Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

PubMed Central

Liu, Nancy H.; Daumit, Gail L.; Dua, Tarun; Aquila, Ralph; Charlson, Fiona; Cuijpers, Pim; Druss, Benjamin; Dudek, Kenn; Freeman, Melvyn; Fujii, Chiyo; Gaebel, Wolfgang; Hegerl, Ulrich; Levav, Itzhak; Munk Laursen, Thomas; Ma, Hong; Maj, Mario; Elena Medina‐Mora, Maria; Nordentoft, Merete; Prabhakaran, Dorairaj; Pratt, Karen; Prince, Martin; Rangaswamy, Thara; Shiers, David; Susser, Ezra; Thornicroft, Graham; Wahlbeck, Kristian; Fekadu Wassie, Abe; Whiteford, Harvey; Saxena, Shekhar

2017-01-01

Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain limited, and strategies for implementation and scaling up of programmes with a strong evidence base are scarce. Furthermore, the majority of available interventions focus on a single or an otherwise limited number of risk factors. Here we present a multilevel model highlighting risk factors for excess mortality in persons with SMD at the individual, health system and socio‐environmental levels. Informed by that model, we describe a comprehensive framework that may be useful for designing, implementing and evaluating interventions and programmes to reduce excess mortality in persons with SMD. This framework includes individual‐focused, health system‐focused, and community level and policy‐focused interventions. Incorporating lessons learned from the multilevel model of risk and the comprehensive intervention framework, we identify priorities for clinical practice, policy and research agendas. PMID:28127922

Non-animal approaches for consumer safety risk assessments: Unilever's scientific research programme.

PubMed

Carmichael, Paul; Davies, Michael; Dent, Matt; Fentem, Julia; Fletcher, Samantha; Gilmour, Nicola; MacKay, Cameron; Maxwell, Gavin; Merolla, Leona; Pease, Camilla; Reynolds, Fiona; Westmoreland, Carl

2009-12-01

Non-animal based approaches to risk assessment are now routinely used for assuring consumer safety for some endpoints (such as skin irritation) following considerable investment in developing and applying new methods over the past 20 years. Unilever's research programme into non-animal approaches for safety assessment is currently focused on the application of new technologies to risk assessments in the areas of skin allergy, cancer and general toxicity (including inhalation toxicity). In all of these areas, a long-term investment is essential to increase the scientific understanding of the underlying biological and chemical processes that we believe will ultimately form a sound basis for novel risk assessment approaches. Our research programme in these priority areas consists of in-house research as well as Unilever-sponsored academic research, involvement with EU-funded projects (e.g. Sens-it-iv, carcinoGENOMICS), participation in cross-industry collaborative research (e.g. COLIPA, EPAA) and ongoing involvement with other scientific initiatives on non-animal approaches to risk assessment (e.g. UK NC3Rs, US 'Human Toxicology Project' consortium). 2009 FRAME.

The United Nations programme on space applications: priority thematic areas

NASA Astrophysics Data System (ADS)

Haubold, H.

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

Assuring safety without animal testing: Unilever's ongoing research programme to deliver novel ways to assure consumer safety.

PubMed

Westmoreland, Carl; Carmichael, Paul; Dent, Matt; Fentem, Julia; MacKay, Cameron; Maxwell, Gavin; Pease, Camilla; Reynolds, Fiona

2010-01-01

Assuring consumer safety without the generation of new animal data is currently a considerable challenge. However, through the application of new technologies and the further development of risk-based approaches for safety assessment, we remain confident it is ultimately achievable. For many complex, multi-organ consumer safety endpoints, the development, evaluation and application of new, non-animal approaches is hampered by a lack of biological understanding of the underlying mechanistic processes involved. The enormity of this scientific challenge should not be underestimated. To tackle this challenge a substantial research programme was initiated by Unilever in 2004 to critically evaluate the feasibility of a new conceptual approach based upon the following key components: 1.Developing new, exposure-driven risk assessment approaches. 2.Developing new biological (in vitro) and computer-based (in silico) predictive models. 3.Evaluating the applicability of new technologies for generating data (e.g. "omics", informatics) and for integrating new types of data (e.g. systems approaches) for risk-based safety assessment. Our research efforts are focussed in the priority areas of skin allergy, cancer and general toxicity (including inhaled toxicity). In all of these areas, a long-term investment is essential to increase the scientific understanding of the underlying biology and molecular mechanisms that we believe will ultimately form a sound basis for novel risk assessment approaches. Our research programme in these priority areas consists of in-house research as well as Unilever-sponsored academic research, involvement in EU-funded projects (e.g. Sens-it-iv, Carcinogenomics), participation in cross-industry collaborative research (e.g. Colipa, EPAA) and ongoing involvement with other scientific initiatives on non-animal approaches to risk assessment (e.g. UK NC3Rs, US "Human Toxicology Project" consortium).

European commission research on stratospheric ozone depletion

NASA Astrophysics Data System (ADS)

Amanatidis, G. T.; Ott, H.

1995-02-01

The research policy of the European Commission (EC) on the stratospheric ozone depletion, which is implemented through the ENVIRONMENT Programme is described. The strategy of this stratospheric ozone research, which is developed to address the open scientific questions, requires a coordinated and balanced programme which is based on long term measurements, process studies at regional or global scale, laboratory studies, continuous and accurate measurements of ultraviolet (UV) radiation and development of instrumentation. These research activities, whenever necessary, take form of extensive and coordinated experiments (EASOE 1991/92, SESAME 1994-95), while the overall objective is to provide a firm scientific basis for future European Union (EU) policy actions in this area. Finally, priorities which have been identified for future research in the ENVIRONMENT and CLIMATE Programme (1994-1998) are also detailed.

Priorities for research in child maltreatment, intimate partner violence and resilience to violence exposures: results of an international Delphi consensus development process.

PubMed

Wathen, C Nadine; MacGregor, Jennifer C D; Hammerton, Joanne; Coben, Jeffrey H; Herrman, Helen; Stewart, Donna E; MacMillan, Harriet L

2012-08-21

Intimate partner violence (IPV) and child maltreatment (CM) are major global public health problems. The Preventing Violence Across the Lifespan (PreVAiL) Research Network, an international group of over 60 researchers and national and international knowledge-user partners in CM and IPV, sought to identify evidence-based research priorities in IPV and CM, with a focus on resilience, using a modified Delphi consensus development process. Review of existing empirical evidence, PreVAiL documents and team discussion identified a starting list of 20 priorities in the following categories: resilience to violence exposure (RES), CM, and IPV, as well as priorities that cross-cut the content areas (CC), and others specific to research methodologies (RM) in violence research. PreVAiL members (N = 47) completed two online survey rounds, and one round of discussions via three teleconference calls to rate, rank and refine research priorities. Research priorities were: to examine key elements of promising or successful programmes in RES/CM/IPV to build intervention pilot work; CC: to integrate violence questions into national and international surveys, and RM: to investigate methods for collecting and collating datasets to link data and to conduct pooled, meta and sub-group analyses to identify promising interventions for particular groups. These evidence-based research priorities, developed by an international team of violence, gender and mental health researchers and knowledge-user partners, are of relevance for prevention and resilience-oriented research in the areas of IPV and CM.

Priorities for research in child maltreatment, intimate partner violence and resilience to violence exposures: results of an international Delphi consensus development process

PubMed Central

2012-01-01

Background Intimate partner violence (IPV) and child maltreatment (CM) are major global public health problems. The Preventing Violence Across the Lifespan (PreVAiL) Research Network, an international group of over 60 researchers and national and international knowledge-user partners in CM and IPV, sought to identify evidence-based research priorities in IPV and CM, with a focus on resilience, using a modified Delphi consensus development process. Methods Review of existing empirical evidence, PreVAiL documents and team discussion identified a starting list of 20 priorities in the following categories: resilience to violence exposure (RES), CM, and IPV, as well as priorities that cross-cut the content areas (CC), and others specific to research methodologies (RM) in violence research. PreVAiL members (N = 47) completed two online survey rounds, and one round of discussions via three teleconference calls to rate, rank and refine research priorities. Results Research priorities were: to examine key elements of promising or successful programmes in RES/CM/IPV to build intervention pilot work; CC: to integrate violence questions into national and international surveys, and RM: to investigate methods for collecting and collating datasets to link data and to conduct pooled, meta and sub-group analyses to identify promising interventions for particular groups. Conclusions These evidence-based research priorities, developed by an international team of violence, gender and mental health researchers and knowledge-user partners, are of relevance for prevention and resilience-oriented research in the areas of IPV and CM. PMID:22908894

Zoonoses and marginalised infectious diseases of poverty: where do we stand?

PubMed

Molyneux, David; Hallaj, Zuhair; Keusch, Gerald T; McManus, Donald P; Ngowi, Helena; Cleaveland, Sarah; Ramos-Jimenez, Pilar; Gotuzzo, Eduardo; Kar, Kamal; Sanchez, Ana; Garba, Amadou; Carabin, Helene; Bassili, Amal; Chaignat, Claire L; Meslin, Francois-Xavier; Abushama, Hind M; Willingham, Arve L; Kioy, Deborah

2011-06-14

Despite growing awareness of the importance of controlling neglected tropical diseases as a contribution to poverty alleviation and achieving the Millennium Development Goals, there is a need to up-scale programmes to achieve wider public health benefits. This implementation deficit is attributable to several factors but one often overlooked is the specific difficulty in tackling diseases that involve both people and animals - the zoonoses. A Disease Reference Group on Zoonoses and Marginalised Infectious Diseases (DRG6) was convened by the Special Programme for Research and Training in Tropical Diseases (TDR), a programme executed by the World Health Organization and co-sponsored by UNICEF, UNDP, the World Bank and WHO. The key considerations included: (a) the general lack of reliable quantitative data on their public health burden; (b) the need to evaluate livestock production losses and their additional impacts on health and poverty; (c) the relevance of cross-sectoral issues essential to designing and implementing public health interventions for zoonotic diseases; and (d) identifying priority areas for research and interventions to harness resources most effectively. Beyond disease specific research issues, a set of common macro-priorities and interventions were identified which, if implemented through a more integrated approach by countries, would have a significant impact on human health of the most marginalised populations characteristically dependent on livestock.

Zoonoses and marginalised infectious diseases of poverty: Where do we stand?

PubMed Central

2011-01-01

Despite growing awareness of the importance of controlling neglected tropical diseases as a contribution to poverty alleviation and achieving the Millennium Development Goals, there is a need to up-scale programmes to achieve wider public health benefits. This implementation deficit is attributable to several factors but one often overlooked is the specific difficulty in tackling diseases that involve both people and animals - the zoonoses. A Disease Reference Group on Zoonoses and Marginalised Infectious Diseases (DRG6) was convened by the Special Programme for Research and Training in Tropical Diseases (TDR), a programme executed by the World Health Organization and co-sponsored by UNICEF, UNDP, the World Bank and WHO. The key considerations included: (a) the general lack of reliable quantitative data on their public health burden; (b) the need to evaluate livestock production losses and their additional impacts on health and poverty; (c) the relevance of cross-sectoral issues essential to designing and implementing public health interventions for zoonotic diseases; and (d) identifying priority areas for research and interventions to harness resources most effectively. Beyond disease specific research issues, a set of common macro-priorities and interventions were identified which, if implemented through a more integrated approach by countries, would have a significant impact on human health of the most marginalised populations characteristically dependent on livestock. PMID:21672216

A woman's leadership in mobilizing an Indian community for drug control.

PubMed

Bedi, K

1995-01-01

Crime prevention is usually given a lower priority and underestimated as an area of policing. Detection and seizures attract priority and headlines, not the prevention of delinquency and breach of peace, which have all the potential of violent crime. Policing is for people: therefore, people must be made partners in policing. Once that goal is achieved, the whole system becomes transparent and accountable. Resources that cannot come from the police or Government alone come from participative policing. The present article describes a unique and innovative programme in substance abuse management by a combined initiative of community and police officials, which led to the establishment of the Navjyoti Delhi Police Foundation for Correction, De-Addiction and Rehabilitation.

Expanding contraceptive choice in the developing world: lessons from the Lao People's Democratic Republic and the Republic of Zambia.

PubMed

d'Arcangues, Catherine M; Ba-Thike, Katherine; Say, Lale

2013-12-01

Women need different forms of contraception over their lifetime. In the developed world, they have access to some 20 different methods. In developing countries, only a few options are available. This paper focuses on four under-used methods: intrauterine devices, implants, emergency contraception and female condoms. It examines reasons for their low uptake, strategies used for their adoption, and challenges in sustaining these efforts, in two countries: Laos and Zambia. In-country documentation and reports from international partners were reviewed; questionnaires were sent and interviews carried out with ministry officials, senior providers, and local representatives of international organisations and international non-governmental organisations. In Laos, the family planning programme is relatively young; its challenges include ensuring the sustainability of services and supplies, improving the quality of IEC to dispel misconceptions surrounding contraception, and developing novel distribution systems to reach rural populations. Zambia has a much older programme, which lost ground in the face of competing health priorities. Its challenges include strengthening the supply chain management, coordinating the multiple groups of providers and ensuring the sustainability of services in rural areas. The contrast offered by Laos and Zambia illustrates the importance of regular evaluation to identify priority areas for improving contraceptive delivery.

How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS

PubMed Central

2012-01-01

Background Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders′ perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. Methods A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Results Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify priorities and inform sector-wide planning, whereby health service statistics were used to rank the burden of disease. However, many respondents remarked that health system challenges are not captured by such statistics. In all countries funding for health was reported to fall short of requirements and a need for further priority setting to match actual resource availability was identified. Pooled health sector funds have been established to some extent, but development partners′ lack of flexibility in the allocation of funds according to country-generated priorities was identified as a major constraint. Conclusions Although we found consensus on health priorities across all levels in the study countries, current funding falls short of addressing these identified areas. The nature of external funding, as well as programme-specific investment, was found to distort priority setting. There are signs that existing interventions have had limited effects beyond meeting the needs of disease-specific programmes. A need for more comprehensive health system strengthening (HSS) was identified, which requires a strong vision as to what the term means, coupled with a clear strategy and commitment from national and international decision makers in order to achieve stated goals. Prospective studies and action research, accompanied by pilot programmes, are recommended as deliberate strategies for HSS. PMID:23231820

How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS.

PubMed

Jenniskens, Françoise; Tiendrebeogo, Georges; Coolen, Anne; Blok, Lucie; Kouanda, Seni; Sataru, Fuseini; Ralisimalala, Andriamampianina; Mwapasa, Victor; Kiyombo, Mbela; Plummer, David

2012-12-11

Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify priorities and inform sector-wide planning, whereby health service statistics were used to rank the burden of disease. However, many respondents remarked that health system challenges are not captured by such statistics.In all countries funding for health was reported to fall short of requirements and a need for further priority setting to match actual resource availability was identified. Pooled health sector funds have been established to some extent, but development partners' lack of flexibility in the allocation of funds according to country-generated priorities was identified as a major constraint. Although we found consensus on health priorities across all levels in the study countries, current funding falls short of addressing these identified areas. The nature of external funding, as well as programme-specific investment, was found to distort priority setting. There are signs that existing interventions have had limited effects beyond meeting the needs of disease-specific programmes. A need for more comprehensive health system strengthening (HSS) was identified, which requires a strong vision as to what the term means, coupled with a clear strategy and commitment from national and international decision makers in order to achieve stated goals. Prospective studies and action research, accompanied by pilot programmes, are recommended as deliberate strategies for HSS.

Setting research priorities by applying the combined approach matrix.

PubMed

Ghaffar, Abdul

2009-04-01

Priority setting in health research is a dynamic process. Different organizations and institutes have been working in the field of research priority setting for many years. In 1999 the Global Forum for Health Research presented a research priority setting tool called the Combined Approach Matrix or CAM. Since its development, the CAM has been successfully applied to set research priorities for diseases, conditions and programmes at global, regional and national levels. This paper briefly explains the CAM methodology and how it could be applied in different settings, giving examples and describing challenges encountered in the process of setting research priorities and providing recommendations for further work in this field. The construct and design of the CAM is explained along with different steps needed, including planning and organization of a priority-setting exercise and how it could be applied in different settings. The application of the CAM are described by using three examples. The first concerns setting research priorities for a global programme, the second describes application at the country level and the third setting research priorities for diseases. Effective application of the CAM in different and diverse environments proves its utility as a tool for setting research priorities. Potential challenges encountered in the process of research priority setting are discussed and some recommendations for further work in this field are provided.

Developing INFOMAR's Seabed Mapping Data to Support a Sustainable Marine Economy

NASA Astrophysics Data System (ADS)

Judge, M. T.; Guinan, J.

2016-02-01

As Ireland's national seabed mapping programme, INFOMAR1 (INtegrated mapping FOr the sustainable development of Ireland's MARine resource) enters its eleventh year it continues to provide pivotal seabed mapping data products, e.g. databases, charts and physical habitat maps to support Ireland's Integrated Marine Plan. The programme, jointly coordinated by the Geological Survey of Ireland and the Marine Institute, has gained a world class reputation for developing seabed mapping technologies, infrastructure and expertise. In the government's current Integrated Marine Plan, the programme's critical role in marine spatial planning enabling infrastructural development, research and education has been cited2. INFOMAR's free data policy supports a thriving maritime economy by promoting easy access to seabed mapping datasets that underpin; maritime safety, security and surveillance, governance, business development, research and technology innovation and infrastructure. The first hydrographic surveys of the national marine mapping programme mapped the extent of Ireland's deepest offshore area, whilst in recent years the focus has been to map the coastal and shallow areas. Targeted coastal areas include 26 bays and 3 priority areas for which specialised equipment, techniques and vessels are required. This talk will discuss how the INFOMAR programme has evolved to address the scientific and technological challenges of seabed mapping across a range of water depths; particularly the challenges associated with addressing inshore data gaps. It will describe how the data converts to bathymetric and geological maps detailing seabed characteristics and habitats. We will expand on how maps are: incorporated into collaborative marine projects such as EMODnet, commercialised to identify marine resources and used as marine decision support tools that drive policy and promote protection of the vastly under discovered marine area.

Exploring stakeholders' views of medical education research priorities: a national survey.

PubMed

Dennis, Ashley A; Cleland, Jennifer A; Johnston, Peter; Ker, Jean S; Lough, Murray; Rees, Charlotte E

2014-11-01

Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These priority areas are in harmony with a range of current drivers in UK medical education. They provide a platform of evidence on which to base decisions about MER programmes in Scotland and beyond. © 2014 John Wiley & Sons Ltd.

Backing the winners and the research infrastructure.

PubMed

Leliveld, H

1985-04-26

The industrial policy of the Dutch government is a priority area policy, that backs the winners of today and, even more, the potential winners of tomorrow. Important elements of this policy are the selection of high-chance activities, setting up new and informal relationships, promoting co-operation and supporting industrial research and development. To this end the government has set up Innovative Research Programmes and an Innovation Stimulation Scheme. Co-operation of universities and industry is essential for these programmes to succeed. Also international co-operation is a precondition to a firm position of European industry. The establishment of the Center for Bio-Pharmaceutical Sciences is entirely in line with the objectives of this policy.

Empowering people to be healthier: public health nutrition through the Ottawa Charter.

PubMed

Flynn, Mary A T

2015-08-01

The WHO's Ottawa Charter highlights five priority areas for taking action in public health. Only one of them is at the individual level as action at more upstream intervention levels, such as community or policy levels, is critical for enabling individuals to succeed. The objective of the present paper is to give insight into the many complex processes involved in public health nutrition by describing the Ottawa Charter's five priority areas for taking action using public health nutrition initiatives I have been involved in. Evidence-based guidelines for healthy eating and infant feeding provide an essential basis for individuals to 'develop personal skills' (Action Area 1). 'Re-orienting health services' (Action Area 2) can address the needs of vulnerable population subgroups, such as the culturally sensitive diabetes prevention programme established for an Indo-Asian community in Canada. Identifying geographic areas at high risk of childhood obesity enables better strategic planning and targeting of resources to 'strengthen community action' (Action Area 3). Calorie menu labelling can 'create supportive environments' (Action Area 4) through encouraging a demand for less energy-dense, healthier food options. 'Building healthy public policy' (Action Area 5) to implement mandatory folic acid food fortification for prevention of birth defects has many advantages over a voluntary approach. In conclusion, evaluation and evidence-based decision-making needs to take account of different strategies used to take action in each of these priority areas. For this, the randomised control trial needs adaptation to determine the best practice in public health nutrition where interventions play out in real life with all its confounding factors.

A database to manage flood risk in Catalonia

NASA Astrophysics Data System (ADS)

Echeverria, S.; Toldrà, R.; Verdaguer, I.

2009-09-01

We call priority action spots those local sites where heavy rain, increased river flow, sea storms and other flooding phenomena can cause human casualties or severe damage to property. Some examples are campsites, car parks, roads, chemical factories… In order to keep to a minimum the risk of these spots, both a prevention programme and an emergency response programme are required. The flood emergency plan of Catalonia (INUNCAT) prepared in 2005 included already a listing of priority action spots compiled by the Catalan Water Agency (ACA), which was elaborated taking into account past experience, hydraulic studies and information available by several knowledgeable sources. However, since land use evolves with time this listing of priority action spots has become outdated and incomplete. A new database is being built. Not only does this new database update and expand the previous listing, but adds to each entry information regarding prevention measures and emergency response: which spots are the most hazardous, under which weather conditions problems arise, which ones should have their access closed as soon as these conditions are forecast or actually given, which ones should be evacuated, who is in charge of the preventive actions or emergency response and so on. Carrying out this programme has to be done with the help and collaboration of all the organizations involved, foremost with the local authorities in the areas at risk. In order to achieve this goal a suitable geographical information system is necessary which can be easily used by all actors involved in this project. The best option has turned out to be the Spatial Data Infrastructure of Catalonia (IDEC), a platform to share spatial data on the Internet involving the Generalitat de Catalunya, Localret (a consortium of local authorities that promotes information technology) and other institutions.

Co-producing a digital educational programme for registered children's nurses to improve care of children and young people admitted with self-harm.

PubMed

Latif, Asam; Carter, Timothy; Rychwalska-Brown, Lucy; Wharrad, Heather; Manning, Joseph

2017-06-01

Despite the increasing prevalence of hospital admissions for self-harm in children and young people (CYP), there is paucity of registered children's nurse (rCN) training or involvement of children to improve care for this often stigmatized patient group. This article describes a participatory approach towards using co-production with CYP and rCN to develop a digital educational programme to improve nurses' knowledge, attitudes and confidence in caring for CYP with self-harm injuries. A priority-setting workshop with rCNs was used to establish consensus of information needs. This was followed by an e-learning content development workshop undertaken with CYP whom had previously experienced hospital admissions for self-harm injuries. Findings from the nurse priority-setting workshop identified three educational priorities: (1) knowledge of self-harm, (2) effective communication and (3) risk management. The CYP subsequently developed these topic areas to ensure the contents and design of the e-learning resource had fidelity by reflecting the experiences of CYP and needs when cared for in hospital. This article illustrates that involving service users to co-develop educational materials is a feasible and important step in designing educational resources and ensures the content is relevant, appropriate and sensitive to both the recipient of care and those responsible for its delivery.

On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs.

PubMed

Karunaweera, Nadira D; Galappaththy, Gawrie Nl; Wirth, Dyann F

2014-02-18

Malaria is one of the most important tropical diseases that has caused devastation throughout the history of mankind. Malaria eradication programmes in the past have had many positive effects but failed to wipe out malaria from most tropical countries, including Sri Lanka. Encouraged by the impressive levels of reduction in malaria case numbers during the past decade, Sri Lanka has launched a programme to eliminate malaria by year 2014. This article reviews the historical milestones associated with the malaria eradication programme that failed subsequently and the events that led to the launch of the ongoing malaria elimination plans at national-level and its strategies that are operational across the entire country. The existing gaps in knowledge are also discussed together with the priority areas for research to fill in these gaps that are posing as challenges to the envisaged goal of wiping out malaria from this island nation.

Health technology assessment: research trends and future priorities in Europe.

PubMed

Nielsen, Camilla Palmhøj; Funch, Tina Maria; Kristensen, Finn Børlum

2011-07-01

To provide an overview of health services research related to health technology assessment (HTA) and to identify research priorities from a European perspective. Several methods were used: systematic review of articles indexed with the MeSH term 'technology assessment' in PubMed from February 1999-2009; online survey among experts; and conference workshop discussions. Research activity in HTA varies considerably across Europe. The research was categorised into six areas: (1) the breadth of analysis in HTA (such as economic, organizational and social aspects); (2) HTA products developed to meet the needs of policy-makers (such as horizon scanning, mini-HTA, and core HTA); (3) handling life-cycle perspectives in relation to technologies; (4) topics that challenge existing methods and for which HTA should be developed to address the themes more comprehensively (such as public health interventions and organizational interventions); (5) development of HTA capacity and programmes; and (6) links between policy and HTA. An online survey showed that the three areas that were given priority were the relationship between HTA and policy-making (71%), the impact of HTA (62%) and incorporating patient aspects in HTA (50%). Policy-makers highlighted HTA and innovation processes as their main research priority (42%). Areas that the systematic review identified as future priorities include issues within the six existing research areas such as disinvestment, developing evidence for new technologies, assessing the wider effects of technology use, and determining how HTA affects decision-making. In addition, relative effectiveness and individualized treatments are areas of growing interest. The research priorities identified are important for obtaining high quality and cost-effective health care in Europe. Managing the introduction, use and phasing out of technologies challenges health services throughout Europe, and these processes need to be improved to successfully manage future more general challenges. An ageing population and a diminishing workforce both require strong efforts to ensure effective and well-organized use of human resources and technologies. Furthermore, Europe needs to focus on innovation. This is closely linked to use of technologies and calls for future research.

The common objectives of the European Nordic countries and the role of space

NASA Astrophysics Data System (ADS)

Lehnert, Christopher; Giannopapa, Christina; Vaudo, Ersilia

2016-11-01

The European Space Agency (ESA) has twenty two Member States with common goals of engaging in European space activities. However, the various Member States have a variety of governance structures, strategic priorities regarding space and other sectorial areas depending on their cultural and geopolitical aspirations. The Nordic countries, namely Denmark, Finland, Norway and Sweden, have similarities which result often in common geopolitical and cultural aspects. These in turn shape their respective priorities and interests in setting up their policies in a number of sectorial areas like shipping and fisheries, energy, immigration, agriculture, security and defence, infrastructures, climate change and the Arctic. Space technology, navigation, earth observation, telecommunication and integrated applications can assist the Nordic countries in developing, implementing and monitoring policies of common interest. This paper provides an in-depth overview and a comprehensive assessment of these common interests in policy areas where space can provide support in their realisation. The first part provides a synthesis of the Nordic countries respective priorities through analysing their government programmes and plans. The priorities are classified according to the six areas of sustainability: energy, environment and climate change, transport, knowledge and innovation, natural resources (fisheries, agriculture, forestry, mining, etc), and security and external relations. Although the national strategies present different national perspectives, at the same time, there are a number of similarities when it comes to overall policy objectives in a number of areas such as the Arctic and climate change. In other words, even though the Arctic plays a different role in each country's national context and there are clear differences as regards geography, access to resources and security policies, the strategies display common general interest in sustainable development and management of resources, protection of the environment, international cooperation and regional security. The second part of this paper focuses on the national space strategies and indicates the main priorities and trends. The priorities vary from one country to the other and can include science, navigation, earth observation, human space flight, launchers, technology development, and/or applications. The motivation for investing in space activities also change (e.g. international cooperation, industrial competitiveness, societal benefits, job creation).

Priority interventions to improve maternal and child diets in Sub-Saharan Africa and South Asia.

PubMed

Masters, William A; Rosettie, Katherine; Kranz, Sarah; Pedersen, Sarah H; Webb, Patrick; Danaei, Goodarz; Mozaffarian, Dariush

2018-04-01

Nutrition-sensitive interventions to improve overall diet quality are increasingly needed to improve maternal and child health. This study demonstrates feasibility of a structured process to leverage local expertise in formulating programmes tailored for current circumstances in South Asia and Africa. We assembled 41 stakeholders in 2 regional workshops and followed a prespecified protocol to elicit programme designs listing the human and other resources required, the intervention's mechanism for impact on diets, target foods and nutrients, target populations, and contact information for partners needed to implement the desired programme. Via this protocol, participants described 48 distinct interventions, which we then compared against international recommendations and global goals. Local stakeholders' priorities focused on postharvest food systems to improve access to nutrient-dense products (75% of the 48 programmes) and on production of animal sourced foods (58%), as well as education and social marketing (23%) and direct transfers to meet food needs (12.5%). Each programme included an average of 3.2 distinct elements aligned with those recommended by United Nations system agencies in the Framework for Action produced by the Second International Conference on Nutrition in 2014 and the Compendium of Actions for Nutrition developed for the Renewed Efforts Against Child Hunger initiative in 2016. Our results demonstrate that a participatory process can help local experts identify their own priorities for future investments, as a first step in a novel process of rigorous, transparent, and independent priority setting to improve diets among those at greatest risk of undernutrition. © 2017 The Authors. Maternal and Child Nutrition published by John Wiley & Sons, Ltd.

