB) control, medical colleges of India were involved in the Revised National TB Control Programme (RNTCP) of Government of India (GOI). This report documents the unique and extraordinary course of events that led to the involvement of medical colleges in the RNTCP of GOI. It also reports the contributions made by the medical colleges to TB control in India. For more than a decade, medical colleges have been providing diagnostic services (Designated Microscopy Centres), treatment [Directly Observed Treatment (DOT) Centres] referral for treatment, recording and reporting data, carrying out advocacy for RNTCP and conducting operational research relevant to RNTCP. Medical colleges are contributing to diagnosis and treatment of human immunodeficiency virus (HIV)-TB co-infection and development of laboratory infrastructure for early diagnosis of multidrug-resistant and/or extensively drug-resistant TB (M/XDR-TB) and DOTS-Plus sites for treatment of MDR-TB cases. Overall, at a national level, medical colleges have contributed to 25 per cent of TB suspects referred for diagnosis; 23 per cent of ‘new smear-positives’ diagnosed; 7 per cent of DOT provision within medical college; and 86 per cent treatment success rate among new smear-positive patients. As the Programme widens its scope, future challenges include sustenance of this contribution and facilitating universal access to quality TB care; greater involvement in operational research relevant to the Programme needs; and better co-ordination mechanisms between district, state, zonal and national level to encourage their involvement. PMID:23563371
Stoner, T J; Dowd, B; Carr, W P; Maldonado, G; Church, T R; Mandel, J
OBJECTIVE: To determine the effect of a voucher for free mammography on compliance with recommended mammography screening guidelines. STUDY DESIGN: Vouchers for free mammography distributed to a random sample of women over the age of 50 in two rural southern Minnesota counties. The vouchers were good for one year. Baseline and follow-up data were collected and rates of compliance with current mammography guidelines were observed for the voucher group and a control group of women living in the same counties. METHODS: Logistic regression models were used to estimate the effect of the voucher on compliance with mammography guidelines and the impact of factors potentially influencing the effectiveness of the voucher. PRINCIPAL FINDINGS: The voucher improved mammography rates primarily through increasing screening among women who were out of compliance at baseline. CONCLUSIONS: Vouchers, even when distributed randomly within a population of rural Midwestern women, can significantly improve compliance rates. Vouchers are no less effective a means of increasing screening among vulnerable women than among other women. PMID:9566175
..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM... facilities for food preparation and service, are common facilities or private facilities. (c)...
Sigmon, Stacey C; Higgins, Stephen T
Previous studies by our group have used money given contingent on abstinence to reduce drug use by individuals with schizophrenia. In this study, we examined the sensitivity of marijuana use by individuals with serious mental illness to voucher-based contingent reinforcement, which represents the first study to date investigating the efficacy of voucher incentives with this population. This within-subject reversal design consisted of three conditions: 4-week baseline, 12-week voucher intervention, and 4-week baseline. During baseline periods, subjects received 10 US dollars vouchers per urine specimen, independent of urinalysis results. During voucher intervention, only specimens testing negative for marijuana earned vouchers, with total possible earnings of 930 US dollars. Seven adults with schizophrenia or other serious mental illnesses participated in the study. The percentage of marijuana-negative specimens was significantly greater during voucher intervention than during baseline periods. These results provide evidence that marijuana use among individuals with serious mental illness is sensitive to voucher-based incentives and further support the potential feasibility of using voucher-based contingency management to reduce substance abuse in this challenging population.
... vouchers? (a) Local boards and PIC's must provide the following activities and services through vouchers or... is not a local board or a PIC, it may provide such services directly. (b) Local boards and...
... vouchers? (a) Local boards and PIC's must provide the following activities and services through vouchers or... is not a local board or a PIC, it may provide such services directly. (b) Local boards and...
... vouchers? (a) Local boards and PIC's must provide the following activities and services through vouchers or... is not a local board or a PIC, it may provide such services directly. (b) Local boards and...
Braae, Uffe Christian; Magnussen, Pascal; Harrison, Wendy; Ndawi, Benedict; Lekule, Faustin; Johansen, Maria Vang
Taenia solium is found throughout sub-Saharan Africa and co-endemic with schistosomiasis in many regions. Taenia solium leads to taeniosis and neurocysticercosis - the leading cause of preventable epilepsy globally. This study aimed to assess the effects of the National Schistosomiasis Control Programme on prevalence of taeniosis and porcine cysticercosis over a four year period in Tanzania. School-based mass drug administration (MDA) of praziquantel was carried out based on schistosomiasis endemicity. Four human and five porcine cross-sectional surveys were carried out from 2012 to 2015 in Mbozi and Mbeya district in Tanzania. Three rounds of school-based MDA of praziquantel were delivered in Mbozi and two in Mbeya. The prevalence of taeniosis and porcine cysticercosis was estimated annually. Stool samples were collected from humans and prevalence of taeniosis estimated by copro-Ag-ELISA. Blood samples from pigs were collected to estimate cysticercosis prevalence by Ag-ELISA. "Track-and-treat" of taeniosis cases was carried out after each survey. In total 12082 stool samples and 4579 porcine serum samples were collected. Significantly fewer children (≤ 15) from Mbozi were infected throughout the study than children from Mbeya who showed a significant decrease in copro-Ag prevalence after the first treatment only. During the final survey in Mbozi the prevalence of taeniosis in adults (1.8%) was significantly lower (p = 0.031, OR 0.40, CI: 0.17-0.89), compared to baseline (4.1%). The prevalence of porcine cysticercosis (8%) had also dropped significantly (p = 0.002, OR 0.49, CI: 0.32-0.76) in this district compared to baseline (13%), whereas no significant difference was seen in Mbeya compared to baseline. The study suggests that three rounds of MDA targeting schistosomiasis in school-aged children combined with 'track-and-treat' contributed to a reduction in prevalence of T. solium in this population, and also had a spillover effect on adults in treated
Kawonga, Mary; Blaauw, Duane; Fonn, Sharon
With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in
Shaul, Marnie S.
This report provides information on Cleveland's and Milwaukee's publicly funded school voucher programs, using previous research and reviews of state laws, school district and voucher program records, state budgets, voucher-related reports and articles, and site visits and interviews. Researchers examined eligibility criteria; public and voucher…
Carlson, Deven; Haveman, Robert; Kaplan, Thomas; Wolfe, Barbara
Using data on housing voucher recipients with school-aged children residing across the state of Wisconsin, we perform a three-stage analysis of the relationship between voucher receipt and the educational opportunities of children in recipient households. First, we examine the extent to which voucher receipt results in households relocating to a…
Kemerer, Frank R.
This paper discusses the legal implications of "Zelman v. Simmons-Harris," the Supreme Court ruling on education vouchers. The ruling opens the way for vouchers, as concerns the federal judiciary, but the decision did not abrogate many states' restrictive provisions regarding publicly funded voucher and tax-benefit programs. Nor did the decision…
Sullivan Brown, Kathleen
This paper examines the burden of vouchers to be all things to all constituencies. Proponents and opponents envision vouchers as accomplishing many objectives. To some, vouchers represent an educational reform that brings change to public schools and saves children from monopolistic bureaucrats. To others, they signify a threat to the very…
Eckes, Suzanne E.; Mead, Julie; Ulm, Jessica
Some private, religious schools that accept vouchers have been accused of discriminating against certain populations of students through their admissions processes. Discriminating against disfavored groups (e.g., racial minorities, LGBT students, students with disabilities, religious minorities) in voucher programs raises both legal and policy…
Describes the privately-funded voucher movement implemented by J. Patrick Rooney, James R. Leininger, Michael S. Joyce, John T. Walton, and Theodore J. Forstmann. An important feature of most of the programs is that parents have to pay partial tuition. Vouchers resources are focused on poor children in inner cities. (MMU)
Budney, Alan J.; Moore, Brent A.; Rocha, Heath L.; Higgins, Stephen T.
Ninety cannabis-dependent adults seeking treatment were randomly assigned to receive cognitive-behavioral therapy, abstinence-based voucher incentives, or their combination. Treatment duration was 14 weeks, and outcomes were assessed for 12 months post treatment. Findings suggest that (a) abstinence-based vouchers were effective for engendering…
Fleming, David J.; Mitchell, William; McNally, Michael
School voucher programs challenge the traditional role of the public school as the builder of citizens, raising the question of whether private schools can provide a civic education of equal quality. In this study, we use survey data from the Milwaukee voucher program to investigate the relative benefits in civic outcomes of attending a voucher…
Green, Preston C., III
This article provides an overview of non-religion-based state constitutional challenges to educational voucher and tax credit/scholarship programs. The first section discusses litigation examining whether education voucher programs violate constitutional provisions requiring the legislature to provide an efficient system of public schools. The…
Carlson, Deven E.; Cowen, Joshua M.
In this paper we explore the relationship between students' residential location and participation in Milwaukee's large, widely available private school voucher program. We are interested in one overarching question: do voucher schools disproportionately draw students from better public schools and city neighborhoods, or do they draw students most…
Ellen, Ingrid Gould; Horn, Keren Mertens; Schwartz, Amy Ellen
Housing choice vouchers provide low-income households with additional income to spend on rental housing in the private market. The assistance vouchers provide is substantial, offering the potential to dramatically expand the neighborhood--and associated public schools--that low-income households can reach. However, existing research on the program…
Lara, Bernardo; Mizala, Alejandra; Repetto, Andrea
In this article the authors analyze the effect of private voucher education on student academic performance using new data on Chilean students and a novel identification strategy. Most schools in Chile provide either primary or secondary education. The authors analyze the effect of private voucher education on students who are forced to enroll at…
Coulson, Andrew J.
This paper compares voucher and tax credit programs on how well they manifest the necessary conditions for market education and allow all families to participate in that market. Voucher programs include targeted and universal programs. The tax credit proposal is a nonrefundable, education credit composed of: a parental choice credit for taxpayers…
Chingos, Matthew M.; Peterson, Paul E.
In the first study, using a randomized experiment to measure the impact of school vouchers on college enrollment, Matthew Chingos and Paul Peterson, professor of government at Harvard University, examine the college-going behavior through 2011 of students who participated in a voucher experiment as elementary school students in the late 1990s.…
State-funded voucher programs have stoked political controversy, culture clashes, and pitched court battles. Sometimes referred to as "scholarships," these vouchers enable students of limited means (or without access to a good public school) to attend a private school. Roughly 30,000 children in Ohio take advantage of a publicly funded…
Petry, Nancy M.; Alessi, Sheila M.; Hanson, Tressa; Sierra, Sean
Contingency management (CM) interventions frequently utilize vouchers as reinforcers, but a prize-based system is also efficacious. This study compared these approaches. Seventy-four cocaine-dependent methadone outpatients were randomly assigned to standard treatment (ST), ST plus a maximum of $585 in contingent vouchers, or ST plus an expected…
... based on direct measurement of the work actually performed by voucher administrators. The study will... the costs involved in each task, including salaries, benefits, and overhead. Ultimately, the findings... on direct measurement of the work actually performed by voucher administrators. The study...
Recent research on statewide voucher programs in Louisiana and Indiana has found that public school students that received vouchers to attend private schools subsequently scored lower on reading and math tests compared to similar students that remained in public schools. The magnitudes of the negative impacts were large. A case to use taxpayer…
Petry, Nancy M.; Alessi, Sheila M.; Marx, Jacqueline; Austin, Mark; Tardif, Michelle
Contingency management (CM) interventions usually use vouchers as reinforcers, but a new technique awards chances of winning prizes. This study compares these approaches. In community treatment centers, 142 cocaine- or heroin-dependent outpatients were randomly assigned to standard treatment (ST), ST with vouchers, or ST with prizes for 12 weeks.…
In this article, Jim Carl uses archival sources and interviews to chronicle the effort to bring school vouchers to New Hampshire. In 1973, the New Hampshire Department of Education initiated a plan, funded by the U.S. Office of Economic Opportunity, to institute vouchers in a handful of school districts. Though the initiative had the support of…
... Regulation Supplement; DoD Voucher Processing AGENCY: Defense Acquisition Regulations System, Department of Defense (DoD). ACTION: Proposed rule. SUMMARY: DoD is proposing to amend the Defense Federal Acquisition Regulation Supplement (DFARS) to update DoD's voucher processing procedures and better accommodate the use...
Osipian, Ararat L.
Higher education in Russia is currently being reformed. A standardized computer-graded test and educational vouchers were introduced to make higher education more accessible, fund it more effectively, and reduce corruption in admissions to public colleges. The voucher project failed and the test faces furious opposition. This paper considers…
Agasisti, Tommaso; Barbieri, Gianna; Murtinu, Samuele
This article estimates the effect of an administrative change in a voucher policy implemented by an Italian Regional government. The voucher was initiated in 2000, and is intended to help families that want to enroll their children in private schools. In 2008, the policy was changed, making the administrative procedure required for obtaining the…
... URBAN DEVELOPMENT Housing Choice Voucher (HCV) Family Self-Sufficiency (FSS) Program AGENCY: Office of... Voucher Program) with public and private resources to enable eligible families to achieve economic...; enter into a Contract of Participation with each eligible family that opts to participate in the...
Shafiq, M. Najeeb
A targeted educational voucher scheme (TEVS) is often proposed for the poor in developing countries. Essentially, TEVS involves issuing vouchers to poor households, thus enabling them to pay tuition and fees for their children's schooling at participating non-public schools. However, little is known about TEVS' design in developing countries. This…
This book reveals that, far from being the result of a groundswell of support for parental choice in American education, the origins of school vouchers are seated in identity politics, religious schooling, and educational entrepreneurship. As the most radical form of "school choice," vouchers remain controversial in education today. The U.S.…
Mavunga, George; Cachalia, Fahmida
This study compared how the cohort of extended diploma students enrolled at a comprehensive South African university in 2012 perceived the programmes for which they were enrolled at the beginning of their first year and towards the end of the year. Data were gathered using questionnaires and semi-structured interviews involving students enrolled…
This commentary is in response to Tim Keller's article "The National Implications of 'Cain v. Horne.'" In his analysis, Keller asserts that the Arizona Supreme Court wrongfully struck down a voucher program for students with special needs by characterizing the voucher as aid to schools rather than aid to students. In this response to…
McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C
This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency.
Woolnough, Helen M; Davidson, Marilyn J; Fielden, Sandra L
This paper presents the experiences of executive and non-executive UK National Health Service (NHS) Trust directors and senior managers as mentors in a career development and mentoring programme for a cohort of 27 female mental health nurses from six NHS mental health trusts. Baseline interview data was collated from 27 mentors prior to the programme. Twenty-four mentors participated in semi-structured telephone interviews investigating their experiences of being a mentor at the end of the programme. The interview transcripts were analysed using thematic content analysis. Experience as a mentor impacted on mentors in a variety of ways and the common themes which emerged from the data included: increased understanding of the mentoring role, increased awareness of career barriers for female mental health nurses, improved ground-level insight in relation to nursing staff and the patients they care for, improved professional reputation, increased networks, new insights into organizational issues, personal enjoyment and fulfilment and desire to implement organizational change. All mentors interviewed stated that they would consider becoming a mentor again. The mentoring relationship was an invaluable learning experience for mentors and results from this study suggested that trained mentors have an important role to play as change agents in the NHS.
Kuhl, R.; Gritzner, C.; Friedrichs, D.
Mainly sounding rockets but also stratospheric balloons have played a crucial role in implementing the German Space Programme since many years. Research activities were conducted in the fields of Microgravity Research, Space Science, Earth Observation, Space Technology Development, and Education. Currently, the mesosphere and ionosphere of the Earth and the photosphere and chromosphere of the Sun are in the focus of German research activities in the field of Space Science. Microgravity related topics are studied in the disciplines of Life and Physical Sciences during ballistic TEXUS and MAPHEUS rocket flights. A lot of student activities are currently supported by the agencies SNSB and DLR under the auspices of the Swedish-German programme REXUS/BEXUS.
Harris, Stewart B.; Naqshbandi Hayward, Mariam; Tompkins, Jordan W.
Abstract Rationale, aims and objectives Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real‐world evaluation. Method Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real‐world comprehensive evaluations in health care settings. Results The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub‐steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built‐in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. Conclusions This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale‐up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. PMID:26804339
Marques, Luis; Praja, Joäo; Thompson, David
The programme Ciencia Viva of the Portuguese Ministry of Science and Technology aims to create a greater understanding of science and science education amongst scientists, teachers, school children and the general public, each of whom is encouraged to cooperate and interact through regular contacts. The purpose is to improve practical, experimental and other forms of investigative work. To accomplish such work in schools, an overview of the state of science education worldwide is presented in terms of old and new traditions of the teaching of the physical and historical sciences the latter including the teaching of fieldwork. Traditional practices are compared with those established recently in various parts of the world in which more carefully considered understanding of the nature of science and science education has been established. In illustration of good practice, an outline is offered of the nature and rationale of two sets of curricular materials. These were designed by a team comprising staff members of the University of Aveiro and secondary school teachers and were trialled in schools. These activities are concerned with the internal rock cycle and the internal energy of the Earth in relation to plate tectonic theory. They are also related to the processes of weathering, erosion, transportation and deposition of sedimentary rocks and structures (like wave and current ripple marks) which were formed as part of the external rock cycle driven by the Sun's energy. The account concludes with an outline of the sub programme 'Geology in Summer', a fieldwork programme which introduces a holistic understanding of the workings of the outer part of the Earth to the general public. Students' perspectives and teachers' views about these experiences are generally very positive and are presented at the end. The whole programme was evaluated by an international team of scientists and science educators.
Festinger, David S.; Dugosh, Karen L.; Kirby, Kimberly C.; Seymour, Brittany L.