Priority interventions to improve maternal and child diets in Sub‐Saharan Africa and South Asia

PubMed Central

Masters, William A.; Rosettie, Katherine; Kranz, Sarah; Pedersen, Sarah H.; Webb, Patrick; Danaei, Goodarz; Adekugbe, Olayinka; Adhikar, Ramesh Kant; Amatya, Archana; Atomsa, Gudina Egata; Badham, Jane; Bhattacharjee, Lalita; Bhattarai, Manav; Baye, Kaleab; Beyero, Mesfin; Brahmbhatt, Viral; Chandrasekhar, S.; Chandyo, Ram Krishna; Christensen, Cheryl; Covic, Namukolo; Dalton, Babukiika; Desai, Sonalde; Dufour, Charlotte; Fracassi, Patrizia; Getahun, Zewditu; Gulati, Seema; Haidar, Jemal; Hailu, Tesfaye; Kapil, Umesh; Kazi‐Hutchins, Nabeeha; Kebede, Aweke; Kinabo, Joyce; Kussaga, Jamal Bakari; Levin, Carol; Mavrotas, George; Mehta, Ranju; Mohan, Sailesh; Mwanja, Wilson Waiswa; Oguntona, Babatunde; Oladipo, Abiodun; Oniang'o, Ruth; Paarlberg, Robert; Pandey Rana, Pooja; Prabhakaran, D.; Prakash, V.; Puri, Seema; Roy, S. K.; Sharma, Rekha; Shivakoti, Sabnam; Sibanda, Simbarashe; Sodjinou, Roger; Thorne‐Lyman, Andrew; Tom, Carol; Trilok‐Kumar, Geeta; Vosti, Steven; Wamani, Henry; Wendelin, Akwilina

2017-01-01

Abstract Nutrition‐sensitive interventions to improve overall diet quality are increasingly needed to improve maternal and child health. This study demonstrates feasibility of a structured process to leverage local expertise in formulating programmes tailored for current circumstances in South Asia and Africa. We assembled 41 stakeholders in 2 regional workshops and followed a prespecified protocol to elicit programme designs listing the human and other resources required, the intervention's mechanism for impact on diets, target foods and nutrients, target populations, and contact information for partners needed to implement the desired programme. Via this protocol, participants described 48 distinct interventions, which we then compared against international recommendations and global goals. Local stakeholders' priorities focused on postharvest food systems to improve access to nutrient‐dense products (75% of the 48 programmes) and on production of animal sourced foods (58%), as well as education and social marketing (23%) and direct transfers to meet food needs (12.5%). Each programme included an average of 3.2 distinct elements aligned with those recommended by United Nations system agencies in the Framework for Action produced by the Second International Conference on Nutrition in 2014 and the Compendium of Actions for Nutrition developed for the Renewed Efforts Against Child Hunger initiative in 2016. Our results demonstrate that a participatory process can help local experts identify their own priorities for future investments, as a first step in a novel process of rigorous, transparent, and independent priority setting to improve diets among those at greatest risk of undernutrition. PMID:28971572

Going beyond the vertical: leveraging a national HIV quality improvement programme to address other health priorities in Haiti.

PubMed

Joseph, Jean Paul; Jerome, Gregory; Lambert, Wesler; Almazor, Patrick; Cupidon, Colette Eugene; Hirschhorn, Lisa R

2015-07-01

Although the central role of quality to achieve targeted population health goals is widely recognized, how to spread the capacity to measure and improve quality across programmes has not been widely studied. We describe the successful leveraging of expertise and framework of a national HIV quality improvement programme to spread capacity and improve quality across a network of clinics in HIV and other targeted areas of healthcare delivery in rural Haiti.The work was led by Zamni LaSante, a Haitian nongovernment organization and its sister organization, Partners In Health working in partnership with the Haitian Ministry of Health in the Plateau Central and Lower Artibonite regions in 12 public sector facilities.Data included routinely collected organizational assessments of facility quality improvement capacity, national HIV performance measures and Zamni LaSante programme records.We found that facility quality improvement capacity increased with spread from HIV to other areas of inpatient and outpatient care, including tuberculosis (TB), maternal health and inpatient services in all 12 supported healthcare facilities. A significant increase in the quality of HIV care was also seen in most areas, including CD4 monitoring, TB screening, HIV treatment (all P < 0.01) and nutritional assessment and prevention of mother-to-child transmission (both P < .05), with an increase in average facility performance from 39 to 72% (P < .01).In conclusion, using a diagonal approach to leverage a national vertical programme for wider benefit resulted in accelerated change in professional culture and increased capacity to spread quality improvement activities across facilities and areas of healthcare delivery. This led to improvement within and beyond HIV care and contributed to the goal of quality of care for all.

A Report on Education and Training in the International Council on Archives' Africa Programme

ERIC Educational Resources Information Center

Lowry, James

2017-01-01

In 2015, the International Council on Archives launched its Africa Programme (2015-2020) in order to coordinate its support for African archives and archivists. The Programme is focused on two strategic priorities: advocacy and education and training. This article examines the education and training component of the Programme. It begins by…

Global Framework for Climate Services (GFCS): status of implementation

NASA Astrophysics Data System (ADS)

Lucio, Filipe

2015-04-01

The World Climate Conference-3 (Geneva 2009) unanimously decided to establish the Global Framework for Climate Services (GFCS), a UN-led initiative spearheaded by WMO to guide the development and application of science-based climate information and services in support of decision-making in climate sensitive sectors. By promoting science-based decision-making, the GFCS is empowering governments, communities and companies to build climate resilience, reduce vulnerabilities and adapt to impacts. The initial priority areas of GFCS are Agriculture and Food Security; Disaster Risk Reduction; Health; and Water Resources. The implementation of GFCS is well underway with a governance structure now fully established. The governance structure of GFCS includes the Partner Advisory Committee (PAC), which is GFCS's stakeholder engagement mechanism. The membership of the PAC allows for a broad participation of stakeholders. The European Organisation for the Exploitation of Meteorological Satellites (EUMETSAT), the European Commission (EC), the Food and Agriculture Organization of the UN (FAO), the Global Water Partnership (GWP), the International Federation of Red Cross and Red Crescent Societies (IFRC), the International Union of Geodesy and Geophysics (IUGG), United Nations Environment Programme (UNEP), the United Nations Institute for Training and Research (UNITAR), the World Business Council for Sustainable Development (WBCSD), the World Food Programme (WFP) and WMO have already joined the PAC. Activities are being implemented in various countries in Africa, the Caribbean, Asia and Pacific Small Islands Developing States through flagship projects and activities in the four priority areas of GFCS to enable the development of a Proof of Concept. The focus at national level is on strengthening institutional capacities needed for development of capacities for co-design and co-production of climate services and their application in support of decision-making in climate sensitive sectors. Establishment of regional capacities through climate centres to support national institutional capacities is a major focus. The Proof of Concept will be replicated in other parts of the world to ensure worldwide improvements in climate services for the four priority areas to facilitate the reduction of society's vulnerability to climate-related hazards and the advancement of the key global development goals. To streamline and harness climate research and knowledge in support of GFCS implementation, regional research plans or agendas are being shaped in different regions. For example, a Climate Research for Development Agenda for Africa (CR4D) is being developed under the leadership of the World Climate Research Programme (WCRP) and in cooperation with the African Union Commission and other partners. Similarly, regional climate research priorities are being developed for Latin America and the Caribbean, following the WCRP Conference for Latin America and the Caribbean (Montevideo, March 2014). Availability of regional research plans or agendas would ensure more effective research and involvement of national experts in climate research activities.

An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

PubMed

Cowman, Seamus; Gethin, Georgina; Clarke, Eric; Moore, Zena; Craig, Gerardine; Jordan-O'Brien, Julie; McLain, Niamh; Strapp, Helen

2012-02-01

To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. The study used a survey method. A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. conclusion: Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The determination of research and education priorities is therefore an absolute requirement in developing services. © 2011 Blackwell Publishing Ltd.

Sexual Orientation Topics in Educational Leadership Programmes across the USA

ERIC Educational Resources Information Center

Jennings, Todd

2012-01-01

This investigation examines the inclusion of sexual orientation topics within the formal curriculum of 55 public college and university educational administration/leadership programmes across the USA. The findings indicate that programmes place a low priority upon sexual orientation compared to other diversity topics and that 59.5% of programmes…

Needs assessment for master of nursing programmes among Bangladesh nurses.

PubMed

Lee, T W; Kim, H S; Kim, S; Chu, S H; Kim, M S; Lee, S J; Lim, S; Jeon, Y; Park, H J; Anowar, M N; Begum, T

2016-03-01

This study aimed to assess the intent to enrol in a master of nursing programme among Bangladesh nurses, identify preferred programme options and measure the association among intent to enrol in the programme, clinical competency and job satisfaction. Personal and professional aspects of potential students pursuing graduate education are beneficial in devising educational strategies. However, considering the pressing needs for higher nursing education, there are no masters of nursing programmes in Bangladesh. This study used a descriptive correlational design. Nurses working in Bangladesh public sector were recruited to participate in a self-administered survey (n = 260). The questionnaire consisted of perception of job satisfaction, clinical competency and the need for educational options, including the intent to enrol in a master of nursing programme, preferred specialty area, curriculum content and career goals after graduation. Data were analysed using descriptive statistics and point-biserial correlation. Ninety per cent of the respondents reported that they intended to enrol in a master of nursing programme. Intention was significantly correlated with clinical competency but not with job satisfaction. The most preferred specialty areas were nursing management and education. Half of the respondents responded that teaching at nursing schools was a career goal after graduation. The results of the needs assessment for the programme reflected the unique interest and priorities of the current status of Bangladesh. The results indicate a strong motivation to enrol in a master of nursing programme, confidence in clinical competence and high demand for programme in nursing management and education. These findings should be considered to design the programme in order to meet the interest of Bangladesh nurses. Educational needs assessments should take precedence to ensure the best possible educational outcome and to produce competent nurses who will contribute in achieving the Millennium Development Goals of Bangladesh. © 2016 International Council of Nurses.

Using lot quality-assurance sampling and area sampling to identify priority areas for trachoma control: Viet Nam.

PubMed

Myatt, Mark; Mai, Nguyen Phuong; Quynh, Nguyen Quang; Nga, Nguyen Huy; Tai, Ha Huy; Long, Nguyen Hung; Minh, Tran Hung; Limburg, Hans

2005-10-01

To report on the use of lot quality-assurance sampling (LQAS) surveys undertaken within an area-sampling framework to identify priority areas for intervention with trachoma control activities in Viet Nam. The LQAS survey method for the rapid assessment of the prevalence of active trachoma was adapted for use in Viet Nam with the aim of classifying individual communes by the prevalence of active trachoma among children in primary school. School-based sampling was used; school sites to be sampled were selected using an area-sampling approach. A total of 719 communes in 41 districts in 18 provinces were surveyed. Survey staff found the LQAS survey method both simple and rapid to use after initial problems with area-sampling methods were identified and remedied. The method yielded a finer spatial resolution of prevalence than had been previously achieved in Viet Nam using semiquantitative rapid assessment surveys and multistage cluster-sampled surveys. When used with area-sampling techniques, the LQAS survey method has the potential to form the basis of survey instruments that can be used to efficiently target resources for interventions against active trachoma. With additional work, such methods could provide a generally applicable tool for effective programme planning and for the certification of the elimination of trachoma as a blinding disease.

Diseases of livestock in the Pacific Islands region: setting priorities for food animal biosecurity.

PubMed

Brioudes, Aurélie; Warner, Jeffrey; Hedlefs, Robert; Gummow, Bruce

2015-03-01

Most Pacific Island countries and territories (PICTs) have developing economies and face a critical shortage of veterinarians with limited financial resources allocated to their animal disease surveillance programmes. Thus, animal health authorities have to set priorities for better focusing their scarce resources. The main objective of this study was to identify animal diseases perceived to be of importance by decision makers within selected PICTs, at the regional and national levels, to ensure better targeting of animal health resources. A second objective was to investigate whether the targeted surveillance programmes resulting from this rationalized approach would also benefit the local communities engaged in livestock production. A multi-criteria prioritization process was developed, involving local experts, to score and rank 132 animal diseases based on their priority at the regional and national levels for four PICTs: Fiji, Papua New Guinea, Solomon Islands, and Vanuatu, which form part of a regional Food Animal Biosecurity Network. In parallel interviews with farmers and field animal health and production workers were conducted to assess their perception of animal diseases. The list of the top-twenty ranked diseases for the Pacific Islands region shows a mix of endemic zoonotic diseases (such as leptospirosis ranked first; brucellosis third; tuberculosis sixth; and endoparasites and ectoparasites, respectively eleventh and thirteenth) with exotic diseases (such as HPAI ranked second, FMD fifth, and rabies ninth). There were different disease ranking lists for each of the four targeted PICTs, confirming different strategies of disease prevention and control may be required for each country, rather than a regional approach. Interviewed animal health and production workers were unfamiliar with most of the prioritized diseases and a majority acknowledged that they would not be able to recognize clinical signs if outbreaks were to occur in their area. Leptospirosis, which is endemic and identified as the top priority disease at the regional level, was never mentioned by any interviewed farmer. Farmers did not name any emerging infectious diseases as priorities. Instead, they identified endemic diseases (parasites, flu, coccidiosis, and scabies) as the most important. While animal disease priorities appear to differ widely between the targeted regions and countries, it also varies significantly between experts and farmers. Better targeted surveillance programmes may thus result in more rational and transparent allocation of resources, and thus enhanced food security, but may not directly match the needs of the local communities. Copyright © 2015 Elsevier B.V. All rights reserved.

Research priorities for specialized nursing practice in the United Arab Emirates.

PubMed

Al-Yateem, N; Al-Tamimi, M; Brenner, M; Altawil, H; Ahmad, A; Brownie, S

2017-08-25

Globally, nurses are undertaking expanded and more specialized roles in healthcare planning and service delivery in response to changing patterns and levels of health service demand. This means the nursing profession is increasingly considered as leaders in health service policy, research and practice. The United Arab Emirates has strengthened nursing governance and practice by establishing a Nursing and Midwifery Council and increasing the activity of nursing specialization, service leadership and research. This study aimed to identify clinically relevant research priorities to facilitate nursing contributions to evidence-based care and strengthening health services in the country. A two-stage Delphi study design was used. The first round involved 783 participants. The second round involved 1116 participants, as more clinical settings were accessed. In total, 58 research priorities across a variety of nursing specialties (paediatrics, emergency care, intensive care, labour and maternity care, operating theatre and long-term care) were identified as highly important. These identified priorities will guide a more informed programme of research in each nursing specialty, with the aim of strengthening the evidence base to improving outcomes for patients and their families in the United Arab Emirates. The findings provide guidance on key areas for nurses to focus research contributions to enhance evidence-based care and strengthen health systems. The identified priorities may also guide researchers in academic institutions to conduct research informed by current, clinically relevant issues. The findings may help inform funders and policymakers to support allocation of funding to research that has potential to contribute to enhancing nursing care in specialist areas. © 2017 International Council of Nurses.

The TACIS Nuclear Programme: Assistance in Upgrading Russian Nuclear Power Stations - An Overview of the Individual Projects in the Internet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bieth, Michel; Schoels, Hubert

2006-07-01

The European Union' TACIS1 programme has been established for the New Independent States (NIS), among them in the Russian Federation since 1991. One priority of TACIS funding is Nuclear Safety. The European Commission has made available a total of 944 Million Euros for nuclear safety programmes covering the period 1991-2003. The TACIS nuclear safety programme is devoted to the improvement of the safety of Soviet designed nuclear installations in providing technology and safety culture transfer. JRC is carrying out works in the following areas: On-Site Assistance for TACIS operating Nuclear Power Plants; Design Safety and Dissemination of TACIS results; Reactormore » Pressure Vessel Embrittlement for VVER; Regulatory Assistance; Industrial Waste Management; Nuclear Safeguards; All TACIS projects, dealing with these areas of activity are now available in so called Project Description Sheets (PDS) or Project Results Sheets (PRS) in the Internet for everybody. JRC has created in the Internet an easy to open and to browse database which contains the result of works in relation to the above mentioned nuclear activities. This presentation gives an on-line overview of the app. 430 projects which have been implemented so far since the outset of the TACIS Nuclear Programme in the Russian Federation, which is representative to the other CIS countries, benefiting from the TACIS. The presentation will mainly consist of an on-line-demonstration of the TACIS Nuclear WEB Page, created by JRC. (authors)« less

On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs

PubMed Central

2014-01-01

Malaria is one of the most important tropical diseases that has caused devastation throughout the history of mankind. Malaria eradication programmes in the past have had many positive effects but failed to wipe out malaria from most tropical countries, including Sri Lanka. Encouraged by the impressive levels of reduction in malaria case numbers during the past decade, Sri Lanka has launched a programme to eliminate malaria by year 2014. This article reviews the historical milestones associated with the malaria eradication programme that failed subsequently and the events that led to the launch of the ongoing malaria elimination plans at national-level and its strategies that are operational across the entire country. The existing gaps in knowledge are also discussed together with the priority areas for research to fill in these gaps that are posing as challenges to the envisaged goal of wiping out malaria from this island nation. PMID:24548783

Assessing Rural Sustainable Development potentialities using a Dominance-based Rough Set Approach.

PubMed

Boggia, Antonio; Rocchi, Lucia; Paolotti, Luisa; Musotti, Francesco; Greco, Salvatore

2014-11-01

Rural Development is a priority in Europe and it is supported by specific, financial programmes. At the same time, sustainability is the key word for the European Union to construct programmes and policies for all human activities. However, measuring sustainability of rural areas is not easy, due to their particular features. The improvement of knowledge on sustainability in rural areas is important to build long term policies and strategies for those territories. The objective of this study is the development of a decision support system based on the Dominance-based Rough Set Approach (DRSA), to assess the level of Rural Sustainable Development in specific areas. We used DRSA to analyze the level of sustainability of the 92 municipalities of the Region of Umbria, Italy. The results were synthesized in a final ranking, taking into account the equilibrium and the integration between development and sustainability of each municipality. DRSA showed a high potential in the context of management or planning, and for supporting Decision Makers. DRSA is able to give a ranking as well as an explanation of the main factors driving sustainable development in rural areas. Copyright © 2014 Elsevier Ltd. All rights reserved.

Priority setting and implementation in a centralized health system: a case study of Kerman province in Iran.

PubMed

Khayatzadeh-Mahani, Akram; Fotaki, Marianna; Harvey, Gillian

2013-08-01

The question of how priority setting processes work remains topical, contentious and political in every health system across the globe. It is particularly acute in the context of developing countries because of the mismatch between needs and resources, which is often compounded by an underdeveloped capacity for decision making and weak institutional infrastructures. Yet there is limited research into how the process of setting and implementing health priorities works in developing countries. This study aims to address this gap by examining how a national priority setting programme works in the centralized health system of Iran and what factors influence its implementation at the meso and micro levels. We used a qualitative case study approach, incorporating mixed methods: in-depth interviews at three levels and a textual analysis of policy documents. The data analysis showed that the process of priority setting is non-systematic, there is little transparency as to how specific priorities are decided, and the decisions made are separated from their implementation. This is due to the highly centralized system, whereby health priorities are set at the macro level without involving meso or micro local levels or any representative of the public. Furthermore, the two main benefit packages are decided by different bodies (Ministry of Health and Medical Education and Ministry of Welfare and Social Security) and there is no co-ordination between them. The process is also heavily influenced by political pressure exerted by various groups, mostly medical professionals who attempt to control priority setting in accordance with their interests. Finally, there are many weaknesses in the implementation of priorities, resulting in a growing gap between rural and urban areas in terms of access to health services.

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

PubMed Central

Sagili, Karuna D; Satyanarayana, Srinath; Chadha, Sarabjit S; Wilson, Nevin C; Kumar, Ajay M V; Oeltmann, John E; Chadha, Vineet K; Nagaraja, Sharath Burugina; Ghosh, Smita; Q Lo, Terrence; Volkmann, Tyson; Willis, Matthew; Shringarpure, Kalpita; Reddy, Ravichandra Chinnappa; Kumar, Prahlad; Nair, Sreenivas A; Rao, Raghuram; Yassin, Mohammed; Mwangala, Perry; Zachariah, Rony; Tonsing, Jamhoih; Harries, Anthony D; Khaparde, Sunil

2018-01-01

ABSTRACT Background: The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. Objectives: To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. Methods: From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project’s core activities and outcomes. Results: In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. Conclusions: OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects. PMID:29553308

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice.

PubMed

Sagili, Karuna D; Satyanarayana, Srinath; Chadha, Sarabjit S; Wilson, Nevin C; Kumar, Ajay M V; Moonan, Patrick K; Oeltmann, John E; Chadha, Vineet K; Nagaraja, Sharath Burugina; Ghosh, Smita; Q Lo, Terrence; Volkmann, Tyson; Willis, Matthew; Shringarpure, Kalpita; Reddy, Ravichandra Chinnappa; Kumar, Prahlad; Nair, Sreenivas A; Rao, Raghuram; Yassin, Mohammed; Mwangala, Perry; Zachariah, Rony; Tonsing, Jamhoih; Harries, Anthony D; Khaparde, Sunil

2018-01-01

The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project's core activities and outcomes. In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects.

Using lot quality-assurance sampling and area sampling to identify priority areas for trachoma control: Viet Nam.

PubMed Central

Myatt, Mark; Mai, Nguyen Phuong; Quynh, Nguyen Quang; Nga, Nguyen Huy; Tai, Ha Huy; Long, Nguyen Hung; Minh, Tran Hung; Limburg, Hans

2005-01-01

OBJECTIVE: To report on the use of lot quality-assurance sampling (LQAS) surveys undertaken within an area-sampling framework to identify priority areas for intervention with trachoma control activities in Viet Nam. METHODS: The LQAS survey method for the rapid assessment of the prevalence of active trachoma was adapted for use in Viet Nam with the aim of classifying individual communes by the prevalence of active trachoma among children in primary school. School-based sampling was used; school sites to be sampled were selected using an area-sampling approach. A total of 719 communes in 41 districts in 18 provinces were surveyed. FINDINGS: Survey staff found the LQAS survey method both simple and rapid to use after initial problems with area-sampling methods were identified and remedied. The method yielded a finer spatial resolution of prevalence than had been previously achieved in Viet Nam using semiquantitative rapid assessment surveys and multistage cluster-sampled surveys. CONCLUSION: When used with area-sampling techniques, the LQAS survey method has the potential to form the basis of survey instruments that can be used to efficiently target resources for interventions against active trachoma. With additional work, such methods could provide a generally applicable tool for effective programme planning and for the certification of the elimination of trachoma as a blinding disease. PMID:16283052

"Out" Gay and Lesbian Faculty and the Inclusion of Sexual Orientation Topics in Teacher Preparation Programmes in the USA

ERIC Educational Resources Information Center

Jennings, Todd

2010-01-01

Do "out" lesbian and gay faculty influence the inclusion of sexual orientation as a form of diversity in their teacher preparation programmes? Data gathered from 142 teacher preparation programmes across the USA (representing the preparation of 23,000-30,000 new teachers annually) suggest they do not. Likewise, the priority placed upon…

The African Hospitalist Fellowship.

PubMed

Daniels, A D; Buys, H; Dunkley, R; Wilmshurst, J M

2017-10-31

The African Paediatric Fellowship Programme is rolling out a training course for newly qualified paediatricians to equip them with the leadership skills to function in complex general paediatric settings. The care of children in Africa carries its own unique demands, from the layering effects of multiple conditions through to establishing and sustaining services under severe resource constraints. This novel training concept aims to strengthen confidence and knowledge in areas that are not priorities during standard general paediatric training. The skills gained are considered of great relevance in assisting general paediatricians to achieve their full potential in their careers.

What are today's priorities in research?

PubMed

1994-01-01

The World Health Organization (WHO) Global Programme on AIDS has identified priority areas of HIV/AIDS-related research. Vaccine trials are need to evaluate their effectiveness and their accessibility and availability (supply and price) to developing countries with the greatest need. The pharmaceutical industry and national governments should work to develop microbicidal agents for use in the vagina. Research on the care of people with AIDS is needed to document the best way to provide their care in developing countries and to improve their quality of life. Another research priority is the resurgence of tuberculosis (TB): its association with HIV infection, and management of TB in areas where the HIV prevalence is high. WHO would like to see research establishing simplified case management regimes for the control and management of sexually transmitted diseases (STDs), STD case management that can be integrated into primary health care systems or at the primary health care level, simple and inexpensive diagnostic tests (particularly for women, who often are asymptomatic), and integration of STD management into family planning programs. More research needs to conducted on the availability and use of female condoms, so women can enhance their capability of protecting themselves. WHO would like more HIV/AIDS-related behavior research in the following areas: descriptive research, economic impact, community support, women's empowerment, and behavior change. HIV/AIDS-related researchers should ask themselves 3 fundamental questions: Does it work? What is the best way to do it? What does it cost?

Implementation research: towards universal health coverage with more doctors in Brazil

PubMed Central

Oliveira, Aimê; Trindade, Josélia Souza; Barreto, Ivana CHC; Palmeira, Poliana Araújo; Comes, Yamila; Santos, Felipe OS; Santos, Wallace; Oliveira, João Paulo Alves; Pessoa, Vanira Matos; Shimizu, Helena Eri

2017-01-01

Abstract Objective To evaluate the implementation of a programme to provide primary care physicians for remote and deprived populations in Brazil. Methods The Mais Médicos (More Doctors) programme was launched in July 2013 with public calls to recruit physicians for priority areas. Other strategies were to increase primary care infrastructure investments and to provide more places at medical schools. We conducted a quasi-experimental, before-and-after evaluation of the implementation of the programme in 1708 municipalities with populations living in extreme poverty and in remote border areas. We compared physician density, primary care coverage and avoidable hospitalizations in municipalities enrolled (n = 1450) and not enrolled (n = 258) in the programme. Data extracted from health information systems and Ministry of Health publications were analysed. Findings By September 2015, 4917 physicians had been added to the 16 524 physicians already in place in municipalities with remote and deprived populations. The number of municipalities with ≥ 1.0 physician per 1000 inhabitants doubled from 163 in 2013 to 348 in 2015. Primary care coverage in enrolled municipalities (based on 3000 inhabitants per primary care team) increased from 77.9% in 2012 to 86.3% in 2015. Avoidable hospitalizations in enrolled municipalities decreased from 44.9% in 2012 to 41.2% in 2015, but remained unchanged in control municipalities. We also documented higher infrastructure investments in enrolled municipalities and an increase in the number of medical school places over the study period. Conclusion Other countries having shortages of physicians could benefit from the lessons of Brazil’s programme towards achieving universal right to health. PMID:28250510

The Scottish Government's Rural and Environmental Science and Analytical Services Strategic Research Progamme

NASA Astrophysics Data System (ADS)

Dawson, Lorna; Bestwick, Charles

2013-04-01

The Strategic Research Programme focuses on the delivery of outputs and outcomes within the major policy agenda areas of climate change, land use and food security, and to impact on the 'Wealthier', 'Healthier' and 'Greener' strategic objectives of the Scottish Government. The research is delivered through two programmes: 'Environmental Change' and 'Food, Land and People'; the core strength of which is the collaboration between the Scottish Government's Main Research Providers-The James Hutton Institute, the Moredun Research Institute, Rowett Institute of Nutrition and Health University of Aberdeen, Scotland's Rural College, Biomathematics and Statistics Scotland and The Royal Botanic Gardens Edinburgh. The research actively seeks to inform and be informed by stakeholders from policy, farming, land use, water and energy supply, food production and manufacturing, non-governmental organisations, voluntary organisations, community groups and general public. This presentation will provide an overview of the programme's interdisciplinary research, through examples from across the programme's themes. Examples will exemplify impact within the Strategic Programme's priorities of supporting policy and practice, contributing to economic growth and innovation, enhancing collaborative and multidisciplinary research, growing scientific resilience and delivering scientific excellence. http://www.scotland.gov.uk/Topics/Research/About/EBAR/StrategicResearch/future-research-strategy/Themes/ http://www.knowledgescotland.org/news.php?article_id=295

Development of a matrix to evaluate the threat of biological agents used for bioterrorism.

PubMed

Tegnell, A; Van Loock, F; Baka, A; Wallyn, S; Hendriks, J; Werner, A; Gouvras, G

2006-10-01

Adequate public health preparedness for bioterrorism includes the elaboration of an agreed list of biological and chemical agents that might be used in an attack or as threats of deliberate release. In the absence of counterterrorism intelligence information, public health authorities can also base their preparedness on the agents for which the national health structures would be most vulnerable. This article aims to describe a logical method and the characteristics of the variables to be brought in a weighing process to reach a priority list for preparedness. The European Union, in the aftermath of the anthrax events of October 2001 in the United States, set up a task force of experts from multiple member states to elaborate and implement a health security programme. One of the first tasks of this task force was to come up with a list of priority threats. The model, presented here, allows Web-based updates for newly identified agents and for the changes occurring in preventive measures for agents already listed. The same model also allows the identification of priority protection action areas.

An Evaluation of Health Information and Wellness Priorities among Socioeconomically Disadvantaged Students

ERIC Educational Resources Information Center

Morris-Paxton, Angela A.; Van Lingen, Johanna M.; Elkonin, Diane

2017-01-01

Objective: A critical evaluation of a salutogenic, wellness education programme was conducted with a group of first-year socioeconomically disadvantaged higher education students, in order to assess the value they placed on health information and wellness priorities. Methods: This study took a mixed-methods approach utilising a…

Redesigning the AIDS response for long-term impact

PubMed Central

Bertozzi, Stefano; Piot, Peter

2011-01-01

Abstract Three decades since the human immunodeficiency virus (HIV) was identified, the pandemic of acquired immunodeficiency syndrome (AIDS) has developed into diverse epidemics around the world. In many populations, HIV infection has become endemic. While there is good progress on expanding access to treatment, with an estimated 6.6 million people on antiretroviral therapy at the end of 2010, prevention efforts are still highly inadequate with 2.6 million new infections occurring in 2009. Demand for treatment is increasing while funding is becoming more scarce and activism is waning. In 2007, the Joint United Nations Programme on HIV/AIDS (UNAIDS) established an independent forum called aids2031 to take a critical look at the global HIV/AIDS response. This paper outlines four key areas for a re-designed AIDS response based on the deliberations of this initiative and on the learning and experience of the first three decades of the epidemic: (i) a new culture of knowledge generation and utilization; (ii) transformed prevention and treatment to increase effectiveness; (iii) increased efficiency through better management and maximizing synergies with other programmes; and (iv) investment for the long term. Across all these areas is a strong emphasis on local capacity building, leadership, programme priorities and budgets. PMID:22084531

Priorities in national space strategies and governance of the member states of the European Space Agency

NASA Astrophysics Data System (ADS)

Adriaensen, Maarten; Giannopapa, Christina; Sagath, Daniel; Papastefanou, Anastasia

2015-12-01

The European Space Agency (ESA) has twenty Member States with a variety of strategic priorities and governance structures regarding their space activities. A number of countries engage in space activities exclusively though ESA, while others have also their own national space programme. Some consider ESA as their prime space agency and others have additionally their own national agency with respective programmes. The main objective of this paper is to provide an up-to date overview and a holistic assessment of strategic priorities and the national space governance structures in 20 ESA Member States. This analysis and assessment has been conducted by analysing the Member States public documents, information provided at ESA workshop on this topic and though unstructured interviews. The paper is structured to include two main elements: priorities and trends in national space strategies and space governance in ESA Member States. The first part of this paper focuses on the content and analysis of the national space strategies and indicates the main priorities and trends in Member States. The priorities are categorised with regards to technology domains, the role of space in the areas of sustainability and the motivators that boost engagement in space. These vary from one Member State to another and include with different levels of engagement in technology domains amongst others: science and exploration, navigation, Earth observation, human space flight, launchers, telecommunications, and integrated applications. Member States allocate a different role of space as enabling tool adding to the advancement of sustainability areas including: security, resources, environment and climate change, transport and communication, energy, and knowledge and education. The motivators motivating reasoning which enhances or hinders space engagement also differs. The motivators identified are industrial competitiveness, job creation, technology development and transfer, social benefits, international cooperation, and European non-dependence. The second part of the paper provides a categorisation of national space governance structures in ESA Member States. Different governance models are identified depending on the responsible ministries for space for a number of space related organisations and ESA. In the case of ESA, these can typically vary from the more traditional ministry of science and/or education, the ministry of industry and/or innovation to the more recent ones being the ministry of economy and the ministry of transport. Recognising the transverse nature of space and its potential as a tool for a number of policies like agriculture, environment, maritime, disaster management, etc., other ministries are more and more getting involved in space activities. The development and implementation of the space strategy and policy of a Member State is realised though the engagement of an implementing entity. The type, role and activity vary from Member State to Member State.

Nursing students' career preferences: a Norwegian study.

PubMed

Kloster, Torill; Høie, Magnhild; Skår, Randi

2007-07-01

This paper is a report of a study to identify Norwegian undergraduate nursing students' career preferences at the beginning and end of their nursing education programme, together with their reasons for these preferences. International studies have shown that recruitment and retention of nurses in areas such as aged care and psychiatric nursing is difficult. It is important to know why some working areas are popular whilst others are not, so that nursing schools produce graduates who meet the needs of the community. All students starting their nursing education programme in 2001/2002 in five Norwegian university colleges were invited to complete questionnaires at the beginning and end of their nursing education programme. In phase 1, 620 of 782 commencing students completed questionnaires (response rate 79.2%). In their third year, phase 2, 473 questionnaires were distributed (response rate 82.6%, n = 386). The questionnaire included closed questions about career preferences and open-ended questions seeking the reasons for the preferences. The study revealed changes in preferences between the beginning and the end of the nursing education programme. In phase 1, midwifery and paediatric nursing were ranked highest and in phase 2 working in medical/surgical ward, midwifery and psychiatric nursing were preferred. Working in aged care institutions remained unpopular throughout. Clinical experiences and professional challenges were often given as reasons for preferences. Nursing educators, clinical nurses and policymakers must reconsider their priorities and improve working conditions for nurses in aged care in order to meet society's need for nurses.

The Contribution of Professional Accreditation to Quality Assurance in Higher Education

ERIC Educational Resources Information Center

de Paor, Cathal

2016-01-01

This article examines the extent to which the professional accreditation of professional higher education programmes can complement other quality assurance endeavours being carried out. An analysis of a sample of professional accreditation reports for pharmacy education programmes in Ireland provides insight into the priorities of the regulatory…

Range-wide connectivity of priority areas for Greater Sage-Grouse: Implications for long-term conservation from graph theory

USGS Publications Warehouse

Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

2017-01-01

The delineation of priority areas in western North America for managing Greater Sage-Grouse (Centrocercus urophasianus) represents a broad-scale experiment in conservation biology. The strategy of limiting spatial disturbance and focusing conservation actions within delineated areas may benefit the greatest proportion of Greater Sage-Grouse. However, land use under normal restrictions outside priority areas potentially limits dispersal and gene flow, which can isolate priority areas and lead to spatially disjunct populations. We used graph theory, representing priority areas as spatially distributed nodes interconnected by movement corridors, to understand the capacity of priority areas to function as connected networks in the Bi-State, Central, and Washington regions of the Greater Sage-Grouse range. The Bi-State and Central networks were highly centralized; the dominant pathways and shortest linkages primarily connected a small number of large and centrally located priority areas. These priority areas are likely strongholds for Greater Sage-Grouse populations and might also function as refugia and sources. Priority areas in the Central network were more connected than those in the Bi-State and Washington networks. Almost 90% of the priority areas in the Central network had ≥2 pathways to other priority areas when movement through the landscape was set at an upper threshold (effective resistance, ER12). At a lower threshold (ER4), 83 of 123 priority areas in the Central network were clustered in 9 interconnected subgroups. The current conservation strategy has risks; 45 of 61 priority areas in the Bi-State network, 68 of 123 in the Central network, and all 4 priority areas in the Washington network had ≤1 connection to another priority area at the lower ER4threshold. Priority areas with few linkages also averaged greater environmental resistance to movement along connecting pathways. Without maintaining corridors to larger priority areas or a clustered group, isolation of small priority areas could lead to regional loss of Greater Sage-Grouse

Economic evaluation of occupational health and safety programmes in health care.

PubMed

Guzman, J; Tompa, E; Koehoorn, M; de Boer, H; Macdonald, S; Alamgir, H

2015-10-01

Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector. To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework. Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions. We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes. Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Complex adaptive systems: a tool for interpreting responses and behaviours.

PubMed

Ellis, Beverley

2011-01-01

Quality improvement is a priority for health services worldwide. There are many barriers to implementing change at the locality level and misinterpreting responses and behaviours can effectively block change. Electronic health records will influence the means by which knowledge and information are generated and sustained among those operating quality improvement programmes. To explain how complex adaptive system (CAS) theory provides a useful tool and new insight into the responses and behaviours that relate to quality improvement programmes in primary care enabled by informatics. Case studies in two English localities who participated in the implementation and development of quality improvement programmes. The research strategy included purposefully sampled case studies, conducted within a social constructionist ontological perspective. Responses and behaviours of quality improvement programmes in the two localities include both positive and negative influences associated with a networked model of governance. Pressures of time, resources and workload are common issues, along with the need for education and training about capturing, coding, recording and sharing information held within electronic health records to support various information requirements. Primary care informatics enables information symmetry among those operating quality improvement programmes by making some aspects of care explicit, allowing consensus about quality improvement priorities and implementable solutions.

Balancing efficiency, equity and feasibility of HIV treatment in South Africa – development of programmatic guidance

PubMed Central

2013-01-01

South Africa, the country with the largest HIV epidemic worldwide, has been scaling up treatment since 2003 and is rapidly expanding its eligibility criteria. The HIV treatment programme has achieved significant results, and had 1.8 million people on treatment per 2011. Despite these achievements, it is now facing major concerns regarding (i) efficiency: alternative treatment policies may save more lives for the same budget; (ii) equity: there are large inequalities in who receives treatment; (iii) feasibility: still only 52% of the eligible population receives treatment. Hence, decisions on the design of the present HIV treatment programme in South Africa can be considered suboptimal. We argue there are two fundamental reasons to this. First, while there is a rapidly growing evidence-base to guide priority setting decisions on HIV treatment, its included studies typically consider only one criterion at a time and thus fail to capture the broad range of values that stakeholders have. Second, priority setting on HIV treatment is a highly political process but it seems no adequate participatory processes are in place to incorporate stakeholders’ views and evidences of all sorts. We propose an alternative approach that provides a better evidence base and outlines a fair policy process to improve priority setting in HIV treatment. The approach integrates two increasingly important frameworks on health care priority setting: accountability for reasonableness (A4R) to foster procedural fairness, and multi-criteria decision analysis (MCDA) to construct an evidence-base on the feasibility, efficiency, and equity of programme options including trade-offs. The approach provides programmatic guidance on the choice of treatment strategies at various decisions levels based on a sound conceptual framework, and holds large potential to improve HIV priority setting in South Africa. PMID:24107435

Some factors affecting rubella seronegative prevalence among pregnant women in a North West England region between April 2011 and March 2013.

PubMed

Ogundele, Michael; Ghebrehewet, Sam; Chawla, Anu

2016-06-01

Rubella is usually a mild viral illness, but during pregnancy, it can have potentially devastating effects causing fetal losses and severe congenital malformations (congenital rubella syndrome). Rubella is now rare in most developed countries following a successful vaccination programme. We aimed to investigate differences in epidemiological profile of pregnant women screened antenatally in Liverpool to identify risk factors for rubella immunity. All samples were tested with the Elecsys Rubella IgG immunoassay kit. A result <10 IU/ml was considered to be seronegative. The seronegativity prevalence among pregnant women in Liverpool (6.3%) is higher than average value for the North West region (3.7%). The seronegative rates varied with age (15.4% for <15 years, 18.7% for 15-20 years, compared with 2% for 30-35 years). The areas with the highest seronegative rates correspond with areas of Liverpool with high pockets of socioeconomic deprivation. The highest proportion of seronegative women were among the youngest age groups. Local areas with highest level of deprivation should be given priority and additional resources to develop targeted programmes and pathways to implement appropriate interventions such as MMR catch-up programmes and put in place arrangements for offering MMR vaccination in maternity units. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

What's new in graduate medical education?

PubMed

Hernandez, Raquel G

2016-12-01

The development of new graduate medical education programmes provides both opportunities and challenges. Efforts to address physician workforce shortages as well as a realisation that curricula need to be updated to adjust to our rapidly changing healthcare environment have resulted in more educators considering the "how to" and "what's new" of programme development. Understanding the Next Accreditation System, an accreditation system introduced by the Accreditation Council of Graduate Medical Education in 2012, is critical to the success of new as well as existing residency and fellowship programmes. Although many educators are aware of the general rational for the Next Accreditation System, an in-depth understanding of the meaning of Next Accreditation System is necessary from an experiential and theoretical perspective to be able to successfully launch new programmes and moves towards accreditation. A new paediatric categorical residency programme and a new paediatric surgical programme were developed at our institution immediately following the implementation of Next Accreditation System. We provide a series of insights and perspectives based on our experience relative to what priorities we saw outlined from both the programmatic and the institutional perspective to have our graduate medical education programmes reviewed for accreditation. During this discussion, the following objectives are outlined: to overview the Next Accreditation System as a framework and priorities, to discuss the opportunities and challenges that may exist in developing new programmes, and to discuss future directions in the evaluation of trainees and assessment of training competency. Although challenges are outlined, we hope to relay the continued excitement and opportunities that exist relative to enhancing training curricula for future graduate medical education programme builders.

The Role of the United Nations Committee on the Peaceful Uses of Outer Space in Building Capacity

NASA Astrophysics Data System (ADS)

Haubold, Hans

The Office for Outer Space Affairs (OOSA) will provide an overview of achievements of UN- COPUOS, UNISPACE Conferences, particularly the establishment of the Programme on Space Applications and its priority thematic areas, UN-affiliated Regional Centres for Space Science and Technology Education, the International Committee on Global Navigation Satellite Systems (ICG), the UN Platform for Space-based Information for Disaster Management and Emergency Response (UN-Spider), and legal framework governing space activities of UN Member States. OOSA will review results of the United Nations Basic Space Science Initiative, particularly the development of networks of astronomical telescope facilities, planetariums, and instrument arrays for space research in developing nations. The mission of OOSA, implemented through on-going programmes developed for the International Heliophysical Year 2007 (IHY2007) and the International Year of Astronomy 2009 (IYA2009) will be highlighted.

A Synthesis of Students' Theses in the Accredited HHSI Master's Programme.

PubMed

Kinnunen, Ulla-Mari; Saranto, Kaija

2018-01-01

Education in Health Informatics (HI) has been a key priority to guarantee knowledge and skills for professionals working in healthcare settings. One of the early academic models to teach HI are the recommendations provided by the International Medical Informatics Association. The paper describes the curriculum developed for master's degrees and the status of a paradigm used in informatics education, as well as research in the health and human services fields. The aim is to synthesise the methodological focuses in students' theses and discuss the future needs for development. The paradigm guides informatics research. The research focuses, questions and applied research methods were coded for 152 master's degree theses. Based on the results, the most often used method was qualitative. The most frequent research area was steering and organising of information management in work processes. The results guide teachers in supervising the theses of the Health and Human Services Informatics (HHSI) programme and tutoring new students.

Strategic emphases for tropical diseases research: a TDR perspective.

PubMed

Remme, Jan H F; Blas, Erik; Chitsulo, Lester; Desjeux, Philippe M P; Engers, Howard D; Kanyok, Thomas P; Kengeya Kayondo, Jane F; Kioy, Deborah W; Kumaraswami, Vasanthapuram; Lazdins, Janis K; Nunn, Paul P; Oduola, Ayoade; Ridley, Robert G; Toure, Yeya T; Zicker, Fabio; Morel, Carlos M

2002-10-01

Setting priorities for health research is a difficult task, especially for the neglected diseases of the poor. A new approach to priority setting for tropical diseases research has been adopted by the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (known as the TDR). Priorities are defined on the basis of a comprehensive analysis of research needs and research opportunities for each of the ten major tropical diseases in the TDR portfolio. The resulting strategic emphases matrix reflects the priorities for tropical diseases research from the perspective of the TDR. Its purpose is not to impose global research priorities, but we believe the results could be useful to other organizations.

Developing plans and priorities for climate science in service to society

NASA Astrophysics Data System (ADS)

Asrar, Ghassem; Busalacchi, Antonio; Hurrell, James

2012-03-01

World Climate Research Programme (WCRP) Open Science Conference; Denver, Colorado, 24-28 October 2011 The WCRP Open Science Conference (OSC), which had the theme "Climate Research in Service to Society," was held to consult with the international community of experts on future plans and priorities for the WCRP. More than 1900 participants, including 541 young scholars from 86 nations and 300 scientists from developing nations, made the conference a success. Several major scientific priorities emerged from OSC.

Spring Seminars Report. Information Technology and Education Programme. Occasional Paper ITE/3/85.

ERIC Educational Resources Information Center

Lewis, R.

This report contains excerpts from papers and summaries of discussions and program actions carried out during a series of seminars held to establish research priorities under the Information Technology and Education Programme (ITE) in the United Kingdom. The seminar on "Information Technology" (IT) included Kenneth Ruthven's…

SUPPORT Tools for evidence-informed health Policymaking (STP) 3: Setting priorities for supporting evidence-informed policymaking

PubMed Central

2009-01-01

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers have limited resources for developing – or supporting the development of – evidence-informed policies and programmes. These required resources include staff time, staff infrastructural needs (such as access to a librarian or journal article purchasing), and ongoing professional development. They may therefore prefer instead to contract out such work to independent units with more suitably skilled staff and appropriate infrastructure. However, policymakers may only have limited financial resources to do so. Regardless of whether the support for evidence-informed policymaking is provided in-house or contracted out, or whether it is centralised or decentralised, resources always need to be used wisely in order to maximise their impact. Examples of undesirable practices in a priority-setting approach include timelines to support evidence-informed policymaking being negotiated on a case-by-case basis (instead of having clear norms about the level of support that can be provided for each timeline), implicit (rather than explicit) criteria for setting priorities, ad hoc (rather than systematic and explicit) priority-setting process, and the absence of both a communications plan and a monitoring and evaluation plan. In this article, we suggest questions that can guide those setting priorities for finding and using research evidence to support evidence-informed policymaking. These are: 1. Does the approach to prioritisation make clear the timelines that have been set for addressing high-priority issues in different ways? 2. Does the approach incorporate explicit criteria for determining priorities? 3. Does the approach incorporate an explicit process for determining priorities? 4. Does the approach incorporate a communications strategy and a monitoring and evaluation plan? PMID:20018110

SUPPORT Tools for evidence-informed health Policymaking (STP) 3: Setting priorities for supporting evidence-informed policymaking.

PubMed

Lavis, John N; Oxman, Andrew D; Lewin, Simon; Fretheim, Atle

2009-12-16

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers have limited resources for developing--or supporting the development of--evidence-informed policies and programmes. These required resources include staff time, staff infrastructural needs (such as access to a librarian or journal article purchasing), and ongoing professional development. They may therefore prefer instead to contract out such work to independent units with more suitably skilled staff and appropriate infrastructure. However, policymakers may only have limited financial resources to do so. Regardless of whether the support for evidence-informed policymaking is provided in-house or contracted out, or whether it is centralised or decentralised, resources always need to be used wisely in order to maximise their impact. Examples of undesirable practices in a priority-setting approach include timelines to support evidence-informed policymaking being negotiated on a case-by-case basis (instead of having clear norms about the level of support that can be provided for each timeline), implicit (rather than explicit) criteria for setting priorities, ad hoc (rather than systematic and explicit) priority-setting process, and the absence of both a communications plan and a monitoring and evaluation plan. In this article, we suggest questions that can guide those setting priorities for finding and using research evidence to support evidence-informed policymaking. These are: 1. Does the approach to prioritisation make clear the timelines that have been set for addressing high-priority issues in different ways? 2. Does the approach incorporate explicit criteria for determining priorities? 3. Does the approach incorporate an explicit process for determining priorities? 4. Does the approach incorporate a communications strategy and a monitoring and evaluation plan?

[Contribution of humanities and social sciences to the training of healthcare professionals in Africa: an experience in the context of the mother and child Priority Solidarity Fund].

PubMed

Cauli, Marie

2013-01-01

The mother-and-child Priority Solidarity Fund is a programme supported by Coopération Française in the fields of health, higher education and new technologies. It aims to achieve the Millennium Development Goals of reducing maternal and infantile mortality. This programme, focused on the training of trainers, is developing two innovative plans: digital resources and the integration of the humanities and social sciences. This second aspect is decisive: by aligning content, skills, and needs, it can place greater emphasis on preventive care and give a real meaning to the work of trainers.

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

PubMed Central

Yao, Katy; Nkengasong, John N.

2014-01-01

Background Since its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented widely throughout Africa, as well as in the Caribbean, Central and South America, and Southeast Asia. Objective We compiled results from local, national and global studies to provide a broad view of the programme and identify directions for the future. The review consists of two companion papers; this paper focuses on content analysis, examining various thematic components of the SLMTA programme and future priorities. Methods A systematic literature search identified 28 published articles about implementing the SLMTA programme. Results for various components of the SLMTA programme were reviewed and summarised. Results Local and national studies provide substantial information on previous experiences with quality management systems; variations on SLMTA implementation; building human resource capacity for trainers, mentors and auditors; the benefits and effectiveness of various types of mentorship; the importance of management buy-in to ensure country ownership; the need to instill a culture of quality in the laboratory; success factors and challenges; and future directions for the programme. Conclusions Local, national and global results suggest that the SLMTA programme has been overwhelmingly successful in transforming laboratory quality management. There is an urgent need to move forward in four strategic directions: progression (continued improvement in SLMTA laboratories), saturation (additional laboratories within countries that have implemented SLMTA), expansion (implementation in additional countries), and extension (adapting SLMTA for implementation beyond the laboratory), to lead to transformation of overall health systems and patient care. PMID:29043200

Public health nutrition capacity: assuring the quality of workforce preparation for scaling up nutrition programmes.

PubMed

Shrimpton, Roger; du Plessis, Lisanne M; Delisle, Hélène; Blaney, Sonia; Atwood, Stephen J; Sanders, David; Margetts, Barrie; Hughes, Roger

2016-08-01

To describe why and how capacity-building systems for scaling up nutrition programmes should be constructed in low- and middle-income countries (LMIC). Position paper with task force recommendations based on literature review and joint experience of global nutrition programmes, public health nutrition (PHN) workforce size, organization, and pre-service and in-service training. The review is global but the recommendations are made for LMIC scaling up multisectoral nutrition programmes. The multitude of PHN workers, be they in the health, agriculture, education, social welfare, or water and sanitation sector, as well as the community workers who ensure outreach and coverage of nutrition-specific and -sensitive interventions. Overnutrition and undernutrition problems affect at least half of the global population, especially those in LMIC. Programme guidance exists for undernutrition and overnutrition, and priority for scaling up multisectoral programmes for tackling undernutrition in LMIC is growing. Guidance on how to organize and scale up such programmes is scarce however, and estimates of existing PHN workforce numbers - although poor - suggest they are also inadequate. Pre-service nutrition training for a PHN workforce is mostly clinical and/or food science oriented and in-service nutrition training is largely restricted to infant and young child nutrition. Unless increased priority and funding is given to building capacity for scaling up nutrition programmes in LMIC, maternal and child undernutrition rates are likely to remain high and nutrition-related non-communicable diseases to escalate. A hybrid distance learning model for PHN workforce managers' in-service training is urgently needed in LMIC.

Use of programme budgeting and marginal analysis to set priorities for local NHS dental services: learning from the north east of England.

PubMed

Holmes, R D; Steele, J G; Exley, C; Vernazza, C R; Donaldson, C

2018-05-03

Priority setting is necessary where competing demands exceed the finite resources available. The aim of the study was to develop and test a prioritization framework based upon programme budgeting and marginal analysis (PBMA) as a tool to assist National Health Service (NHS) commissioners in their management of resources for local NHS dental services. Twenty-seven stakeholders (5 dentists, 8 commissioners and 14 patients) participated in a case-study based in a former NHS commissioning organization in the north of England. Stakeholders modified local decision-making criteria and applied them to a number of different scenarios. The majority of financial resources for NHS dental services in the commissioning organization studied were allocated to primary care dental practitioners' contracts in perpetuity, potentially constraining commissioners' abilities to shift resources. Compiling the programme budget was successful, but organizational flux and difficulties engaging local NHS commissioners significantly impacted upon the marginal analysis phase. NHS dental practitioners' contracts resemble budget-silos which do not facilitate local resource reallocation. 'Context-specific' factors significantly challenged the successful implementation and impact of PBMA. A local PBMA champion embedded within commissioning organizations should be considered. Participants found visual depiction of the cost-value ratio helpful during their initial priority setting deliberations.

Development and use of the generic WHO/CDC logic model for vitamin and mineral interventions in public health programmes

PubMed Central

De-Regil, Luz Maria; Peña-Rosas, Juan Pablo; Flores-Ayala, Rafael; del Socorro Jefferds, Maria Elena

2015-01-01

Objective Nutrition interventions are critical to achieve the Millennium Development Goals; among them, micronutrient interventions are considered cost-effective and programmatically feasible to scale up, but there are limited tools to communicate the programme components and their relationships. The WHO/CDC (Centers for Disease Control and Prevention) logic model for micronutrient interventions in public health programmes is a useful resource for planning, implementation, monitoring and evaluation of these interventions, which depicts the programme theory and expected relationships between inputs and expected Millennium Development Goals. Design The model was developed by applying principles of programme evaluation, public health nutrition theory and programmatic expertise. The multifaceted and iterative structure validation included feedback from potential users and adaptation by national stakeholders involved in public health programmes' design and implementation. Results In addition to the inputs, main activity domains identified as essential for programme development, implementation and performance include: (i) policy; (ii) products and supply; (iii) delivery systems; (iv) quality control; and (v) behaviour change communication. Outputs encompass the access to and coverage of interventions. Outcomes include knowledge and appropriate use of the intervention, as well as effects on micronutrient intake, nutritional status and health of target populations, for ultimate achievement of the Millennium Development Goals. Conclusions The WHO/CDC logic model simplifies the process of developing a logic model by providing a tool that has identified high-priority areas and concepts that apply to virtually all public health micronutrient interventions. Countries can adapt it to their context in order to support programme design, implementation, monitoring and evaluation for the successful scale-up of nutrition interventions in public health. PMID:23507463

A research agenda for helminth diseases of humans: basic research and enabling technologies to support control and elimination of helminthiases.

PubMed

Lustigman, Sara; Geldhof, Peter; Grant, Warwick N; Osei-Atweneboana, Mike Y; Sripa, Banchob; Basáñez, María-Gloria

2012-01-01

Successful and sustainable intervention against human helminthiases depends on optimal utilisation of available control measures and development of new tools and strategies, as well as an understanding of the evolutionary implications of prolonged intervention on parasite populations and those of their hosts and vectors. This will depend largely on updated knowledge of relevant and fundamental parasite biology. There is a need, therefore, to exploit and apply new knowledge and techniques in order to make significant and novel gains in combating helminthiases and supporting the sustainability of current and successful mass drug administration (MDA) programmes. Among the fields of basic research that are likely to yield improved control tools, the Disease Reference Group on Helminth Infections (DRG4) has identified four broad areas that stand out as central to the development of the next generation of helminth control measures: 1) parasite genetics, genomics, and functional genomics; 2) parasite immunology; 3) (vertebrate) host-parasite interactions and immunopathology; and 4) (invertebrate) host-parasite interactions and transmission biology. The DRG4 was established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR). The Group was given the mandate to undertake a comprehensive review of recent advances in helminthiases research in order to identify notable gaps and highlight priority areas. This paper summarises recent advances and discusses challenges in the investigation of the fundamental biology of those helminth parasites under the DRG4 Group's remit according to the identified priorities, and presents a research and development agenda for basic parasite research and enabling technologies that will help support control and elimination efforts against human helminthiases.

How Do Development Assistance Partners Conceptualise and Prioritise Evidence in Priority Setting (PS) for Health Programmes Relevant to Low Income Countries? A Qualitative Study

ERIC Educational Resources Information Center

Kapiriri, Lydia; Sinding, Christina; Arnold, Emmy

2017-01-01

There is limited literature on how donors conceptualise and prioritise evidence in healthcare priority setting (PS) affecting low income countries (LICs). We interviewed 35 donors and reviewed their websites to describe how they conceptualise, prioritise and perceive the role evidence plays in their organisation's healthcare prioritisation…

Mechanisms which help explain implementation of evidence-based practice in residential aged care facilities: a grounded theory study.

PubMed

Masso, Malcolm; McCarthy, Grace; Kitson, Alison

2014-07-01

The context for the study was a nation-wide programme in Australia to implement evidence-based practice in residential aged care, in nine areas of practice, using a wide range of implementation strategies and involving 108 facilities. The study drew on the experiences of those involved in the programme to answer the question: what mechanisms influence the implementation of evidence-based practice in residential aged care and how do those mechanisms interact? The methodology used grounded theory from a critical realist perspective, informed by a conceptual framework that differentiates between the context, process and content of change. People were purposively sampled and invited to participate in semi-structured interviews, resulting in 44 interviews involving 51 people during 2009 and 2010. Participants had direct experience of implementation in 87 facilities, across nine areas of practice, in diverse locations. Sampling continued until data saturation was reached. The quality of the research was assessed using four criteria for judging trustworthiness: credibility, transferability, dependability and confirmability. Data analysis resulted in the identification of four mechanisms that accounted for what took place and participants' experiences. The core category that provided the greatest understanding of the data was the mechanism On Common Ground, comprising several constructs that formed a 'common ground' for change to occur. The mechanism Learning by Connecting recognised the ability to connect new knowledge with existing practice and knowledge, and make connections between actions and outcomes. Reconciling Competing Priorities was an ongoing mechanism whereby new practices had to compete with an existing set of constantly shifting priorities. Strategies for reconciling priorities ranged from structured approaches such as care planning to more informal arrangements such as conversations during daily work. The mechanism Exercising Agency bridged the gap between agency and action. It was the human dimension of change, both individually and collectively, that made things happen. The findings are consistent with the findings of others, but fit together in a novel way and add to current knowledge about how to improve practices in residential aged care. Each of the four mechanisms is necessary but none are sufficient for implementation to occur. Copyright © 2013 Elsevier Ltd. All rights reserved.

An assessment to prioritise the critical erosion-prone sub-watersheds for soil conservation in the Gumti basin of Tripura, North-East India.

PubMed

Ahmed, Istak; Das Pan, Nibedita; Debnath, Jatan; Bhowmik, Moujuri

2017-10-31

Erosion-induced land degradation problem has emerged as a serious environmental issue across the world. Assessment of this problem through modelling can generate valuable quantitative information for the planners to identify priority areas for proper soil conservation measures. The Gumti River basin of Tripura falls under humid tropical climate and experiences soil erosion for a prolonged period which has turned into a major environmental issue. Increased sediment supply through top soil erosion is one of the major reasons for reduced navigability of this river. Thus, the present study is an attempt to prioritize the sub-watersheds of the Gumti basin by estimating soil loss through the USLE (Universal Soil Loss Equation) model. For that purpose, five parameters of the USLE model were processed, computed and overlaid in a GIS environment. The result shows that potential mean annual soil loss of the Gumti basin ranges between 0.03 and 114.08 t ha -1  year -1 . The resultant values of soil loss were classified into five categories considering the minimum and maximum values. It has been identified that low, moderate, high, very high and severe soil loss categories occupy 68.71, 8.94, 5.86, 5.02 and 11.47% of the basin respectively. Moreover, it has been recognised that sub-watersheds like SW7, SW8, SW12, SW21, SW24 and SW29 fall under very high priority class for which mitigation measures are essential. Therefore, the present study recommends mitigation measures through terrace cultivation, as an alternative of shifting cultivation in the hilly areas and through construction of check dams at the appropriate sites of the erosion prone sub-watersheds. Moreover, proper afforestation programmes that have been implemented successfully in other parts of Tripura through the Japan International Cooperation Agency, Joint Forest Management, and National Afforestation Programme should be initiated in the highly erosion-prone areas of the Gumti River basin.