The efficacy of contingency management (CM) for treating drug abuse is well supported. The most widely used form of CM is voucher-based reinforcement therapy (VBRT), where clients receive an escalating schedule of vouchers that can be redeemed for goods and services for meeting treatment goals. Though generally rejected due to concerns about potential harms to drug using participants, research suggests that cash may be a more effective reinforcer. This three-group randomized trial compared the efficacy of cash-based reinforcement therapy (CBRT) to VBRT and a non-CM condition on cocaine abstinence and treatment attendance; and examined whether CBRT resulted in greater levels of harm than VBRT. Findings indicated that the CBRT was as effective as VBRT when compared to the non-CM condition and that it did not increase rates of drug use, cravings, or high-risk behaviors. Future research should examine potential cost savings associated with a cash-based CM approach as this could have important implications for the wider adoption of the CM model. PMID:24746956
Festinger, David S; Dugosh, Karen L; Kirby, Kimberly C; Seymour, Brittany L
The efficacy of contingency management (CM) for treating drug abuse is well supported. The most widely used form of CM is voucher-based reinforcement therapy (VBRT), where clients receive an escalating schedule of vouchers that can be redeemed for goods and services for meeting treatment goals. Though generally rejected due to concerns about potential harms to drug using participants, research suggests that cash may be a more effective reinforcer. This three-group randomized trial compared the efficacy of cash-based reinforcement therapy (CBRT) to VBRT and a non-CM condition on cocaine abstinence and treatment attendance; and examined whether CBRT resulted in greater levels of harm than VBRT. Findings indicated that the CBRT was as effective as VBRT when compared to the non-CM condition and that it did not increase rates of drug use, cravings, or high-risk behaviors. Future research should examine potential cost savings associated with a cash-based CM approach as this could have important implications for the wider adoption of the CM model.
Stepanek, Ondrej; Horin, Petr
Of 34 breeds kept in the Czech Republic 45,604 sheep were genotyped for codons 136, 154 and 171 in the prion protein gene (PRNP) during the years 2006-2014. In this cohort, haplotypes ARR, ARQ, ARH, AHQ, VRQ, AHR and ARK were detected. The haplotype AF141RQ associated with susceptibility to atypical scrapie was observed in nine out of 30 breeds analysed for this purpose. In addition, six rare nonsynonymous substitutions producing haplotypes AT137RQ, AN138RQ, AG151RQ, AH151RQ, ARL168Q and ARQE175 were identified in various breeds. Due to their low frequencies, these polymorphisms are of no potential importance for the breeding programme. With regard to their genetic particularity, Sumavka, Valachian and Cameroon breeds were screened for additional polymorphisms. Further haplotypes, AR143RQ and AS146RQ, were found in Sumavka and Cameroon, and in Valachian sheep, respectively. Frequencies of the ARR (resistance-associated), VRQ (susceptibility-associated) haplotypes, and of the most resistant ARR/ARR genotype calculated for sheep born in the years 2001-2003 and 2011-2013 documented effects of the 10 year-lasting national breeding programme. The total frequency of ARR doubled from 36.8 to 75.8 %, while the frequency of VRQ decreased from 4 to 0.7 %. The total frequency of the ARR/ARR genotype increased from 17.7 to 59 %. These data show that the national scrapie resistance breeding programme has had an important desirable effect on haplotype and genotype frequencies of PRNP in Czech sheep.
Rodriguez-Campos, Sabrina; González, Sergio; de Juan, Lucía; Romero, Beatriz; Bezos, Javier; Casal, Carmen; Álvarez, Julio; Fernández-de-Mera, Isabel G; Castellanos, Elena; Mateos, Ana; Sáez-Llorente, José L; Domínguez, Lucas; Aranaz, Alicia
Spoligotyping and mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) analysis are the international standard techniques for molecular typing of members of the Mycobacterium tuberculosis complex. To enable the exploitation of molecular typing data for epidemiological purposes, the creation of large databases is indispensable. Here we describe mycoDB.es, a database for animal tuberculosis which forms part of the Spanish national programme for eradication of bovine tuberculosis. This database has been created as an epidemiological tool at national level and contains spoligotype patterns of 17,273 isolates clustered in 401 different spoligotypes of Mycobacterium bovis, Mycobacterium caprae and M. tuberculosis. The database offers an overview of the present spoligotypes, to a lower extent also of MIRU-VNTR types, affected animal species and furthermore of the spatial distribution of these genotypes.
Watt, Claire; Abuya, Timothy; Warren, Charlotte E; Obare, Francis; Kanya, Lucy; Bellows, Ben
This study tests the group-level causal relationship between the expansion of Kenya's Safe Motherhood voucher program and changes in quality of postnatal care (PNC) provided at voucher-contracted facilities. We compare facilities accredited since program inception in 2006 (phase I) and facilities accredited since 2010-2011 (phase II) relative to comparable non-voucher facilities. PNC quality is assessed using observed clinical content processes, as well as client-reported outcome measures. Two-tailed unpaired t-tests are used to identify differences in mean process quality scores and client-reported outcome measures, comparing changes between intervention and comparison groups at the 2010 and 2012 data collection periods. Difference-in-differences analysis is used to estimate the reproductive health (RH) voucher program's causal effect on quality of care by exploiting group-level differences between voucher-accredited and non-accredited facilities in 2010 and 2012. Participation in the voucher scheme since 2006 significantly improves overall quality of postnatal care by 39% (p=0.02), where quality is defined as the observable processes or components of service provision that occur during a PNC consultation. Program participation since phase I is estimated to improve the quality of observed maternal postnatal care by 86% (p=0.02), with the largest quality improvements in counseling on family planning methods (IRR 5.0; p=0.01) and return to fertility (IRR 2.6; p=0.01). Despite improvements in maternal aspects of PNC, we find a high proportion of mothers who seek PNC are not being checked by any provider after delivery. Additional strategies will be necessary to standardize provision of packaged postnatal interventions to both mother and newborn. This study addresses an important gap in the existing RH literature by using a strong evaluation design to assess RH voucher program effectiveness on quality improvement.
Watt, Claire; Abuya, Timothy; Warren, Charlotte E.; Obare, Francis; Kanya, Lucy; Bellows, Ben
This study tests the group-level causal relationship between the expansion of Kenya’s Safe Motherhood voucher program and changes in quality of postnatal care (PNC) provided at voucher-contracted facilities. We compare facilities accredited since program inception in 2006 (phase I) and facilities accredited since 2010-2011 (phase II) relative to comparable non-voucher facilities. PNC quality is assessed using observed clinical content processes, as well as client-reported outcome measures. Two-tailed unpaired t-tests are used to identify differences in mean process quality scores and client-reported outcome measures, comparing changes between intervention and comparison groups at the 2010 and 2012 data collection periods. Difference-in-differences analysis is used to estimate the reproductive health (RH) voucher program’s causal effect on quality of care by exploiting group-level differences between voucher-accredited and non-accredited facilities in 2010 and 2012. Participation in the voucher scheme since 2006 significantly improves overall quality of postnatal care by 39% (p=0.02), where quality is defined as the observable processes or components of service provision that occur during a PNC consultation. Program participation since phase I is estimated to improve the quality of observed maternal postnatal care by 86% (p=0.02), with the largest quality improvements in counseling on family planning methods (IRR 5.0; p=0.01) and return to fertility (IRR 2.6; p=0.01). Despite improvements in maternal aspects of PNC, we find a high proportion of mothers who seek PNC are not being checked by any provider after delivery. Additional strategies will be necessary to standardize provision of packaged postnatal interventions to both mother and newborn. This study addresses an important gap in the existing RH literature by using a strong evaluation design to assess RH voucher program effectiveness on quality improvement. PMID:25835713
Berman, Jonathan; Radhakrishna, Tanya
The Neglected Tropical Disease Voucher Program is a Congressionally-mandated program intended to promote approval of products for tropical diseases because it provides spectacular financial compensation consequent to FDA approval of a priority product. Three drug approvals–artemether/lumifantrine for malaria, bedaquiline for multidrug resistant tuberculosis, miltefosine for leishmaniasis–have received Tropical Disease Vouchers to date. We give our view of the type of products that might qualify for a Tropical Disease Voucher, financial considerations in venturing capital to support product development, clinical ramifications of a successful product approval, and an overall evaluation of the Program. PMID:27573627
Dunn, Kelly E; Sigmon, Stacey C; Thomas, Colleen S; Heil, Sarah H; Higgins, Stephen T
This study evaluated the efficacy of a contingency management (CM) intervention to promote smoking cessation in methadone-maintained patients. Twenty participants, randomized into contingent (n=10) or noncontingent (n=10) experimental conditions, completed the 14-day study. Abstinence was determined using breath carbon monoxide and urine cotinine levels. Contingent participants received voucher-based incentives for biochemical evidence of smoking abstinence. Noncontingent participants earned vouchers independent of smoking status. Contingent participants achieved significantly more smoking abstinence and longer durations of continuous smoking abstinence than did noncontingent participants. These results support the potential efficacy of using voucher-based CM to promote smoking cessation among methadone-maintained patients.
García-Fernández, Gloria; Secades-Villa, Roberto; García-Rodríguez, Olaya; Sánchez-Hervás, Emilio; Fernández-Hermida, José R; Higgins, Stephen T
This study compares the efficacy of the Community Reinforcement Approach (CRA) with and without an incentive program for cocaine-dependent patients in Spain. A total of 58 patients were randomly assigned to the CRA or CRA plus vouchers condition. In the CRA plus vouchers group, mean percentage of cocaine-negative samples was 97.07%, versus 79.76% in the no-voucher group. Those treated in the CRA plus vouchers condition also achieved greater improvements in psychosocial functioning than those treated in the CRA condition. The present results show that treatment outcome is better if incentives are delivered contingent upon the submission of cocaine-free urine specimens.
Guerra, N B; Pires, E M; Martins, G de C; Lima Filho, J B; Guerra, G N; Borges, L B; Tavares, M O; Cavalcante, M L; de Melo Filho, A B; de Oliveira, A R
The effectiveness of the Quality Control System (QCS) implemented by the Fundação de Assistência ao Escolar (FAE) for quality control of food products from different types and origins purchased by the National School-Feeding Programme (NSFP) in Pernambuco, Northeast Brazil, was evaluated. Physicochemical, microbiological, microscopical and organopetical analyses were performed in 4,860 food samples and the main causes of alterations were detected. Perishability was the characteristic used for distribution of food items into 3 main groups: A, B, and C. In accordance with 972 Quality Certificates between 1985 and 1988, 31.89 of the samples were rejected. The main reasons for rejection were innacuracies of net weight and drained weight and high moisture contents. Group B presented the smallest number of altered samples (27%); for Groups A and C these values were 33% and 44%, respectively. Our data lead to the conclusion that the QCS implemented by FAE is of paramount importance for an adequate quality control of foods provided to beneficiaries and for a good cost effectiveness of the school-feeding programme.
Hughes, A; Mesher, D; White, J; Soldan, K
The English national human papillomavirus (HPV) immunisation programme has offered vaccination to girls aged 12 years at the start of each school year since September 2008. A catch-up programme has offered vaccination to girls up to 18 years. Delivery is predominantly school-based, with some general practitioner (GP)-based immunisation. The relationship between HPV immunisation coverage and deprivation (index of multiple deprivation, IMD) was assessed by geographical area (N=151) for each school year offered the HPV vaccine between 2008 to 2011 using the Spearman’s rank correlation coefficient, and compared to that for adequate cervical screening of women aged 25 to 49 years. Coverage at age 12 showed no significant association with IMD at the area-level (p=0.12). Within the catch-up years, there was some suggestion of higher deprivation being associated with lower coverage. This was not significant for girls offered immunisation under 16 years (in compulsory education) (p=0.09), but was more marked and statistically significant for older girls (p<0.0001). The proportion of women aged 25 to 49 years with an adequate cervical screen was negatively associated with deprivation (p<0.0001). School-based HPV immunisation delivery appears to be successfully reducing inequalities in cervical cancer control at area-level. However, the catch-up cohorts above the age of compulsory education may face increased inequality. Further investigation is needed into individual-level factors associated with coverage.
Ladhani, Shamez N; Campbell, Helen; Parikh, Sydel R; Saliba, Vanessa; Borrow, Ray; Ramsay, Mary
The United Kingdom is the first country to introduce Bexsero(®) (GSK Biologicals), a multicomponent, protein-based vaccine against meningococcal group B (MenB), into the national infant immunisation programme. This vaccine is like no other licensed vaccine and poses a number of implementation and surveillance challenges in England. From 01 September 2015, UK infants were offered a reduced two dose primary immunisation schedule at 2 and 4 months followed by a booster at 12 months. Because of high rates of fever post-vaccination, parents were advised to give their infants three doses of prophylactic paracetamol, with the first dose given as soon as possible after the primary MenB vaccination dose. Since the vaccine only protects against 73-88% of MenB strains causing invasive disease in England, clinical isolates and PCR-positive samples will require extensive characterisation by the Meningococcal Reference Unit (MRU) at Public Health England (PHE) in order to monitor vaccine effectiveness and identify potential vaccine failures. PHE is also conducting detailed clinical and epidemiological surveillance to assess the impact of the MenB immunisation programme on the morbidity and mortality associated with invasive meningococcal disease in infants and young children.
Henry, Colette; Titterington, Albert; Wiseman, Kate
A partnership among Dundalk Institute of Technology (Ireland), Coca Cola, and government encourages young entrepreneurs through formal education in business management, workshops, mentoring, and financial rewards provided by the corporation's National Enterprise Award. (SK)
Glenn, Irene M; Dallery, Jesse
Nicotine replacement products are commonly used to promote smoking cessation, but alternative and complementary methods may increase cessation rates. The current experiment compared the short-term effects of a transdermal nicotine patch to voucher-based reinforcement of smoking abstinence on cigarette smoking. Fourteen heavy smokers (7 men and 7 women) completed the four 5-day phases of the study: baseline, patch treatment, voucher treatment, and return to baseline. The order of the two treatment phases was counterbalanced across participants. In the patch treatment condition, participants wore a 14-mg transdermal nicotine patch every day. In the voucher treatment condition, participants received vouchers contingent on abstinence from smoking, defined as producing carbon monoxide (CO) readings of < or =4 parts per million. Participants e-mailed two video clips per day showing them breathing into a CO monitor and the resulting CO reading to clinic staff. In the voucher treatment, 24% of samples were negative, and 5% of samples were negative in the patch treatment. Results suggest that contingent vouchers were more effective than transdermal nicotine patches in promoting abstinence.
Hall, Elizabeth A.; Prendergast, Michael L.; Roll, John M.; Warda, Umme
This study assessed a 26-week voucher-based intervention to reinforce abstinence and participation in treatment-related activities among substance-abusing offenders court referred to outpatient treatment under drug diversion legislation (California's Substance Abuse and Crime Prevention Act). Standard treatment consisted of criminal justice supervision and an evidence-based model for treating stimulant abuse. Participants were randomly assigned to four groups, standard treatment (ST) only, ST plus vouchers for testing negative, ST plus vouchers for performing treatment plan activities, and ST plus vouchers for testing negative and/or performing treatment plan activities. Results indicate that voucher-based reinforcement of negative urines and of treatment plan tasks (using a flat reinforcement schedule) showed no statistically significant effects on measures of retention or drug use relative to the standard treatment protocol. It is likely that criminal justice contingencies had a stronger impact on participants' treatment retention and drug use than the relatively low-value vouchers awarded as part of the treatment protocol. PMID:20463918
This paper explores the origins of the Diet, Nutrition and Cancer Programme (DNCP) of the National Cancer Institute (NCI) and its fate under its first director, Gio Batta Gori. The DNCP is used to explore the emergence of federal support for research on diet, nutrition and cancer following the 1971 Cancer Act, the complex relations between cancer prevention and therapeutics in the NCI during the 1970s, the broader politics around diet, nutrition and cancer during that decade, and their relations to Senator George McGovern’s select committee on Nutrition and Human Needs. It also provides a window onto the debates and struggles over whether NCI research should be funded by contracts or grants, the nature of the patronage system within the federal cancer research agency, how a director, Gio Gori, lost patronage within that system and how a tightening of the budget for cancer research in the mid-to-late 1970s affected the DNCP. PMID:23112384
The US National Science Foundation (NSF) has initiated a new funding programme that will create schemes to increase diversity in science, technology, engineering and mathematics (STEM). The initiative - Inclusion across the Nation of Communities of Learners of Underrepresented Discoverers in Engineering and Science (INCLUDES) - aims to increase the participation of women, those with a low socioeconomic status, people with disabilities and those from minority racial backgrounds.
Murhekar, M. V.; Kolappan, C.; Gopi, P. G.; Chakraborty, A. K.; Sehgal, S. C.
OBJECTIVE: To assess the tuberculosis (TB) situation in the tribal community of Car Nicobar island 15 years after the national TB programme was implemented in this area after an intensive phase of TB control in 1986. METHODS: The entire population of Car Nicobar was enumerated through a house-to-house survey. Children aged <14 years were tuberculin tested and read for reaction sizes. Individuals aged >15 years were asked about the presence of chest symptoms (cough, chest pain, and unexplained fever for two weeks or longer and haemoptysis), and sputum samples were collected from patients with chest symptoms. Sputum samples were examined for presence of acid-fast bacilli. FINDINGS: Among the 4,543 children enumerated, 4,351 (95.8%) were tuberculin tested and read. Of the 981 children without bacille Calmette-Guerin scars, 161 (16.4%) were infected with TB. A total of 77 cases who were smear-positive for TB were detected from among 10,570 people aged >15 years; the observed smear-positive case prevalence was 728.5 per 100,000. The standardized prevalence of TB infection, annual risk of TB infection, and prevalence of cases smear-positive for TB were 17.0%, 2.5%, and 735.3 per 100,000, respectively. CONCLUSION: The prevalence of TB infection and smear-positive cases of TB increased significantly between 1986 and 2002. Such escalation took place despite the implementation of the national TB programme on this island, which was preceded by a set of special anti-TB measures that resulted in sputum conversion in a substantially large proportion of the smear-positive cases prevalent in the community. The most likely reason for the increase seems to be the absence of a district TB programme with enough efficiency to sustain the gains made from the one-time initial phase of special anti-TB measures. High risk of transmission of TB infection currently observed on this island calls for a drastic and sustained improvement in TB control measures. PMID:15640919
van der Heijden, O. G.; Conyn-van Spaendonck, M. A.; Plantinga, A. D.; Kretzschmar, M. E.