Suggestions in maternal and child health for the National Technology Assessment Programme: a consideration of consumer and professional priorities.

PubMed

Johanson, R; Rigby, C; Newburn, M; Stewart, M; Jones, P

2002-03-01

In North Staffordshire, the Achieving Sustainable Quality in Maternity (ASQUAM) meetings provide the programme for clinical guidelines and audit over the following year. The ASQUAM clinical effectiveness programme has attempted to address a number of the issues identified as obstacles to informed democratic prioritization. For example, it became clear that a number of topics raised were actually research questions. The organizers therefore decided to split the fourth ASQUAM day into an 'audit' morning and a 'research' afternoon. The meeting organized by RJ, CR and PJ in partnership with the Midwives Information and Resource Service and the National Childbirth Trust, was timed to allow the research ideas to feed into the national Health Technology Assessment (HTA) programme. This meeting was designed to increase the profile of ASQUAM amongst consumers and to increase their representation at the meeting. Objectives were to choose a new set of research priorities for the year 2000, and to ascertain the voting pattern of comparison to health professionals. There was overall agreement in terms of priorities, with the consumer group prioritizing 8 of the 10 topics chosen by the professionals (or 10 of the 11). No significant differences between the proportions of voted cast for each topic by professionals and consumers were found apart from topic 20. The numbers of consumers were small which does limit the number the validity of statistical comparisons. Nevertheless, it is clear that voting patterns were similar. Overall the process suggests that democratic prioritization is a viable option and one that may become essential within the framework of clinical and research governance.

Domestic Violence and Abuse Prevention Programmes in the Early Years Classroom: A Pastoral, Academic and Financial Priority?

ERIC Educational Resources Information Center

McKee, Bronagh E.; Mason, Sarah

2015-01-01

Prevention programmes underpin every child's right to "feel" safe and to "be" safe from all forms of harm. Delivered in schools across the globe, they aim to equip children with knowledge about safety and the skills to seek help early. By drawing upon international prevalence and impact research, as well as the legal, policy…

A scoping review of intimate partner violence assistance programmes within health care settings.

PubMed

Sprague, Sheila; Scott, Taryn; Garibaldi, Alisha; Bzovsky, Sofia; Slobogean, Gerard P; McKay, Paula; Spurr, Hayley; Arseneau, Erika; Memon, Muzammil; Bhandari, Mohit; Swaminathan, Aparna

2017-01-01

Background : The lifetime prevalence of intimate partner violence (IPV) for women presenting to health care settings is estimated to be 38-59%. With the goal of providing help to victims of abuse, numerous IPV assistance programmes have been developed and evaluated across multiple health care settings. Objective : Our scoping review provides an overview of this literature to identify key areas for potential evidence-based recommendations and to focus research priorities. Methods : We conducted a search of MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and psycINFO. We used broad eligibility criteria to identify studies that evaluated the effectiveness of IPV assistance programmes delivered within health care settings. We completed all screening and data extraction independently and in duplicate. We used descriptive statistics to summarize all data. Results : Forty-three studies met all eligibility criteria and were included in our scoping review. Nine categories of assistance programmes were identified: counselling/advocacy, safety assessment/planning, referral, providing IPV resources, home visitation, case management, videos, provider cueing, and system changes. Characteristics of programmes amongst studies frequently reporting positive results included those in which one type of active assistance was used (77.8% of studies reported positive results), a counsellor, community worker, or case manager provided the intervention (83.3% of studies reported positive results), and programmes that were delivered over more than five sessions (100.0% of studies reported positive results). Conclusions : IPV assistance programmes are heterogeneous with regards to the types of assistance they include and how they are delivered and evaluated. This heterogeneity creates challenges in identifying which IPV assistance programmes, and which aspects of these programmes, are effective. However, it appears that many different types of IPV assistance programmes can have positive impacts on women.

A scoping review of intimate partner violence assistance programmes within health care settings

PubMed Central

Sprague, Sheila; Scott, Taryn; Garibaldi, Alisha; Bzovsky, Sofia; Slobogean, Gerard P.; McKay, Paula; Spurr, Hayley; Arseneau, Erika; Memon, Muzammil; Bhandari, Mohit; Swaminathan, Aparna

2017-01-01

ABSTRACT Background: The lifetime prevalence of intimate partner violence (IPV) for women presenting to health care settings is estimated to be 38–59%. With the goal of providing help to victims of abuse, numerous IPV assistance programmes have been developed and evaluated across multiple health care settings. Objective: Our scoping review provides an overview of this literature to identify key areas for potential evidence-based recommendations and to focus research priorities. Methods: We conducted a search of MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and psycINFO. We used broad eligibility criteria to identify studies that evaluated the effectiveness of IPV assistance programmes delivered within health care settings. We completed all screening and data extraction independently and in duplicate. We used descriptive statistics to summarize all data. Results: Forty-three studies met all eligibility criteria and were included in our scoping review. Nine categories of assistance programmes were identified: counselling/advocacy, safety assessment/planning, referral, providing IPV resources, home visitation, case management, videos, provider cueing, and system changes. Characteristics of programmes amongst studies frequently reporting positive results included those in which one type of active assistance was used (77.8% of studies reported positive results), a counsellor, community worker, or case manager provided the intervention (83.3% of studies reported positive results), and programmes that were delivered over more than five sessions (100.0% of studies reported positive results). Conclusions: IPV assistance programmes are heterogeneous with regards to the types of assistance they include and how they are delivered and evaluated. This heterogeneity creates challenges in identifying which IPV assistance programmes, and which aspects of these programmes, are effective. However, it appears that many different types of IPV assistance programmes can have positive impacts on women. PMID:28649297

Range-wide network of priority areas for greater sage-grouse - a design for conserving connected distributions or isolating individual zoos?

USGS Publications Warehouse

Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

2015-09-08

The network of areas delineated in 11 Western States for prioritizing management of greater sage-grouse (Centrocercus urophasianus) represents a grand experiment in conservation biology and reserve design. We used centrality metrics from social network theory to gain insights into how this priority area network might function. The network was highly centralized. Twenty of 188 priority areas accounted for 80 percent of the total centrality scores. These priority areas, characterized by large size and a central location in the range-wide distribution, are strongholds for greater sage-grouse populations and also might function as sources. Mid-ranking priority areas may serve as stepping stones because of their location between large central and smaller peripheral priority areas. The current network design and conservation strategy has risks. The contribution of almost one-half (n = 93) of the priority areas combined for less than 1 percent of the cumulative centrality scores for the network. These priority areas individually are likely too small to support viable sage-grouse populations within their boundary. Without habitat corridors to connect small priority areas either to larger priority areas or as a clustered group within the network, their isolation could lead to loss of sage-grouse within these regions of the network. 

Microswimmers - From Single Particle Motion to Collective Behavior

NASA Astrophysics Data System (ADS)

Gompper, Gerhard; Bechinger, Clemens; Herminghaus, Stephan; Isele-Holder, Rolf; Kaupp, U. Benjamin; Löwen, Hartmut; Stark, Holger; Winkler, Roland G.

2016-11-01

Locomotion of autonomous microswimmers is a fascinating field at the cutting edge of science. It combines the biophysics of self-propulsion via motor proteins, artificial propulsion mechanisms, swimming strategies at low Reynolds numbers, the hydrodynamic interaction of swimmers, and the collective motion and synchronisation of large numbers of agents. The articles of this Special Issue are based on the lecture notes of an international summer school, which was organized by the DFG Priority Programme 1726 "Microswimmers - From Single Particle Motion to Collective Behaviour" in the fall of 2015. The minireviews provide a broad overview of the field, covering both elementary and advanced material, as well as selected areas from current research.

Liberating the potential: the role of non-nurses in adding value to nurse education.

PubMed

Dickinson, Julie

2006-01-01

In this paper, I have attempted to explore the role of non-nurse lecturers in adding value to nurse education programmes. In measuring "added-value" in higher education, I have embraced a more comprehensive approach including investigating the views of "Experts"; including the nurse and non-nurse lecturers themselves, and various United Kingdom stakeholders such as the Government, the Nursing and Midwifery Council and the Quality Assurance Agency. The students' views are also taken into account, when considering both the content of the programmes and how they are delivered. The complexity of "objective measurement" is considered, and the requirements of a "good" teaching experience. The potential areas for adding value include: health and social care policy priorities which encourage partnership working, the blurring of professional boundaries, and inter-professional working. Professional-specific changes embracing extended and enhanced roles and the concepts of specialist and assistant practitioners. Other areas include the Higher Education agendas including transferable skills and adult and student-centred learning. I conclude by discussing the latest policy changes and suggest that the role of the non-nurse lecturer needs more exploration to provide the best value for all.

Pain: A content review of undergraduate pre-registration nurse education in the United Kingdom.

PubMed

Mackintosh-Franklin, Carolyn

2017-01-01

Pain is a global health issue with poor assessment and management of pain associated with serious disability and detrimental socio economic consequences. Pain is also a closely associated symptom of the three major causes of death in the developed world; Coronary Heart Disease, Stroke and Cancer. There is a significant body of work which indicates that current nursing practice has failed to address pain as a priority, resulting in poor practice and unnecessary patient suffering. Additionally nurse education appears to lack focus or emphasis on the importance of pain assessment and its management. A three step online search process was carried out across 71 Higher Education Institutes (HEIs) in the United Kingdom (UK) which deliver approved undergraduate nurse education programmes. Step one to find detailed programme documentation, step 2 to find reference to pain in the detailed documents and step 3 to find reference to pain in nursing curricula across all UK HEI websites, using Google and each HEIs site specific search tool. The word pain featured minimally in programme documents with 9 (13%) documents making reference to it, this includes 3 occurrences which were not relevant to the programme content. The word pain also featured minimally in the content of programmes/modules on the website search, with no references at all to pain in undergraduate pre-registration nursing programmes. Those references found during the website search were for continuing professional development (CPD) or Masters level programmes. In spite of the global importance of pain as a major health issue both in its own right, and as a significant symptom of leading causes of death and illness, pain appears to be a neglected area within the undergraduate nursing curriculum. Evidence suggests that improving nurse education in this area can have positive impacts on clinical practice, however without educational input the current levels of poor practice are unlikely to improve and unnecessary patient suffering will continue. Undergraduate nurse education in the UK needs to review its current approach to content and ensure that pain is appropriately and prominently featured within pre-registration nurse education. Copyright © 2016 Elsevier Ltd. All rights reserved.

Graduates' Experiences Of, and Attitudes Towards, the Inclusion of Employability-Related Support in Undergraduate Degree Programmes; Trends and Variations by Subject Discipline and Gender

ERIC Educational Resources Information Center

O'Leary, Simon

2017-01-01

Enhancing graduate employability is a priority for many stakeholders in higher education and this research explores graduates' experiences of, and attitudes towards, the inclusion of employability-related support in undergraduate degree programmes. A literature review is supplemented by primary research on a targeted sample of 104 graduates from…

Critical interactions between Global Fund-supported programmes and health systems: a case study in Lao People's Democratic Republic.

PubMed

Mounier-Jack, Sandra; Rudge, James W; Phetsouvanh, Rattanaxay; Chanthapadith, Chansouk; Coker, Richard

2010-11-01

In Lao PDR, investment by the Global Fund to Fight AIDS, Tuberculosis and Malaria has played an important role in scaling up the response to HIV and tuberculosis (TB). As part of a series of case studies on how Global Fund-supported programmes interact with national health systems, we assessed the nature and extent of integration of the Global Fund portfolios within the national HIV and TB programmes, the integration of the HIV and TB programmes within the general health system, and system-wide effects of Global Fund support in Lao PDR. The study relied on a literature review and 35 interviews with key stakeholders using the Systemic Rapid Assessment Toolkit and thematic analysis. In Lao PDR, the HIV and TB programmes remain vertical and mostly weakly integrated with the general health system. However, Global Fund investments have extended the network of facilities delivering care at local level, resulting in greater integration with primary care and improved access for patients, particularly for TB. For HIV, as the prevalence remains low, services primarily target high-risk groups in urban areas. Less integrated functions include procurement and drug supply, and monitoring and evaluation. HIV and TB programmes are only starting to coordinate with each other. Global Fund-supported activities are generally integrated within the national disease programmes, except for monitoring and evaluation. Synergies of Global Fund support with the health system include improved access to services, institutional strengthening and capacity building, improved family planning (with wider condom distribution through HIV/AIDS social marketing programmes), and the delivery of add-on interventions, such as vaccinations and health education, alongside Global Fund-supported interventions at community level. Unintended consequences concern the lack of alignment between national stated priorities (maternal and child health) and the strong focus of external partners, such as the Global Fund, on financing communicable disease programmes.

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed Central

Gericke, Christian A.; Kurowski, Christoph; Ranson, M. Kent; Mills, Anne

2005-01-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals. PMID:15868020

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed

Gericke, Christian A; Kurowski, Christoph; Ranson, M Kent; Mills, Anne

2005-04-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.

Space strategy and governance of ESA small member states

NASA Astrophysics Data System (ADS)

Sagath, Daniel; Papadimitriou, Angeliki; Adriaensen, Maarten; Giannopapa, Christina

2018-01-01

The European Space Agency (ESA) has twenty-two Member States with a variety of governance structures and strategic priorities regarding their space activities. The objective of this paper is to provide an up-to date overview and a holistic assessment of the national space governance structures and strategic priorities of the eleven smaller Member States (based on annual ESA contributions). A link is made between the governance structure and the main strategic objectives. The specific needs and interests of small and new Member States in the frame of European Space Integration are addressed. The first part of the paper focuses on the national space governance structures in the eleven smaller ESA Member States. The governance models of these Member States are identified including the responsible ministries and the entities entrusted with the implementation of space strategy/policy and programmes of the country. The second part of this paper focuses on the content and analysis of the national space strategies and indicates the main priorities and trends in the eleven smaller ESA Member States. The priorities are categorised with regards to technology domains, the role of space in the areas of sustainability and the motivators for space investments. In a third and final part, attention is given to the specific needs and interests of the smaller Member States in the frame of European space integration. ESA instruments are tailored to facilitate the needs and interests of the eleven smaller and/or new Member States.

Researching routine immunization-do we know what we don't know?

PubMed

Clements, C John; Watkins, Margaret; de Quadros, Ciro; Biellik, Robin; Hadler, James; McFarland, Deborah; Steinglass, Robert; Luman, Elizabeth; Hennessey, Karen; Dietz, Vance

2011-11-03

The Expanded Programme on Immunization (EPI), launched in 1974, has developed and implemented a range of strategies and practices over the last three decades to ensure that children and adults receive the vaccines they need to help protect them against vaccine-preventable diseases. Many of these strategies have been implemented, resulting in immunization coverage exceeding 80% among children one year of age in many countries. Yet millions of infants remain under-immunized or unimmunized, particularly in poorer countries. In November 2009, a panel of external experts met at the United States Centers for Disease Control and Prevention (CDC) to review and identify areas of research required to strengthen routine service delivery in developing countries. Research opportunities were identified utilizing presentations emphasizing existing research, gaps in knowledge and key questions. Panel members prioritized the topics, as did other meeting participants. Several hundred research topics covering a wide range were identified by the panel members and participants. However there were relatively few topics for which there was a consensus that immediate investment in research is warranted. The panel identified 28 topics as priorities. 18 topics were identified as priorities by at least 50% of non-panel participants; of these, five were also identified as priorities by the panel. Research needs included identifying the best ways to increase coverage with existing vaccines and introduce new vaccines, integrate other services with immunizations, and finance immunization programmes. There is an enormous range of research that could be undertaken to support routine immunization. However, implementation of strategic plans, rather than additional research will have the greatest impact on raising immunization coverage and preventing disease, disability, and death from vaccine-preventable diseases. The panel emphasized the importance of tying operational research to programmatic needs, with a focus on efforts to scale up proven best practices in each country, facilitating the full implementation of immunization strategies. Copyright © 2011. Published by Elsevier Ltd.. All rights reserved.

Preferences for the normative basis of health care priority setting: some evidence from two countries.

PubMed

Olsen, Jan Abel; Richardson, Jeff

2013-04-01

The present paper concerns the criteria people would prefer for prioritising health programmes. It differs from most empirical studies as subjects were not asked about their personal preferences for programmes per se. Rather, they were asked about the principles that should guide the choice of programmes. Four different principles were framed as arguments for alternative programmes. The results from population surveys in Australia and Norway suggest that people are least supportive of the principle that decision makers should follow the stated preferences of the public. Rather, respondents expressed more support for decisions based upon health maximisation, equality and urgency. Copyright © 2012 John Wiley & Sons, Ltd.

Translating childhood tuberculosis case management research into operational policies.

PubMed

Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

2011-08-01

The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.

Threats from urban expansion, agricultural transformation and forest loss on global conservation priority areas.

PubMed

Veach, Victoria; Moilanen, Atte; Di Minin, Enrico

2017-01-01

Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss.

Threats from urban expansion, agricultural transformation and forest loss on global conservation priority areas

PubMed Central

Moilanen, Atte; Di Minin, Enrico

2017-01-01

Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss. PMID:29182662

A training programme to build cancer research capacity in low- and middle-income countries: findings from Guatemala.

PubMed

Arnold, Lauren D; Barnoya, Joaquin; Gharzouzi, Eduardo N; Benson, Peter; Colditz, Graham A

2014-04-01

Guatemala is experiencing an increasing burden of cancer but lacks capacity for cancer prevention, control and research. In partnership with a medical school in the United States of America, a multidisciplinary Cancer Control Research Training Institute was developed at the Instituto de Cancerología (INCAN) in Guatemala City. This institute provided a year-long training programme for clinicians that focused on research methods in population health and sociocultural anthropology. The programme included didactic experiences in Guatemala and the United States as well as applied training in which participants developed research protocols responsive to Guatemala's cancer needs. Although INCAN is the point of referral and service for Guatemala's cancer patients, the institute's administration is also interested in increasing cancer research - with a focus on population health. INCAN is thus a resource for capacity building within the context of cancer prevention and control. Trainees increased their self-efficacy for the design and conduct of research. Value-added benefits included establishment of an annual cancer seminar and workshops in cancer pathology and qualitative analysis. INCAN has recently incorporated some of the programme's components into its residency training and established a research department. A training programme for clinicians can build cancer research capacity in low- and middle-income countries. Training in population-based research methods will enable countries such as Guatemala to gather country-specific data. Once collected, such data can be used to assess the burden of cancer-related disease, guide policy for reducing it and identify priority areas for cancer prevention and treatment.

Executive summary for the Micronutrient Powders Consultation: Lessons Learned for Operational Guidance

PubMed Central

Nyhus Dhillon, Christina; Sarkar, Danya; Klemm, Rolf DW; Neufeld, Lynnette M; Rawat, Rahul; Tumilowicz, Alison

2017-01-01

Abstract Iron deficiency anaemia is estimated to be the leading cause of years lived with disability among children. Young children's diets are often inadequate in iron and other micronutrients, and provision of essential vitamin and minerals has long been recommended. With the limited programmatic success of iron drop/syrup interventions, interest in micronutrient powders (MNP) has increased. MNP are a mixture of vitamins and minerals, enclosed in single‐dose sachets, which are stirred into a child's portion of food immediately before consumption. MNP are an efficacious intervention for reducing iron deficiency anaemia and filling important nutrient gaps in children 6–23 months of age. As of 2014, 50 countries have implemented MNP programmes including 9 at a national level. This paper provides an overview of a 3‐paper series, based on findings from the “Micronutrient Powders Consultation: Lessons Learned for Operational Guidance” held by the USAID‐funded Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. The objectives of the Consultation were to identify and summarize the most recent MNP programme experiences and lessons learned for operationalizing MNP for young children and prioritize an implementation research agenda. The Consultation was composed of 3 working groups that used the following methods: deliberations among 49 MNP programme implementers and experts, a review of published and grey literature, questionnaires, and key informant interviews, described in this overview. The following articles summarize findings in 3 broad programme areas: planning, implementation, and continual programme improvement. The papers also outline priorities for implementation research to inform improved operationalization of MNP. PMID:28960876

Food for all.

PubMed

Ganzin, M

1975-01-01

Ensuring food for all requires an interdisciplinary approach, an evaluation of all sectors of the economy and the formulation of objectives which include proper nutrition in overall development plans. It is my contention that the introduction of nutrition priorities at this level, complemented with the traditional immediate and short-term measures of food aid, nutrition programmes, health campaigns and nutrition education will do much to alleviate the world's food problems. Priorities must be defined, planning structures strengthened, and politicians convinced that objectives can be reached. Otherwise, meagre resources will continue to give low priority to agriculture and social reform and we will have accomplished little toward our objective of food for all.

Through Kazan ASPERA to Modern Projects

NASA Astrophysics Data System (ADS)

Gusev, Alexander; Kitiashvili, Irina; Petrova, Natasha

Now the European Union form the Sixth Framework Programme. One of its the objects of the EU Programme is opening national researches and training programmes. The Russian PhD students and young astronomers have business and financial difficulties in access to modern databases and astronomical projects and so they has not been included in European overview of priorities. Modern requirements to the organization of observant projects on powerful telescopes assumes painstaking scientific computer preparation of the application. A rigid competition for observation time assume preliminary computer modeling of target object for success of the application. Kazan AstroGeoPhysics Partnership

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets

PubMed Central

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-01-01

Abstract National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0–92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women’s access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable and effective HIV response and align government planning with international priorities for gender equality. PMID:28973358

"Don't wait for them to come to you, you go to them". A qualitative study of recruitment approaches in community based walking programmes in the UK.

PubMed

Matthews, Anne; Brennan, Graham; Kelly, Paul; McAdam, Chloe; Mutrie, Nanette; Foster, Charles

2012-08-10

This study aimed to examine the experiences of walking promotion professionals on the range and effectiveness of recruitment strategies used within community based walking programmes within the United Kingdom. Two researchers recruited and conducted semi-structured interviews with managers and project co-ordinators of community based walking programmes, across the UK, using a purposive sampling frame. Twenty eight interviews were conducted, with community projects targeting participants by age, physical activity status, socio-demographic characteristics (i.e. ethnic group) or by health status. Three case studies were also conducted with programmes aiming to recruit priority groups and also demonstrating innovative recruitment methods. Data analysis adopted an approach using analytic induction. Two types of programmes were identified: those with explicit health aims and those without. Programme aims which required targeting of specific groups adopted more specific recruitment methods. The selection of recruitment method was dependent on the respondent's awareness of 'what works' and the resource capacity at their disposal. Word of mouth was perceived to be the most effective means of recruitment but using this approach took time and effort to build relationships with target groups, usually through a third party. Perceived effectiveness of recruitment was assessed by number of participants rather than numbers of the right participants. Some programmes, particularly those targeting younger adult participants, recruited using new social communication media. Where adopted, social marketing recruitment strategies tended to promote the 'social' rather than the 'health' benefits of walking. Effective walking programme recruitment seems to require trained, strategic, labour intensive, word-of-mouth communication, often in partnerships, in order to understand needs and develop trust and motivation within disengaged sedentary communities. Walking promotion professionals require better training and resources to deliver appropriate recruitment strategies to reach priority groups.

[Going into the 21st century: should one dream or act?].

PubMed

Coosemans, M

1991-01-01

A historical review of vector control is made. Despite the available tools, vector borne diseases are still a priority in Public Health. Magic tools, like DDT, were often misused. Adapted strategies and structures for vector control are now required. Progress will mainly result from research and evaluation done in the framework of vector control programmes. Discovery of new tools will find in these operational programmes a point of fall for their application.

Global priorities for conservation across multiple dimensions of mammalian diversity

PubMed Central

Graham, Catherine H.; Costa, Gabriel C.; Hedges, S. Blair; Penone, Caterina; Radeloff, Volker C.; Rondinini, Carlo; Davidson, Ana D.

2017-01-01

Conservation priorities that are based on species distribution, endemism, and vulnerability may underrepresent biologically unique species as well as their functional roles and evolutionary histories. To ensure that priorities are biologically comprehensive, multiple dimensions of diversity must be considered. Further, understanding how the different dimensions relate to one another spatially is important for conservation prioritization, but the relationship remains poorly understood. Here, we use spatial conservation planning to (i) identify and compare priority regions for global mammal conservation across three key dimensions of biodiversity—taxonomic, phylogenetic, and traits—and (ii) determine the overlap of these regions with the locations of threatened species and existing protected areas. We show that priority areas for mammal conservation exhibit low overlap across the three dimensions, highlighting the need for an integrative approach for biodiversity conservation. Additionally, currently protected areas poorly represent the three dimensions of mammalian biodiversity. We identify areas of high conservation priority among and across the dimensions that should receive special attention for expanding the global protected area network. These high-priority areas, combined with areas of high priority for other taxonomic groups and with social, economic, and political considerations, provide a biological foundation for future conservation planning efforts. PMID:28674013

Global priorities for conservation across multiple dimensions of mammalian diversity.

PubMed

Brum, Fernanda T; Graham, Catherine H; Costa, Gabriel C; Hedges, S Blair; Penone, Caterina; Radeloff, Volker C; Rondinini, Carlo; Loyola, Rafael; Davidson, Ana D

2017-07-18

Conservation priorities that are based on species distribution, endemism, and vulnerability may underrepresent biologically unique species as well as their functional roles and evolutionary histories. To ensure that priorities are biologically comprehensive, multiple dimensions of diversity must be considered. Further, understanding how the different dimensions relate to one another spatially is important for conservation prioritization, but the relationship remains poorly understood. Here, we use spatial conservation planning to ( i ) identify and compare priority regions for global mammal conservation across three key dimensions of biodiversity-taxonomic, phylogenetic, and traits-and ( ii ) determine the overlap of these regions with the locations of threatened species and existing protected areas. We show that priority areas for mammal conservation exhibit low overlap across the three dimensions, highlighting the need for an integrative approach for biodiversity conservation. Additionally, currently protected areas poorly represent the three dimensions of mammalian biodiversity. We identify areas of high conservation priority among and across the dimensions that should receive special attention for expanding the global protected area network. These high-priority areas, combined with areas of high priority for other taxonomic groups and with social, economic, and political considerations, provide a biological foundation for future conservation planning efforts.

Medical research--a comparative study of the situation in the RSA and in certain other countries.

PubMed

Brink, A J

1983-02-05

Research as a whole, with medical research as part thereof, is supported by organizational systems which differ in different countries. The basis for research support is nearly always one of two types: projects (short-term research) conducted by individuals, or programme research (a more extended form) carried out by a number of people in a defined field and under the direction of a person uniquely suited to lead the research. The other important form of research undertaking is one of national importance which assumes dimensions necessitating the creation of specific facilities in the form of buildings, research equipment and a staffing establishment (usually termed an 'institute'). Certain aspects relating to medical research as seen in other countries could well be adapted to our own needs, such as the introduction of research work communities (as found in Holland), and the establishment of priority research programmes in order to develop areas of neglect (as done in Germany). Adjustments can also be made to our training programmes and bursary schemes. In particular, attention can be paid to the re-employment of active research workers who have reached retirement age, and to the creation of full-time research posts in different categories at universities. In whatever manner our available research funds are calculated for comparison with those available elsewhere, whether based on money available per capita, size in relation to other research programmes or percentage of gross national product, the position of South Africa appears to be embarrassingly inferior.

A mixed method evaluation of adult tier 2 lifestyle weight management service provision across a county in Northern England.

PubMed

Ells, L; Watson, P; Carlebach, S; O'Malley, C; Jones, D; Machaira, T; Whittaker, V; Clements, H; Walker, P; Needham, K; Summerbell, C; Coulton, V; Araujo-Soares, V

2018-06-01

Adult obesity in the UK remains a public health priority. Current guidance recommends local areas provide multicomponent interventions to treat adults with overweight and obesity; however, there is currently a dearth of published evidence on the evaluation of these programmes. This study reports on a mixed method evaluation of seven tier 2 weight management programmes funded by a local authority in the North of England through their public health grant (a lifestyle multicomponent weight management programme for the treatment of adults with overweight and obesity, but not severe obesity, or obesity with severe co-morbidities). Data collected from over 2000 participants demonstrated that the proportion of participants achieving 5% initial body weight loss was comparable to that reported in recent UK weight management trials. Two services exceeded national criteria of 30% of participants achieving 5% initial body weight loss at 12 weeks, although long term data was limited. Greater weight loss was also observed in participants aged 35-44 and those without co-morbidities. This study provides important learning points for improvements in real world weight management services, these include: standardised data collection and management tools; staff training and communication requirements; the importance of programmes that are joined up to wider support services; and the importance of providing ongoing peer and provider support, continuous monitoring and feedback, and physical activities tailored to user needs. © 2018 World Obesity Federation.

Relationships between anopheline mosquitoes and topography in West Timor and Java, Indonesia.