In order to improve the prevention of cases of congenital rubella syndrome in The Netherlands, in 1987 the selective vaccination strategy against rubella infection in girls was replaced by mass vaccination. This decision was supported by mathematical model analyses carried out by Van Druten and De Boo. In order to compare the predicted impact of the rubella vaccination programme with the current available data in more detail, a similar model was built. Although the model predicts elimination of the rubella virus, data show that virus circulation is still present at a higher level than expected by the model. Simulation studies indicate that import of infection and a lower vaccine effectiveness, related to possible asymptomatic reinfection of vaccinated people, could be sources contributing to the present virus circulation. Even though the number of infections is much higher than the number of reported cases of disease, limited serosurveillance data and case notification data show that females of childbearing age are well protected by immunization. PMID:10030716
Scientific findings need to be verifiable and grounded in repeatability. With specimen-level research this is in part achieved with the deposition of voucher specimens. These are labeled, curated, data-based specimens that have been deposited in a collection or museum, available for verification of the work and to ensure researchers are calling the same taxa by the same names. Voucher specimens themselves are the subject of research, from the discovery of new species by taxonomists to ecologists documenting historical records of invasive species. Our objective was to quantify the frequency of voucher specimen deposition in biodiversity and community ecology research through a survey of the peer-reviewed literature about arthropods, from 1989 until 2014. Overall rates of voucher deposition were alarmingly low, at under 25%. This rate increased significantly over time, with 35% of papers reporting on vouchers in 2014. Relative to the global mean, entomological research had a significantly higher rate of voucher deposition (46%), whereas researchers studying crustaceans deposited vouchers less than 6% of the time, significantly less than the mean. Researchers working in museums had a significantly higher frequency of voucher deposition. Our results suggest a significant culture shift about the process of vouchering specimens is required. There must be more education and mentoring about voucher specimens within laboratories and across different fields of study. Principal investigators and granting agencies need a proactive approach to ensuring specimen-level data are properly, long-term curated. Editorial boards and journals can also adopt policies to ensure papers are published only if explicit statements about the deposition of voucher specimens is provided. Although the gap is significant, achieving a higher rate of voucher specimen deposition is a worthy goal to ensure all research efforts are preserved for future generations. PMID:26339546
McAuley, Andrew; Perry, Samantha; Hunter, Carole
Abstract Aims To assess the effectiveness for Scotland's National Naloxone Programme (NNP) by comparison between 2006–10 (before) and 2011–13 (after NNP started in January 2011) and to assess cost‐effectiveness. Design This was a pre–post evaluation of a national policy. Cost‐effectiveness was assessed by prescription costs against life‐years gained per opioid‐related death (ORD) averted. Setting Scotland, in community settings and all prisons. Intervention Brief training and standardized naloxone supply became available to individuals at risk of opioid overdose. Measurements ORDs as identified by National Records of Scotland. Look‐back determined the proportion of ORDs who, in the 4 weeks before ORD, had been (i) released from prison (primary outcome) and (ii) released from prison or discharged from hospital (secondary). We report 95% confidence intervals for effectiveness in reducing the primary (and secondary) outcome in 2011–13 versus 2006–10. Prescription costs were assessed against 1 or 10 life‐years gained per averted ORD. Findings In 2006–10, 9.8% of ORDs (193 of 1970) were in people released from prison within 4 weeks of death, whereas only 6.3% of ORDs in 2011–13 followed prison release (76 of 1212, P < 0.001; this represented a difference of 3.5% [95% confidence interval (CI) = 1.6–5.4%)]. This reduction in the proportion of prison release ORDs translates into 42 fewer prison release ORDs (95% CI = 19–65) during 2011–13, when 12 000 naloxone kits were issued at current prescription cost of £225 000. Scotland's secondary outcome reduced from 19.0 to 14.9%, a difference of 4.1% (95% CI = 1.4–6.7%). Conclusions Scotland's National Naloxone Programme, which started in 2011, was associated with a 36% reduction in the proportion of opioid‐related deaths that occurred in the 4 weeks following release from prison. PMID:26642424
Gor, Seth Omondi; Osoro, Kennedy O.
This study assessed the success or failure of plan implementation in Kenya by investigating the extent to which planned estimates for educational projects were actually attained. Using six sets of five-year national development plans, we calculated an implementation ratio for each program showing actual expenditure as a ratio of planned…
Surveillance is a key component of the French plan for prevention of healthcare-associated infection (HAI) and has progressively evolved in the past decades. We describe the development and current organisation of surveillance of HAI in France and summarise key achievements and results. Surveillance of HAI is under the auspice of the national institute for public health surveillance through a central coordinating structure, the Reseau d alerte, d investigation et de surveillance des infections nosocomiales (RAISIN), which consists of five regional coordinating structures, two national advisory committees of the Ministry of Health and public health agencies. Surveillance includes the performance of national prevalence surveys every five years (latest in 2006), specific surveillance networks to follow trends and characterise HAI that are national priority, and mandatory reporting of HAI that meet specific criteria for alert purposes. RAISIN prioritises activities, defines technical specifications of surveillance systems, coordinates their implementation, and supports response to alerts, emergences or outbreaks of HAI. We demonstrate that the French surveillance program of HAI has become comprehensive and contributes to evaluating the impact of control and prevention of HAI. Data from RAISIN indicate a general decrease in the risk of HAI in acute care in France. They show a decrease in HAI during recent years, particularly of those related to methicillin-resistant Staphylococcus aureus (MRSA) for which a drop of 38% was documented between 2001 and 2006. RAISIN is also integrated into European surveillance of HAI coordinated by the European Centre for Disease Control.
Boddam-Whetham, Luke; Gul, Xaher; Al-Kobati, Eman; Gorter, Anna C
ABSTRACT In conflict-affected states, vouchers have reduced barriers to reproductive health services and have enabled health programs to use targeted subsidies to increase uptake of specific health services. Vouchers can also be used to channel funds to public- and private-service providers and improve service quality. The Yamaan Foundation for Health and Social Development in Yemen and the Marie Stopes Society (MSS) in Pakistan—both working with Options Consultancy Services—have developed voucher programs that subsidize voluntary access to long-acting reversible contraceptives (LARCs) and permanent methods (PMs) of family planning in their respective fragile countries. The programs focus on LARCs and PMs because these methods are particularly difficult for poor women to access due to their cost and to provider biases against offering them. Using estimates of expected voluntary uptake of LARCs and PMs for 2014 based on contraceptive prevalence rates, and comparing these with uptake of LARCs and PMs through the voucher programs, we show the substantial increase in service utilization that vouchers can enable by contributing to an expanded method choice. In the governorate of Lahj, Yemen, vouchers for family planning led to an estimated 38% increase in 2014 over the expected use of LARCs and PMs (720 vs. 521 expected). We applied the same approach in 13 districts of Punjab, Khyber Pakhtunkhwa (KPK), and Sindh provinces in Pakistan. Our calculations suggest that vouchers enabled 10 times more women than expected to choose LARCs and PMs in 2014 in those areas of Pakistan (73,639 vs. 6,455 expected). Voucher programs can promote and maintain access to family planning services where existing health systems are hampered. Vouchers are a flexible financing approach that enable expansion of contraceptive choice and the inclusion of the private sector in service delivery to the poor. They can keep financial resources flowing where the public sector is prevented from
Brooker, Simon; Beasley, Michael; Ndinaromtan, Montanan; Madjiouroum, Ester Mobele; Baboguel, Marie; Djenguinabe, Elie; Hay, Simon I.; Bundy, Don A. P.
OBJECTIVE: To design and implement a rapid and valid epidemiological assessment of helminths among schoolchildren in Chad using ecological zones defined by remote sensing satellite sensor data and to investigate the environmental limits of helminth distribution. METHODS: Remote sensing proxy environmental data were used to define seven ecological zones in Chad. These were combined with population data in a geographical information system (GIS) in order to define a sampling protocol. On this basis, 20 schools were surveyed. Multilevel analysis, by means of generalized estimating equations to account for clustering at the school level, was used to investigate the relationship between infection patterns and key environmental variables. FINDINGS: In a sample of 1023 schoolchildren, 22.5% were infected with Schistosoma haematobium and 32.7% with hookworm. None were infected with Ascaris lumbricoides or Trichuris trichiura. The prevalence of S. haematobium and hookworm showed marked geographical heterogeneity and the observed patterns showed a close association with the defined ecological zones and significant relationships with environmental variables. These results contribute towards defining the thermal limits of geohelminth species. Predictions of infection prevalence were made for each school surveyed with the aid of models previously developed for Cameroon. These models correctly predicted that A. lumbricoides and T. trichiura would not occur in Chad but the predictions for S. haematobium were less reliable at the school level. CONCLUSION: GIS and remote sensing can play an important part in the rapid planning of helminth control programmes where little information on disease burden is available. Remote sensing prediction models can indicate patterns of geohelminth infection but can only identify potential areas of high risk for S. haematobium. PMID:12471398
The historical National Programme for Information Technology (NPfIT) in England was the most expensive (~$20billion) and ambitious politically-driven IT-based transformations of public services ever undertaken. Nation-wide implementation of integrated electronic health record (EHR) systems in hospitals was at the heart of the NPfIT (~$10billion). We conducted the first longitudinal, prospective, and sociotechnical case study implementation and adoption of national EHRs implementations in 12 'early adopter' hospitals across England. This paper reports the arrival, implementation process, and stakeholders' experiences of one EHR software (Millennium) at a National Health Service's (NHS) general hospital participating in NPfIT, hereafter called Alpha. From the outset, Alpha envisioned the implementation of EHR as a practice of change management to improve its performance. This vision attributed to the establishment of a 'design authority' at Alpha, including users from various capacities and levels. The 'design authority' was perceived a key contributor to appropriate (compared to other hospitals we studied) clinical engagement and bottom-up approach to deploying EHR. Through conducting several hundreds of group and individual workflow familiarization, Alpha adopted a novel approach to training staff on EHR software. This led to greater local configuration and high sense of ownership among users, which transformed work practices towards overall better performance of the hospital. Contrary to painful and turbulent experiences of EHR implementation via NPfIT route in the English hospitals, this in-depth case study revealed the importance of vision (change management) and insightful leadership in 'working out' EHR. We advocate envisioning EHRs as change management endeavors to enhance their complex, multi-dimensional, and sociotechnical adoption in healthcare settings.
Chandra-Mouli, Venkatraman; Gibbs, Susannah; Badiani, Rita; Quinhas, Fernandes; Svanemyr, Joar
Adolescent sexual and reproductive health gained particular traction in Mozambique following the 1994 International Conference on Population and Development leading to the inception of Programa Geração Biz (PGB), a multi-sectoral initiative that was piloted starting in 1999 and fully scaled-up to all provinces by 2007. We conducted a systematic review of the literature to gather information on PGB and analyzed how it planned and managed the scale-up effort using the WHO-ExpandNet framework. PGB's activities comprised a clear and credible innovation. Appropriate resource and user organizations further facilitated national scale-up. Challenges relating to the complex nature of the multi-sectoral approach and resistance due to norms about adolescent sexual and reproductive health hindered scaling-up in some geographic areas. The national government exhibited commitment and ownership to PGB through budgetary support and integration into multiple policies. This study adds to the documentation of successful scaling-up strategies that can provide guidance for policy makers and programme managers.
Background Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. Methods We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. Results The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Conclusion Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human
Darsie, R F; Courtney, G W; Pradhan, S P
During 1994, field studies were conducted in the Midwestern Region of Nepal. Two camps were located in the "inner terai," low mountain valleys between the Churia Range and the Mahabarat Lekh. A third camp was in the mountains at Jumla. Visits were made to 2 high mountain sites, Simikot, Humla District, and Rara National Park. The result from all these sampling sites was the recovery of 6 new country records, 5 in the genus Aedes and 1 in the genus Heizmannia. Some mosquitoes in the Nepal checklist had no voucher specimens. Locality data are given for 9 of these. Biodata on another species that is quite rare in Nepal are given.
The UN Secretariat has granted 105,000 fellowships, including 5000 in the past 3 years to allow citizens of developing countries the opportunity to study in developed and other developing countries. Some of the recipients include developing country officials who were, thus, enabled to attend seminars, training programs, or workshops or to visit industrial facilities. Occasionally, the UN fellowship program designed and implemented special projects to deal with emergency situations. Such a project was used to train a substantial number of Chadian nationals when the country was faced with an acute shortage of qualified people to maintain its infrastructure and socioeconomic system. About 20-30% of the total number of fellowships/scholarships has been awarded to women nominated by their national governments. This has led to an increase in the role played by women in development projects. In addition, some projects have specifically sought improvements in women's status. Additionally financing has been obtained to develop supplementary elements in projects to ensure the fullest possible involvement of women or to help women attain technical or other skills in sectors where women are underrepresented. Fellowship recipients have returned to play important leadership roles in their native countries.
Owing to the incompleteness of available data, there is no conclusive evidence on the effectiveness of sentencing policies in various countries. Insufficient data at both the regional and international levels also make it difficult to draw any firm conclusions on general trends in sentencing policies for offenders convicted of drug-related infractions. Regional, and particularly national, circumstances influence the pattern of penal measures against drug offences in any given country. Thus, drug legislation reflects the socio-cultural, religious and other values of a nation. There is a growing tendency to apply measures of treatment and social reintegration to drug-addicted persons who have committed minor offences rather than to impose prison sentences on them. Drug addiction is increasingly recognized as a disease, which should be cured in an appropriate treatment setting, but the data available indicate that the application of this measure to drug offenders is rather restricted. Another apparent tendency is the move to decriminalize the simple use of drugs and, at the same time, to provide more severe penalties for drug trafficking. In certain countries, however, there is a trend towards increased penalties for illicit drug use as well.
St. Jude Medical's Cardiac Rhythm Management Division, formerly known as Pacesetter Systems, Inc., incorporated Apollo technology into the development of the programmable pacemaker system. This consists of the implantable pacemaker together with a physician's console containing the programmer and a data printer. Physician can communicate with patient's pacemaker by means of wireless telemetry signals transmitted through the communicating head held over the patient's chest. Where earlier pacemakers deliver a fixed type of stimulus once implanted, Programalith enables surgery free "fine tuning" of device to best suit the patient's changing needs.
Baumann, Eric; Merolla, Anthony
User controls number of clock pulses to prevent burnout. New digital programmable pulser circuit in three formats; freely running, counted, and single pulse. Operates at frequencies up to 5 MHz, with no special consideration given to layout of components or to terminations. Pulser based on sequential circuit with four states and binary counter with appropriate decoding logic. Number of programmable pulses increased beyond 127 by addition of another counter and decoding logic. For very large pulse counts and/or very high frequencies, use synchronous counters to avoid errors caused by propagation delays. Invaluable tool for initial verification or diagnosis of digital or digitally controlled circuity.
Basson, Jean-Charles; Haschar-Noé, Nadine; Theis, Ivan
Inspired by the Hygienist Movement, which associates good health with regular, moderate exercise, the National Health and Nutrition Program identifies a lack of physical activity as a risk factor for many chronic diseases. As such, the Program encourages people to take care of their bodies by inciting a moral obligation to develop a physically active lifestyle and follow a healthy diet. With the overall goal of improving the health of the population by acting on nutrition, the Program focuses on primary prevention, screening and early treatment of conditions like heart disease, cancer, obesity, osteoporosis and diabetes. As an incentive program developed in keeping with the biopolitical views of the 1970s that saw education as an alternative means to hospitals for achieving good health, the Program is also a good public action tool for controlling costs. PMID:24289937
Graham, Tanya; Alderson, Phil; Stokes, Tim
Background There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence). Methods Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE’s guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis. Results Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take “on trust” the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills. Conclusions We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice. PMID:25811754
Graham, D A; Clegg, T A; Lynch, M; More, S J
A risk factor study was conducted to identify variables associated with initial positive or inconclusive results for bovine viral diarrhoea virus (BVDV) in ear punch samples collected from calves between 1st January and 15th July 2012 (the study period) as part of the voluntary phase of the Irish national BVD eradication programme based on testing of ear tag tissue samples from calves born in participating herds. Univariable analysis indicated significant associations with the following factors: herd type; the number of cows in the herd; the number of calves born in the study period; the number of calves tested in the study period; the number of cattle purchased in 2011, between 2009 and 2011 and between 2007 and 2011; the number of tested calves whose dams had been purchased within 9 months of their calving date; and the percentage of calf mortality within 28 days of birth. The percentage of the cows in each herd that was homebred, location (province) the number of separate land parcels used by each herd, the presence of an associated sheep enterprise and the purchase of cattle through marts were not found to be significant. An initial logistic regression model was developed to model the probability of a herd having one or more BVD virus-positive or inconclusive calves. When vaccination status was initially excluded, province, log of the numbers of cows in the herd, the number of cows purchased between 2009 and 2011, the number of tested calves whose dams had been purchased within 9 months of their calving date and calf mortality were significant. When vaccination status was included, using a subset of the data based on farmers responding to a survey on vaccination status, it was retained as a significant variable along with the same variables already listed, showing a significant 2-way interaction with the log of the number of cows. There was not a significant association between an initial positive or inconclusive result and the length of time for which herds
Ji, Chang-Ho C.; Boyatt, Ed
The purpose of this study is to investigate why parents choose parochial schools, whether parochial-school parents are likely to favor school vouchers, and what factors lie behind their support for vouchers. To this end, this study gives special attention to parents' personal religiosity. The sample of parents was taken from five large Protestant…
Yun, John T.
A new report published by the Manhattan Institute for Education Policy, "The Effect of Special Education Vouchers on Public School Achievement: Evidence from Florida's McKay Scholarship Program," attempts to examine the complex issue of how competition introduced through school vouchers affects student outcomes in public schools. The…
Gill, Brian P.; Timpane, P. Michael; Ross, Karen E.; Brewer, Dominic J.
Two proposals for education reform are school vouchers and charter schools, both of which have raised controversy with regard to their effectiveness and efficiency. At the present time, there is insufficient evidence to provide a crisp, clear bottom-line judgment of the wisdom of voucher and charter programs. This book identifies and articulates…
Greene, Jay P.; Winters, Marcus A.
This study evaluates the initial effect of Washington, DC's Opportunity Scholarship Program (OSP) on the academic performance of public schools and its effects on the opportunities that District students have to attend integrated schools. The OSP is a federally sponsored school voucher program that provides vouchers worth up to $7,500 for an…
Paul, Kelli M.; Metcalf, Kim K.; Legan, Natalie A.
Research suggests that families who make active choices regarding their child's education differ from families who do not. Differences between families of private (voucher), charter, and public school students were examined using data collected as part of the evaluation of the Cleveland Scholarship and Tutoring Program. While both voucher and…
Specimen vouchering is a critical aspect of systematics, especially in genetic studies where the identity of a DNA sample needs to be assured. It can be difficult to obtain a high quality voucher after DNA extraction when dealing with tiny and delicate invertebrates that often do not survive the ext...