PubMed

Ndoen, Ermi; Wild, Clyde; Dale, Pat; Sipe, Neil; Dale, Mike

2010-08-26

Malaria is a serious health issue in Indonesia. Mosquito control is one aspect of an integrated malaria management programme. To focus resources on priority areas, information is needed about the vectors and their habitats. This research aimed to identify the relationship between anopheline mosquitoes and topography in West Timor and Java. Study areas were selected in three topographic types in West Timor and Java. These were: coastal plain, hilly (rice field) and highland. Adult mosquitoes were captured landing on humans identified to species level and counted. Eleven species were recorded, four of which were significant for malaria transmission: Anopheles aconitus, Anopheles barbirostris, Anopheles subpictus and Anopheles sundaicus. Each species occupied different topographies, but only five were significantly associated: Anopheles annularis, Anopheles vagus and Anopheles subpictus (Java only) with hilly rice fields; Anopheles barbirostris, Anopheles maculatus and Anopheles subpictus (West Timor only) with coastal areas. Information on significant malaria vectors associated with specific topography is useful for planning the mosquito control aspect of malaria management.

Ada Quality and Style: Guidelines for Professional Programmers

DTIC Science & Technology

1991-01-01

occured because entry queues are serviced in FIFO order, not by priority. There is another situation referred to as a race condition. A program like the...the value of ’COUNT. A task can be removed from an entry queue due to execution of an abort statement as well as expiration of a timed entry call. The...is not defined by the language and may vary from time sliced to preemptive priority. Some implementations (e.g., VAX Ada) provide several choices

Ada Quality and Style: Guidelines for Professional Programmers, Version 02.01.01

DTIC Science & Technology

1992-12-01

47, 78, 79 predicate queue , entry not prioritized, 95 as function name, 22 for boolean object, 21 R preemptive scheduling. 118 race condition. 49...when lower priority tasks are given service while higher priority tasks remain blocked. In the above example, this occurred because entry queues are...from an entry queue 100 Ada QUALITY AND STYLE due to execution of an abort statement as well as expiration of a timed entry call. The use of this

Project Copernicus: Cooperation Programme in Europe on Nature and Industry through Coordinated University Study. Round Table. Unesco-Standing Conference of Rectors, Presidents, and Vice Chancellors of the European Universities (CRE) (Catania, Sicily, April 5-8, 1989). Number 32. Papers on Higher Education.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

This Project COPERNICUS (Cooperation Programme in Europe for Research on Nature and Industry through Coordinated University Studies) Round Table report considers efforts to identify priorities and objectives of the new alliance between the higher education community, industry, and international organizations in addressing today's environmental…

Tritium technology development in EEC laboratories contributions to design goals for NET

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dinner, P.; Chazalon, M.; Leger, D.

1988-09-01

An overview is given of the tritium technology activities carried out in the European national laboratories associated with the European Fusion Programme and in the European Joint Research Center. The relationship of these activities to the Next European Torus (NET) design priorities is discussed, and the current status of the research is summarised. Future developments, required for NET, which will be addressed in the definition of the next 5-year programme are also presented.

The National Action Plan for the Prevention and Control of Non-communicable Diseases and Health Promotion in Pakistan--Cardiovascular diseases.

PubMed

Nishtar, Sania; Faruqui, Azhar M A; Mattu, Mohamad A; Mohamud, Khalif Bile; Ahmed, Ashfaq

2004-12-01

The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) incorporates prevention and control of cardiovascular diseases (CVD) as part of a comprehensive and integrated non-communicable Disease (NCD) prevention effort. In this programme, surveillance of cardiovascular risk factors is part of an integrated population-based NCD surveillance system. The population approach to CVD prevention is a priority area in this programme with a focus on broad policy measures and behavioural change communication. The former include revision of the current policy on diet and nutrition to expand its focus on under-nutrition; the development of a physical activity policy; strategies to limit the production of, and access to, ghee as a medium for cooking and agricultural and fiscal policies that increase the demand for, and make healthy food more accessible. The programme focuses attention on improving the quality of prevention programmes within primary and basic health sites and integrates concerted primary and secondary prevention programmes into health services as part of a comprehensive and sustainable, scientifically valid, and resource-sensitive programme for all categories of healthcare providers. It promotes screening for raised blood pressure at the population level and screening for dyslipidaemia and diabetes in high-risk groups only. It highlights the need to ensure the availability of aspirin, beta blockers, thiazides, ACE inhibitors, statins and penicillin at all levels of healthcare. The programme points out the need to conduct clinical end-point trials in the native Pakistani setting to define cost-effective therapeutic strategies for primary and secondary prevention of CVDs. Emphasis is laid on building capacity of health systems in support of CVD prevention and control and building a coalition or network of organizations to add momentum to CVD prevention and control efforts.

Use of demand for and spatial flow of ecosystem services to identify priority areas.

PubMed

Verhagen, Willem; Kukkala, Aija S; Moilanen, Atte; van Teeffelen, Astrid J A; Verburg, Peter H

2017-08-01

Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas of unique demand-supply connections (flow zones). We tested ways to account for ES demand and flow zones to identify priority areas in the European Union. We mapped the capacity and demand of a global (carbon sequestration), a regional (flood regulation), and 3 local ESs (air quality, pollination, and urban leisure). We used Zonation software to identify priority areas for ESs based on 6 tests: with and without accounting for ES demand and 4 tests that accounted for the effect of ES flow zone. There was only 37.1% overlap between the 25% of priority areas that encompassed the most ESs with and without accounting for ES demand. The level of ESs maintained in the priority areas increased from 23.2% to 57.9% after accounting for ES demand, especially for ESs with a small flow zone. Accounting for flow zone had a small effect on the location of priority areas and level of ESs maintained but resulted in fewer flow zones without ES maintained relative to ignoring flow zones. Accounting for demand and flow zones enhanced representation and distribution of ESs with local to regional flow zones without large trade-offs relative to the global ES. We found that ignoring ES demand led to the identification of priority areas in remote regions where benefits from ES capacity to society were small. Incorporating ESs in conservation planning should therefore always account for ES demand to identify an effective priority network for ESs. © 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Training in the prevention of cervical cancer: advantages of e-learning

PubMed Central

Company, Assumpta; Montserrat, Mireia; Bosch, Francesc X; de Sanjosé, Silvia

2015-01-01

Cervical cancer remains the second most common cancer for women worldwide and is the cancer priority in most low- and middle-income countries (LMIC). The development of vaccines against the human papilloma virus (HPV) and the impact of technology both for the detection of HPV and cervical cancer represent milestones and new opportunities in prevention. New internet-based technologies are generating mass access to training programmes. This article presents the methodology for developing an online training programme for the prevention of cervical cancer as well as the results obtained during the four year period wherein the same programme was delivered in Latin America. PMID:26557878

Training in the prevention of cervical cancer: advantages of e-learning.

PubMed

Company, Assumpta; Montserrat, Mireia; Bosch, Francesc X; de Sanjosé, Silvia

2015-01-01

Cervical cancer remains the second most common cancer for women worldwide and is the cancer priority in most low- and middle-income countries (LMIC). The development of vaccines against the human papilloma virus (HPV) and the impact of technology both for the detection of HPV and cervical cancer represent milestones and new opportunities in prevention. New internet-based technologies are generating mass access to training programmes. This article presents the methodology for developing an online training programme for the prevention of cervical cancer as well as the results obtained during the four year period wherein the same programme was delivered in Latin America.

Nutrition advocacy and national development: the PROFILES programme and its application.

PubMed

Burkhalter, B R; Abel, E; Aguayo, V; Diene, S M; Parlato, M B; Ross, J S

1999-01-01

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.

The ECHI project: health indicators for the European Community.

PubMed

Kramers, Pieter G N

2003-09-01

Within the EU Health Monitoring Programme (HMP), the ECHI project has proposed a comprehensive list of 'European Community Health Indicators'. In the design of the indicator set, a set of explicit criteria was applied. These included: i) be comprehensive and coherent, i.e. cover all domains of the public health field; ii) take account of earlier work, especially that by WHO-Europe, OECD and Eurostat; and iii) cover the priority areas that Member States and Community health policies currently pursue. Flexibility is an important characteristic of the present proposal. In ECHI, this has been emphasized by the definition of 'user-windows'. These are subsets from the overall indicator list, each of which should reflect a specific user's requirement or interest. The proposed indicators are, in most cases, defined as generic indicators, i.e. their actual operational definitions have not yet been attempted. This work has been, and is being carried out to a large part by other projects financed under the HMP, which cover specific areas of public health or areas of data collection. Apart from indicators covered by regularly available data, indicators (or issues) have been proposed for which data are currently difficult to collect but which from a policy point of view would be needed. All this points to the fact that establishing an indicator list which is actually used by Member States is a continuously developing process. This process is now continued by the first strand of the new EU Public Health Action Programme.

Executive summary for the Micronutrient Powders Consultation: Lessons Learned for Operational Guidance.

PubMed

Nyhus Dhillon, Christina; Sarkar, Danya; Klemm, Rolf Dw; Neufeld, Lynnette M; Rawat, Rahul; Tumilowicz, Alison; Namaste, Sorrel Ml

2017-09-01

Iron deficiency anaemia is estimated to be the leading cause of years lived with disability among children. Young children's diets are often inadequate in iron and other micronutrients, and provision of essential vitamin and minerals has long been recommended. With the limited programmatic success of iron drop/syrup interventions, interest in micronutrient powders (MNP) has increased. MNP are a mixture of vitamins and minerals, enclosed in single-dose sachets, which are stirred into a child's portion of food immediately before consumption. MNP are an efficacious intervention for reducing iron deficiency anaemia and filling important nutrient gaps in children 6-23 months of age. As of 2014, 50 countries have implemented MNP programmes including 9 at a national level. This paper provides an overview of a 3-paper series, based on findings from the "Micronutrient Powders Consultation: Lessons Learned for Operational Guidance" held by the USAID-funded Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. The objectives of the Consultation were to identify and summarize the most recent MNP programme experiences and lessons learned for operationalizing MNP for young children and prioritize an implementation research agenda. The Consultation was composed of 3 working groups that used the following methods: deliberations among 49 MNP programme implementers and experts, a review of published and grey literature, questionnaires, and key informant interviews, described in this overview. The following articles summarize findings in 3 broad programme areas: planning, implementation, and continual programme improvement. The papers also outline priorities for implementation research to inform improved operationalization of MNP. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

The Irish Seabed Mapping Programme: INFOMAR - Integrated Mapping Survey for the Sustainable Developments of Ireland's Marine Resources. Progress to Date.

NASA Astrophysics Data System (ADS)

Sacchetti, F.; Benetti, S.; Fitzpatrick, F.

2006-12-01

During the last six years, the Geological Survey of Ireland and the Marine Institute of Ireland worked together on the multimillion Irish National Seabed Survey project with the purpose of mapping the Irish marine territory using a suite of remote sensing equipment, from multibeam to seismic, achieving 87% coverage of the marine zone. Ireland was the first country in the world to carry out an extensive mapping project of their extended Exclusive Economic Zone. The Irish National Seabed Survey is now succeeded by the multiyear INFOMAR Programme. INFOMAR will concentrate initially on mapping twenty-six selected priority bays, three sea areas and the fisheries-protection "Biologically Sensitive Area", and then will complete 100% mapping of the remainder of the EEZ. Designed to incorporate all elements of an integrated mapping programme, the key data acquisition will include hydrography, oceanographic, geological and heritage data. These data sets discharge Ireland's obligations under international treaties to which she is signatory and the uses of these data are vast and multipurpose: from management plans for inshore fishing, aquaculture, coastal protection and engineering works, to environmental impact assessments related to licensing activity and support to the evolving needs of integrated coastal zone management. INFOMAR also includes a data management, exchange and integration programme for the establishment of a National Marine Data Discovery and Exchange Service; providing improved dissemination of information to researchers, policy makers, the public and private sector and the adoption of standard operating procedures in data management to facilitate inter-agency data integration. During the first year of activity, INFOMAR carried out an integrated survey from the national research vessel, the RV Celtic Explorer, acquiring hydrographic, geophysical and groundtruthing data from Bantry and Dunmanus Bays, located off the South West coast of Ireland. Airborne LiDAR (Light Detection And Ranging) and small-vessel mapping surveys have also been carried out, giving detailed bathymetric, topographic and habitat information for the shoaler waters and inshore areas. This presentation will focus both on the general framework and scope of INFOMAR and the initial results and experiences of this year's survey.

[Youth health care: much prevention for little money].

PubMed

Verloove-Vanhorick, S P; Verkerk, P H; van Leerdam, F J M; Reijneveld, S A; Hirasing, R A

2003-05-10

As part of government policy, the 'Youth healthcare' prevention programme is offered free of charge to all children aged 0 to 19 years who are resident in the Netherlands. It consists of a programme of primary prevention (including vaccinations, information and advice) and secondary prevention (screening, surveillance, early diagnosis) and individual prevention and care. Many elements from the programme package have been shown to have a favourable cost-effectiveness relationship, in terms of health benefits and financially. Other elements have a social priority. The present government expenditure for the total youth healthcare package is about 380 million euros per year, that is 1900 euros per child. In terms of conditions prevented or years of life gained, this is cheaper than accepted prevention programmes for adults. The present approach can only be maintained and strengthened, if the expenditure is increased so that new programme elements can be investigated and--if found effective--implemented.

Global patterns of terrestrial vertebrate diversity and conservation

PubMed Central

Jenkins, Clinton N.; Pimm, Stuart L.; Joppa, Lucas N.

2013-01-01

Identifying priority areas for biodiversity is essential for directing conservation resources. Fundamentally, we must know where individual species live, which ones are vulnerable, where human actions threaten them, and their levels of protection. As conservation knowledge and threats change, we must reevaluate priorities. We mapped priority areas for vertebrates using newly updated data on >21,000 species of mammals, amphibians, and birds. For each taxon, we identified centers of richness for all species, small-ranged species, and threatened species listed with the International Union for the Conservation of Nature. Importantly, all analyses were at a spatial grain of 10 × 10 km, 100 times finer than previous assessments. This fine scale is a significant methodological improvement, because it brings mapping to scales comparable with regional decisions on where to place protected areas. We also mapped recent species discoveries, because they suggest where as-yet-unknown species might be living. To assess the protection of the priority areas, we calculated the percentage of priority areas within protected areas using the latest data from the World Database of Protected Areas, providing a snapshot of how well the planet’s protected area system encompasses vertebrate biodiversity. Although the priority areas do have more protection than the global average, the level of protection still is insufficient given the importance of these areas for preventing vertebrate extinctions. We also found substantial differences between our identified vertebrate priorities and the leading map of global conservation priorities, the biodiversity hotspots. Our findings suggest a need to reassess the global allocation of conservation resources to reflect today’s improved knowledge of biodiversity and conservation. PMID:23803854

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT)

PubMed Central

Vallières, Frédérique; Hyland, Philip; Murphy, Jamie; Hansen, Maj; Shevlin, Mark; Elklit, Ask; Ceannt, Ruth; Armour, Cherie; Wiedemann, Nana; Munk, Mette; Dinesen, Cecilie; O’Hare, Geraldine; Cunningham, Twylla; Askerod, Ditte; Spitz, Pernille; Blackwell, Noeline; McCarthy, Angela; O’Dowd, Leonie; Scott, Shirley; Reid, Tracey; Mokake, Andreas; Halpin, Rory; Perera, Camila; Gleeson, Christina; Frost, Rachel; Flanagan, Natalie; Aldamman, Kinan; Tamrakar, Trina; Louison Vang, Maria; Sherwood, Larissa; Travers, Áine; Haahr-Pedersen, Ida; Walshe, Catherine; McDonagh, Tracey; Bramsen, Rikke Holm

2018-01-01

ABSTRACT In this paper we present a description of the Horizon2020, Marie Skłodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology. PMID:29372015

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT).

PubMed

Vallières, Frédérique; Hyland, Philip; Murphy, Jamie; Hansen, Maj; Shevlin, Mark; Elklit, Ask; Ceannt, Ruth; Armour, Cherie; Wiedemann, Nana; Munk, Mette; Dinesen, Cecilie; O'Hare, Geraldine; Cunningham, Twylla; Askerod, Ditte; Spitz, Pernille; Blackwell, Noeline; McCarthy, Angela; O'Dowd, Leonie; Scott, Shirley; Reid, Tracey; Mokake, Andreas; Halpin, Rory; Perera, Camila; Gleeson, Christina; Frost, Rachel; Flanagan, Natalie; Aldamman, Kinan; Tamrakar, Trina; Louison Vang, Maria; Sherwood, Larissa; Travers, Áine; Haahr-Pedersen, Ida; Walshe, Catherine; McDonagh, Tracey; Bramsen, Rikke Holm

2018-01-01

In this paper we present a description of the Horizon2020, Marie Skłodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology.

Analysis of the barriers and enablers to implementing lifestyle management practices for women with PCOS in Singapore.

PubMed

Ko, Henry; Teede, Helena; Moran, Lisa

2016-06-16

Polycystic ovary syndrome (PCOS) is a condition that affects women of reproductive age and manifests with adverse reproductive, metabolic and psychological consequences. Evidence-based PCOS guidelines recommend lifestyle management first line for infertility. In Singapore women with PCOS can attend the PCOS Clinic at the Kandang Kerbau Women and Children's Hospital for infertility treatment. However lifestyle integration into infertility management is currently limited and barriers and enablers to progress remain unclear. All PCOS clinic staff undertook semi-structured interviews to investigate perceived barriers for staff and consumers for the integration of lifestyle into infertility management. This study utilised various tools including an 8P Ishikawa diagram model to identify and categorise barriers. A modified Hanlon method was then used to prioritise barriers within the Singaporean context considering organisational, cultural and financial constraints. Propriety, economics, acceptability, resources and legality (PEARL) criteria were also incorporated into this decision-making tool. In the 8P model, there were five factors contributing to the 'procedure (consultations and referral processes)' barrier, one 'policy (government and hospitals)' factor, five 'place' factors, two 'product (lifestyle management programme)' barriers, two 'people (programme capacity)' factors, four 'process (integration)' factors, three 'promotion' barriers and three 'price' factors. Of the prioritised barriers, two were identified across each of 'procedures', 'place', 'product' and 'people' and four related to 'processes'. There were no barriers identified that for 'policies', 'promotion' and 'price' that can be addressed. There is a clear need to integrate lifestyle into infertility management in PCOS, in line with current national and international evidence-based guidelines. The highest priority identified improvement opportunity was to develop a collaborative lifestyle management programme across hospital services. Reductions in variation of delivery and strengthening support within the lifestyle programme are other identified priorities. The strength of this study is that this is the first study to utilise a pragmatic quality improvement method for barriers identification and prioritisation in the area of lifestyle management for women with PCOS. This project identified factors that may provide easy improvements, but also identified some local factors that may be very difficult to change. The major limitation of this study is that it is only looking at the Singapore setting, so may have limited applicability to other countries. However, results from quality improvement projects are meant to be context specific.

[The National Programme for Disease Management Guidelines. Goals, contents, patient involvement].

PubMed

Ollenschläger, G; Kopp, I; Lelgemann, M; Sänger, S; Klakow-Franck, R; Gibis, B; Gramsch, E; Jonitz, G

2007-03-01

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.

International consensus on military research priorities and gaps - Survey results from the 4th International Congress on Soldiers' Physical Performance.

PubMed

Lovalekar, Mita; Sharp, Marilyn A; Billing, Daniel C; Drain, Jace R; Nindl, Bradley C; Zambraski, Edward J

2018-06-06

The objectives of this study were to identify perceived priorities related to military personnel's health and physical performance, among attendees at the 4th International Congress on Soldiers' Physical Performance (ICSPP), and to determine if perceived priorities had changed between the 3rd ICSPP survey held in 2014 and the 4th ICSPP survey held in 2017. Electronic survey. Respondents were asked to grade priority areas on a Likert scale, and average ratings were used to rank priority areas. Responses to free text questions were analyzed qualitatively. Responses to the 4th ICSPP survey were described and compared to responses to the 3rd ICSPP survey. The 4th ICSPP survey respondents were a diverse group (40.6% military, 58.9% civilian). The two most important priority areas identified were physical demands in operational environments (mean score=4.41/5) and measuring physical performance/fitness (4.38/5), which were also the top two areas in the 3rd ICSPP survey. There was remarkable overlap in the rankings of priority areas between the two surveys. Sleep and nutrition were emerging priority areas and were perceived as relatively more important in the 4th ICSPP survey compared to the 3rd ICSPP survey. The greatest perceived emerging threat was resilience/psychological fitness of recruits (4.16/5). Physiological status monitoring (2.79/4) was identified as the most important technology. Despite the diverse backgrounds of the respondents, there was a clear continuing consensus about perceived important priority areas influencing military personnel's health and physical performance. Soldier resiliency and assessment of physiological status were research topics identified as top priorities. Copyright © 2018 Sports Medicine Australia. All rights reserved.

Large-scale drivers of malaria and priority areas for prevention and control in the Brazilian Amazon region using a novel multi-pathogen geospatial model.

PubMed

Valle, Denis; Lima, Joanna M Tucker

2014-11-20

Most of the malaria burden in the Americas is concentrated in the Brazilian Amazon but a detailed spatial characterization of malaria risk has yet to be undertaken. Utilizing 2004-2008 malaria incidence data collected from six Brazilian Amazon states, large-scale spatial patterns of malaria risk were characterized with a novel Bayesian multi-pathogen geospatial model. Data included 2.4 million malaria cases spread across 3.6 million sq km. Remotely sensed variables (deforestation rate, forest cover, rainfall, dry season length, and proximity to large water bodies), socio-economic variables (rural population size, income, and literacy rate, mortality rate for children age under five, and migration patterns), and GIS variables (proximity to roads, hydro-electric dams and gold mining operations) were incorporated as covariates. Borrowing information across pathogens allowed for better spatial predictions of malaria caused by Plasmodium falciparum, as evidenced by a ten-fold cross-validation. Malaria incidence for both Plasmodium vivax and P. falciparum tended to be higher in areas with greater forest cover. Proximity to gold mining operations was another important risk factor, corroborated by a positive association between migration rates and malaria incidence. Finally, areas with a longer dry season and areas with higher average rural income tended to have higher malaria risk. Risk maps reveal striking spatial heterogeneity in malaria risk across the region, yet these mean disease risk surface maps can be misleading if uncertainty is ignored. By combining mean spatial predictions with their associated uncertainty, several sites were consistently classified as hotspots, suggesting their importance as priority areas for malaria prevention and control. This article provides several contributions. From a methodological perspective, the benefits of jointly modelling multiple pathogens for spatial predictions were illustrated. In addition, maps of mean disease risk were contrasted with that of statistically significant disease clusters, highlighting the critical importance of uncertainty in determining disease hotspots. From an epidemiological perspective, forest cover and proximity to gold mining operations were important large-scale drivers of disease risk in the region. Finally, the hotspot in Western Acre was identified as the area that should receive highest priority from the Brazilian national malaria prevention and control programme.

Master Environmental Plan for Fort Devens, Massachusetts

DTIC Science & Technology

1992-04-01

sites located in proximity to each other were grouped together. The rationale for the order of priority assigned to the study areas in this section is...following priority categories: 1. High priority for action. All group 1 study areas have known contamination. Group IA includes sites that have ongoing...remedial investigations. Group 1B includes sites that have ongoing site inspections. 2. Moderate to high priority for action. Study areas in groups 3

Building the road to a regional zoonoses strategy: A survey of zoonoses programmes in the Americas

PubMed Central

Freire de Carvalho, Mary H.; Hoet, Armando E.; Vigilato, Marco A. N.; Pompei, Julio C.; Cosivi, Ottorino; del Rio Vilas, Victor J.

2017-01-01

Background In recent years, global public health security has been threatened by zoonotic disease emergence as exemplified by outbreaks of H5N1 and H1N1 influenza, SARS, and most recently Ebola and Zika. Additionally, endemic zoonoses, such as rabies, burden countries year after year, placing demands on limited finances and personnel. To survey the baseline status of the emerging and endemic zoonoses programmes of the Latin American and the Caribbean (LAC) countries, the Pan American Health Organization (PAHO) conducted a survey of priority emerging and endemic zoonoses, countries´ prioritization criteria and methodologies, and suggestions to strengthen countries capacities and regional approaches to zoonoses control. Methods A fillable online questionnaire was sent to the zoonoses programme managers of the Ministries of Health (MOH) and Ministries of Agriculture (MAg) of 33 LAC countries from January to April of 2015. The questionnaire comprised 36 single, multiple choice and open-ended questions to inform the objectives of the survey. A descriptive exploratory analysis was completed. Results Fifty-four ministries (26 MOH, 25 MAg, and 3 combined responses) in 31 LAC countries responded to the survey. Within the ministries, 22 (85%) MOH, 5 (20%) MAg, and 2 (67%) combined entities indicated they had specialized zoonoses units. For endemic zoonoses, 32 of 54 ministries responded that they conduct formal prioritization exercises, most of them annually (69%). The three priority endemic zoonoses for the MOHs were leptospirosis, rabies, and brucellosis while the three priorities for the MAgs were brucellosis, rabies, and tuberculosis. Diagnosis for rabies and leptospirosis were cited as the capacities most in need of development. The most needed cross-cutting capacity was coordination between stakeholders. For emerging zoonoses, 28 ministries performed formal prioritization exercises. The top prioritization criteria were probability of introduction into the country and impact. The three priority emerging zoonoses for the MOHs were Ebola viral disease, avian influenza, and Chikungunya while for the MAgs were avian influenza, bovine spongiform encephalopathy and West Nile virus disease. Surveillance for avian influenza and Ebola, and diagnosis for BSE were quoted as the capacities most needed. For all zoonoses, the majority of respondents (69%) ranked their relationship with the other Ministry as productive or very productive, and 31% minimally productive. Many countries requested a formal regional network, better regional communication and collaboration, and integrated surveillance. Conclusions The survey is the first comprehensive effort to date to inform the status of zoonoses programmes in LAC. The information collected here will be used to develop a regional strategy for zoonoses (both endemic and emerging), increase efforts, advocacy, and promote prompt identification and management of EIDs and improvement of endemic programmes. PMID:28333986

Building the road to a regional zoonoses strategy: A survey of zoonoses programmes in the Americas.

PubMed

Maxwell, Melody J; Freire de Carvalho, Mary H; Hoet, Armando E; Vigilato, Marco A N; Pompei, Julio C; Cosivi, Ottorino; Del Rio Vilas, Victor J

2017-01-01

In recent years, global public health security has been threatened by zoonotic disease emergence as exemplified by outbreaks of H5N1 and H1N1 influenza, SARS, and most recently Ebola and Zika. Additionally, endemic zoonoses, such as rabies, burden countries year after year, placing demands on limited finances and personnel. To survey the baseline status of the emerging and endemic zoonoses programmes of the Latin American and the Caribbean (LAC) countries, the Pan American Health Organization (PAHO) conducted a survey of priority emerging and endemic zoonoses, countries´ prioritization criteria and methodologies, and suggestions to strengthen countries capacities and regional approaches to zoonoses control. A fillable online questionnaire was sent to the zoonoses programme managers of the Ministries of Health (MOH) and Ministries of Agriculture (MAg) of 33 LAC countries from January to April of 2015. The questionnaire comprised 36 single, multiple choice and open-ended questions to inform the objectives of the survey. A descriptive exploratory analysis was completed. Fifty-four ministries (26 MOH, 25 MAg, and 3 combined responses) in 31 LAC countries responded to the survey. Within the ministries, 22 (85%) MOH, 5 (20%) MAg, and 2 (67%) combined entities indicated they had specialized zoonoses units. For endemic zoonoses, 32 of 54 ministries responded that they conduct formal prioritization exercises, most of them annually (69%). The three priority endemic zoonoses for the MOHs were leptospirosis, rabies, and brucellosis while the three priorities for the MAgs were brucellosis, rabies, and tuberculosis. Diagnosis for rabies and leptospirosis were cited as the capacities most in need of development. The most needed cross-cutting capacity was coordination between stakeholders. For emerging zoonoses, 28 ministries performed formal prioritization exercises. The top prioritization criteria were probability of introduction into the country and impact. The three priority emerging zoonoses for the MOHs were Ebola viral disease, avian influenza, and Chikungunya while for the MAgs were avian influenza, bovine spongiform encephalopathy and West Nile virus disease. Surveillance for avian influenza and Ebola, and diagnosis for BSE were quoted as the capacities most needed. For all zoonoses, the majority of respondents (69%) ranked their relationship with the other Ministry as productive or very productive, and 31% minimally productive. Many countries requested a formal regional network, better regional communication and collaboration, and integrated surveillance. The survey is the first comprehensive effort to date to inform the status of zoonoses programmes in LAC. The information collected here will be used to develop a regional strategy for zoonoses (both endemic and emerging), increase efforts, advocacy, and promote prompt identification and management of EIDs and improvement of endemic programmes.

Research priorities on diarrhoeal diseases to support the Control of Diarrhoeal Diseases (CDD) programme in Indonesia.

PubMed

Sunoto

1986-01-01

A comprehensive program review of Indonesia's Control of Diarrheal Diseases (CDD) program conducted in 1983 indicated that considerable success has been achieved in this area. Oral rehydration solution (ORS) is widely available, there has been community involvement, a strong managerial structure has developed, baseline data on diarrhea morbidity and mortality are being collected, and staff have received adequate training. At the same time, there have been some problems: inadequate use of ORS, a lack of coordination among CDD programs, insufficient surveillance, budgetary problems, and a lack of laboratory support. During the last 10 years, diarrhea mortality in Indonesia has been reduced by 50-70%, to about 20,000 (20% of child mortality). The Government has established the goal of reducing mortality from diarrhea to less than 1% of child deaths by the year 2000. A major strategy for achieving this goal is integrating family planning, nutrition, maternal-child health, immunization, and CDD programs. Another strategy involves improving research in this area. Areas for further research include: epidemiologic studies, rehydration treatment, antidiarrheal agents, social aspects, immunity and vaccine development, and laboratory examination. The cause of diarrheal diseases is not only enteric infection, it is indirectly caused by acute respiratory infection, malnutrition, measles and other systemic infection as well as the health knowledge and education of the mother. Priority is to be given to 7 areas of research: 1) the use of home-prepared rehydration fluids, 2) feeding practices during acute diarrhea that can prevent chronic diarrhea and malnutrition, 3) the determinants of progression to chronic diarrhea, 4) the impact of simple health information on hygienic and feeding practices on mortality, 5) the potential of using traditional birth attendants in ORS campaigns, 6) traditional attitudes and practices, and 7) the effectiveness of traditional medicines in diarrhea treatment.