A Friedman Foundation report attempts to find empirical support for the contention that competition from private schools, through voucher programs, improves the effectiveness of public schools. In the first year of Ohio's new EdChoice voucher program, the report claims to have found substantial academic gains at public schools exposed to the…
Secades-Villa, Roberto; García-Rodríguez, Olaya; Higgins, Stephen T; Fernández-Hermida, José R; Carballo, José L
The aim of this study was to assess the efficacy of the community reinforcement approach (CRA) plus vouchers treatment in achieving cocaine abstinence and treatment retention among patients enrolled in an outpatient program for cocaine dependence in Spain. Forty-three patients were randomly assigned to one of two treatment conditions in a community setting: CRA plus vouchers or standard care. Of the patients who received the CRA plus vouchers program, 73% completed 24 weeks of treatment, as compared with 42% of the patients who received standard care who did. In the CRA plus vouchers group, 40% of the patients achieved 24 weeks of continuous cocaine abstinence, as compared with 21% of the patients in the standard care group who did. These results support the effectiveness and generalizability of the CRA plus vouchers treatment in a community setting outside of the United States. Further follow-up is required to confirm the long-term maintenance of the results.
Roll, J M; Reilly, M P; Johanson, C E
Contingency-management interventions that provide reinforcement in the form of exchangeable vouchers, contingent on drug abstinence, are among the most effective substance abuse treatment strategies available. Factors known to contribute to the efficacy of these interventions include voucher magnitude and the schedule with which vouchers are made available. Another potential factor may be the delay between earning a voucher and exchanging it for a desired good or service. The authors adapted a laboratory analog of a voucher program to examine the effects of immediacy of reinforcement and its interaction with reinforcer magnitude. Abstinent cigarette smokers made repeated choices between puffs on a cigarette and points worth a variety of monetary values (10 cents-2 dollars). The time at which these points could be exchanged for money varied from the end of the session to 1 or 3 weeks. Results indicated that longer exchange delays and tower magnitude reinforcers increased the number of choices for drug.
Williams, Andrew James; Wyatt, Katrina M.; Williams, Craig A.; Logan, Stuart; Henley, William E.
Schools are common sites for obesity prevention interventions. Although many theories suggest that the school context influences weight status, there has been little empirical research. The objective of this study was to explore whether features of the school context were consistently and meaningfully associated with pupil weight status (overweight or obese). Exploratory factor analysis of routinely collected data on 319 primary schools in Devon, England, was used to identify possible school-based contextual factors. Repeated cross-sectional multilevel analysis of five years (2006/07-2010/11) of data from the National Child Measurement Programme was then used to test for consistent and meaningful associations. Four school-based contextual factors were derived which ranked schools according to deprivation, location, resource and prioritisation of physical activity. None of which were meaningfully and consistently associated with pupil weight status, across the five years. The lack of consistent associations between the factors and pupil weight status suggests that the school context is not inherently obesogenic. In contrast, incorporating findings from education research indicates that schools may be equalising weight status, and obesity prevention research, policy and practice might need to address what is happening outside schools and particularly during the school holidays. PMID:26700027
Hansen, N; Hay, G; Cowan, S; Jepsen, P; Bygum Krarup, H; Obel, N; Weis, N; Brehm Christensen, P
The prevalence of chronic hepatitis B virus (HBV) infection in Denmark is not clear. The primary aim of this study was to estimate the prevalence of chronic HBV infection in Denmark. The capture–recapture method was used to estimate the total population diagnosed with chronic HBV infection in Denmark using four nationwide registers. The population with undiagnosed chronic HBV infection was estimated by incorporating data from a two-year nationwide HBsAg screening programme in pregnant women. We identified 4,466 individuals with chronic HBV infection in the four registers until the end of 2007, and the capture–recapture estimate of the total population diagnosed with chronic hepatitis B was 7,112 (95% confidence interval (CI): 6,953–10,747). Only 17% of the identified patients attended recommended clinical care according to national guidelines. Including undiagnosed patients, the current population alive with HBV infection was 10,668 (95% CI: 10,224–16,164), corresponding to a prevalence of 0.24% (95% CI: 0.23–0.37%) in the Danish population older than 15 years. The estimated prevalence of chronic HBV infection among adults in Denmark was lower than reported from other northern European countries. Only half of the infected population had been diagnosed, and a minority attended specialised clinical care.
Obare, Francis; Warren, Charlotte; Abuya, Timothy; Askew, Ian; Bellows, Ben
Although available evidence indicates that vouchers improve service utilization among the target populations, we do not know whether increased utilization results from improved access (new clients who would not have used services without the voucher) or from shifting clients from non-accredited to contracted service providers. This paper examines whether the safe motherhood voucher program in Kenya is associated with improved access to health facility delivery using information on births within two years preceding the survey in voucher and comparison sites. Data were collected in 2010-2011 and in 2012 among 2933 and 3094 women aged 15-49 years reporting 962 and 1494 births within two years before the respective surveys. Analysis entails cross-tabulations and estimation of multilevel random-intercept logit models. The results show that the proportion of births occurring at home declined by more than 10 percentage points while the proportion of births delivered in health facilities increased by a similar margin over time in voucher sites. The increase in facility-based births occurred in both public and private health facilities. There was also a significant increase in the likelihood of facility-based delivery (odds ratios [OR]: 2.04; 95% confidence interval [CI]: 1.40-2.98 in the 2006 voucher arm; OR: 1.72; 95% CI: 1.22-2.43 in the 2010-2011 voucher arm) in voucher sites over time. In contrast, there were no significant changes in the likelihood of facility-based delivery in the comparison arm over time. These findings suggest that the voucher program contributed to improved access to institutional delivery by shifting births from home to health facilities. However, available evidence from qualitative data shows that some women who purchased the vouchers did not use them because of high transportation costs to accredited facilities. The implication is that substantial improvements in service uptake could be achieved if the program subsidized transportation costs as
Ayoubi, Rami M.; Massoud, Hiba K.
Given the need for major reform of the higher education programmes in Syria, and answering the voices that question the role of European Union (EU) in assisting the development of the higher education sector, this study presents an analysis of the contribution of (TEMPUS) Programme in modernising higher education in Syria. The study compares the…
Carle, C; Alexander, P; Columb, M; Johal, J
We designed and internally validated an aggregate weighted early warning scoring system specific to the obstetric population that has the potential for use in the ward environment. Direct obstetric admissions from the Intensive Care National Audit and Research Centre's Case Mix Programme Database were randomly allocated to model development (n = 2240) or validation (n = 2200) sets. Physiological variables collected during the first 24 h of critical care admission were analysed. Logistic regression analysis for mortality in the model development set was initially used to create a statistically based early warning score. The statistical score was then modified to create a clinically acceptable early warning score. Important features of this clinical obstetric early warning score are that the variables are weighted according to their statistical importance, a surrogate for the FI O2 /Pa O2 relationship is included, conscious level is assessed using a simplified alert/not alert variable, and the score, trigger thresholds and response are consistent with the new non-obstetric National Early Warning Score system. The statistical and clinical early warning scores were internally validated using the validation set. The area under the receiver operating characteristic curve was 0.995 (95% CI 0.992-0.998) for the statistical score and 0.957 (95% CI 0.923-0.991) for the clinical score. Pre-existing empirically designed early warning scores were also validated in the same way for comparison. The area under the receiver operating characteristic curve was 0.955 (95% CI 0.922-0.988) for Swanton et al.'s Modified Early Obstetric Warning System, 0.937 (95% CI 0.884-0.991) for the obstetric early warning score suggested in the 2003-2005 Report on Confidential Enquiries into Maternal Deaths in the UK, and 0.973 (95% CI 0.957-0.989) for the non-obstetric National Early Warning Score. This highlights that the new clinical obstetric early warning score has an excellent ability to
Silverman, K; Chutuape, M A; Bigelow, G E; Stitzer, M L
Voucher-based reinforcement of cocaine abstinence has been one of the most effective means of treating cocaine abuse in methadone patients, but it has not been effective in all patients. This study was designed to determine if we could promote cocaine abstinence in a population of treatment-resistant cocaine abusing methadone patients by increasing the magnitude of voucher-based abstinence reinforcement. Participants were 29 methadone patients who previously failed to achieve sustained cocaine abstinence when exposed to an intervention in which they could earn up to $1155 in vouchers (exchangeable for goods/services) for providing cocaine-free urines. Each patient was exposed in counterbalanced order to three 9-week voucher conditions that varied in magnitude of voucher reinforcement. Patients were exposed to a zero, low and high magnitude condition in which they could earn up to $0, $382, or $3480 in vouchers for providing cocaine-free urines. Analyses for 22 patients exposed to all three conditions showed that increasing voucher magnitude significantly increased patients' longest duration of sustained cocaine abstinence (P<0.001) and percent of cocaine-free urines (P<0.001), and significantly decreased patients' reports of cocaine injections (P=0.024). Almost half (45%) of the patients in the high magnitude condition achieved >/=4 weeks of sustained cocaine abstinence, whereas only one patient in the low and none in the zero magnitude condition achieved more than 2 weeks. Reinforcement magnitude was a critical determinant of the effectiveness of this abstinence reinforcement intervention.
Background In an attempt to address a complex disease burden, including improving progress towards MDGs 4 and 5, South Africa recently introduced a re-engineered Primary Health Care (PHC) strategy, which has led to the development of a national community health worker (CHW) programme. The present study explored the development of a cell phone-based and paper-based monitoring and evaluation (M&E) system to support the work of the CHWs. Methods One sub-district in the North West province was identified for the evaluation. One outreach team comprising ten CHWs maintained both the paper forms and mHealth system to record household data on community-based services. A comparative analysis was done to calculate the correspondence between the paper and phone records. A focus group discussion was conducted with the CHWs. Clinical referrals, data accuracy and supervised visits were compared and analysed for the paper and phone systems. Results Compared to the mHealth system where data accuracy was assured, 40% of the CHWs showed a consistently high level (>90% correspondence) of data transfer accuracy on paper. Overall, there was an improvement over time, and by the fifth month, all CHWs achieved a correspondence of 90% or above between phone and paper data. The most common error that occurred was summing the total number of visits and/or activities across the five household activity indicators. Few supervised home visits were recorded in either system and there was no evidence of the team leader following up on the automatic notifications received on their cell phones. Conclusions The evaluation emphasizes the need for regular supervision for both systems and rigorous and ongoing assessments of data quality for the paper system. Formalization of a mHealth M&E system for PHC outreach teams delivering community based services could offer greater accuracy of M&E and enhance supervision systems for CHWs. PMID:25106499
George, R.; Yadla, V.L.
To combat biomass scarcity and ensure a cleaner cooking environment with less drudgery, among other things, a variety of improved stoves are promoted under National Programme on Improved Cookstoves (NPIC). Mamta Stove (MS) is one among such improved stoves. An indepth study was undertaken covering a sample of twenty-five rural families with the primary objective of assessing fuel saving potential of MS under field conditions through Kitchen Performance Test (KPT). Conventional stove (CS) used in almost all the families was shielded horse-shoe shaped stove with a negligible proportion using three stone open fire. Nearly 88% depended only on zero private cost fuels. The mean number of persons for whom the stoves were used on the days of field measurements in case of CS and MS were 5.6 and 5.7 respectively with an SD of 1.16 and standard adult equivalent (SAE) was approximately 4. Cooking pots included a concave roasting pan, a deep frying pan and flat bottomed pots. The mean daily fuel consumption on CS and MS were estimated to be 4.88 kg and 3.75 kg respective, thereby, resulting in fuel saving to the tune of 24% on MS. The paper discusses at length the design features of CS and MS, meal pattern, cooking habits, need for user training, consumerism in the area of cooking and stove technology, economics of switching over to MS and policy implications of commercialization of hitherto subsidized stove program. Further, salient characteristics of high and low cooking fuel consumers on MS are presented to bring to limelight their profile.
... money order payable to the order of the Food and Drug Administration. The user fee identification (ID... HUMAN SERVICES Food and Drug Administration Fee for Using a Priority Review Voucher in Fiscal Year 2011 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration...
Sorensen, James L; Haug, Nancy A; Delucchi, Kevin L; Gruber, Valerie; Kletter, Evan; Batki, Steven L; Tulsky, Jacqueline P; Barnett, Paul; Hall, Sharon
This clinical trial evaluated a contingency management intervention designed to improve medication adherence among HIV-positive methadone maintenance patients. After a 4-week baseline observation phase, eligible participants (N=66) were randomly assigned to: (a) medication coaching sessions every other week to assist with adherence strategies (comparison group) or (b) medication coaching plus voucher reinforcement for opening electronic medication caps on time (voucher group). Baseline adherence (percent doses taken/percent total possible doses) was 51% using electronic measurement, 75% using self-report and 75% using pill count. The intervention was provided for 12 weeks, with a 4-week follow-up. The primary outcome results of the clinical trial indicated effectiveness during the intervention, with significant mean adherence differences between voucher and comparison groups using electronic measurement (78% versus 56%), pill count (86% versus 75%), and self-report (87% versus 69%). Differences between groups faded after vouchers were discontinued. Contingency management shows promise as a strategy to promote antiretroviral medication adherence in this population.
Glenn, Irene M.; Dallery, Jesse
Nicotine replacement products are commonly used to promote smoking cessation, but alternative and complementary methods may increase cessation rates. The current experiment compared the short-term effects of a transdermal nicotine patch to voucher-based reinforcement of smoking abstinence on cigarette smoking. Fourteen heavy smokers (7 men and 7…
... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Standard Form 44, Purchase Order-Invoice-Voucher. 53.301-44 Section 53.301-44 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS Illustrations of Forms 53.301-44 Standard Form...
... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Standard Form 44, Purchase Order-Invoice-Voucher. 53.301-44 Section 53.301-44 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS Illustrations of Forms 53.301-44 Standard Form...
... 48 Federal Acquisition Regulations System 2 2012-10-01 2012-10-01 false Standard Form 44, Purchase Order-Invoice-Voucher. 53.301-44 Section 53.301-44 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS Illustrations of Forms 53.301-44 Standard Form...
... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Standard Form 44, Purchase Order-Invoice-Voucher. 53.301-44 Section 53.301-44 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS Illustrations of Forms 53.301-44 Standard Form...
... 48 Federal Acquisition Regulations System 2 2013-10-01 2013-10-01 false Standard Form 44, Purchase Order-Invoice-Voucher. 53.301-44 Section 53.301-44 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS Illustrations of Forms 53.301-44 Standard Form...
Fung, Chanel Kit-Ho; Lam, Chi-Chung
The issue of education vouchers has been widely researched as they are seen by many people as an effective strategy for improving the quality of education services. Striving to enhance the quality of the kindergarten education service in Hong Kong, the government of the Hong Kong Special Administrative Region has committed a substantial sum of…
Li, Hui; Wong, Jessie Ming Sin; Wang, X. Christine
Educational authorities in the Hong Kong Special Administrative Region (HKSAR) of China introduced an early childhood education voucher system in 2007 with two implicit goals: to turn profit kindergartens into non-profit ones and to curtail parental choice. This initiative has caused a great deal of controversy locally and internationally, so the…
Cowen, Joshua M.; Fleming, David J.; Witte, John F.; Wolf, Patrick J.
This article contributes to research concerning the determinants of student mobility between public and private schools. The authors analyze a unique set of data collected as part of a new evaluation of Milwaukee's citywide voucher program. The authors find several important patterns. Students who switch from the private to the public sector were…
Sweetland, Scott R.
It is a long held belief that Vouchers and charter schools are among the most recognized buzzwords in today's education marketplace. Advocates assert that the quality of education will improve if consumers (i.e., parents) have greater access to schooling alternatives. Along with this assertion is the implied belief that costs of education will…
Hess, Frederick M.; McGuinn, Patrick
This paper examines how the introduction of the Cleveland, Ohio, voucher experiment in 1995 affected the administration and leadership of the city's public schools. The paper focuses on the nature of political and bureaucratic responses to competition and describes the short-term consequences of competition and how such consequences might…
Fortson, Jane G.; Sanbonmatsu, Lisa
Using data from the Moving to Opportunity randomized housing voucher experiment, we estimate the direct effects of housing and neighborhood quality on child health. We show that, five years after random assignment, housing mobility has little impact on overall health status, asthma, injuries, and body mass index. The few effects that we observe…
... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Congregate housing: Voucher housing assistance payment. 982.608 Section 982.608 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT...
... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Housing certificate and housing voucher programs. 8.28 Section 8.28 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development NONDISCRIMINATION BASED ON HANDICAP IN FEDERALLY ASSISTED PROGRAMS...
... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Congregate housing: Voucher housing assistance payment. 982.608 Section 982.608 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT...
Brooks, Fred; Lewinson, Terri; Aszman, Jennifer; Wolk, Jim
Objective: A total of 6 years after displacement by a Housing Opportunities for People Everywhere (HOPE VI) project, this research examines residents who returned to the redeveloped community and residents who decided to keep their vouchers and were living in private sector housing. Respondents were compared on the following variables: application…
... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Congregate housing: Voucher housing assistance payment. 982.608 Section 982.608 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT...
... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Housing certificate and housing voucher programs. 8.28 Section 8.28 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development NONDISCRIMINATION BASED ON HANDICAP IN FEDERALLY ASSISTED PROGRAMS...
... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Housing certificate and housing voucher programs. 8.28 Section 8.28 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development NONDISCRIMINATION BASED ON HANDICAP IN FEDERALLY ASSISTED PROGRAMS...
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Housing certificate and housing voucher programs. 8.28 Section 8.28 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development NONDISCRIMINATION BASED ON HANDICAP IN FEDERALLY ASSISTED PROGRAMS...
... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Housing certificate and housing voucher programs. 8.28 Section 8.28 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development NONDISCRIMINATION BASED ON HANDICAP IN FEDERALLY ASSISTED PROGRAMS...
... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Congregate housing: Voucher housing assistance payment. 982.608 Section 982.608 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT...
... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Congregate housing: Voucher housing assistance payment. 982.608 Section 982.608 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT...
Mizala, Alejandra; Torche, Florencia
This paper analyzes the socioeconomic stratification of achievement in the Chilean voucher system using a census of 4th and 8th graders, a multilevel methodology, and accounting for unobserved selectivity into school sector. Findings indicate that the association between the school's aggregate family socioeconomic status (SES) and test scores is…
Egalite, Anna J.; Mills, Jonathan N.; Wolf, Patrick J.
The question of how school choice programs affect the racial stratification of schools is highly salient in the field of education policy. We use a student-level panel data set to analyze the impacts of the Louisiana Scholarship Program (LSP) on racial stratification in public and private schools. This targeted school voucher program provides…
... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false SF 44, Purchase Order... PROCEDURES Simplified Acquisition Methods 213.306 SF 44, Purchase Order-Invoice-Voucher. (a)(1) The micro...) card may be used instead of an SF 44 for aviation fuel and oil (see http://www.desc.dla.mil);...
... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false SF 44, Purchase Order... PROCEDURES Simplified Acquisition Methods 213.306 SF 44, Purchase Order-Invoice-Voucher. (a)(1) The micro... acquisition threshold may be made for— (A) Fuel and oil. U.S. Government fuel cards may be used in lieu of...
... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false SF 44, Purchase Order... PROCEDURES Simplified Acquisition Methods 213.306 SF 44, Purchase Order-Invoice-Voucher. (a)(1) The micro... acquisition threshold may be made for— (A) Fuel and oil. U.S. Government fuel cards may be used in lieu of...
... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false SF 44, Purchase Order... PROCEDURES Simplified Acquisition Methods 213.306 SF 44, Purchase Order-Invoice-Voucher. (a)(1) The micro... acquisition threshold may be made for— (A) Fuel and oil. U.S. Government fuel cards may be used in lieu of...
... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false SF 44, Purchase Order... PROCEDURES Simplified Acquisition Methods 213.306 SF 44, Purchase Order-Invoice-Voucher. (a)(1) The micro... acquisition threshold may be made for— (A) Fuel and oil. U.S. Government fuel cards may be used in lieu of...
Finn, Chester E., Jr.; Hentges, Christina M.; Petrilli, Michael J.; Winkler, Amber M.
Of all the arguments that critics of school voucher programs advance, the one that may resonate loudest with the public concerns school accountability. Opponents say it's not fair to hold public schools accountable for their results (under No Child Left Behind and similar systems) and then let private schools receive taxpayer dollars--however…
Huerta, Luis A.; d'Entremont, Chad
This article examines an emerging preference for education tax credit programs in a post-"Zelman" era. First, the authors detail the origin of tax credits and the types of existing plans. Second, they review the assumptions underlying the supposed advantages that may favor tax credits as a feasible alternative to vouchers. Third, they…
Sequoia Inst., San Jose, CA.
Covered in this report are the main events that occurred in the Alum Rock voucher project between July 1974 and January 1976. Measures considered to be functioning effectively at the beginning of this time span were the concepts of alternative education, open enrollment, programs that vary their capacity in response to parent demand within the…
In this NEPC Policy Memo, Professor Welner explains that the most honest and conscientious approach to reporting the fiscal impact of tax credit vouchers is to provide a range of outcomes and let the readers--not the legislative analysts themselves--speculate on which is most likely. If a bottom line is demanded, it should be couched in as many…
Figlio, David N.; Hart, Cassandra M. D.
Voucher options like tuition tax credit-funded scholarship programs have become increasingly popular in recent years. One argument for such school choice policies is that public schools will improve the quality of education they offer when faced with competition for their students. This study examines the effects of private school competition on…
Metcalf, Kim K.; Legan, Natalie A.
School vouchers, particularly since the landmark U.S. Supreme Court ruling on the Cleveland program, are one of the most contentious issues in American education. Seemingly contradictory results across available studies have caused confusion among diverse audiences. The authors suggest that these divergent findings are, in part, due to three…
Florida's 1999 A-plus program was a consequential accountability program that embedded vouchers in an accountability regime. Under Florida rules, scores of students in several special education (ESE) and limited English proficient (LEP) categories were not included in the computation of school grades. One might expect these rules to induce F…
Thomas, Robert G.
This paper describes the use of tuition tax credits and vouchers as political alternatives of choice and competition in a progressive society. School and public administration theorists identify two distinct finance models: the rational and the political. The first part of this paper examines and describes these two models. The next part…
A key component of current school reform efforts focuses on increasing parental choice through voucher systems and programs that provide tax benefits for contributions to scholarship programs for private school tuition. Indeed, proposals to adopt such programs have been or currently are being considered in four-fifths of the states, and about half…
Nguyen, Quynh C.; Rehkopf, David H.; Schmidt, Nicole M.
Objectives. To assess the mental health effects on adolescents of low-income families residing in high-poverty public housing who received housing vouchers to assist relocation. Methods. We defined treatment effects to compare 2829 adolescents aged 12 to 19 years in families offered housing vouchers versus those living in public housing in the Moving to Opportunity experiment (1994–1997; Boston, MA; Baltimore, MD; Chicago, IL; Los Angeles, CA; New York, NY). We employed model-based recursive partitioning to identify subgroups with heterogeneous treatment effects on psychological distress and behavior problems measured in 2002. We tested 35 potential baseline treatment modifiers. Results. For psychological distress, Chicago participants experienced null treatment effects. Outside Chicago, boys experienced detrimental effects, whereas girls experienced beneficial effects. Behavior problems effects were null for adolescents who were aged 10 years or younger at baseline. For adolescents who were older than 10 years at baseline, violent crime victimization, unmarried parents, and unsafe neighborhoods increased adverse treatment effects. Adolescents who were older than 10 years at baseline without learning problems or violent crime victimization, and whose parents moved for better schools, experienced beneficial effects. Conclusions. Health effects of housing vouchers varied across subgroups. Supplemental services may be necessary for vulnerable subgroups for whom housing vouchers alone may not be beneficial. PMID:26794179
Public Policy Forum, 2008
Changes in the Milwaukee Parental Choice Program's enabling legislation were intended to increase program ability to enroll dissatisfied public school students while ensuring some third-party accountability for voucher schools. After changes in eligibility requirements and the lifting of the enrollment cap, enrollment did grow, but much of the…
Shafiq, M. Najeeb
Targeted educational voucher schemes [TEVS] are often proposed for poor children in developing countries. This article explores the design of an effective TEVS using three policy instruments: regulation, support services, and finance. The regulation design addresses the rules that must be adhered to by participating households, children, and…
McDonell, Michael G.; Howell, Donelle N,; McPherson, Sterling; Cameron, Jennifer M.; Srebnik, Debra; Roll, John M.; Ries, Richard K.
This study assessed the effects of a contingency management (CM) intervention for alcohol consumption in 10 alcohol-dependent participants. An ABCA design was used. Vouchers were provided contingent on results of ethyl glucuronide (EtG) urine tests (an alcohol biomarker with a 2-day detection period) and alcohol breath tests during the C phase.…
... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Voucher tenancy: Payment standard amount and schedule. 982.503 Section 982.503 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN...
In 1955, Milton Friedman authored a foundational paper proposing a shift in funding and governance mechanisms for public K-12 schools, suggesting that parents be awarded tuition vouchers that they could use to pay for private sector education services for their children, rather than relying on government provided neighborhood schools. Friedman…
In June 2015, the Colorado Supreme Court struck down a successful voucher program in Douglas County, invoking a provision of the state constitution that harks back to an era of widespread prejudice against Catholics. But because of the court's reliance on this discriminatory provision, its decision could well be overturned by the U.S. Supreme…
Angrist, Joshua D.; Bettinger, Eric; Bloom, Erik; King, Elizabeth; Kremer, Michael
This paper examines the impact of Colombia's Programa de Ampliacion de Cobertura de la Educacion Secundaria (PACES), which provided over 125,000 poor students with private secondary school vouchers, many of which were awarded by lottery. Researchers surveyed lottery winners and losers to compare educational and other outcomes. Results showed no…
Cho, Soowon; Epstein, Samantha W; Mitter, Kim; Hamilton, Chris A; Plotkin, David; Mitter, Charles; Kawahara, Akito Y
Butterflies and moths (Lepidoptera) comprise significant portions of the world's natural history collections, but a standardized tissue preservation protocol for molecular research is largely lacking. Lepidoptera have traditionally been spread on mounting boards to display wing patterns and colors, which are often important for species identification. Many molecular phylogenetic studies have used legs from pinned specimens as the primary source for DNA in order to preserve a morphological voucher, but the amount of available tissue is often limited. Preserving an entire specimen in a cryogenic freezer is ideal for DNA preservation, but without an easily accessible voucher it can make specimen identification, verification, and morphological work difficult. Here we present a procedure that creates accessible and easily visualized "wing vouchers" of individual Lepidoptera specimens, and preserves the remainder of the insect in a cryogenic freezer for molecular research. Wings are preserved in protective holders so that both dorsal and ventral patterns and colors can be easily viewed without further damage. Our wing vouchering system has been implemented at the University of Maryland (AToL Lep Collection) and the University of Florida (Florida Museum of Natural History, McGuire Center of Lepidoptera and Biodiversity), which are among two of the largest Lepidoptera molecular collections in the world.
... Voucher program serves more than 2 million households, at a total subsidy cost of $18.2 billion per year... funding that PHAs receive includes the housing subsidy itself, plus administrative fees to cover the costs... reimbursing PHAs for the costs of program administration was loosely based on empirical evidence. Over...
Pedroni, Thomas C.
Critical educational researchers in the United States and elsewhere are missing something essential in their inattention to considerable support among Black urban women for market-based educational reforms, including vouchers. While the educational left has engaged in important empirical and theoretical work demonstrating the particularly negative…
Freis, Ruth; Miller, Miriam
The vendor/voucher, or purchase of service, system for child care delivery is discussed as a logical model for communities which are looking for a method of developing a new system or have outgrown their current program. Discussion initially focuses on the increasing need for child care, cost/benefit aspects of child care, the regulation of child…
... Voucher (HCV) Program Administrative Fee study. The purpose of the study is to collect accurate information on the costs of administering the HCV program across a representative sample of high performing... for the HCV program. The study is proceding in multiple phases. This request is for data collection...
... Notice Also Lists the Following Information Title of Proposal: Housing Choice Voucher (HCV) Program... requested, as well as the PHA's objectives and plans for administering the HCV program. The application is... the HCV program. PHAs are also required to maintain financial reports in accordance with...
... Housing Choice Voucher (HCV) Program Administrative Fee study. The purpose of the study is to collect accurate information on the costs of administering the HCV program across a representative sample of high... formula for the HCV program. The study is proceeding in multiple phases. This request is for...
Universities UK, 2014
This factsheet, the first in a series on innovation and growth, provides an overview of the benefits of innovation vouchers, and gives some examples of how universities and Local Enterprise Partnerships (LEPs) are including them in their European Structural and Investment Funds (ESIF) strategies. [For the second factsheet in the series,…
Greene, Jay P.; Winters, Marcus A.
This study examined whether the existence or threat of competition would cause public schools to improve, focusing on Florida's A+ Program, which combined educational vouchers and high stakes testing. The theory behind the program is that chronically failing public schools will have an incentive to improve if they must compete with other schools…
Reviews the case of school choice in Argentina, in view of recent research on socioeconomic segregation in the educational system. Reveals that Argentina has neither demand subsidy programs or voucher systems. Argues that Argentina's strong regulations encourage parents with greater economic or political capacity to choose how their children are…
Finn, Chester E., Jr.; Hentges, Christina M.; Petrilli, Michael J.; Winkler, Amber M.
Critics of school voucher programs argue that private schools that receive taxpayer dollars should be held accountable to the same standards as public schools. School choice supporters counter that private schools should be left alone to answer to the parents of their students. The authors advocate for a re-visit to the discussion of…
This report is a retrospective account of a single research project conducted between 1973 and 1976 which involved a field study of the administrative feasibility of vouchers for skill training in the Work Incentive Program (WIN) in Portland, Oregon. (The program was designed to change relationships among clients, WIN staff, and training vendors,…
The voucher training program for Work Incentive Program (WIN) clients described within this interim report is a system for providing occupational training to clients through entitlements rather than direct service (client and trainer are in a direct relationship facilitated by the agency). The basic program objective, discussed in the…
Portales, Jaime; Heilig, Julian Vasquez
Findings from this study show that educational and mobility opportunities for families and students participating in the Chilean voucher system are not homogenously distributed. Some families and students use and benefit from the system, while others will remain marginalized. The quantitative results in this study demonstrate that students of…
Fleming, David J.; Cowen, Joshua M.; Witte, John F.; Wolf, Patrick J.
We examine what factors predict why some parents enroll their children in voucher schools while other parents with similar types of children and from similar neighborhoods do not. Furthermore, we investigate how aware parents are of their educational options, where they get their information, and what school characteristics they deem the most…
Hardin-Fanning, F; Gokun, Y
Introduction Grocery vouchers that specifically target foods associated with reduced cardiovascular disease (CVD) risk result in increased consumption of those foods. In regions with disproportionately high CVD rates, there is little research concerning the impact of vouchers on purchases of risk-reducing foods when there are no restrictions placed on grocery voucher redemption. Since many food assistance programs place few restrictions on type of foods that can be purchased, identifying demographic factors associated with purchasing habits is a prerequisite to promoting healthy eating. The purpose of this study was to determine the associations of age, gender, education and income level with purchasing of healthful foods through the use of a grocery voucher in a rural food desert (poverty rate of ≥20% and ≥33% of residents living >16 km from a large grocery store) with high rates of chronic disease. Methods The effectiveness of an intervention that included a media campaign, a $5 grocery voucher, local heart healthy food branding and a grocery store event was tested. Brief nutritional articles were published in both local newspapers during four consecutive weeks. These articles explained the physiological actions of healthy foods and listed a health-promoting recipe. During the fourth week of the media campaign, a voucher for a $5 grocery gift card redeemable at one of either community grocery stores was also printed in both local newspapers. In each store, foods that are known to be associated with a reduced risk of CVD were marked with a blue logo. Participants (N=311) completed a questionnaire that assessed demographics and usual servings of fruits, vegetables and grains. Participants received a $5 grocery card and a list of labelled foods. Returned grocery receipts were stapled to the questionnaires to analyse the relationship between demographics and food choices. Results Participants who bought at least one labelled food item were older (M=48.5, SD=14
Cepeda, J.; Marroquín, W.; Villar, Y.
The experiences in two Risk Management courses organised by the Universidad Centroamericana "José Simeón Cañas" (UCA) and the "América Latina Genera" project of the BCPR-UNDP (Bureau for Crisis Prevention and Recovery of the United Nations Development Programme) are presented focusing on the design of teaching material and the selection and use of information-communication technologies (ICT) during the learning process. The organisation of these courses has posed three main challenges: the integration of a gender-equity approach in a subject that has traditionally lacked of it, the preparation of specialised teaching material for an audience with varied backgrounds and experience, and a widespread distribution of students and lecturers in different countries and with significant differences in ICT resources. These courses have combined tutorials, video-conferences, forums, chats, a media centre with video and podcast, and other resources to allow a close follow-up of the students' progress and strengthen the learning process. A specialised database of information within the "América Latina Genera" project has also been used intensively. Even though the building of capacity has been important, the emphasis of the courses has been on the practical application of projects in the students' work environment and in other real situations. The first course took place between June and December 2008 and consisted of a combination of on-site and distance education. The 15 students that registered the course included officials of local and central government institutions, private consultants, university staff and members of non-governmental organisations. Lecturers from the United States Geological Survey and the International Centre for Geohazards broadcasted videoconferences from the United States and Norway, respectively. The second course started in November 2008 and is scheduled to finish in February 2009. This course has been fully developed using distance education
...Section 8(c)(1) of the United States Housing Act of 1937 (USHA) requires the Secretary to publish FMRs periodically, but not less than annually, adjusted to be effective on October 1 of each year. This notice publishes the FMRs for the Housing Choice Voucher, the Moderate Rehabilitation, the project-based voucher, and any other programs requiring their use. Today's notice provides final FY......
Ahmed, Shakil; Khan, M Mahmud
Demand-side financing (DSF) is used in the less-developed countries of the world to improve access to healthcare and to encourage market supply. Under DSF, households receive vouchers that can be used to pay for healthcare services. This study evaluated the effects of a universal DSF on maternal healthcare service utilization in Bangladesh. A household survey was conducted in and around the voucher scheme area one year after the initiation of the project. Women who gave birth within a year prior to the survey were interviewed. The utilization rates of maternal health services were found to be higher for all socioeconomic groups in the project area than in the comparison areas. Voucher recipients in the project area were 3.6 times more likely to be assisted by skilled health personnel during delivery, 2.5 times more likely to deliver the baby in a health facility, 2.8 times more likely to receive postnatal care (PNC), 2.0 times more likely to get antenatal care (ANC) services and 1.5 times more likely to seek treatment for obstetric complications than pregnant women not in the program. The degree of socioeconomic inequality in maternal health service utilization was also lower in the project area than in the comparison area. The use of vouchers evidenced much stronger demand-increasing effects on the poor. Poor voucher recipients were 4.3 times more likely to deliver in a health facility and two times more likely to use skilled health personnel at delivery than the non-poor recipients. Contrary to the inverse equity hypothesis, the voucher scheme reduced inequality even in the short run. Despite these improvements, socioeconomic disparity in the use of maternal health services has remained pro-rich, implying that demand-side financing alone will be insufficient to achieve the Millennium Development Goal for maternal health. A comprehensive system-wide approach, including supply-side strengthening, will be needed to adequately address maternal health concerns in poor
Bravo, David; Mukhopadhyay, Sankar; Todd, Petra E.
This paper studies the effects of school reform in Chile, which adopted a nationwide school voucher program along with school decentralization reforms in 1981. Since then, Chile has had a relatively unregulated, competitive market in primary and secondary education. It therefore provides a unique setting in which to study how these reforms affected school attainment and labor market outcomes. This paper develops and estimates a dynamic model of school attendance and work decisions using panel data from the 2002 and 2004 waves of the Encuesta de Protección Social survey. Some individuals in the sample completed their schooling before the voucher reforms were introduced, while others had the option of using the vouchers over part or all of their schooling careers. The impacts of the voucher reform are identified from differences in the schooling and work choices made and earnings returns received by similar aged individuals who were differentially exposed to the voucher system. Simulations based on the estimated model show that the voucher reform significantly increased the demand for private subsidized schools and decreased the demand for both public and nonsubsidized private schools. It increased high school (grades 9–12) graduation rates by 3.6 percentage points and the percentage completing at least two years of college by 2.6 percentage points. Individuals from poor and non-poor backgrounds on average experienced similar schooling attainment gains. The reform also increased lifetime utility and modestly reduced earnings inequality. PMID:22059095
..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... recognized for the purposes of these regulations if made in: (1) The National Center for Genetic...
..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... recognized for the purposes of these regulations if made in: (1) The National Center for Genetic...
..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... recognized for the purposes of these regulations if made in: (1) The National Center for Genetic...
Niza, Claudia; Rudisill, Caroline; Dolan, Paul
In this cluster randomised trial (N=1060), we tested the impact of financial incentives (£5 voucher vs. £200 lottery) framed as a gain or loss to promote Chlamydia screening in students aged 18–24 years, mimicking the standard outreach approach to student in halls of residence. Compared to the control group (1.5%), the lottery increased screening to 2.8% and the voucher increased screening to 22.8%. Incentives framed as gains were marginally more effective (10.5%) that loss-framed incentives (7.1%). This work fundamentally contributes to the literature by testing the predictive validity of Prospect Theory to change health behaviour in the field. PMID:25061507
Amass, Leslie; Kamien, Jonathan
Voucher-based reinforcement therapy (VBRT) is an effective drug abuse treatment, but the cost of VBRT rewards has limited its dissemination. Obtaining VBRT incentives through donations may be one way to overcome this barrier. Two direct mail campaigns solicited donations for use in VBRT for pregnant, postpartum, and parenting drug users in Toronto, Ontario, Canada, and in Los Angeles, California. In Toronto, 19% of those contacted over 2 months donated $8,000 ($4,000/month) of goods and services. In Los Angeles, nearly 26% of those contacted over 34 months donated $161,000 ($4,472/month) of goods and services. Maintaining voucher programs by soliciting donations is feasible and sustainable. The methods in this article can serve as a guide for successful donation solicitation campaigns. Donations offer an alternative for obtaining VBRT rewards for substance abuse treatment and may increase its dissemination. PMID:15122959
Marlowe, Douglas B; Kirby, Kimberly C; Festinger, David S; Merikle, Elizabeth P; Tran, Giao Q; Platt, Jerome J
Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling (n=39) or day treatment (n=40). Participants in both conditions received equivalent individual cognitive-behavioral counseling and earned equivalent payment vouchers for providing cocaine-negative urine samples. However, day treatment participants attended significantly more psychoeducational and recreational groups and received two meals per day. Prior to random assignment, more participants expressed a preference for day treatment and participants were more likely to return for an initial appointment following assignment to day treatment. However, no significant between-groups differences in tenure or abstinence were detected during the 3-month course of treatment. These null findings were attributable to an absence of a dose-response effect for the group interventions in the day treatment condition. In addition, there may have been a ceiling effect from the vouchers, which masked the influence of the additional day treatment components.
Garcia-Rodriguez; Olaya; Secades-Villa, Roberto; Higgins, Stephen T.; Fernandez-Hermida, Jose R.; Carballo, Jose L.
This study analyzed the viability of financing a voucher program for cocaine addicts in Spain through public and private donations. Of the 136 companies contacted, 52 (38%) provided donations. The difference between the benefits (15,670[euros]/$20,371) and the costs (3,734[euros]/$4,854) was 11,936[euros]/$15,517. The type of reinforcer a company…
Business continuity programmes provide an important function within organisations, especially when aligned with and supportive of the organisation's goals, objectives and organisational culture. Continuity programmes for large, complex international organisations, unlike those for compact national companies, are more difficult to design, build, implement and maintain. Programmes for international organisations require attention to structural design, support across organisational leadership and hierarchy, seamless integration with the organisation's culture, measured success and demonstrated value. This paper details practical, but sometimes overlooked considerations for building successful global business continuity programmes.
Rohsenow, Damaris J.; Tidey, Jennifer W.; Martin, Rosemarie A.; Colby, Suzanne M.; Sirota, Alan D.; Swift, Robert M.; Monti, Peter M.
Residential drug treatment provides an opportunity to intervene with smokers substance use disorders (SUD). A randomized controlled clinical trial compared: (1) Contingent Vouchers (CV) for smoking abstinence to Noncontingent Vouchers (NCV), crossed with (2) Motivational Interviewing (MI) or Brief Advice (BA), for 184 smokers in SUD treatment. During the voucher period, 36% of carbon monoxide readings indicated smoking abstinence for those receiving CV versus 13% with NCV (p < .001). Post-treatment point-prevalence abstinence rates were low (3–4% at each follow up), with more abstinence when CV was combined with MI (6.6% on average) than with BA (0% on average). No differential effects on drug use or motivation to quit smoking occurred. Thus, CV had limited effects on long-term smoking abstinence in this population but effects were improved when CV was combined with MI. More effective methods are needed to increase motivation to quit smoking and quit rates in this high-risk population. PMID:25805668
Epstein, Samantha W.; Mitter, Kim; Hamilton, Chris A.; Plotkin, David; Mitter, Charles
Butterflies and moths (Lepidoptera) comprise significant portions of the world’s natural history collections, but a standardized tissue preservation protocol for molecular research is largely lacking. Lepidoptera have traditionally been spread on mounting boards to display wing patterns and colors, which are often important for species identification. Many molecular phylogenetic studies have used legs from pinned specimens as the primary source for DNA in order to preserve a morphological voucher, but the amount of available tissue is often limited. Preserving an entire specimen in a cryogenic freezer is ideal for DNA preservation, but without an easily accessible voucher it can make specimen identification, verification, and morphological work difficult. Here we present a procedure that creates accessible and easily visualized “wing vouchers” of individual Lepidoptera specimens, and preserves the remainder of the insect in a cryogenic freezer for molecular research. Wings are preserved in protective holders so that both dorsal and ventral patterns and colors can be easily viewed without further damage. Our wing vouchering system has been implemented at the University of Maryland (AToL Lep Collection) and the University of Florida (Florida Museum of Natural History, McGuire Center of Lepidoptera and Biodiversity), which are among two of the largest Lepidoptera molecular collections in the world. PMID:27366654
Karen Logan describes how a team of continence advisers designed and implemented a training programme that allows local nurses to meet the national occupational standards and competencies in catheterisation and catheter care.
Resources Available to Member States for the Advancement of Women through Technical Co-operation Programmes of the United Nations System and through Programmes of Non-Governmental Organizations in Consultative Status.
United Nations Educational, Scientific, and Cultural Organization, Paris (France).
Part One contains information on United Nations technical cooperation programs which provide assistance on the request of the government concerned and are intended to help to prepare more people to contribute toward the progress of their countries by advising, showing, or teaching them or by giving them the opportunity to exchange and develop the…
Rohsenow, Damaris J; Tidey, Jennifer W; Kahler, Christopher W; Martin, Rosemarie A; Colby, Suzanne M; Sirota, Alan D
Identifying predictors of abstinence with voucher-based treatment is important for improving its efficacy. Smokers with substance use disorders have very low smoking cessation rates so identifying predictors of smoking treatment response is particularly important for these difficult-to-treat smokers. Intolerance for Smoking Abstinence Discomfort (IDQ-S), motivation to quit smoking, nicotine dependence severity (FTND), and cigarettes per day were examined as predictors of smoking abstinence during and after voucher-based smoking treatment with motivational counseling. We also investigated the relationship between IDQ-S and motivation to quit smoking. Smokers in residential substance treatment (n=184) were provided 14days of vouchers for complete smoking abstinence (CV) after a 5-day smoking reduction lead-in period or vouchers not contingent on abstinence. Carbon monoxide readings indicated about 25% of days abstinent during the 14days of vouchers for abstinence in the CV group; only 3-4% of all participants were abstinent at follow-ups. The IDQ-S Withdrawal Intolerance scale and FTND each significantly predicted fewer abstinent days during voucher treatment; FTND was nonsignificant when controlling for variance shared with withdrawal intolerance. The one significant predictor of 1-month abstinence was pretreatment motivation to quit smoking, becoming marginal (p<.06) when controlling for FTND. Lower withdrawal intolerance significantly predicted 3month abstinence when controlling for FTND. Higher withdrawal intolerance pretreatment correlated with less motivation to quit smoking. Implications for voucher-based treatment include the importance of focusing on reducing these expectancies of anticipated smoking withdrawal discomfort, increasing tolerance for abstinence discomfort, and increasing motivation.
This booklet was written specifically for anyone who writes computer programs at the Lawrence Berkeley National Laboratory. It is intended to provide basic information on how the law of copyright applies to computer software. It is not intended to be a legal reference for copyright attorneys, but an accessible reference for the people whose creative efforts result in software others want to use. Whether you are a chemist who writes software to help you with your work or a professional Berkeley Lab programmer you should benefit from this booklet. The information in this booklet is written in an informal conversational style, not a legal style. It is simply a direct response to a need for information that I have observed. Since I have written it from a programmer`s viewpoint and for a programmer`s use, it does not cover copyright law in general and focuses only on those areas of copyright law specific to computer software. Moreover, it does not attempt to address other areas of law that may be applicable to computer software. It is certainly not intended to replace the timely legal advice of Berkeley Lab`s Patent Department. However, just as it is helpful to read the computer manual before calling tech support, it will also be helpful to read this booklet before calling the Patent Department, not so much to answer any and all questions, but to give you the vocabulary to better understand and digest the information provided by the Department.
Diplomatic and operational adaptations to global health programmes in post-conflict settings: contributions of monitoring and evaluation systems to health sector development and 'nation-building' in South Sudan.
Kevany, Sebastian; Hatfield, Amanda; Workneh, Nibretie Gobezie; Durrani, Bilal Aurang Zeb; Bekele, Yonas; Khan, Usma; White, Karen; Myrick, Roger
Monitoring and evaluation (M&E) systems are an essential element of functioning and accountable global health programmes. In post-conflict settings, the role of M&E systems is also critical to ensure that health services are being delivered to those populations and regions most in need. Given the inherent challenges of health service delivery in such environments, a range of both diplomatic and operational adaptations to M&E procedures are necessary. Using the '12 components' of a functioning M&E system as a conceptual and analytical framework, we observed and reviewed the key challenges to M&E systems in South Sudan as part of a broader review of United Nations Development Programme (UNDP) activities supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Based on additional interview-based reviews and analyses of M&E activities, a list of adaptations to standardized M&E procedures in response to post-conflict environmental challenges was developed. The study concludes that development and implementation of M&E systems in post-conflict environments requires extensive adaptations to conventional procedures. Flexible and adaptable as well as 'diplomatically sensitized' M&E systems are considered to be essential to the successful completion of M&E-related activities, and may also contribute to broader international relations, 'nation-building', and peace-keeping goals.
It has been recommended that nursing staff who are new to paediatric intensive care should be offered an orientation programme There is no guidance currently available to influence the content or duration of such a programme on a national level A multi-centre research study was carried out to identify the existing provision of orientation programmes and how beneficial these are perceived to be Supernumerary status and effective mentoring are seen as essential to the success of these programmes Many new starters perceive that they receive inadequate preparation on stress management and psychosocial issues National communication between paediatric intensive care educators will help to improve and develop orientation programme provision.
Muralidharan and Sundararaman report a randomised controlled trial of a school voucher experiment in Andhra Pradesh, India. The headline findings are that there are no significant academic differences between voucher winners and losers in Telugu, mathematics, English, and science/social studies, although because the private schools appear to use…
Greene, Jay P.; Winters, Marcus A.
This study evaluates the initial effect of Washington, D.C.'s Opportunity Scholarship Program (OSP) on the academic performance of public schools and its effects on the opportunities that District students have to attend integrated schools. The OSP is a federally sponsored school voucher program that provides vouchers worth up to $7,500 for an…
Schwerdt, Guido; Messer, Dolores; Woessmann, Ludger; Wolter, Stefan C.
Lifelong learning is often promoted in ageing societies, but little is known about its returns or governments' ability to advance it. This paper evaluates the effects of a large-scale randomized field experiment issuing vouchers for adult education in Switzerland. We find no significant average effects of voucher-induced adult education on…
The Milwaukee voucher program, as implemented in 1990, allowed only nonsectarian private schools to participate in the program. However, following a Wisconsin Supreme Court ruling, the program was expanded to include religious private schools in 1998. This second phase of the voucher program led to more than a three-fold increase in the number of…
Chingos, Matthew M.; Peterson, Paul E.
We provide the first experimental estimates of the long-term impacts of a voucher to attend private school by linking data from a privately sponsored voucher initiative in New York City, which awarded the scholarships by lottery to low-income families, to administrative records on college enrollment and degree attainment. We find no significant…
West, Anne; Sparkes, Jo; Balabanov, Todor
The use of demand-side financing mechanisms and vouchers for postcompulsory secondary-level education was examined through case studies of funding practices in the following countries: Austria; France; the United Kingdom; the United States; and Wallonia (the French community of Belgium). Different models of voucher use were identified in the…
Lauder, W; Roxburgh, M; Atkinson, John; Banks, Pauline; Kane, Helen
Asynchronous communication has become the dominant mode of on-line instruction and has been incorporated into Flying Start NHS, an on-line programme for newly qualified NMAHPs in the transition phase from student to registered practitioner. On-line programmes have a number of objectives including the delivery of educational materials and the development of on-line communities. This study sought to provide a direct and objective understanding of the quality of the on-line community within Flying Start NHS and give an indication of areas of strength and weakness. The study used mixed methods including a Gricean analysis of on-line communication focusing on quantity, quality, relevance, and manner, and a thematic analysis of communication content. There was little evidence that students engaged in the type of interactive communication essential for creating on-line learning communities. The majority of postings related to progression through Flying Start. The small number of communications which did begin to engage with the learning materials were limited with little evidence of the development of critical debate. Analysis of the qualitative data indicates that the period of transition continues to be stressful with Flying Start NHS being undertaken concurrently with local CPD being seen as duplication of effort.
Borrego-Jaraba, Francisco; Garrido, Pilar Castro; García, Gonzalo Cerruela; Ruiz, Irene Luque; Gómez-Nieto, Miguel Ángel
Because of the global economic turmoil, nowadays a lot of companies are adopting a “deal of the day” business model, some of them with great success. Generally, they try to attract and retain customers through discount coupons and gift cards, using, generally, traditional distribution media. This paper describes a framework, which integrates intelligent environments by using NFC, oriented to the full management of this kind of businesses. The system is responsible for diffusion, distribution, sourcing, validation, redemption and managing of vouchers, loyalty cards and all kind of mobile coupons using NFC, as well as QR codes. WingBonus can be fully adapted to the requirements of marketing campaigns, voucher providers, shop or retailer infrastructures and mobile devices and purchasing habits. Security of the voucher is granted by the system by synchronizing procedures using secure encriptation algorithms. The WingBonus website and mobile applications can be adapted to any requirement of the system actors. PMID:23673675
Versek, Brian E.; Carpenedo, Carolyn M.; Rosenwasser, Beth J.; Dugosh, Karen Leggett; Bresani, Elena; Kirby, Kimberly C.
Voucher-based reinforcement therapy (VBRT) is an efficacious contingency management intervention for substance use disorders that provides escalating voucher values to reinforce continuous abstinence and typically resets escalated values to the initial low level upon detection of drug use. The objective of this study involving 130 methadone-maintained outpatients receiving VBRT was to investigate whether resets 1) increase risk for adverse events (AEs) and 2) delay return to abstinence in relation to magnitude of voucher reset. Weeks following resets were examined for increased likelihood of AEs using a Poisson regression. A Cox proportional hazards model was used to determine if higher resets increased the number of days until a negative urine specimen. Results showed that resets did not increase the likelihood of AEs nor were higher resets related to an increased delay to abstinence. Research involving larger samples is needed to produce sufficient data directly addressing safety concerns of various treatment stakeholders. PMID:20598837
Borrego-Jaraba, Francisco; Garrido, Pilar Castro; García, Gonzalo Cerruela; Ruiz, Irene Luque; Gómez-Nieto, Miguel Angel
Because of the global economic turmoil, nowadays a lot of companies are adopting a "deal of the day" business model, some of them with great success. Generally, they try to attract and retain customers through discount coupons and gift cards, using, generally, traditional distribution media. This paper describes a framework, which integrates intelligent environments by using NFC, oriented to the full management of this kind of businesses. The system is responsible for diffusion, distribution, sourcing, validation, redemption and managing of vouchers, loyalty cards and all kind of mobile coupons using NFC, as well as QR codes. WingBonus can be fully adapted to the requirements of marketing campaigns, voucher providers, shop or retailer infrastructures and mobile devices and purchasing habits. Security of the voucher is granted by the system by synchronizing procedures using secure encriptation algorithms. The WingBonus website and mobile applications can be adapted to any requirement of the system actors.
Basic Training Course in Systematic Curriculum Development. Course Two: Introduction to Methods and Processes of Curriculum Development. Unit 3: Translating National Goals Into Educational Programmes.
Matiru, Barbara, Ed.; Sachsenmeier, Peter, Ed.
Curriculum developers have a responsibility to fully understand national goals and to translate them into educational programs that will equip citizens to realize these goals. This topic is discussed in this manual for a basic training course in systematic curriculum development, designed for students in developing nations. A brief description of…
Background Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government’s role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize
McDonell, Michael G; Howell, Donelle N; McPherson, Sterling; Cameron, Jennifer M; Srebnik, Debra; Roll, John M; Ries, Richard K
This study assessed the effects of a contingency management (CM) intervention for alcohol consumption in 10 alcohol-dependent participants. An ABCA design was used. Vouchers were provided contingent on results of ethyl glucuronide (EtG) urine tests (an alcohol biomarker with a 2-day detection period) and alcohol breath tests during the C phase. The percentage of negative urines was 35% during the first baseline phase, 69% during the C phase, and 20% during the return-to-baseline phase. Results suggest that EtG urine tests may be a feasible method to deliver CM to promote alcohol abstinence.
Schimmer, Joshua; Breazzano, Steven
Gene therapy reimbursement continues to be an intense topic of discussion in the field given the unique and durable benefits from a single administration and generally small patient populations against a reimbursement framework that is not optimized for such "cures" or long-lived benefits. As more gene therapy programs enter the market and late-stage development, it is increasingly important for the field to define a reimbursement model that works for all stakeholders in order to encourage the next wave of innovation. To add to the discussion around new payment models and potential solutions, we propose a flexible voucher system that takes advantage of existing infrastructure, precedent, and regulatory frameworks.
Nationally approved adult numeracy teacher training programmes were started in September 2002 following the introduction of subject specifications by the Department for Education and Skills and the Further National Training Organisation in England. These programmes delivered by higher education institutions and further education colleges were…
Elacqua, Gregory; Contreras, Dante; Salazar, Felipe; Santos, Humberto
There is persistent debate over the role of scale of operations in education. Some argue that school franchises offer educational services more effectively than small independent schools. Skeptics counter that large centralized operations create hard-to-manage bureaucracies and foster diseconomies of scale and that small schools are more effective…
Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.