[Seroprevalence of HIV infection in the context of a mobile counseling and voluntary testing strategy in rural areas of Côte d'Ivoire].

PubMed

Dagnan, N'cho Simplice; Tiembré, Issaka; Bi Vroh, Joseph Benié; Diaby, Badara; Zengbe-Acray, Pétronille; Attoh-Touré, Harvey; Adjoua, Didier; Ekra, Kouadio Daniel; Tagliante-Saracino, Janine

2013-01-01

In Côte d'Ivoire, HIV testing and counselling has been identified as a priority in the National 2006-2010 AIDS Strategic Plan, which is designed to evaluate the prevalence of HIV in rural areas measured by means of a mobile strategy. We conducted a cross-sectional descriptive and analytical study from 1st April, 2007 to 31st March 2008 in six rural areas of Côte d'Ivoire: Dabou, San Pedro, Abengourou, Tanda, Daloa, and Soubré*. The study population consisted of subjects attending the mobile voluntary counselling and testing units. The mean prevalence of HIV infection in this study was 5.30%. The mean prevalence rate in men was 5.26%, with a peak of 7.55% in the 30-34 years age-group. The mean prevalence rate in women was 5.35%, with a peak of 6.59% in the same age-group. Type HIV-1 was predominant (84.2% of the total). The most affected area was Dabou, with a rate three times higher (15.83%) than the average rate observed during the study. More educated people (university level) presented 3.5-fold (for men) or 6-fold (for women) higher infection rates than illiterate people. Although 100% of people who tested positive received a medical or community referral according to their specific needs, only 62.1% were first-line referred for medical care. In the light of the results of this study, we believe that community mobilization must be redirected to the most severely affected populations to facilitate earlier diagnosis. Actions such as training and prevention based on communication to encourage changes of behaviour should therefore be priorities in the national counselling and testing programme.

Association between Food for Life, a Whole Setting Healthy and Sustainable Food Programme, and Primary School Children’s Consumption of Fruit and Vegetables: A Cross-Sectional Study in England

PubMed Central

Jones, Mat; Pitt, Hannah; Oxford, Liz; Bray, Issy; Kimberlee, Richard; Orme, Judy

2017-01-01

The promotion of dietary health is a public health priority in England and in other countries. Research shows that the majority of children do not consume the recommended amount of fruit and vegetables (F&V). There has been relatively little research on the impact of programmes, such as Food for Life, that (a) integrate action on nutrition and food sustainability issues, and (b) are delivered as commissions in a local authority area. The study sought to assess pupil F&V in schools engaged with the Food for Life (FFL) programme. The design was a cross-sectional study comparing pupils in FFL engaged (n = 24) and non-engaged (n = 23) schools. A total of 2411 pupils aged 8–10 completed a validated self-report questionnaire. After adjusting for confounders, pupils in schools engaged with FFL consumed significantly more servings of F&V compared to pupils in comparison schools (M = 2.03/1.54, p < 0.001). Pupils in FFL schools were twice as likely to eat five or more portions of F&V per day (Odds Ratio = 2.07, p < 0.001, Confidence Interval = 1.54, 2.77). Total F&V consumption was significantly higher (p < 0.05) amongst pupils in schools with a higher level FFL award. Whilst limitations include possible residual confounding, the study suggests primary school engagement with the FFL programme may be an effective way of improving children’s dietary health. PMID:28613266

Association between Food for Life, a Whole Setting Healthy and Sustainable Food Programme, and Primary School Children's Consumption of Fruit and Vegetables: A Cross-Sectional Study in England.

PubMed

Jones, Mat; Pitt, Hannah; Oxford, Liz; Bray, Issy; Kimberlee, Richard; Orme, Judy

2017-06-14

The promotion of dietary health is a public health priority in England and in other countries. Research shows that the majority of children do not consume the recommended amount of fruit and vegetables (F&V). There has been relatively little research on the impact of programmes, such as Food for Life, that (a) integrate action on nutrition and food sustainability issues, and (b) are delivered as commissions in a local authority area. The study sought to assess pupil F&V in schools engaged with the Food for Life (FFL) programme. The design was a cross-sectional study comparing pupils in FFL engaged (n = 24) and non-engaged (n = 23) schools. A total of 2411 pupils aged 8-10 completed a validated self-report questionnaire. After adjusting for confounders, pupils in schools engaged with FFL consumed significantly more servings of F&V compared to pupils in comparison schools (M = 2.03/1.54, p < 0.001). Pupils in FFL schools were twice as likely to eat five or more portions of F&V per day (Odds Ratio = 2.07, p < 0.001, Confidence Interval = 1.54, 2.77). Total F&V consumption was significantly higher ( p < 0.05) amongst pupils in schools with a higher level FFL award. Whilst limitations include possible residual confounding, the study suggests primary school engagement with the FFL programme may be an effective way of improving children's dietary health.

Vaccine-preventable diseases: the role of the European Centre for Disease Prevention and Control.

PubMed

Kramarz, P; Lopalco, P L; Huitric, E; Pastore Celentano, L

2014-05-01

The role of the European Centre for Disease Prevention and Control (ECDC) is to strengthen the capacity of the European Union (EU) Member States to protect human health through the prevention and control of infectious diseases. The main objective of the programme on vaccine-preventable diseases and invasive bacterial infections (VPD) is to provide robust evidence and high-quality technical support to the EU Member States to help them in their efforts to prevent and control VPD. Since the establishment of ECDC, several existing VPD surveillance networks have been transferred to ECDC, namely EU-IBIS, DIPNET and EUVAC. In addition to surveillance of diseases, ECDC is collecting information and monitoring other parameters that are of crucial importance for a well-functioning immunization system, including vaccination coverage. The VPD programme also provides independent scientific opinions in the area of immunization and initiates and coordinates scientific studies in the area of vaccination to answer specific questions of public health importance, including risk perception and analysis of behaviour in different population groups. One of the overall ECDC priorities over recent years is the Centre's involvement in measles elimination. The 'Message' tool and the 'Measles Atlas' are examples of work aiming at supporting the efforts of Member States in the elimination phase. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Tracking patterns of needs during a telephone follow-up programme for family caregivers of persons with stroke.

PubMed

Bakas, Tamilyn; Jessup, Nenette M; McLennon, Susan M; Habermann, Barbara; Weaver, Michael T; Morrison, Gwendolyn

2016-09-01

Programmes that address stroke family caregiver needs and skill-building are recommended based on the literature and patient care guidelines for stroke rehabilitation. The purpose of this study was to explore patterns of perceived needs and skill-building during a stroke caregiver intervention programme. Descriptive statistics were used to analyse data from 123 stroke caregivers enrolled in the intervention group of a randomised controlled clinical trial. Caregivers received eight weekly telephone sessions, with a booster session a month later. At each session, the Caregiver Needs and Concerns Checklist (CNCC) was used to identify and prioritise current needs that were then addressed through skill-building strategies. Perceived needs changed over time. Information about stroke was the highest priority need during Session 1. Managing survivor emotions and behaviours was the highest priority for Sessions 2 through 4. Caregivers generally waited until Sessions 5 through 9 to address their own emotional and physical health needs. Physical and instrumental care needs were relatively low but stable across all nine sessions. Skill-building was consistently high, though it peaked during Sessions 2 and 3. Tracking patterns of needs and skill-building suggest appropriate timing for targeting different types of family caregiver support during stroke rehabilitation. Implications for Rehabilitation Family caregivers of stroke survivors play an essential role in the rehabilitation process of the stroke survivor. Identifying and addressing the priority needs and concerns of stroke caregivers during the early discharge period enables caregivers to provide sustained support for the stroke survivor. Rehabilitation professionals are in a key position to address evolving caregiver needs and concerns as they transition to home settings with follow-up care.

Nutrition advocacy and national development: the PROFILES programme and its application.

PubMed Central

Burkhalter, B. R.; Abel, E.; Aguayo, V.; Diene, S. M.; Parlato, M. B.; Ross, J. S.

1999-01-01

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

Silicone rod extraction followed by liquid desorption-large volume injection-programmable temperature vaporiser-gas chromatography-mass spectrometry for trace analysis of priority organic pollutants in environmental water samples.

PubMed

Delgado, Alejandra; Posada-Ureta, Oscar; Olivares, Maitane; Vallejo, Asier; Etxebarria, Nestor

2013-12-15

In this study a priority organic pollutants usually found in environmental water samples were considered to accomplish two extraction and analysis approaches. Among those compounds organochlorine compounds, pesticides, phthalates, phenols and residues of pharmaceutical and personal care products were included. The extraction and analysis steps were based on silicone rod extraction (SR) followed by liquid desorption in combination with large volume injection-programmable temperature vaporiser (LVI-PTV) and gas chromatography-mass spectrometry (GC-MS). Variables affecting the analytical response as a function of the programmable temperature vaporiser (PTV) parameters were firstly optimised following an experimental design approach. The SR extraction and desorption conditions were assessed afterwards, including matrix modification, time extraction, and stripping solvent composition. Subsequently, the possibility of performing membrane enclosed sorptive coating extraction (MESCO) as a modified extraction approach was also evaluated. The optimised method showed low method detection limits (3-35 ng L(-1)), acceptable accuracy (78-114%) and precision values (<13%) for most of the studied analytes regardless of the aqueous matrix. Finally, the developed approach was successfully applied to the determination of target analytes in aqueous environmental matrices including estuarine and wastewater samples. © 2013 Elsevier B.V. All rights reserved.

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets.

PubMed

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-12-01

National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0-92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women's access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable and effective HIV response and align government planning with international priorities for gender equality. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Determining areas that require indoor insecticide spraying using Multi Criteria Evaluation, a decision-support tool for malaria vector control programmes in the Central Highlands of Madagascar

PubMed Central

Rakotomanana, Fanjasoa; Randremanana, Rindra V; Rabarijaona, Léon P; Duchemin, Jean Bernard; Ratovonjato, Jocelyn; Ariey, Frédéric; Rudant, Jean Paul; Jeanne, Isabelle

2007-01-01

Background The highlands of Madagascar present an unstable transmission pattern of malaria. The population has no immunity, and the central highlands have been the sites of epidemics with particularly high fatality. The most recent epidemic occurred in the 1980s, and caused about 30,000 deaths. The fight against malaria epidemics in the highlands has been based on indoor insecticide spraying to control malaria vectors. Any preventive programme involving generalised cover in the highlands will require very substantial logistical support. We used multicriteria evaluation, by the method of weighted linear combination, as basis for improved targeting of actions by determining priority zones for intervention. Results Image analysis and field validation showed the accuracy of mapping rice fields to be between 82.3% and 100%, and the Kappa coefficient was 0.86 to 0.99. A significant positive correlation was observed between the abundance of the vector Anopheles funestus and temperature; the correlation coefficient was 0.599 (p < 0.001). A significant negative correlation was observed between vector abundance and human population density: the correlation coefficient was -0.551 (p < 0.003). Factor weights were determined by pair-wise comparison and the consistency ratio was 0.04. Risk maps of the six study zones were obtained according to a gradient of risk. Nine of thirteen results of alert confirmed by the Epidemiological Surveillance Post were in concordance with the risk map. Conclusion This study is particularly valuable for the management of vector control programmes, and particularly the reduction of the vector population with a view to preventing disease. The risk map obtained can be used to identify priority zones for the management of resources, and also help avoid systematic and generalised spraying throughout the highlands: such spraying is particularly difficult and expensive. The accuracy of the mapping, both as concerns time and space, is dependent on the availability of data. Continuous monitoring of malaria transmission factors must be undertaken to detect any changes. A regular case notification allows risk map to be verified. These actions should therefore be implemented so that risk maps can be satisfactorily assessed. PMID:17261177

Spatial planning for a green economy: National-level hydrologic ecosystem services priority areas for Gabon

PubMed Central

Tallis, Heather; Cole, Aaron; Schill, Steven; Martin, Erik; Heiner, Michael; Paiz, Marie-Claire; Aldous, Allison; Apse, Colin; Nickel, Barry

2017-01-01

Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of “green” economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces), leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES) are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country’s extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds) total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate potential conflicts. Collectively, our results provide insight into strategies to protect HES as part of Gabon’s development strategy, while providing a replicable methodology for application to new scales, geographies, and policy contexts. PMID:28594870

Acting within an increasingly confined space: A qualitative study of sexual behaviours and healthcare needs among men who have sex with men in a provincial Tanzanian city.

PubMed

Larsson, Markus; Mohamed Shio, Jasmine; Ross, Michael W; Agardh, Anette

2017-01-01

To explore risk perceptions, sexual practices and healthcare needs among men who have sex with men in the provincial city of Tanga in northern Tanzania. Previous research suggests that HIV/STIs are increasing problems for this population. Yet, few studies have been conducted outside the urban area of Dar es Salaam, which has limited our knowledge about the HIV/STI risk factors and healthcare needs among men who have sex with men who live outside major metropolitan areas. During three months in 2013, 10 in-depth interviews with men who have sex with men were conducted in Tanga. Data were interpreted through qualitative content analysis. The theme that emerged was labelled "Acting within an increasingly confined space". The theme reflects the interference of stigma in men's lives, and in the face of potential discrimination, men perceived their sexual and healthcare choices as limited. This created obstacles for forming romantic and sexual relationships, insisting on consistent condom use with sexual partners, maintaining open and conducive relationships with family, and accessing healthcare services when required. Sexual stigma is a concern as it contributes to HIV/STI risk-related behaviours among men who have sex with men. Priority should be given to programmes that support same-sex practicing men in their efforts to make informed choices regarding their sexual health. Creating safe cyber networks provides an opportunity to reach this population with targeted sexual health education messages. Such programmes might be even more urgent in smaller towns and rural areas where gay specific initiatives are more limited than in urban areas.

Acting within an increasingly confined space: A qualitative study of sexual behaviours and healthcare needs among men who have sex with men in a provincial Tanzanian city

PubMed Central

Mohamed Shio, Jasmine; Ross, Michael W.; Agardh, Anette

2017-01-01

Objective To explore risk perceptions, sexual practices and healthcare needs among men who have sex with men in the provincial city of Tanga in northern Tanzania. Previous research suggests that HIV/STIs are increasing problems for this population. Yet, few studies have been conducted outside the urban area of Dar es Salaam, which has limited our knowledge about the HIV/STI risk factors and healthcare needs among men who have sex with men who live outside major metropolitan areas. Method During three months in 2013, 10 in-depth interviews with men who have sex with men were conducted in Tanga. Data were interpreted through qualitative content analysis. Results The theme that emerged was labelled “Acting within an increasingly confined space”. The theme reflects the interference of stigma in men’s lives, and in the face of potential discrimination, men perceived their sexual and healthcare choices as limited. This created obstacles for forming romantic and sexual relationships, insisting on consistent condom use with sexual partners, maintaining open and conducive relationships with family, and accessing healthcare services when required. Conclusions Sexual stigma is a concern as it contributes to HIV/STI risk-related behaviours among men who have sex with men. Priority should be given to programmes that support same-sex practicing men in their efforts to make informed choices regarding their sexual health. Creating safe cyber networks provides an opportunity to reach this population with targeted sexual health education messages. Such programmes might be even more urgent in smaller towns and rural areas where gay specific initiatives are more limited than in urban areas. PMID:28817626

Cost-effective priorities for global mammal conservation.

PubMed

Carwardine, Josie; Wilson, Kerrie A; Ceballos, Gerardo; Ehrlich, Paul R; Naidoo, Robin; Iwamura, Takuya; Hajkowicz, Stefan A; Possingham, Hugh P

2008-08-12

Global biodiversity priority setting underpins the strategic allocation of conservation funds. In identifying the first comprehensive set of global priority areas for mammals, Ceballos et al. [Ceballos G, Ehrlich PR, Soberón J, Salazar I, Fay JP (2005) Science 309:603-607] found much potential for conflict between conservation and agricultural human activity. This is not surprising because, like other global priority-setting approaches, they set priorities without socioeconomic objectives. Here we present a priority-setting framework that seeks to minimize the conflicts and opportunity costs of meeting conservation goals. We use it to derive a new set of priority areas for investment in mammal conservation based on (i) agricultural opportunity cost and biodiversity importance, (ii) current levels of international funding, and (iii) degree of threat. Our approach achieves the same biodiversity outcomes as Ceballos et al.'s while reducing the opportunity costs and conflicts with agricultural human activity by up to 50%. We uncover shortfalls in the allocation of conservation funds in many threatened priority areas, highlighting a global conservation challenge.

Work Programme, 2003.

ERIC Educational Resources Information Center

European Centre for the Development of Vocational Training, Thessaloniki (Greece).

This publication presents work program 2003 in light of the new medium-term priorities 2003-06 and activities 2003 as a consistent and systematic translation of this multiannual approach, specifying activities and outputs to meet the medium-term strategy. A main strategic activity is described--further development of a knowledge management system…

Sustainability and public health nutrition at school: assessing the integration of healthy and environmentally sustainable food initiatives in Vancouver schools.

PubMed

Black, Jennifer L; Velazquez, Cayley E; Ahmadi, Naseam; Chapman, Gwen E; Carten, Sarah; Edward, Joshua; Shulhan, Stephanie; Stephens, Teya; Rojas, Alejandro

2015-09-01

To describe the development and application of the School Food Environment Assessment Tools and a novel scoring system to assess the integration of healthy and environmentally sustainable food initiatives in elementary and secondary schools. The cross-sectional study included direct observations of physical food environments and interviews with key school personnel regarding food-related programmes and policies. A five-point scoring system was then developed to assess actions across six domains: (i) food gardens; (ii) composting systems; (iii) food preparation activities; (iv) food-related teaching and learning activities; and availability of (v) healthy food; and (vi) environmentally sustainable food. Vancouver, Canada. A purposive sample of public schools (n 33) from all six sectors of the Vancouver Board of Education. Schools scored highest in the areas of food garden and compost system development and use. Regular integration of food-related teaching and learning activities and hands-on food preparation experiences were also commonly reported. Most schools demonstrated rudimentary efforts to make healthy and environmentally sustainable food choices available, but in general scored lowest on these two domains. Moreover, no schools reported widespread initiatives fully supporting availability or integration of healthy or environmentally sustainable foods across campus. More work is needed in all areas to fully integrate programmes and policies that support healthy, environmentally sustainable food systems in Vancouver schools. The assessment tools and proposed indicators offer a practical approach for researchers, policy makers and school stakeholders to assess school food system environments, identify priority areas for intervention and track relevant changes over time.

Comparative study of nutritional status of urban and rural Nigerian school children.

PubMed

Oninla, S O; Owa, J A; Onayade, A A; Taiwo, O

2007-02-01

Nutritional assessment in the community is essential for accurate planning and implementation of intervention programmes to reduce morbidity and mortality associated with under-nutrition. The study was, therefore, carried out to determine and compare the nutritional status of children attending urban and rural public primary schools in Ife Central Local Government Area (ICLGA) of Nigeria. The schools were stratified into urban and rural, and studied schools were selected by balloting. Information obtained on each pupil was entered into a pre-designed proforma. The weight and height were recorded for each pupil, and converted to nutritional indices (weight for age, weight for height, height for age). A total of 749 pupils (366 and 383 children from the rural and urban communities, respectively) were studied. The overall prevalent rates of underweight, wasting and stunting were 61.2, 16.8 and 27.6%, respectively. In the rural area these were 70.5, 17.8 and 35.8%, while in the urban they were 52.2, 15.9 and 19.8%, respectively. The mean nutritional indices (Weight for Age, Weight for Height and Height for Age) were found to be significantly lower among the rural pupils than urban pupils (P < 0.001 in each case). The present study shows that malnutrition (underweight, wasting and stunting) constituted major health problems among school children in Nigeria. This is particularly so in the rural areas. Therefore, prevention of malnutrition should be given a high priority in the implementation of the ongoing primary health care programmes with particular attention paid to the rural population.

Assessing missed opportunities for the prevention of mother-to-child HIV transmission in an Eastern Cape local service area.

PubMed

Rispel, L C; Peltzer, K; Phaswana-Mafuya, N; Metcalf, C A; Treger, L

2009-03-01

Prevention of new HIV infections is a critical imperative for South Africa; the prevention of mother-to-child transmission (PMTCT) is one of the most efficacious HIV prevention interventions. Assessment of a PMTCT programme to determine missed opportunities. The Kouga local service area (LSA), bordering Nelson Mandela Bay Municipality (Port Elizabeth) in the Eastern Cape. An assessment was conducted in 2007 before implementing technical support for strengthening the PMTCT programme, including: interviews with 20 PMTCT managers, 4 maternity staff and 27 other health workers on service provision, management, infrastructure, human resources and the health information system; 296 antenatal clinic users on their service perceptions; 70 HIV-positive women on HIV knowledge, infant feeding, coping, support and service perceptions; 8 representatives from community organisations and 101 traditional health practitioners (THPs). Observations were conducted during site visits to health facilities, and the District Health Information System (DHIS) data were reviewed. Staff had high levels of awareness of HIV policies and most had received some relevant training. Nevirapine uptake varied by clinic, with an average of 56%. There were many missed opportunities for PMTCT, with 67% of pregnant women tested for HIV and only 43% of antenatal care attendees tested during a previous pregnancy. Only 6% of HIV-positive women reported support group participation. Reducing missed opportunities for PMTCT requires strengthening of the formal health sector, intersectoral liaison, and greater community support. Priority areas that require strengthening in the formal health sector include HIV counselling and testing; family planning and nutrition counselling; infant follow-up; human resources; and monitoring and evaluation.

Rapid Damage Mapping for the 2015 M7.8 Gorkha Earthquake using Synthetic Aperture Radar Data from COSMO-SkyMed and ALOS-2 Satellites

NASA Astrophysics Data System (ADS)

Yun, S. H.; Hudnut, K. W.; Owen, S. E.; Webb, F.; Simons, M.; Macdonald, A.; Sacco, P.; Gurrola, E. M.; Manipon, G.; Liang, C.; Fielding, E. J.; Milillo, P.; Hua, H.; Coletta, A.

2015-12-01

The April 25, 2015 M7.8 Gorkha earthquake caused more than 8,000 fatalities and widespread building damage in central Nepal. Four days after the earthquake, the Italian Space Agency's (ASI's) COSMO-SkyMed Synthetic Aperture Radar (SAR) satellite acquired data over Kathmandu area. Nine days after the earthquake, the Japan Aerospace Exploration Agency's (JAXA's) ALOS-2 SAR satellite covered larger area. Using these radar observations, we rapidly produced damage proxy maps derived from temporal changes in Interferometric SAR (InSAR) coherence. These maps were qualitatively validated through comparison with independent damage analyses by National Geospatial-Intelligence Agency (NGA) and the UNITAR's (United Nations Institute for Training and Research's) Operational Satellite Applications Programme (UNOSAT), and based on our own visual inspection of DigitalGlobe's WorldView optical pre- vs. post-event imagery. Our maps were quickly released to responding agencies and the public, and used for damage assessment, determining inspection/imaging priorities, and reconnaissance fieldwork.

Side effects of problem-solving strategies in large-scale nutrition science: towards a diversification of health.

PubMed

Penders, Bart; Vos, Rein; Horstman, Klasien

2009-11-01

Solving complex problems in large-scale research programmes requires cooperation and division of labour. Simultaneously, large-scale problem solving also gives rise to unintended side effects. Based upon 5 years of researching two large-scale nutrigenomic research programmes, we argue that problems are fragmented in order to be solved. These sub-problems are given priority for practical reasons and in the process of solving them, various changes are introduced in each sub-problem. Combined with additional diversity as a result of interdisciplinarity, this makes reassembling the original and overall goal of the research programme less likely. In the case of nutrigenomics and health, this produces a diversification of health. As a result, the public health goal of contemporary nutrition science is not reached in the large-scale research programmes we studied. Large-scale research programmes are very successful in producing scientific publications and new knowledge; however, in reaching their political goals they often are less successful.

Lessons from the evaluation of the UK's NHS R&D Implementation Methods Programme

PubMed Central

Soper, Bryony; Hanney, Stephen R

2007-01-01

Background Concern about the effective use of research was a major factor behind the creation of the NHS R&D Programme in 1991. In 1994, an advisory group was established to identify research priorities in research implementation. The Implementation Methods Programme (IMP) flowed from this, and its commissioning group funded 36 projects. In 2000 responsibility for the programme passed to the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D, which asked the Health Economics Research Group (HERG), Brunel University, to conduct an evaluation in 2002. By then most projects had been completed. This evaluation was intended to cover: the quality of outputs, lessons to be learnt about the communication strategy and the commissioning process, and the benefits from the projects. Methods We adopted a wide range of quantitative and qualitative methods. They included: documentary analysis, interviews with key actors, questionnaires to the funded lead researchers, questionnaires to potential users, and desk analysis. Results Quantitative assessment of outputs and dissemination revealed that the IMP funded useful research projects, some of which had considerable impact against the various categories in the HERG payback model, such as publications, further research, research training, impact on health policy, and clinical practice. Qualitative findings from interviews with advisory and commissioning group members indicated that when the IMP was established, implementation research was a relatively unexplored field. This was reflected in the understanding brought to their roles by members of the advisory and commissioning groups, in the way priorities for research were chosen and developed, and in how the research projects were commissioned. The ideological and methodological debates associated with these decisions have continued among those working in this field. The need for an effective communication strategy for the programme as a whole was particularly important. However, such a strategy was never developed, making it difficult to establish the general influence of the IMP as a programme. Conclusion Our findings about the impact of the work funded, and the difficulties faced by those developing the IMP, have implications for the development of strategic programmes of research in general, as well as for the development of more effective research in this field. PMID:17309803

Analysis - what is legal medicine?

PubMed

Beran, Roy G

2008-04-01

Legal medicine addresses the interface between medicine and law in health care. The Australian College of Legal Medicine (ACLM) established itself as the peak body in legal and forensic medicine in Australia. It helped establish the Expert Witness Institute of Australia (EWIA), the legal medicine programme at Griffith University and contributes to government enquiries. Public health, disability assessment, competing priorities of privacy verses notification and determination of fitness for a host of pursuits are aspects of legal medicine. Complementing the EWIA, the ACLM runs training programmes emphasising legal medicine skills additional to clinical practice, advocating clinical relevance. Assessment of athletes' fitness and ensuring that prohibited substances are not inadvertently prescribed represent a growing area of legal medicine. Ethical consideration of health care should respect legal medicine principles rather than armchair commentary. International conventions must be respected by legal medicine and dictate physicians' obligations. The NSW courts imposed a duty to provide emergency medical care. Migration and communicable diseases are aspects of legal medicine. Police surgeons provide a face to legal medicine (which incorporates forensic medicine) underpinning its public perception of specialty recognition. Legal medicine deserves its place as a medical specialty in its own right.

Immunization coverage in India for areas served by the Integrated Child Development Services programme. The Integrated Child Development Services Consultants.

PubMed

Tandon, B N; Gandhi, N

1992-01-01

The Integrated Child Development Services (ICDS) programme was launched by the Indian government in October 1975 to provide a package of health, nutrition and informal educational services to mothers and children. In 1988 we studied the impact of ICDS on the immunization coverage of children aged 12-24 months and of mothers of infants in 19 rural, 8 tribal, and 9 urban ICDS projects that had been operational for more than 5 years. Complete coverage with BCG, diphtheria-pertussis-tetanus (DPT) and poliomyelitis vaccines was recorded for 65%, 63%, and 64% of children, respectively, in the ICDS population. By comparison, the coverage in the non-ICDS group was only 22% for BCG, 28% for DPT, and 27% for poliomyelitis. Complete immunization with tetanus toxoid was recorded for 68% of the mothers in the ICDS group and for 40% in the non-ICDS group. Coverage was greater in the urban and lower in the tribal projects. Scheduled castes, scheduled tribes, backward communities, and minorities (groups that have a high priority for social services) had immunization coverages in ICDS projects that were similar to those of higher castes.

From Marginality to the Mainstream: Learning from Action Research for Sustainable Development

ERIC Educational Resources Information Center

Liddy, Mags

2012-01-01

Education for sustainable development establishes the need for change within education; in particular, teacher education is recognised as a priority for reorientation towards sustainability needs. The Ubuntu Network is an action research programme, focusing on supporting teacher educators to explore the integration of development education and…

Viability of Welfare Technology in Mass Technical Literacy Programme

ERIC Educational Resources Information Center

Achintya; Prabha, Manish

2009-01-01

Each developing country should be encouraged to identify its own priorities and develop welfare technology mobilizing its own natural and human resources and should not unnecessarily imitate the stereotyped technologies from the developed countries. The existing curriculum has to be updated and strengthened to include the concept of welfare…

Factors Influencing Adolescent Eating Behaviour: Application and Validation of a Diagnostic Instrument

ERIC Educational Resources Information Center

Benarroch, Alicia; Perez, Silvia; Perales, Javier

2011-01-01

Introduction: Variables that predict the eating behaviour of teenagers are a high-priority objective of nutritional educational programmes. This research work is designed to verify whether the "Food Consumption, Intentions and Preferences Assessment Test" (FCIPAT) is useful when investigating the factors influencing adolescent eating…

Environmental Education: A Priority for the Sustainable Development of Small Island States.