Ansbro, Éimhín M; Gill, Michelle M; Reynolds, Joanna; Shelley, Katharine D; Strasser, Susan; Sripipatana, Tabitha; Tshaka Ncube, Alexander; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W; Mabey, David
Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new
Chopra, Mohit P; Landes, Reid D; Gatchalian, Kirstin M; Jackson, Lisa C; Buchhalter, August R; Stitzer, Maxine L; Marsch, Lisa A; Bickel, Warren K
During a 12-week intervention, opioid dependent participants (N = 120) maintained on thrice-a-week (M, W, F) buprenorphine plus therapist and computer-based counseling were randomized to receive: (a) medication contingencies (MC = thrice weekly dosing schedule vs. daily attendance and single-day 50% dose reduction imposed upon submission of an opioid and/or cocaine positive urine sample); (b) voucher contingency (VC = escalating schedule for opioid and/or cocaine negative samples with reset for drug-positive samples); or (c) standard care (SC), with no programmed consequences for urinalysis results. VC resulted in better 12-week retention (85%) compared to MC (58%; p = 0.009), but neither differed from SC (76% retained). After adjusting for baseline differences in employment, and compared to SC, the MC group achieved 1.5 more continuous weeks of combined opioid/cocaine abstinence (p = 0.030), while the VC group had 2 more total weeks of abstinence (p = 0.048). Drug use results suggest that both the interventions were efficacious, with effects primarily in opioid rather than cocaine test results. Findings should be interpreted in light of the greater attrition associated with medication-based contingencies versus the greater monetary costs of voucher-based contingencies.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Use of Small Area Fair Market Rents for Project Base Vouchers in the Dallas TX Metropolitan Area AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD. ACTION:...
Reichard, Joshua D.
This study was designed to determine whether parent religiosity is a statistically significant school choice factor. The Duke University Religion Index (DUREL) was administered to 215 parents in an urban, PreK-12 religious private school that participated in the Ohio Educational Choice (EdChoice) voucher program. The null hypothesis that there was…
... Integrated Service Network (VISN)) to project-base these vouchers in accordance with 24 CFR part 983. Public... hearing impairments may access this number through TTY by calling the toll-free Federal Relay Service at... clinical services provided by the VA through its community medical centers. Since implementation of...
This study compares segregation levels in Milwaukee public schools and in private schools participating in the Milwaukee voucher program. Using a segregation index that measures the difference between the percent of students in a school who are white and the percentage of school-age children in the greater metro area who are white, it finds that…
Ladd, Helen F.
Although small, carefully managed voucher programs might provide a helpful safety valve for some disadvantaged children, policy makers should be under no illusion that such programs will address the fundamental challenge of providing an adequate education to the large numbers of such students in many urban centers. Contrary to the claims of many…
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Final Fair Market Rents for the Housing Choice Voucher Program and Moderate Rehabilitation Single Room Occupancy Program Fiscal Year 2013; Revised AGENCY: Office of the Assistant...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Final Fair Market Rents for the Housing Choice Voucher Program and Moderate Rehabilitation Single Room Occupancy Program for Fiscal Year 2010; Revised Correction AGENCY: Office of...
Cierniak, Katherine; Stewart, Molly; Ruddy, Anne-Maree
This brief focuses solely on currently operating statewide, general education voucher programs which have income eligibility requirements. In this brief, students in a general education program refer to students whose education is not guided by an Individualized Education Program (IEP). The term general education (classroom, curriculum, setting)…
... requirements: 1. Reporting Requirements. Each applicant must meet PIC reporting requirements. All PHAs are... the end of the last quarter prior to the application deadline date as verified by the PIC Delinquency... unit. In accordance with PIH Notice 2010-25, PHAs are expected to enter the issuance of vouchers in...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false For what activities and services must local boards use contracts or vouchers? 645.221 Section 645.221 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROVISIONS GOVERNING WELFARE-TO-WORK GRANTS General Program...
... and Line of Credit Control System (LOCCS) Voice Response System Access AGENCY: Office of the Chief... of Information Collection: Request Voucher for Grant Payment and Line of Credit Control System (LOCCS... regarding this proposal. Comments should refer to the proposal by name and/or OMB Control Number and...
... URBAN DEVELOPMENT Request Voucher for Grant Payment and Line of Credit Control System (LOCCS) Voice Response System Access Authorization AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice... and Line of Credit Control System (LOCCS) Voice Response System Access Authorization. OMB...
Hsieh, Chang-Tai; Urquiola, Miguel
In 1981, Chile introduced nationwide school choice by providing vouchers to any student wishing to attend private school. As a result, more than 1,000 private schools entered the market, and the private enrollment rate increased by 20 percentage points, with greater impacts in larger, more urban, and wealthier communities. Using differences across…
... are subject to a later audit of actual costs incurred. II. Discussion and Analysis One respondent... used to process vouchers. However, a final regulatory flexibility analysis has been performed... response to the initial regulatory flexibility analysis and no comments were filed by the Chief Counsel...
... the Housing Choice Voucher (HCV) program, to determine initial renewal rents for some expiring project... small area FMRs for the HCV program within certain metropolitan areas, and requests comments on several... calculated for the Demonstration projects will be used only in the Section 8 HCV program and will not...
... each year. This notice publishes the FMRs for the Housing Choice Voucher (HCV) Program for those PHAs... different geographic areas. In the HCV program, the FMR is the basis for determining the ``payment standard... amenities. In addition, all rents subsidized under the HCV program must meet reasonable rent...
Elacqua, Gregory; Martínez, Matías; Santos, Humberto; Urbina, Daniela
This research analyzes the impact of the Adjusted Voucher Law´s school rankings on low-performing schools in Santiago, Chile, and provides evidence on the effects of the pressures of accountability systems on teacher policies and practices. The empirical strategy is based on the fact that schools are ranked according to their position on a set of…
Public Policy Forum, 2014
Milwaukee's Parental Choice Program (MPCP) includes 110 schools today, having experienced both exits and entrants from its roster of 111 schools in the past decade. According to the Wisconsin Department of Public Instruction (DPI), fall 2013 voucher enrollment was 25,820 students, about double the 13,268 enrolled in 2003-2004. Thus, while the…
Fischel, William A.
This article offers an explanation and economic rationale for the failure of vouchers to be generally accepted by the public, suggesting that public schools are in fact a local public good. The reason economists fail to notice this is they look exclusively to the educational activity of the schools. Education is actually a private good, being both…
Since 1988, thousands of rural villagers across Senegal have participated in a basic education program called TOSTAN, which means "breakthrough" in Wolof, the majority language. Supported by UNICEF and implemented in the six national languages of Senegal, TOSTAN goes beyond traditional literacy programs to link literacy learning with…
Fozdar, Bharat Inder; Kumar, Lalita S.; Kannan, S.
This paper presents a report on students who decided to drop out of the BSc program offered by Indira Gandhi National Open University (IGNOU). This study was designed to determine the reasons leading to students' decisions to withdraw from the program. Identified and reported in this study are nine major reasons leading to drop out. Results of…
Afriyie, Sally Adwoa
This article discusses the efficiency of the design of educational activities of the National Commission for Civic Education (NCCE) in Ashaiman municipality in Ghana. Using a descriptive case study design, data was collected from seven (7) Community Based Groups in Ashaiman. The results of the study indicated that to a large extent, there was…
National Swedish Board of Education, Stockholm.
The Swedish National Board of Education's action program for long-term planning of work relating to the teaching of immigrants and minorities is outlined in this report. First, material is presented which describes the background and focus of the program, the immigrant population to be served, and Sweden's general immigration policy as it applies…
Whitmore, Susan C.; Grefsheim, Suzanne F.; Rankin, Jocelyn A.
Background The informationist programme at the Library of the National Institutes of Health (NIH) in Bethesda, MD, USA has grown to 14 informationists working with 40 clinical and basic science research teams. Purpose This case report, intended to contribute to the literature on informationist programmes, describes the NIH informationist programme including implementation experiences, the informationists' training programme, their job responsibilities and programme outcomes. Brief description The NIH informationist programme was designed to enhance the library's service capacity. Over time, the steps for introducing the service to new groups were formalized to ensure support by leadership, the team being served and the library. Job responsibilities also evolved from traditional library roles to a wide range of knowledge management activities. The commitment by the informationist, the team and the library to continuous learning is critical to the programme's success. Results/outcomes NIH scientists reported that informationists saved them time and contributed to teamwork with expert searching and point-of-need instruction. Process evaluation helped refine the programme. Evaluation method High-level, preliminary outcomes were identified from a survey of scientists receiving informationist services, along with key informant interviews. Process evaluation examined service implementation, informationists' training, and service components. Anecdotal evidence has also indicated a favorable response to the programme. PMID:18494648
Mackenzie, Graham; Dougall, Angela
Poverty has a detrimental impact on health and wellbeing. Healthy Start food and vitamin vouchers provide support for low income families across the UK, but at least 25% of eligible women and children miss out. We set out to increase uptake, with an aim of 90% of eligible women and children (n~540 eligible, varying over time) receiving vouchers in the initial team's catchment area by December 2015. Starting with one midwife and one pregnant woman in March 2014 we used the model for improvement to identify ways to improve documentation, sign up, and referral. Weekly data on process measures and monthly data on voucher receipt were plotted on run charts. Comparing medians for January-June 2014 and March-August 2015 there was a 13.3% rise in voucher receipt in Lothian (increase from 313 to 355 women), versus an 8.4% decline for the rest of Scotland (fall from 1688 to 1546 women). Figures varied by team, influenced by staff, family, and area factors. The initial aim proved unrealistic, as signing up a woman for vouchers increases both the numerator and denominator. Accordingly, the percentage uptake has not increased at a regional level (remains at 75%), though the figure for the initiating team ("team 3" in graphs) has increased from 73.0% (January 2014) to 79.0% (November 2015). We have continued testing, achieving recent increases in the number of women referred for welfare rights advice on benefits, tax credits, employment rights, childcare, and debt, securing on average £4,500 per client during 2015/16 (£404k for 89 clients by mid September 2015). This improvement project, part of the Early Years Collaborative in Scotland, has had a measureable impact on pregnant women across Lothian. Success has relied on testing, an electronic maternity record, rapid dissemination of findings through direct engagement with clinical teams, and persistence. Our findings have relevance across the UK, particularly at a time of worsening finances for many families.
Arora, Monika; Chauhan, Kavita; John, Shoba; Mukhopadhyay, Alok
Major noncommunicable diseases (NCDs) share common behavioral risk factors and deep-rooted social determinants. India needs to address its growing NCD burden through health promoting partnerships, policies, and programs. High-level political commitment, inter-sectoral coordination, and community mobilization are important in developing a successful, national, multi-sectoral program for the prevention and control of NCDs. The World Health Organization's “Action Plan for a Global Strategy for Prevention and Control of NCDs” calls for a comprehensive plan involving a whole-of-Government approach. Inter-sectoral coordination will need to start at the planning stage and continue to the implementation, evaluation of interventions, and enactment of public policies. An efficient multi-sectoral mechanism is also crucial at the stage of monitoring, evaluating enforcement of policies, and analyzing impact of multi-sectoral initiatives on reducing NCD burden in the country. This paper presents a critical appraisal of social determinants influencing NCDs, in the Indian context, and how multi-sectoral action can effectively address such challenges through mainstreaming health promotion into national health and development programs. India, with its wide socio-cultural, economic, and geographical diversities, poses several unique challenges in addressing NCDs. On the other hand, the jurisdiction States have over health, presents multiple opportunities to address health from the local perspective, while working on the national framework around multi-sectoral aspects of NCDs. PMID:22628911
Use of food labels, awareness of nutritional programmes and participation in the special supplemental program for Women, Infants and Children (WIC): results from the National Health and Nutrition Examination Survey (2005-2006).
Wojcicki, Janet M; Heyman, Melvin B
Use of nutritional labels in choosing food is associated with healthier eating habits including lower fat intake. Current public health efforts are focusing on the revamping of nutritional labels to make them easier to read and use for the consumer. The study aims to assess the frequency of use of nutritional labels and awareness of the United States Department of Agriculture (USDA) nutritional programmes by low-income women including those participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as surveyed in the National Health and Nutrition Examination Survey 2005-2006. Many low-income women do not regularly use the nutrition facts panel information on the food label and less than half had heard of the USDA Dietary Guidelines for Americans (38.9%). In multivariate logistic regression, we found that WIC participation was associated with reduced use of the nutrition facts panel in choosing food products [odds ratio (OR) 0.45, 95% confidence interval (CI) 0.22-0.91], the health claims information (OR 0.54, 95% CI 0.32-0.28) and the information on carbohydrates when deciding to buy a product (OR 0.44, 95% CI 0.20-0.97) in comparison with WIC eligible non-participants. Any intervention to improve use of nutritional labels and knowledge of the USDA's nutritional programmes needs to target low-income women, including WIC participants. Future studies should evaluate possible reasons for the low use of nutrition labels among WIC participants in comparison with eligible non-participants.
‘Health and happiness is more important than weight’: a qualitative investigation of the views of parents receiving written feedback on their child's weight as part of the National Child Measurement Programme
Syrad, H; Falconer, C; Cooke, L; Saxena, S; Kessel, A S; Viner, R; Kinra, S; Wardle, J; Croker, H
Background The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback. Methods Fifty-two parents of overweight and obese children aged 4–5 years and 10–11 years enrolled in the NCMP programme in England in 2010–2011 participated in qualitative, semi-structured interviews about their perceptions of their child's weight and health risk after receiving weight feedback. Interviews were audio tape recorded and were conducted either by telephone (n = 9) or in the respondents’ homes (n = 41). Interviews were transcribed verbatim and analysed using interpretative thematic analysis. Results Parents who received NCMP written feedback informing them that their child was overweight disregarded the results because they viewed ‘health and happiness as being more important than weight’. The feedback was viewed as less credible because it did not consider the individual child's lifestyle. ‘Broad definitions of healthy’ were described that did not include weight, such as reference to the child having good emotional and physical health and a healthy diet. Parents attributed weight to ‘inherited/acquired factors’ such as genetics or puppy fat, or did not regard their child's ‘appearance’ as reflecting being overweight. ‘Cultural influence’ also meant that being overweight was not viewed negatively by some non-white parents. Conclusions After receiving written weight feedback, parents use methods other than actual weight when evaluating their child's weight status and health risks. Parents’ conceptions of health and weight should be considered when communicating with parents, with the aim of bridging the gap between parental recognition of being overweight and subsequent behaviour change. PMID:26295077
Hunter, Stephanie J; Goodall, Tim I; Walsh, Kerry A; Owen, Richard; Day, John C
A nondestructive, chemical-free method is presented for the extraction of DNA from small insects. Blackflies were submerged in sterile, distilled water and sonicated for varying lengths of time to provide DNA which was assessed in terms of quantity, purity and amplification efficiency. A verified DNA barcode was produced from DNA extracted from blackfly larvae, pupae and adult specimens. A 60-second sonication period was found to release the highest quality and quantity of DNA although the amplification efficiency was found to be similar regardless of sonication time. Overall, a 66% amplification efficiency was observed. Examination of post-sonicated material confirmed retention of morphological characters. Sonication was found to be a reliable DNA extraction approach for barcoding, providing sufficient quality template for polymerase chain reaction amplification as well as retaining the voucher specimen for post-barcoding morphological evaluation.
Maya-Lastra, Carlos A.
Premise of the study: ColectoR was developed to aid botanists in the collection of data for voucher specimens using smartphones, accelerating the process of data capture in situ and its subsequent organization. Methods and Results: ColectoR features a minimalist design that uses an intuitive iconic interface. The integration of external application programming interfaces (APIs) and an automated spreadsheet extends its functionality and increases the information and tools available to the user. This app is currently supported by any Android device. Conclusions: ColectoR provides an efficient method for capturing data in the field while also serving to organize the information into a coherent database, thereby greatly reducing the time required for postcapture data organization and label printing. PMID:27437169
Carder, Paula; Luhr, Gretchen; Kohon, Jacklyn
Affordable housing is an important form of income security for low-income older persons. This article describes characteristics of older persons waitlisted for either public housing or a housing choice voucher (HCV; previously Section 8) in Portland, Oregon. 358 persons (32% response rate) completed a mailed survey with questions about demographics, health and housing status, food insecurity, and preference for housing with services. Findings indicate that many waitlisted older persons experienced homelessness or housing instability, poor health, high hospital use, and food insecurity. Public housing applicants were significantly more likely to report lower incomes, homelessness, and food insecurity than HCV applicants. We conclude with policy implications for housing and health agencies that serve low-income older persons.
Insolia, Gerard; Anderson, Kathleen
This document contains a 40-hour course in programmable logic controllers (PLC), developed for a business-industry technology resource center for firms in eastern Pennsylvania by Northampton Community College. The 10 units of the course cover the following: (1) introduction to programmable logic controllers; (2) DOS primer; (3) prerequisite…
Drossinou-Korea, Maria; Matousi, Dimitra; Panopoulos, Nikolaos; Paraskevopoulou, Aikaterini
The purpose of this work was to understand the school inclusion programmes (SIPs) for students with special educational needs (SEN). The methodology was conducted in the field of special education (SE) and focuses on three case studies of students who was supported by SIPs. The Targeted, Individual, Structured, Inclusion Programme for students…
Brooner, Robert K; Kidorf, Michael S; King, Van L; Stoller, Kenneth B; Neufeld, Karin J; Kolodner, Ken
This 6-month randomized clinical trial (with 3-month follow-up) used a 2x2 design to compare the independent and combined effectiveness of two interventions designed to improve outcomes in treatment-seeking opioid dependent patients (n=236): motivated stepped care (MSC) and contingent voucher incentives (CVI). MSC is an adaptive treatment strategy that uses principles of negative reinforcement and avoidance to motivate both attendance to varying levels of counseling services and brief periods of abstinence [Brooner, R.K., Kidorf, M., 2002. Using behavioral reinforcement to improve methadone treatment participation. Sci. Pract. Perspect. 1, 38-46; Brooner, R.K., Kidorf, M.S., King, V.L., Peirce, J.M., Bigelow, G.E., Kolodner, K., 2004. A modified "stepped care" approach to improve attendance behavior in treatment seeking opioid abusers. J. Subst. Abuse Treat. 27, 223-232]. In contrast, CVI [Higgins, S., Delaney, D.D., Budney, A.J., Bickel, W.K., Hughes, J.R., Foerg, B.A., Fenwick, J.W., 1991. A behavioral approach to achieving initial cocaine abstinence. Am. Psychiatr. 148, 1218-1224] relies on positive reinforcement to motivate drug abstinence. The results showed that the combined approach (MSC+CVI) was associated with the highest proportion of drug-negative urine samples during both the randomized and 3-month follow-up arms of the evaluation. The CVI-only and the MSC-only conditions evidenced similar proportions of drug-negative urine samples that were both significantly greater than the standard care (SC) comparison group. Voucher-based reinforcement was associated with better retention, while adaptive stepped-based care was associated with better adherence to scheduled counseling sessions. These results suggest that both CVI and MSC are more effective than routine care for reducing drug use in opioid dependent outpatients, and that the overall benefits of MSC are enhanced further by adding positive reinforcement.
De Ley, Paul; De Ley, Irma Tandingan; Morris, Krystalynne; Abebe, Eyualem; Mundo-Ocampo, Manuel; Yoder, Melissa; Heras, Joseph; Waumann, Dora; Rocha-Olivares, Axayácatl; Jay Burr, A H; Baldwin, James G; Thomas, W Kelley
Molecular surveys of meiofaunal diversity face some interesting methodological challenges when it comes to interstitial nematodes from soils and sediments. Morphology-based surveys are greatly limited in processing speed, while barcoding approaches for nematodes are hampered by difficulties of matching sequence data with traditional taxonomy. Intermediate technology is needed to bridge the gap between both approaches. An example of such technology is video capture and editing microscopy, which consists of the recording of taxonomically informative multifocal series of microscopy images as digital video clips. The integration of multifocal imaging with sequence analysis of the D2D3 region of large subunit (LSU) rDNA is illustrated here in the context of a combined morphological and barcode sequencing survey of marine nematodes from Baja California and California. The resulting video clips and sequence data are made available online in the database NemATOL (http://nematol.unh.edu/). Analyses of 37 barcoded nematodes suggest that these represent at least 32 species, none of which matches available D2D3 sequences in public databases. The recorded multifocal vouchers allowed us to identify most specimens to genus, and will be used to match specimens with subsequent species identifications and descriptions of preserved specimens. Like molecular barcodes, multifocal voucher archives are part of a wider effort at structuring and changing the process of biodiversity discovery. We argue that data-rich surveys and phylogenetic tools for analysis of barcode sequences are an essential component of the exploration of phyla with a high fraction of undiscovered species. Our methods are also directly applicable to other meiofauna such as for example gastrotrichs and tardigrades.
Cameron, Neil A
This article briefly reviews the history and epidemiology of measles, mumps and rubella disease and the case for introducing combination measles-mumps-rubella (MMR) vaccine into the national childhood immunization schedule in South Africa. Despite adopting the World Health Organization's Measles Elimination strategy in 1996 and achieving a significant decrease the incidence of measles, added effort is needed in South and southern Africa to reach the goal to eliminate endogenous spread measles. Mumps is still common disease of childhood and while there are few sequelae, even the rare complications are important in large populations. Congenital rubella syndrome is seldom reported, but it is estimated that of the million or so children born every year in South Africa over 600 infants are affected to some degree by rubella infection. The naturally acquired immunity to rubella in women of childbearing age in South Africa has been estimated at over 90%, so that introducing a rubella containing vaccine in childhood may paradoxically increase the proportion of girls reaching puberty still susceptible to rubella. The elimination of endogenous measles and rubella is being achieved in many countries in South America, and despite the recent measles epidemic, must still be seriously considered for South and southern Africa. Current constraints and potential steps needed to reach the goal in South Africa are discussed.
Whelan, Jane; Hahné, Susan; Berbers, Guy; van der Klis, Fiona; Wijnands, Yvonne; Boot, Hein
The hexavalent vaccine Infanrix hexa was introduced into the national childhood vaccination schedule in the Netherlands in 2006. It is offered, concomitantly with pneumococcal vaccine (Prevenar), to children at increased risk of hepatitis B, administered in a 4-dose schedule at 2, 3, 4 and 11 months of age. We assessed the immunogenicity of the HBV component of Infanrix hexa co-administered with Prevenar, and compared pertussis and Hib components in Infanrix hexa with the standard Infanrix-IPV+Hib vaccine. Target thresholds for immune responses were achieved for all antigens studied. Over 99% (163/164) of children vaccinated with Infanrix hexa achieved an adequate immune response (≥ 10 mIU/ml) to the HBV component and peak anti-HBs geometric mean concentration (GMC) was 2264 mIU/ml (95%CI:1850-2771 mIU/ml). The GMC of a pertussis component, filamentous hemagglutinin (FHA), of Infanrix-hexa was significantly lower in children vaccinated with Infanrix hexa and Prevenar than in children vaccinated with Infanrix-IPV+Hib. Universal infant HBV vaccination using Infanrix hexa was introduced in The Netherlands in 2011. Despite very high rates of seroconversion for the HBV component of Infanrix hexa, its long term immunogenicity and effectiveness should be monitored after concomitant vaccination.
Mkocha, H; Munoz, B; West, S
Trachoma, a blinding eye disease caused by repeated and prolonged infection with Chlamydia trachomatis, is a significant public health problem for sub-Saharan Africa. Tanzania has had a National Trachoma Task Force since 1999, working on trachoma control in endemic districts. The objective of this study was twofold: first, to determine the current status of infection and clinical trachoma in these districts in Tanzania, and second, to determine if a combination of clinical signs could be used as a surrogate for infection. We conducted a survey for trachoma and infection with C. trachomatis in 75 villages in eight districts of Kongwa, Kilosa, Mpwapwa, Bahi, Kondoa, Manyoni, Monduli and Iramba in Tanzania, which have previously been shown to be endemic. In each village, a random sample of households, and of children within households, was taken for examination. Trachoma was graded using the World Health Organization system, which we expanded, and a swab taken to determine presence of infection. The rates of trachoma ranged from 0% in Iramba District to 15.17% in Monduli District, with large variation in villages within districts. Infection rates were generally lower than trachoma rates, as expected, and most districts had villages with no infection. A combination of clinical signs of trachoma in children, when absent, showed very high specificity for identifying villages with no infection. We conclude that these signs might be useful for monitoring absence of infection in villages, and that districts with trachoma prevalence between 10% and 15% should have village level rapid surveys to avoid unnecessary mass treatment.
Connect: Unesco-UNEP Environmental Education Newsletter, 1983
In 1975 Unesco, with the cooperation of the United Nations Environment Programme (UNEP), launched the current International Environmental Education Programme (IEEP). The initial 3-year phase of the IEEP was fundamentally that of promoting and stimulating environmental education among Unesco member states by (1) elaborating concepts, goals, and…
On 26 February in Lisbon a team from the OECD's Centre for Effective Learning Environments (CELE) presented its first review of a national school building programme. The school building renovation programme in Portugal, which began in March 2007, involves the renovation of 332 schools by 2015. However, Portugal plans to complete 205 by the end of…
Describes the development of the Microelectronics Education Programme for England, Northern Ireland and Wales, including funding, aims, and relationships of the national program with local organizations. The program focuses on incorporating uses/effects of microelectronic technology into the total school curriculum and ways of using this…
Prendergast, Michael L; Hall, Elizabeth A; Roll, John; Warda, Umme
In response to the growing number of drug offenders cycling in and out of the criminal justice system without treatment for underlying drug problems, the judicial system has increasingly adopted drug courts as a strategy to divert these offenders from incarceration to supervised drug treatment. Our aim was to determine if drug court treatment effectiveness could be improved using contingency management, in the form of twice-weekly vouchers, to reinforce abstinence and positive behaviors for 163 clients over 26 weeks. We found no significant differences in outcomes among the study groups, although the Treatment Plan Group that received reinforcement for positive behaviors showed a trend toward poorer performance. We suspect that the influence of the judge within the courtroom had a stronger impact on drug court clients' attitudes, drug use behaviors, and other outcomes than the relatively low-value vouchers awarded as part of the treatment protocol.
Ménard, Didier; Ratsimbasoa, Arsène; Randrianarivelojosia, Milijaona; Rabarijaona, Léon-Paul; Raharimalala, Lucie; Domarle, Olivier; Randrianasolo, Laurence; Randriamanantena, Arthur; Jahevitra, Martial; Andriantsoanirina, Valérie; Rason, Marie-Ange; Raherinjafy, Rogelin; Rakotomalala, Emma; Tuseo, Luciano; Raveloson, Andrianirina
Background In order to improve the monitoring of the antimalarial drug resistance in Madagascar, a new national network based on eight sentinel sites was set up. In 2006/2007, a multi-site randomized clinical trial was designed to assess the therapeutic efficacy of chloroquine (CQ), sulphadoxine-pyrimethamine (SP), amodiaquine (AQ) and artesunate plus amodiaquine combination (ASAQ), the antimalarial therapies recommended by the National Malaria Control Programme (NMCP). Methods Children between six months and 15 years of age, with uncomplicated falciparum malaria, were enrolled. Primary endpoints were the day-14 and day-28 risks of parasitological failure, either unadjusted or adjusted by genotyping. Risks of clinical and parasitological treatment failure after adjustment by genotyping were estimated using Kaplan-Meier survival analysis. Secondary outcomes included fever clearance, parasite clearance, change in haemoglobin levels between Day 0 and the last day of follow-up, and the incidence of adverse events. Results A total of 1,347 of 1,434 patients (93.9%) completed treatment and follow-up to day 28. All treatment regimens, except for the chloroquine (CQ) treatment group, resulted in clinical cure rates above 97.6% by day-14 and 96.7% by day-28 (adjusted by genotyping). Parasite and fever clearance was more rapid with artesunate plus amodiaquine, but the extent of haematological recovery on day-28 did not differ significantly between the four groups. No severe side-effects were observed during the follow-up period. Conclusion These findings (i) constitute an up-dated baseline data on the efficacy of antimalarial drugs recommended by the NMCP, (ii) show that antimalarial drug resistance remains low in Madagascar, except for CQ, compared to the bordering countries in the Indian Ocean region such as the Comoros Archipelago and (iii) support the current policy of ASAQ as the first-line treatment in uncomplicated falciparum malaria. PMID:18394169
The programme for the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics" which was held at the KGU (Kanto Gakuin University) Kannai Media Center (8th floor of Yokohoma Media Business Center (YMBC))
The 180m Five-hundred-meter Aperture Spherical radio Telescope (FAST) - the world's largest single-aperture radio receiver - has become part of the Breakthrough Listen programme, which launched in July 2015 to look for intelligent life beyond Earth.
Shah, L. R.
The various types and forms of credit and non-credit university continuing education programmes are described in these extracts from a paper presented at the Hyderabad conference on university continuing education. (ABM)
The article outlines the evolution, development, and current operational programme of the ISBD's (International Standard Bibliographic Description) within the framework of IFLA (International Federation of Library Associations). (Author/JAB)
This column will be provided each quarter as a source for reliability, radiation results, NASA capabilities, and other information on programmable logic devices and related applications. This quarter's column will include some announcements and some recent radiation test results and evaluations of interest. Specifically, the following topics will be covered: the Military and Aerospace Applications of Programmable Devices and Technologies Conference to be held at GSFC in September, 1998, proton test results, and some total dose results.
This column will be provided each quarter as a source for reliability, radiation results, NASA capabilities, and other information on programmable logic devices and related applications. This quarter's column will include some announcements and some recent radiation test results and evaluations of interest. Specifically, the following topics will be covered: the Military and Aerospace Applications of Programmable Devices and Technologies Conference to be held at GSFC in September, 1998, proton test results, heavy ion test results, and some total dose results.
Oyewale, Tajudeen O.; Ahmed, Shale; Ahmed, Farid; Tazreen, Mona; Uddin, Ziya; Rahman, Anisur; Oyediran, Kola A.
Introduction The study described the effectiveness of a voucher scheme to access sexual and reproductive health and HIV services among young MSM and transgender people aged 15–24 years in Dhaka, Bangladesh, a country with HIV prevalence of less than 0.1%. Methods Descriptive and analytical methods were used to assess the net effects of biodemographic factors of the respondents on the voucher scheme. Effectiveness of the scheme was contextualized as target population coverage, and turnaround time of voucher redemption to access services. Results and discussion A total of 210 (87.9%) out of the 239 vouchers distributed were redeemed. The mean age of the identified young people was 19.6 years (SD = +2.6 years). The coverage of the scheme against the target population of 200 young MSM and 936 young transgender people was 88% (n = 175) and 4% (n = 35) respectively, with P < 0.001. The median turnaround time for voucher redemption was 7 days. The predictors of voucher turnaround time were age, education, and population group (P < 0.001). HIV testing and counselling was accessed by 160 (76%) respondents, one was positive and linked to antiretroviral treatment and 110 (52%) were diagnosed and treated for sexually transmitted infections. Conclusion The voucher scheme was effective in linking young MSM with sexual and reproductive health and HIV services in Dhaka, Bangladesh. The findings are consistent with the low HIV prevalence in the country. The scheme is, however, not optimal for linking young transgender people with services. PMID:26945145
Mackenzie, Graham; Dougall, Angela
Poverty has a detrimental impact on health and wellbeing. Healthy Start food and vitamin vouchers provide support for low income families across the UK, but at least 25% of eligible women and children miss out. We set out to increase uptake, with an aim of 90% of eligible women and children (n~540 eligible, varying over time) receiving vouchers in the initial team's catchment area by December 2015. Starting with one midwife and one pregnant woman in March 2014 we used the model for improvement to identify ways to improve documentation, sign up, and referral. Weekly data on process measures and monthly data on voucher receipt were plotted on run charts. Comparing medians for January-June 2014 and March-August 2015 there was a 13.3% rise in voucher receipt in Lothian (increase from 313 to 355 women), versus an 8.4% decline for the rest of Scotland (fall from 1688 to 1546 women). Figures varied by team, influenced by staff, family, and area factors. The initial aim proved unrealistic, as signing up a woman for vouchers increases both the numerator and denominator. Accordingly, the percentage uptake has not increased at a regional level (remains at 75%), though the figure for the initiating team (“team 3” in graphs) has increased from 73.0% (January 2014) to 79.0% (November 2015). We have continued testing, achieving recent increases in the number of women referred for welfare rights advice on benefits, tax credits, employment rights, childcare, and debt, securing on average £4,500 per client during 2015/16 (£404k for 89 clients by mid September 2015). This improvement project, part of the Early Years Collaborative in Scotland, has had a measureable impact on pregnant women across Lothian. Success has relied on testing, an electronic maternity record, rapid dissemination of findings through direct engagement with clinical teams, and persistence. Our findings have relevance across the UK, particularly at a time of worsening finances for many families. PMID
Meuwissen, Liesbeth E; Gorter, Anna C; Kester, Arnold DM; Knottnerus, J Andre
Background Little is known about how sexual and reproductive (SRH) health can be made accessible and appropriate to adolescents. This study evaluates the impact and sustainability of a competitive voucher program on the quality of SRH care for poor and underserved female adolescents and the usefulness of the simulated patient (SP) method for such evaluation. Methods 28,711 vouchers were distributed to adolescents in disadvantaged areas of Managua that gave free-of-charge access to SRH care in 4 public, 10 non-governmental and 5 private clinics. Providers received training and guidelines, treatment protocols, and financial incentives for each adolescent attended. All clinics were visited by female adolescent SPs requesting contraception. SPs were sent one week before, during (with voucher) and one month after the intervention. After each consultation they were interviewed with a standardized questionnaire. Twenty-one criteria were scored and grouped into four categories. Clinics' scores were compared using non-parametric statistical methods (paired design: before-during and before-after). Also the influence of doctors' characteristics was tested using non-parametric statistical methods. Results Some aspects of service quality improved during the voucher program. Before the program started 8 of the 16 SPs returned 'empty handed', although all were eligible contraceptive users. During the program 16/17 left with a contraceptive method (p = 0.01). Furthermore, more SPs were involved in the contraceptive method choice (13/17 vs.5/16, p = 0.02). Shared decision-making on contraceptive method as well as condom promotion had significantly increased after the program ended. Female doctors had best scores before- during and after the intervention. The improvements were more pronounced among male doctors and doctors older than 40, though these improvements did not sustain after the program ended. Conclusion This study illustrates provider-related obstacles adolescents often
Since 2001 there has been a renewed government focus on skills development and its relationship with combating unemployment in Ghana. Technical and vocational education and training (hereinafter; TVET), delivered through public and private schools, vocational training institutes and informal apprenticeship training, continues to be seen as an…
This paper investigates forms of collaborative doctoral programmes that enable employer engagement in innovation and skills development. Collaborative doctoral programmes exist in different national contexts for the development of the science and technology human capital. Such programmes are also seen as policy tools that enhance relationships…
Veloso, Luísa; Marques, Joana S.; Duarte, Alexandra
In this article we present findings from the evaluation study of a nation-wide school renovation programme in Portugal. The aim is to analyse policy implementation, taking into account school community participation, discussing how the programme requirement to involve users in the renovation was met, examining perceptions of the programme's…
Burner management systems ensure safe admission of fuel to the furnace and prevent explosions. This article describes how programmable control systems can be every bit as safe and reliable as hardwired or standard programmable logic controller-based designs. High-pressure boilers are required by regulatory agencies and insurance companies alike to be equipped with a burner management system (BMS) to ensure safe admission of fuel to the furnace and to prevent explosions. These systems work in parallel with, but independently of, the combustion and feedwater control systems that start up, monitor, and shut down burners and furnaces. Safety and reliability are the fundamental requirements of a BMS. Programmable control system for BMS applications are now available that incorporate high safety and reliability into traditional microprocessor-based designs. With one of these control systems, a qualified systems engineer applying relevant standards, such as the National Fire Protection Assn (NFPA) 85 series, can design and implement a superior BMS.
Gries, Corinna; Gilbert, Edward E; Franz, Nico M
We review the Symbiota software platform for creating voucher-based biodiversity information portals and communities. Symbiota was originally conceived to promote small- to medium-sized, regionally and/or taxonomically themed collaborations of natural history collections. Over the past eight years the taxonomically diverse portals have grown into an important resource in North America and beyond for mobilizing, integrating, and using specimen- and observation-based occurrence records and derivative biodiversity information products. Designed to mirror the conceptual structure of traditional floras and faunas, Symbiota is exclusively web-based and employs a novel data model, information linking, and algorithms to provide highly dynamic customization. The themed portals enable meaningful access to biodiversity data for anyone from specialist to high school student. Symbiota emulates functionality of modern Content Management Systems, providing highly sophisticated yet intuitive user interfaces for data entry, batch processes, and editing. Each kind of content provision may be selectively accessed by authenticated information providers. Occupying a fairly specific niche in the biodiversity informatics arena, Symbiota provides extensive data exchange facilities and collaborates with other development projects to incorporate and not duplicate functionality as appropriate.