ERIC Educational Resources Information Center

Stuart, Sir Kenneth

1994-01-01

This article emphasizes the importance of environmental education for small island states and examines some of the prerequisites for its successful development. Discusses the difficulties of developing cross-curricular interdisciplinary educational programmes with the environment as an integrating theme, and reviews of a number of responses to…

National infection prevention and control programmes: Endorsing quality of care.

PubMed

Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

2014-01-01

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.

40 CFR 35.2015 - State priority system and project priority list.

Code of Federal Regulations, 2010 CFR

2010-07-01

... achieve optimum water quality management consistent with the goals and requirements of the Act. All..., needs and priorities set forth in areawide water quality management plans, and any other factors... priority to projects in priority water quality areas. The priority system may also include the...

40 CFR 35.2024 - Combined sewer overflows.

Code of Federal Regulations, 2010 CFR

2010-07-01

... project priority list, it addresses impaired uses in priority water quality areas which are due to the... must demonstrate to the Administrator that the water quality goals of the Act will not be achieved... priority water quality areas in marine bays and estuaries due to the impacts of combined sewer overflows...

Balancing student/trainee learning with the delivery of patient care in the healthcare workplace: a protocol for realist synthesis

PubMed Central

Sholl, Sarah; Ajjawi, Rola; Allbutt, Helen; Butler, Jane; Jindal-Snape, Divya; Morrison, Jill; Rees, Charlotte

2016-01-01

Introduction A national survey was recently conducted to explore medical education research priorities in Scotland. The identified themes and underlying priority areas can be linked to current medical education drivers in the UK. The top priority area rated by stakeholders was: ‘Understanding how to balance service and training conflicts’. Despite its perceived importance, a preliminary scoping exercise revealed the least activity with respect to published literature reviews. This protocol has therefore been developed so as to understand how patient care, other service demands and student/trainee learning can be simultaneously facilitated within the healthcare workplace. The review will identify key interventions designed to balance patient care and student/trainee learning, to understand how and why such interventions produce their effects. Our research questions seek to address how identified interventions enable balanced patient care-trainee learning within the healthcare workplace, for whom, why and under what circumstances. Methods and analysis Pawson's five stages for undertaking a realist review underpin this protocol. These stages may progress in a non-linear fashion due to the iterative nature of the review process. We will: (1) clarify the scope of the review, identifying relevant interventions and existing programme theories, understanding how interventions act to produce their intended outcomes; (2) search journal articles and grey literature for empirical evidence from 1998 (introduction of the European Working Time Directive) on the UK multidisciplinary team working concerning these interventions, theories and outcomes, using databases such as ERIC, Scopus and CINAHL; (3) assess study quality; (4) extract data; and (5) synthesise data, drawing conclusions. Ethics and dissemination A formal ethical review is not required. These findings should provide an important understanding of how workplace-based interventions influence the balance of trainee learning and service provision. They should benefit various stakeholders involved in workplace-based learning interventions, and inform the medical education research agenda in the UK. PMID:27118289

Global Climate Change Adaptation Priorities for Biodiversity and Food Security

PubMed Central

Hannah, Lee; Ikegami, Makihiko; Hole, David G.; Seo, Changwan; Butchart, Stuart H. M.; Peterson, A. Townsend; Roehrdanz, Patrick R.

2013-01-01

International policy is placing increasing emphasis on adaptation to climate change, including the allocation of new funds to assist adaptation efforts. Climate change adaptation funding may be most effective where it meets integrated goals, but global geographic priorities based on multiple development and ecological criteria are not well characterized. Here we show that human and natural adaptation needs related to maintaining agricultural productivity and ecosystem integrity intersect in ten major areas globally, providing a coherent set of international priorities for adaptation funding. An additional seven regional areas are identified as worthy of additional study. The priority areas are locations where changes in crop suitability affecting impoverished farmers intersect with changes in ranges of restricted-range species. Agreement among multiple climate models and emissions scenarios suggests that these priorities are robust. Adaptation funding directed to these areas could simultaneously address multiple international policy goals, including poverty reduction, protecting agricultural production and safeguarding ecosystem services. PMID:23991125

Global climate change adaptation priorities for biodiversity and food security.

PubMed

Hannah, Lee; Ikegami, Makihiko; Hole, David G; Seo, Changwan; Butchart, Stuart H M; Peterson, A Townsend; Roehrdanz, Patrick R

2013-01-01

International policy is placing increasing emphasis on adaptation to climate change, including the allocation of new funds to assist adaptation efforts. Climate change adaptation funding may be most effective where it meets integrated goals, but global geographic priorities based on multiple development and ecological criteria are not well characterized. Here we show that human and natural adaptation needs related to maintaining agricultural productivity and ecosystem integrity intersect in ten major areas globally, providing a coherent set of international priorities for adaptation funding. An additional seven regional areas are identified as worthy of additional study. The priority areas are locations where changes in crop suitability affecting impoverished farmers intersect with changes in ranges of restricted-range species. Agreement among multiple climate models and emissions scenarios suggests that these priorities are robust. Adaptation funding directed to these areas could simultaneously address multiple international policy goals, including poverty reduction, protecting agricultural production and safeguarding ecosystem services.

Integrating mental health services: the Finnish experience

PubMed Central

Lehtinen, Ville; Taipale, Vappu

2001-01-01

Abstract The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in which mental health has been chosen as one of the eight priority areas. PMID:16896401

76 FR 14379 - Advanced Placement Incentive Program; Office of Elementary and Secondary Education; Overview...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... competitive preference priority. Absolute Priority 1: Promoting Science, Technology, Engineering, and... applications that meet these priorities. These priorities are: Absolute Priority 1: Promoting Science... participation in the core academic areas of English, mathematics, and science; (4) Involving business and...

Threats to polio eradication in high-conflict areas in Pakistan and Nigeria: a polling study of caregivers of children younger than 5 years.

PubMed

SteelFisher, Gillian K; Blendon, Robert J; Guirguis, Sherine; Brulé, Amanda; Lasala-Blanco, Narayani; Coleman, Michael; Petit, Vincent; Ahmed, Mashrur; Mataruse, Noah; Corkum, Melissa; Nisar, Mazhar; Ben-Porath, Eran N; Gigli, Susan; Sahm, Christoph

2015-10-01

Elimination of poliovirus from endemic countries is a crucial step in eradication; however, vaccination programmes in these areas face challenges, especially in regions with conflict. We analysed interviews with caregivers of children living in two polio-endemic countries to assess whether these challenges are largely operational or also driven by resistance or misinformation in the community. We designed and analysed polls based on face-to-face interviews of a random sample of parents and other caregivers of children younger than 5 years in regions of Pakistan and Nigeria at high risk for polio transmission. In both countries, the sample was drawn via a stratified multistage cluster design with random route household selection. The questionnaire covered awareness, knowledge, and attitudes about polio and oral polio vaccine (OPV), trust in vaccination efforts, and caregiver priorities for government action. We assessed experiences of caregivers in accessible higher-conflict areas and compared their knowledge and attitudes with those in lower-conflict areas. Differences were tested with two-sample t tests. The poll consisted of 3396 caregivers from Pakistan and 2629 from Nigeria. About a third of caregivers who responded in higher-conflict areas of Pakistan (Federally Administered Tribal Areas [FATA], 30%) and Nigeria (Borno, 33%) were unable to confirm that their child was vaccinated in the previous campaign. In FATA, 12% of caregivers reported that they were unaware of polio, and in Borno 12% of caregivers reported that vaccinators visited but their child did not receive the vaccine or they did not know whether the child was vaccinated. Additionally, caregivers in higher-conflict areas are less likely to hold beliefs about OPV that could motivate acceptance and are more likely to hold concerns than are caregivers in lower-conflict areas. Beyond the difficulties in reaching homes with OPV, challenges for vaccination programmes in higher-conflict areas extend to limited awareness, negative attitudes, and gaps in trust. Vaccination efforts might need to address underlying attitudes of caregivers through direct communications and the selection and training of local vaccinators. Harvard T H Chan School of Public Health and UNICEF. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Priority for ESD Research: Influencing Adult Citizens

ERIC Educational Resources Information Center

Monroe, Martha C.

2007-01-01

Research in the disciplines of education, science education, and environmental education has a rich history. While research in Education for Sustainable Development (ESD) may be related to these traditions, there is a need for ESD to carve a new niche that promotes high quality and effective ESD programmes. With an eye towards practice and applied…

Educational Module on Environmental Problems in Cities. Environmental Educational Series 4.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Paris (France). Div. of Science, Technical and Vocational Education.

The International Environmental Education Programme (IEEP) of UNESCO has determined that the enhancement of the quality of the built environment is a basic priority for future environmental action, particularly in Europe and North America. This experimental teaching module applies specifically to those two continents, and is intended for use by…

Service-Oriented Architecture and Curriculum Transformation at Manchester Metropolitan University

ERIC Educational Resources Information Center

Stubbs, Mark; Range, Phil

2011-01-01

Purpose: The need to establish more flexible and adaptable university curricula has been recognised as a strategic priority in recent years and has been supported by a number of initiatives including the Curriculum Design and Delivery programme funded by the Joint Information System Committee (JISC) in the UK. The challenges of addressing…

The Gendered Nature of Apprenticeship: Employers? and Young People's Perspectives

ERIC Educational Resources Information Center

Fuller, Alison; Beck, Vanessa; Unwin, Lorna

2005-01-01

Purpose -- Gender segregation has been a persistent feature of apprenticeship programmes in countries around the world. In the UK, the Modern Apprenticeship was launched ten years ago as the governments flagship initiative for training new entrants in a range of occupational sectors. One of its priorities was to increase male and female…

Girls' and Women's Education within Unesco and the World Bank, 1945-2000

ERIC Educational Resources Information Center

Peppin Vaughan, Rosie

2010-01-01

By 2000, girls' and women's education was a priority for international development organisations. While studies have examined the impact of recent campaigns and programmes, there has been less exploration of ideas about girls' and women's education within development thought in the immediate post-colonial period, and the political mechanisms…

Test Theories, Educational Priorities and Reliability of Public Examinations in England

ERIC Educational Resources Information Center

Baird, Jo-Anne; Black, Paul

2013-01-01

Much has already been written on the controversies surrounding the use of different test theories in educational assessment. Other authors have noted the prevalence of classical test theory over item response theory in practice. This Special Issue draws together articles based upon work conducted on the Reliability Programme for England's…

Service Learning: Connecting Higher Education and Civil Society--Are We Meeting the Challenge?

ERIC Educational Resources Information Center

Naidoo, B.; Devnarain, B.

2009-01-01

The decline in civic participation, dwindling support for social services and deficits in state budgets, has created a climate in which higher education, supported by several policies, has to make a commitment to contribute to the reconstruction and development of society by linking academic programmes to community-based priorities (Campbell…

Global child health priorities: what role for paediatric oncologists?

PubMed

Kellie, Stewart J; Howard, Scott C

2008-11-01

Despite increasing globalisation, international mobility and economic interdependence, 9.7 million children aged less than 5 years in low income countries will die this year, almost all from preventable or treatable diseases. Diarrhoea, pneumonia and malaria account for 5 million of these deaths each year, compared to about 150,000 deaths from childhood cancer in low- and middle-income countries. In high-income countries, 80% of the 50,000 children diagnosed with cancer each year survive, yet cancer remains the leading disease-related cause of childhood death. In low- and middle-income countries, where 80% of children live, the 200,000 children diagnosed with cancer each year have limited access to curative treatment, and only about 25% survive. Some might argue that death from paediatric cancer in poor countries is insignificant compared to death from other causes, and that scarce health resources may be better used in other areas of public health. Is there a role for the treatment of children with cancer in these regions? Do international partnerships or 'twinning' programmes enhance local health care or detract from other public health priorities? What is ethical and what is possible? This review examines the health challenges faced by infants and children in low-income countries, and assesses the role and impact of international paediatric oncology collaboration to improve childhood cancer care worldwide.

Scaling up nurse education: An evaluation of a national PhD capacity development programme in South Africa, in the context of the global shortage of nursing graduates.

PubMed

Comiskey, Catherine M; Matthews, Anne; Williamson, Charmaine; Bruce, Judith; Mulaudzi, Mavis; Klopper, Hester

2015-05-01

The global shortage of nursing professionals educated at baccalaureate level and beyond has been highlighted. Within America, services are preparing to treat an additional 32 million individuals under the Health Reform Bill. Within South Africa nursing education outputs do not meet demands. Countries are addressing these shortages by developing advanced nurse roles which require research degrees. To evaluate a national PhD programme within the context of a nurse education strategy and a national health insurance plan. A comparative effectiveness research design was employed. The setting was in South Africa between 2011 and 2013, a county with 51.7 million inhabitants. Participants included PhD candidates, programme facilitators, supervisors and key stakeholders. Data from a one day workshop was analysed using an inductive thematic analysis. Three years of evaluation reports were analysed. A mapping of the alignment of the PhD topics with healthcare priorities, and a comparison of the development of nurse education, of the national and international funder were conducted. The evaluation reports rated the programme highly. Three themes were identified from the workshop. These were, "support" with the sub-themes of burden, leveraging and a physical supportive place; "planning" with the sub-themes of the national context and practice, and "quality" with the sub-themes of processes and monitoring and evaluation. The mapping of PhD topics revealed that research was in line with development priorities. However, further investment and infrastructural changes were necessary to sustain the programme and its impact. To address sustainability and capacity in nations scaling up nurse education and healthcare insurance, it was recommended that top-up degrees for diploma educated nurses be developed along with, the implementation of a national nursing strategy for PhD and post-doctoral training encompassing clinical practice implementation and collaboration. Copyright © 2015 Elsevier Ltd. All rights reserved.

Setting research priorities to reduce malaria burden in a post graduate training programme: lessons learnt from the Nigeria field epidemiology and laboratory training programme scientific workshop.

PubMed

Fawole, Olufunmilayo I; Ajumobi, Olufemi; Poggensee, Gabriele; Nguku, Patrick

2014-01-01

Although several research groups within institutions in Nigeria have been involved in extensive malaria research, the link between the research community and policy formulation has not been optimal. The workshop aimed to assist post graduate students to identify knowledge gaps and to develop relevant Malaria-related research proposals in line with identified research priorities. A training needs assessment questionnaire was completed by 22 students two week prior to the workshop. Also, a one page concept letter was received from 40 residents. Thirty students were selected based the following six criteria: - answerability and ethics; efficacy and impact; deliverability, affordability; scalability, sustainability; health systems, partnership and community involvement; and equity in achieved disease burden reduction. The workshop was over a three day period. The participants at the workshop were 30 Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) residents from cohorts 4 and 5. Ten technical papers were presented by the experts from the academia, National Malaria Elimination (NMEP) Programme, NFELTP Faculty and Implementing partners including CDC/PMI. Draft proposals were developed and presented by the residents. The "strongest need" for training was on malaria prevention, followed by malaria diagnosis. Forty seven new research questions were generated, while the 19 developed by the NMEP were shared. Evaluation revealed that all (100%) students either "agreed" that the workshop objectives were met. Full proposals were developed by some of the residents. A debriefing meeting was held with the NMEP coordinator to discuss funding of the projects. Future collaborative partnership has developed as the residents have supported NMEP to develop a research protocol for a national evaluation. Research prioritization workshops are required in most training programmes to ensure that students embark on studies that address the research needs of their country and foster collaborative linkages.

Research Priorities for NCD Prevention and Climate Change: An International Delphi Survey.

PubMed

Colagiuri, Ruth; Boylan, Sinead; Morrice, Emily

2015-10-16

Climate change and non-communicable diseases (NCDs) are arguably the greatest global challenges of the 21st Century. However, the confluence between them remains under-examined and there is little evidence of a comprehensive, systematic approach to identifying research priorities to mitigate their joint impact. Consequently, we: (i) convened a workshop of academics (n = 25) from the Worldwide Universities Network to identify priority areas at the interface between NCDs and climate change; (ii) conducted a Delphi survey of international opinion leaders in public health and relevant other disciplines; and (iii) convened an expert panel to review and advise on final priorities. Three research areas (water security; transport; conceptualising NCD harms to support policy formation) were listed among the top 10 priorities by >90% of Delphi respondents, and ranked among the top 12 priorities by >60% of respondents who ranked the order of priority. A fourth area (reducing the carbon footprint of cities) was ranked highest by the same >60% of respondents. Our results are consistent with existing frameworks on health and climate change, and extends them by focusing specifically on NCDs. Researching these priorities could progress understanding of climate change and NCDs, and inform global and national policy decisions for mitigating associated harms.

34 CFR 648.33 - What priorities and absolute preferences does the Secretary establish?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false What priorities and absolute preferences does the... AREAS OF NATIONAL NEED How Does the Secretary Make an Award? § 648.33 What priorities and absolute... area of national need and gives absolute preference to one or more of the general disciplines and sub...

34 CFR 648.33 - What priorities and absolute preferences does the Secretary establish?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false What priorities and absolute preferences does the... AREAS OF NATIONAL NEED How Does the Secretary Make an Award? § 648.33 What priorities and absolute... area of national need and gives absolute preference to one or more of the general disciplines and sub...

Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China

PubMed Central

2018-01-01

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km2 representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups (p-values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development. PMID:29682412

Identifying conservation priorities and management strategies based on ecosystem services to improve urban sustainability in Harbin, China.

PubMed

Qu, Yi; Lu, Ming

2018-01-01

Rapid urbanization and agricultural development has resulted in the degradation of ecosystems, while also negatively impacting ecosystem services (ES) and urban sustainability. Identifying conservation priorities for ES and applying reasonable management strategies have been found to be effective methods for mitigating this phenomenon. The purpose of this study is to propose a comprehensive framework for identifying ES conservation priorities and associated management strategies for these planning areas. First, we incorporated 10 ES indicators within a systematic conservation planning (SCP) methodology in order to identify ES conservation priorities with high irreplaceability values based on conservation target goals associated with the potential distribution of ES indicators. Next, we assessed the efficiency of the ES conservation priorities for meeting the designated conservation target goals. Finally, ES conservation priorities were clustered into groups using a K-means clustering analysis in an effort to identify the dominant ES per location before formulating management strategies. We effectively identified 12 ES priorities to best represent conservation target goals for the ES indicators. These 12 priorities had a total areal coverage of 13,364 km 2 representing 25.16% of the study area. The 12 priorities were further clustered into five significantly different groups ( p -values between groups < 0.05), which helped to refine management strategies formulated to best enhance ES across the study area. The proposed method allows conservation and management plans to easily adapt to a wide variety of quantitative ES target goals within urban and agricultural areas, thereby preventing urban and agriculture sprawl and guiding sustainable urban development.

Areas for improvement in community optometry: flashes and floaters take priority.

PubMed

Duncan, Eilidh M; Cassie, Heather; Pooley, Janet; Elouafakoui, Paula; Prior, Maria; Gibb, Elizabeth; Ramsay, Craig; Young, Linda

2018-07-01

A common response to rising demand for healthcare is to extend the role of health professionals and the range of their service provision. Community optometry in Scotland is a recent example of this. Within this context of innovation and change there are challenges to ensuring quality in optometry practice. The purpose of this research is to establish what the priorities are for practice improvement within community optometry and to start a programme to inform strategies to improve practice. A four stage study was conducted: (1) a service-driven topic prioritisation exercise to identify priorities for optometry practice improvement; (2) a review of national and international guidance and UK protocols relating to the identified priority topic; (3) a national theory-based survey identifying current practice and the barriers and facilitators to the target behaviour; and (4) the identification of theory-based intervention options to improve practice. The Behaviour Change Wheel approach to behaviour change intervention development and Theoretical Domains Framework (TDF) provided the underlying theoretical framework. Stakeholders identified 'patients presenting with flashes and floaters' as an important priority for practice improvement. The decision about whether or not to refer patients on to secondary care for further examination is the target behaviour. Guidance for optometrists on this topic is lacking. Six TDF domains were related to the decision about whether or not to refer patients with flashes and floaters to secondary care - 'social influences', 'emotion', 'beliefs about capabilities', 'beliefs about consequences', 'behavioural regulation' and 'reinforcement'. This study has examined current practice in relation to the management of patients with flashes and floaters, identified the most salient targets for future strategies to improve optometry practice and highlighted what form these strategies may take. It demonstrates the use of a flexible, theory-informed approach, which can be used to engage with stakeholders and professionals to inform the design and development of efforts to improve practice in a variety of healthcare settings. © 2018 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

Complementarity and Area-Efficiency in the Prioritization of the Global Protected Area Network.

PubMed

Kullberg, Peter; Toivonen, Tuuli; Montesino Pouzols, Federico; Lehtomäki, Joona; Di Minin, Enrico; Moilanen, Atte

2015-01-01

Complementarity and cost-efficiency are widely used principles for protected area network design. Despite the wide use and robust theoretical underpinnings, their effects on the performance and patterns of priority areas are rarely studied in detail. Here we compare two approaches for identifying the management priority areas inside the global protected area network: 1) a scoring-based approach, used in recently published analysis and 2) a spatial prioritization method, which accounts for complementarity and area-efficiency. Using the same IUCN species distribution data the complementarity method found an equal-area set of priority areas with double the mean species ranges covered compared to the scoring-based approach. The complementarity set also had 72% more species with full ranges covered, and lacked any coverage only for half of the species compared to the scoring approach. Protected areas in our complementarity-based solution were on average smaller and geographically more scattered. The large difference between the two solutions highlights the need for critical thinking about the selected prioritization method. According to our analysis, accounting for complementarity and area-efficiency can lead to considerable improvements when setting management priorities for the global protected area network.

The effectiveness of surrogate taxa to conserve freshwater biodiversity

USGS Publications Warehouse

Stewart, David R.; Underwood, Zachary E.; Rahel, Frank J.; Walters, Annika W.

2018-01-01

Establishing protected areas has long been an effective conservation strategy, and is often based on more readily surveyed species. The potential of any freshwater taxa to be a surrogate of other aquatic groups has not been fully explored. We compiled occurrence data on 72 species of freshwater fish, amphibians, mussels, and aquatic reptiles for the Great Plains, Wyoming. We used hierarchical Bayesian multi-species mixture models and MaxEnt models to describe species distributions, and program Zonation to identify conservation priority areas for each aquatic group. The landscape-scale factors that best characterized aquatic species distributions differed among groups. There was low agreement and congruence among taxa-specific conservation priorities (<20%), meaning that no surrogate priority areas would include or protect the best habitats of other aquatic taxa. We found that common, wide-ranging aquatic species were included in taxa-specific priority areas, but rare freshwater species were not included. Thus, the development of conservation priorities based on a single freshwater aquatic group would not protect all species in the other aquatic groups.

75 FR 146 - Public Comment on Candidate National Enforcement and Compliance Assurance Priorities for Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

... Assurance, is collecting external comment on a set of candidate enforcement and compliance priorities for FY... National Enforcement and Compliance Assurance Priorities for Fiscal Years 2011-2013 AGENCY: Environmental... national priorities to be addressed for fiscal years 2011-2013. EPA selects these priority areas every...

Final priority; National Institute on Disability and Rehabilitation Research--Research Fellowships Program (also known as the Mary E. Switzer Research Fellowships). Final priority.

PubMed

2014-07-28

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Research Fellowships Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice announces a priority for a Distinguished Residential Disability and Rehabilitation Policy Fellowship. We take this action to focus attention on an area of national need. We intend the priority to build research capacity by providing support to highly qualified, experienced researchers, including those who are individuals with disabilities, to conduct policy research in the areas of disability and rehabilitation.

Prioritizing agricultural pesticides used in South Africa based on their environmental mobility and potential human health effects.

PubMed

Dabrowski, James Michael; Shadung, Justinus Madimetja; Wepener, Victor

2014-01-01

South Africa is the largest user of pesticides in sub-Saharan Africa and many studies have highlighted the occurrence of pesticides in water resources. Poor management of water treatment facilities in combination with a relatively high dependency on untreated water from boreholes and rivers creates the potential for exposure of human communities to pesticides and their associated health effects. Pesticide use, physicochemical and toxicity data was therefore used to prioritize pesticides in terms of their potential risk to human health. After eliminating pesticides used in very low quantities, four indices were used to prioritize active ingredients applied in excess of 1000 kg per annum; the quantity index (QI) which ranked pesticides in terms of the quantity of their use; the toxicity potential index (TP) which ranked pesticides according to scores derived for their potential to cause five health effects (endocrine disruption, carcinogenicity, teratogenicity, mutagenicity and neurotoxicity); hazard potential index (HP) which multiplied the TP by an exposure potential score determined by the GUS index for each pesticide (to provide an indication of environmental hazard); and weighted hazard potential (WHP), which multiplied the HP for a pesticide by the ratio of its use to the total use of all pesticides in the country. The top 25 pesticides occurring in each of these indices were identified as priority pesticides, resulting in a combined total of 69 priority pesticides. A principal component analysis identified the indices that were most important in determining why a specific pesticide was included in the final priority list. As crop specific application pesticide use data was available it was possible to identify crops to which priority pesticides were applied to. Furthermore it was possible to prioritize crops in terms of the specific pesticide applied to the crop (by expressing the WHP as a ratio of the total amount of pesticide applied to the crop to the total use of all pesticides applied in the country). This allows for an improved spatial assessment of the use of priority pesticides. The methodology applied here provides a first level of basic, important information that can be used to develop monitoring programmes, identify priority areas for management interventions and to investigate optimal mitigation strategies. © 2013.

Priorities for Developmental Areas in Early Childhood Education: A Comparison of Parents' and Teachers' Priorities

ERIC Educational Resources Information Center

Sackes, Mesut

2013-01-01

The purpose of this study was to examine parents' and early childhood teachers' perceptions of the priorities for developmental areas targeted in the Turkish Early Childhood Education Curriculum for children aged 36-72 months. The sample of this study consisted of 1600 parents and 158 early childhood teachers. The study utilized a survey research…

Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions.

PubMed

Bärnighausen, Till; Bloom, David E

2009-06-26

In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes should prepare participants for the time in an underserved area, stay in close contact with participants throughout the different phases of enrolment and help participants by assigning them mentors, establishing peer support systems or financing education courses relevant to work in underserved areas); enforcement (programmes may use community-based monitoring or outsource enforcement to existing institutions); and evaluation (in order to broaden the evidence on the effectiveness of financial incentives in increasing the health workforce in underserved areas, programmes in developing countries should evaluate their performance; in order to improve the strength of the evidence on the effectiveness of financial incentives, controlled experiments should be conducted where feasible). In comparison to other interventions to increase the supply of health workers to medically underserved areas, financial-incentive programmes have advantages--unlike initiatives using non-financial incentives, they establish legally enforceable commitments to work in underserved areas and, unlike compulsory service policies, they will not be opposed by health workers--as well as disadvantages--unlike initiatives using non-financial incentives, they may not improve the working and living conditions in underserved areas (which are important determinants of health workers' long-term retention) and, unlike compulsory service policies, they cannot guarantee that they will supply health workers to underserved areas who would not have worked in such areas without financial incentives. Financial incentives, non-financial incentives, and compulsory service are not mutually exclusive and may positively affect each other's performance.

Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

PubMed Central

Bärnighausen, Till; Bloom, David E

2009-01-01

In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes should prepare participants for the time in an underserved area, stay in close contact with participants throughout the different phases of enrolment and help participants by assigning them mentors, establishing peer support systems or financing education courses relevant to work in underserved areas); enforcement (programmes may use community-based monitoring or outsource enforcement to existing institutions); and evaluation (in order to broaden the evidence on the effectiveness of financial incentives in increasing the health workforce in underserved areas, programmes in developing countries should evaluate their performance; in order to improve the strength of the evidence on the effectiveness of financial incentives, controlled experiments should be conducted where feasible). In comparison to other interventions to increase the supply of health workers to medically underserved areas, financial-incentive programmes have advantages – unlike initiatives using non-financial incentives, they establish legally enforceable commitments to work in underserved areas and, unlike compulsory service policies, they will not be opposed by health workers – as well as disadvantages – unlike initiatives using non-financial incentives, they may not improve the working and living conditions in underserved areas (which are important determinants of health workers' long-term retention) and, unlike compulsory service policies, they cannot guarantee that they will supply health workers to underserved areas who would not have worked in such areas without financial incentives. Financial incentives, non-financial incentives, and compulsory service are not mutually exclusive and may positively affect each other's performance. PMID:19558682

Patterns of authorship on community health workers in low-and-middle-income countries: an analysis of publications (2012–2016)

PubMed Central

Maleka, Nelisiwe

2018-01-01

Introduction Studies of authorship provide a barometer of local research capacity and ownership of research, considered key to defining appropriate research priorities, developing contextualised responses to health problems and ensuring that research informs policy and practice. This paper reports on an analysis of patterns of research authorship of the now substantial literature on community health workers (CHWs) in low-and-middle-income countries (LMICs) for the 5-year period: 2012–2016. Methods A search of five databases identified a total of 649 indexed publications reporting on CHWs in LMICs and meeting the inclusion criteria. The country, region and income classification of studies, affiliations (country, organisation) of lead (first) and last authors, proportions of all authors locally affiliated, programme area (eg, maternal child health) and funding source were extracted. Results The 649 papers reported experiences from 51 countries, 55% from middle-income countries (MICs) and 32% from low-income countries (LICs), with the remaining 13% multicountry studies. Overall, 47% and 54% of all the papers had a high-income country (HIC) lead and last author, respectively. Authorship followed three patterns: (1) a concentrated HIC pattern, with US-based authors numerically dominating LIC-based and multicountry studies; (2) an MIC pattern of autonomy, with a handful of countries—India, South Africa and Brazil, in particular—leading >70% of their CHW publications and (3) a pattern of unevenness among LICs in their lead authorship of publications varying from 14% (Malawi) to 54% (Uganda). Region, programme area and funding source were all associated with the distribution of authorship across country income categories. Conclusion The findings in this analysis mirror closely that of other authorship studies in global health. Collectively these provide a common message—that investments in global health programmes in the Millennium Development Goal era may have benefited health but not necessarily capacity for knowledge generation in LMICs. PMID:29765777

Patterns of authorship on community health workers in low-and-middle-income countries: an analysis of publications (2012-2016).

PubMed

Schneider, Helen; Maleka, Nelisiwe

2018-01-01

Studies of authorship provide a barometer of local research capacity and ownership of research, considered key to defining appropriate research priorities, developing contextualised responses to health problems and ensuring that research informs policy and practice. This paper reports on an analysis of patterns of research authorship of the now substantial literature on community health workers (CHWs) in low-and-middle-income countries (LMICs) for the 5-year period: 2012-2016. A search of five databases identified a total of 649 indexed publications reporting on CHWs in LMICs and meeting the inclusion criteria. The country, region and income classification of studies, affiliations (country, organisation) of lead (first) and last authors, proportions of all authors locally affiliated, programme area (eg, maternal child health) and funding source were extracted. The 649 papers reported experiences from 51 countries, 55% from middle-income countries (MICs) and 32% from low-income countries (LICs), with the remaining 13% multicountry studies. Overall, 47% and 54% of all the papers had a high-income country (HIC) lead and last author, respectively. Authorship followed three patterns: (1) a concentrated HIC pattern, with US-based authors numerically dominating LIC-based and multicountry studies; (2) an MIC pattern of autonomy, with a handful of countries-India, South Africa and Brazil, in particular-leading >70% of their CHW publications and (3) a pattern of unevenness among LICs in their lead authorship of publications varying from 14% (Malawi) to 54% (Uganda). Region, programme area and funding source were all associated with the distribution of authorship across country income categories. The findings in this analysis mirror closely that of other authorship studies in global health. Collectively these provide a common message-that investments in global health programmes in the Millennium Development Goal era may have benefited health but not necessarily capacity for knowledge generation in LMICs.

The Implementation of a Collaborative Action Research Programme for Developing Inclusive Practices: Social Learning in Small Internal Networks

ERIC Educational Resources Information Center

Angelides, Panayiotis; Georgiou, Renos; Kyriakou, Kyriaki

2008-01-01

The idea of inclusive education has featured very highly in the educational priorities of many educational systems. However, the same educational systems are very often criticised because of the difficulties of their teachers to respond to inclusive environments of learning, where all children, despite their abilities, receive equal opportunities…

The Leisure Operation. Leisure Management Module. Operational Management Programme.

ERIC Educational Resources Information Center

Carver, Gerry

This module on the leisure operation is intended to enable the reader to develop an understanding of the special requirements and priorities in the development and management of a leisure operation. The material is presented in a self-instructional format in four sections. At the beginning of each section is a statement of the objectives that will…

Rethinking Networks in Education: Case Studies of Organisational Development Networks in Neoliberal Contexts

ERIC Educational Resources Information Center

Townsend, Andrew

2013-01-01

In 2002 the National College for School Leadership in England launched what they claimed to be the biggest school networking initiative of its kind. The networks which were members of this programme involved schools working together to achieve shared priorities and can be viewed as examples of organisational development networks. These networks,…

Literacy in a 'Broad and Balanced' Primary School Curriculum: The Potential of a Disciplinary Approach in Irish Classrooms

ERIC Educational Resources Information Center

Burke, Patrick; Welsch, Jodi G.

2018-01-01

The prominence afforded to literacy in the Irish Primary School Curriculum has received considerable attention in recent years, spurred by Programme for International Student Assessment (PISA) rankings, governmental priorities, public commentary and academic debate. At times, this discourse has presented literacy as a separate and distinct entity…

Using plant functional traits to restore Hawaiian rainforest

Treesearch

Rebecca Ostertag; Laura Warman; Susan Cordell; Peter M. Vitousek

2015-01-01

Ecosystem restoration efforts are carried out by a variety of individuals and organizations with an equally varied set of goals, priorities, resources and time-scales. Once restoration of a degraded landscape or community is recognized as necessary, choosing which species to include in a restoration programme can be a difficult and value-laden process (Fry, Power &...

Education and Primary Health Care. UNESCO-UNICEF Co-operative Programme Digest No. 17.

ERIC Educational Resources Information Center

Jabre, Bushra

This digest concentrates on UNICEF's program priorities and summarizes the contents of the first 17 issues of its series on education and primary health care (PHC). Chapter I offers an introduction to PHC. Chapter II describes UNICEF's child health revolution, focusing on the direct and immediate interventions of growth monitoring, oral…

Human Rights Education in Canada: Results from a CTF Teacher Survey

ERIC Educational Resources Information Center

Froese-Germain, Bernie; Riel, Rick; Theoret, Pauline

2013-01-01

The United Nations has placed a high priority on human rights education. Building on the foundation laid by the UN Decade for Human Rights Education (1995-2004), the UN General Assembly launched the World Programme for Human Rights Education in December 2004 "as a global initiative, structured in consecutive phases, to advance the…

Exclusion of agricultural lands in spatial conservation prioritization strategies: consequences for biodiversity and ecosystem service representation

PubMed Central

Durán, América P.; Duffy, James P.; Gaston, Kevin J.

2014-01-01

Agroecosystems have traditionally been considered incompatible with biological conservation goals, and often been excluded from spatial conservation prioritization strategies. The consequences for the representativeness of identified priority areas have been little explored. Here, we evaluate these for biodiversity and carbon storage representation when agricultural land areas are excluded from a spatial prioritization strategy for South America. Comparing different prioritization approaches, we also assess how the spatial overlap of priority areas changes. The exclusion of agricultural lands was detrimental to biodiversity representation, indicating that priority areas for agricultural production overlap with areas of relatively high occurrence of species. By contrast, exclusion of agricultural lands benefits representation of carbon storage within priority areas, as lands of high value for agriculture and carbon storage overlap little. When agricultural lands were included and equally weighted with biodiversity and carbon storage, a balanced representation resulted. Our findings suggest that with appropriate management, South American agroecosystems can significantly contribute to biodiversity conservation. PMID:25143040

Research Priorities for NCD Prevention and Climate Change: An International Delphi Survey

PubMed Central

Colagiuri, Ruth; Boylan, Sinead; Morrice, Emily

2015-01-01

Climate change and non-communicable diseases (NCDs) are arguably the greatest global challenges of the 21st Century. However, the confluence between them remains under-examined and there is little evidence of a comprehensive, systematic approach to identifying research priorities to mitigate their joint impact. Consequently, we: (i) convened a workshop of academics (n = 25) from the Worldwide Universities Network to identify priority areas at the interface between NCDs and climate change; (ii) conducted a Delphi survey of international opinion leaders in public health and relevant other disciplines; and (iii) convened an expert panel to review and advise on final priorities. Three research areas (water security; transport; conceptualising NCD harms to support policy formation) were listed among the top 10 priorities by >90% of Delphi respondents, and ranked among the top 12 priorities by >60% of respondents who ranked the order of priority. A fourth area (reducing the carbon footprint of cities) was ranked highest by the same >60% of respondents. Our results are consistent with existing frameworks on health and climate change, and extends them by focusing specifically on NCDs. Researching these priorities could progress understanding of climate change and NCDs, and inform global and national policy decisions for mitigating associated harms. PMID:26501301

Antimicrobial stewardship – can we afford to do without it?

PubMed Central

Aryee, Anna; Price, Nicholas

2015-01-01

Antimicrobial resistance (AMR) is a rapidly developing and alarming global threat which has been highlighted by national governments and public health bodies including the World Health Organization. The spectre of a ‘post-antibiotic era’ is a real possibility unless curtailing the development and spread of these organisms is given high priority. Numerous studies have shown that AMR is associated with worse outcomes for patients and higher healthcare costs. While clinical data from low and middle income countries is lacking, there is increasing evidence that the problem in these areas is as great, or even greater, than in high income nations. Of the many drivers behind the development of AMR, the most significant is selection pressure caused by antibiotic use. Antimicrobial stewardship programmes are a set of interventions that aim to ensure the judicious use of antimicrobials by preventing their unnecessary use, and by providing targeted and limited therapy in situations where they are warranted. The ultimate goal of these programmes is to provide effective antimicrobial therapy whilst safeguarding their effectiveness for future generations. Whilst they do require an initial investment, they have been shown to be an effective way of controlling antimicrobial use, and have been associated with improved patient outcomes and reduced healthcare costs. PMID:24803175

Præventis, the immunisation register of the Netherlands: a tool to evaluate the National Immunisation Programme.

PubMed

van Lier, A; Oomen, P; de Hoogh, P; Drijfhout, I; Elsinghorst, B; Kemmeren, J; Conyn-van Spaendonck, M; de Melker, H

2012-04-26

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.

Challenging stigma and discrimination in communities: a focus group study identifying UK mental health service users' main campaign priorities.

PubMed

Pinfold, Vanessa; Byrne, Peter; Toulmin, Hilary

2005-06-01

Stigma and discrimination experienced by people with mental health problems have been identified as major obstacles to treatment and recovery. Less is known about how to effectively tackle stigma-discrimination, although there are numerous international, national and local programmes attempting to improve public mental health literacy and anti-discrimination evidenced based practice. To explore mental health service users' views on how campaigns to address stigma and discrimination should prioritise their actions. Qualitative study using focus group discussions, involving 33 persons aged between 25 and 75. A triad of diminished credibility, dis-empowerment with particular reference to communication problems and avoidance by their social network defined experiences of stigma. Reactions to stigma can be placed in four categories: avoid stigma, resign yourself to it, challenge it, or distance yourself from others with a mental health problem. A range of solutions was discussed with most favouring changes within the health services that are currently supporting them over traditional educational programmes with the public. For mental health service users stigma must be tackled on many different levels reflecting the varied and complex impact that negative social reactions have on an individual's life. When asked to prioritise one area, most service users in our sample highlighted reforms within the health service for tackling stigma and discrimination.

What works for wellbeing in culture and sport? Report of a DELPHI process to support coproduction and establish principles and parameters of an evidence review.

PubMed

Daykin, Norma; Mansfield, Louise; Payne, Annette; Kay, Tess; Meads, Catherine; D'Innocenzo, Giorgia; Burnett, Adele; Dolan, Paul; Julier, Guy; Longworth, Louise; Tomlinson, Alan; Testoni, Stefano; Victor, Christina

2017-09-01

There is a growing recognition of the ways in which culture and sport can contribute to wellbeing. A strong evidence base is needed to support innovative service development and a 3-year research programme is being undertaken to capture best evidence of wellbeing impacts and outcomes of cultural and sporting activities in order to inform UK policy and practice. This article provides an overview of methods and findings from an initial coproduction process with key stakeholders that sought to explore and agree principles and parameters of the evidence review for culture, sport and wellbeing (CSW). A two-stage DELPHI process was conducted with a purposeful sample of 57 stakeholders between August and December 2015. Participants were drawn from a range of culture and sport organisations and included commissioners and managers, policy makers, representatives of service delivery organisations (SDOs) and scholars. The DELPHI 1 questionnaire was developed from extensive consultation in July and August 2015. It explored definitions of wellbeing, the role of evidence, quality assessment, and the culture and sport populations, settings and interventions that are most likely to deliver wellbeing outcomes. Following further consultation, the results, presented as a series of ranked statements, were sent back to participants (DELPHI 2), which allowed them to reflect on and, if they wished, express agreement or disagreement with the emerging consensus. A total of 40 stakeholders (70.02%) responded to the DELPHI questionnaires. DELPHI 1 mapped areas of agreement and disagreement, confirmed in DELPHI 2. The exercise drew together the key priorities for the CSW evidence review. The DELPHI process, in combination with face-to-face deliberation, enabled stakeholders to engage in complex discussion and express nuanced priorities while also allowing the group to come to an overall consensus and agree outcomes. The results will inform the CSW evidence review programme until its completion in March 2018.

What works for wellbeing in culture and sport? Report of a DELPHI process to support coproduction and establish principles and parameters of an evidence review

PubMed Central

Daykin, Norma; Mansfield, Louise; Payne, Annette; Kay, Tess; Meads, Catherine; D’Innocenzo, Giorgia; Burnett, Adele; Dolan, Paul; Julier, Guy; Longworth, Louise; Tomlinson, Alan; Testoni, Stefano; Victor, Christina

2016-01-01

Aims: There is a growing recognition of the ways in which culture and sport can contribute to wellbeing. A strong evidence base is needed to support innovative service development and a 3-year research programme is being undertaken to capture best evidence of wellbeing impacts and outcomes of cultural and sporting activities in order to inform UK policy and practice. This article provides an overview of methods and findings from an initial coproduction process with key stakeholders that sought to explore and agree principles and parameters of the evidence review for culture, sport and wellbeing (CSW). Methods: A two-stage DELPHI process was conducted with a purposeful sample of 57 stakeholders between August and December 2015. Participants were drawn from a range of culture and sport organisations and included commissioners and managers, policy makers, representatives of service delivery organisations (SDOs) and scholars. The DELPHI 1 questionnaire was developed from extensive consultation in July and August 2015. It explored definitions of wellbeing, the role of evidence, quality assessment, and the culture and sport populations, settings and interventions that are most likely to deliver wellbeing outcomes. Following further consultation, the results, presented as a series of ranked statements, were sent back to participants (DELPHI 2), which allowed them to reflect on and, if they wished, express agreement or disagreement with the emerging consensus. Results: A total of 40 stakeholders (70.02%) responded to the DELPHI questionnaires. DELPHI 1 mapped areas of agreement and disagreement, confirmed in DELPHI 2. The exercise drew together the key priorities for the CSW evidence review. Conclusion: The DELPHI process, in combination with face-to-face deliberation, enabled stakeholders to engage in complex discussion and express nuanced priorities while also allowing the group to come to an overall consensus and agree outcomes. The results will inform the CSW evidence review programme until its completion in March 2018. PMID:27789779

Examining the policy climate for HIV prevention in the Caribbean tourism sector: a qualitative study of policy makers in the Dominican Republic.

PubMed

Padilla, Mark B; Reyes, Armando Matiz; Connolly, Maureen; Natsui, Shaw; Puello, Adrian; Chapman, Helena

2012-05-01

The Caribbean has the highest prevalence rates of HIV/AIDS outside sub-Saharan Africa, and a broad literature suggests an ecological association between tourism areas and sexual vulnerability. Tourism employees have been shown to engage in high rates of sexual risk behaviours. Nevertheless, no large-scale or sustained HIV prevention interventions have been conducted within the tourism industry. Policy barriers and resources are under-studied. In order to identify the policy barriers and resources for HIV prevention in the tourism sector, our research used a participatory approach involving a multisectoral coalition of representatives from the tourism industry, government, public health and civil society in the Dominican Republic. We conducted 39 in-depth semi-structured interviews with policy makers throughout the country focusing on: prior experiences with HIV prevention policies and programmes in the tourism sector; barriers and resources for such policies and programmes; and future priorities and recommendations. Findings suggest perceptions among policy makers of barriers related to the mobile nature of tourism employees; the lack of centralized funding; fear of the 'image problem' associated with HIV; and the lack of multisectoral policy dialogue and collaboration. Nevertheless, prior short-term experiences and changing attitudes among some private sector tourism representatives suggest emerging opportunities for policy change. We argue that the time is ripe for dialogue across the public-private divide in order to develop regulatory mechanisms, joint responsibilities and centralized funding sources to ensure a sustainable response to the HIV-tourism linkage. Policy priorities should focus on incorporating HIV prevention as a component of occupational health; reinforcing workers' health care rights as guaranteed by existing law; using private sector tourism representatives who support HIV prevention as positive role models for national campaigns; and disseminating a notion of 'investment' in safer tourism environments as a means to positively influence tourist demand.

PS1-20: VDW Operational Committee: Current Activities and Future Directions

PubMed Central

Brown, Jeffrey; McDonald, Sarah; Moore, Kristen; Saylor, Gwyn; Hart, Gene; Hornbrook, Mark; Magid, David; Go, Alan

2010-01-01

Background/Aims: The Virtual Data Warehouse (VDW) is the HMO Research Network (HMORN) approach for facilitating multisite research while protecting the privacy of members and proprietary corporate information. A valid and sustainable VDW is critical to the success of the HMORN, and is needed for HMORN’s inclusion in many of the most important public health initiatives planned for the next few years. Methods: In November 2007 the HMORN Governing Board approved the VDW 5-Year Strategic Plan, including creation of a VDW Operational Committee (VOC), reporting to the Assets Stewardship Committee (ASC) and providing coordinated oversight of the development, maintenance, and enhancement of the VDW. The seven members of the VOC are investigators and analysts representing HMORN’s major consortia projects: CERT, CVRN and CRN. Results: In 2008, the VOC accomplished two major short term goals: Creation of a comprehensive data quality checking system, implemented by seven content area expert Working Groups (WGs) consisting of 23 investigators and 23 programmer\\analysts. The content areas of the WGs are enrollment and demographics, pharmacy, utilization, tumor, vital signs, laboratory, and census. The WGs assessed data availability and completeness for their content area and reported findings to the VOC and ASC, including recommendations for changes and enhancements. WG reports will form the basis for ongoing VDW documentation that will be used to standardize HMORN VDW descriptions for grants and proposals; Development of a budget, staffing plan and priorities for 2009. The 2009 priorities include development of VOC standard operating procedures for creating new data content areas and changing current data areas/definitions, documenting policies for use of the VDW, promoting use of the VDW, and creation of additional WGs for death (new VDW content area), informatics, implementation, and data documentation. The documentation WG will oversee issues such as data dictionaries, data checking documentation, programming resources, a clinical concepts library, user guides, and incorporating updated VDW information in the HMORN Collaboration Toolkit. Looking forward, the VDW 5-year Strategic Plan includes streamlining IRB approval for multisite research and enhancing HMORN informatics capabilities. Conclusions: The newly created VOC has made substantial progress in helping make the HMORN VDW an even more valuable and useful resource for the network.

The Experience of Implementing Urban HEART Barcelona: a Tool for Action.

PubMed

Novoa, Ana M; Pérez, Glòria; Espelt, Albert; Echave, Cynthia; de Olalla, Patricia G; Calvo, M Jesús; Pasarín, Maribel; Diez, Èlia; Borrell, Carme; Calvo, M Jesús; Cormenzana, Berta; Cortés, Imma; Diez, Èlia; Echave, Cynthia; Espelt, Albert; de Olalla, Patrícia G; Gòmez, Josep; Novoa, Ana M; Pallarès, Montserrat; Pérez, Glòria; Rodríguez-Sanz, Maica

2017-10-16

Urban Health Equity Assessment and Response Tool (HEART) is a tool developed by the World Health Organization whose objective is to provide evidence on urban health inequalities so as to help to decide the best interventions aimed to promote urban health equity. The aim of this paper is to describe the experience of implementing Urban HEART in Barcelona city, both the adaptation of Urban HEART to the city of Barcelona, its use as a means of identifying and monitoring health inequalities among city neighbourhoods, and the difficulties and barriers encountered throughout the process. Although ASPB public health technicians participated in the Urban HEART Advisory Group, had large experience in health inequalities analysis and research and showed interest in implementing the tool, it was not until 2015, when the city council was governed by a new left-wing party for which reducing health inequalities was a priority that Urban HEART could be used. A provisional matrix was developed, including both health and health determinant indicators, which allowed to show how some neighbourhoods in the city systematically fare worse for most of the indicators while others systematically fare better. It also allowed to identify 18 neighbourhoods-those which fared worse in most indicators-which were considered a priority for intervention, which entered the Health in the Barcelona Neighbourhoods programme and the Neighbourhoods Plan. This provisional version was reviewed and improved by the Urban HEART Barcelona Working Group. Technicians with experience in public health and/or in indicator and database management were asked to indicate suitability and relevance from a list of potential indicators. The definitive Urban HEART Barcelona version included 15 indicators from the five Urban HEART domains and improved the previous version in several requirements. Several barriers were encountered, such as having to estimate indicators in scarcely populated areas or finding adequate indicators for the physical context domain. In conclusion, the Urban HEART tool allowed to identify urban inequalities in the city of Barcelona and to include health inequalities in the public debate. It also allowed to reinforce the community health programme Health in the Barcelona Neighbourhoods as well as other city programmes aimed at reducing health inequalities. A strong political will is essential to place health inequalities in the political agenda and implement policies to tackle them.

Dengue infection.

PubMed

Guzman, Maria G; Gubler, Duane J; Izquierdo, Alienys; Martinez, Eric; Halstead, Scott B

2016-08-18

Dengue is widespread throughout the tropics and local spatial variation in dengue virus transmission is strongly influenced by rainfall, temperature, urbanization and distribution of the principal mosquito vector Aedes aegypti. Currently, endemic dengue virus transmission is reported in the Eastern Mediterranean, American, South-East Asian, Western Pacific and African regions, whereas sporadic local transmission has been reported in Europe and the United States as the result of virus introduction to areas where Ae. aegypti and Aedes albopictus, a secondary vector, occur. The global burden of the disease is not well known, but its epidemiological patterns are alarming for both human health and the global economy. Dengue has been identified as a disease of the future owing to trends toward increased urbanization, scarce water supplies and, possibly, environmental change. According to the WHO, dengue control is technically feasible with coordinated international technical and financial support for national programmes. This Primer provides a general overview on dengue, covering epidemiology, control, disease mechanisms, diagnosis, treatment and research priorities.

Rapid damage mapping for the 2015 M7.8 Gorkha earthquake using synthetic aperture radar data from COSMO-SkyMed and ALOS-2 satellites

USGS Publications Warehouse

Yun, Sang-Ho; Hudnut, Kenneth W.; Owen, Susan; Webb, Frank; Simons, Mark; Sacco, Patrizia; Gurrola, Eric; Manipon, Gerald; Liang, Cunren; Fielding, Eric; Milillo, Pietro; Hua, Hook; Coletta, Alessandro

2015-01-01

The 25 April 2015 Mw 7.8 Gorkha earthquake caused more than 8000 fatalities and widespread building damage in central Nepal. The Italian Space Agency’s COSMO–SkyMed Synthetic Aperture Radar (SAR) satellite acquired data over Kathmandu area four days after the earthquake and the Japan Aerospace Exploration Agency’s Advanced Land Observing Satellite-2 SAR satellite for larger area nine days after the mainshock. We used these radar observations and rapidly produced damage proxy maps (DPMs) derived from temporal changes in Interferometric SAR coherence. Our DPMs were qualitatively validated through comparison with independent damage analyses by the National Geospatial-Intelligence Agency and the United Nations Institute for Training and Research’s United Nations Operational Satellite Applications Programme, and based on our own visual inspection of DigitalGlobe’s WorldView optical pre- versus postevent imagery. Our maps were quickly released to responding agencies and the public, and used for damage assessment, determining inspection/imaging priorities, and reconnaissance fieldwork.

Training medical assistants for surgery.

PubMed Central

Vaz, F.; Bergström, S.; Vaz, M. da l.; Langa, J.; Bugalho, A.

1999-01-01

A successful programme is reported from Mozambique for training middle-level health workers to perform fairly advanced surgical procedures in remote areas where the services of consultants are virtually unobtainable. Manpower and financial constraints obliged Mozambique to train medical assistants to perform surgical work in rural areas, where three broad priorities were identified: pregnancy-related complications, trauma-related complications, and emergency inflammatory conditions. Since 1984, 20 health workers have emerged from three-year courses to become técnicos de cirurgía (assistant medical officers), and it is expected that there will be 46 by 1999. The training comprises two years of lectures and practical sessions in the Maputo Central Hospital, and a practical internship lasting a year at a provincial hospital. Three workshops organized since 1989 suggest that the upgraded personnel are performing well. More detailed evaluation and follow-up are in progress. Throughout 1995 a follow-up was conducted on 14 assistant medical officers. They performed 10,258 surgical operations, some 70% of which were emergency interventions. Low rates of complication occurred and postoperative mortality amounted to 0.4% and 0.1% in emergency and elective interventions respectively. PMID:10516791

Setting practical conservation priorities for birds in the Western Andes of Colombia.

PubMed

Ocampo-Peñuela, Natalia; Pimm, Stuart L

2014-10-01

We aspired to set conservation priorities in ways that lead to direct conservation actions. Very large-scale strategic mapping leads to familiar conservation priorities exemplified by biodiversity hotspots. In contrast, tactical conservation actions unfold on much smaller geographical extents and they need to reflect the habitat loss and fragmentation that have sharply restricted where species now live. Our aspirations for direct, practical actions were demanding. First, we identified the global, strategic conservation priorities and then downscaled to practical local actions within the selected priorities. In doing this, we recognized the limitations of incomplete information. We started such a process in Colombia and used the results presented here to implement reforestation of degraded land to prevent the isolation of a large area of cloud forest. We used existing range maps of 171 bird species to identify priority conservation areas that would conserve the greatest number of species at risk in Colombia. By at risk species, we mean those that are endemic and have small ranges. The Western Andes had the highest concentrations of such species-100 in total-but the lowest densities of national parks. We then adjusted the priorities for this region by refining these species ranges by selecting only areas of suitable elevation and remaining habitat. The estimated ranges of these species shrank by 18-100% after accounting for habitat and suitable elevation. Setting conservation priorities on the basis of currently available range maps excluded priority areas in the Western Andes and, by extension, likely elsewhere and for other taxa. By incorporating detailed maps of remaining natural habitats, we made practical recommendations for conservation actions. One recommendation was to restore forest connections to a patch of cloud forest about to become isolated from the main Andes. © 2014 Society for Conservation Biology.

Reproductive management of dairy herds in New Zealand: attitudes, priorities and constraints perceived by farmers managing seasonal-calving, pasture-based herds in four regions.

PubMed

Brownlie, T S; Weir, A M; Tarbotton, I; Morton, J M; Heuer, C; McDougall, S

2011-01-01

To examine attitudes, priorities, and constraints pertaining to herd reproductive management perceived by farmers managing seasonal-calving, pasture-based dairy herds in four regions of New Zealand, and to explore how these varied with demographic and biophysical factors. Key decision makers (KDM) on 133 dairy herds in four dairy regions (Waikato, Taranaki, and north and south Canterbury) were interviewed between May and July 2009. They were asked to provide demographic and biophysical data about the farm, and to rate their attitude in relation to their own personality traits, management issues and priorities, and likely constraints affecting reproductive performance in their herds. Associations between demographic factors and attitudes, priorities and constraints were analysed using univariable and multivariable proportional-odds regression models. Farms in the regions studied in the South Island were larger, had larger herds and more staff than farms in the regions studied in the North Island. The farms in the South Island were more likely to be owned by a corporation, managed by younger people or people who had more education, and the herds were more likely to be fed a higher percentage of supplementary feed. The majority of KDM rated the current genetics, milksolids performance and reproductive performance of their herds as high or very high, and >70% believed that the reproductive performance had remained the same or improved over the preceding 3 years. Despite this, improving reproductive performance was the most highly rated priority for the next 3 years. The constraints considered most likely to have affected reproductive performance in the last 2 years were anoestrous cows, protracted calving periods, and low body condition scores; those considered least likely were artificial breeding and heat detection. Of the variables examined related to attitudes, priorities and likely constraints, there were significant differences between region for 10/40, and with age and occupation of the KDM for 24/40 and 5/40, respectively (p<0.05). The majority of KDM reported the current reproductive performance of their herds to be high or very high, yet rated improving reproductive performance as a very high priority for the next 3 years. Mismatch between perceived and actual performance may result in reduced uptake of extension programmes designed to improve performance, and accurate benchmarking may help increase uptake and engagement. Further work is needed to determine whether the attitudes and perceptions about performance of farmers affect the likelihood of changes in their management behaviour which translate to measurable change in the actual reproductive performance of their herds. The variation in attitude, priorities and perceived constraints among age groups and region indicates that design of extension programmes may need to vary with these demographics.

Prioritizing conservation areas for coastal plant diversity under increasing urbanization.

PubMed

Doxa, Aggeliki; Albert, Cécile Hélène; Leriche, Agathe; Saatkamp, Arne

2017-10-01

Coastal urban expansion will continue to drive further biodiversity losses, if conservation targets for coastal ecosystems are not defined and met. Prioritizing areas for future protected area networks is thus an urgent task in such urbanization-threatened ecosystems. Our aim is to quantify past and future losses of coastal vegetation priority areas due to urbanization and assess the effectiveness of the existing protected area network for conservation. We conduct a prioritization analysis, based on 82 coastal plants, including common and IUCN red list species, in a highly-urbanized but biotically diverse region, in South-Eastern France. We evaluate the role of protected areas, by taking into account both strict and multi-use areas. We assess the impact of past and future urbanization on high priority areas, by combining prioritization analyses and urbanization models. We show that half of the highly diverse areas have already been lost due to urbanization. Remaining top priority areas are also among the most exposed to future urban expansion. The effectiveness of the existing protected area (PA) network is only partial. While strict PAs coincide well with top priority areas, they only represent less than one third of priority areas. The effectiveness of multi-use PAs, such as the Natura 2000 network, also remains limited. Our approach highlights the impact of urbanization on plant conservation targets. By modelling urbanization, we manage to identify those areas where protection could be more efficient to limit further losses. We suggest to use our approach in the future to expand the PA network in order to achieve the 2020 Aichi biodiversity targets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Spatial analysis of ecosystem service relationships to improve targeting of payments for hydrological services

PubMed Central

Manson, Robert H.; Ricketts, Taylor H.; Geissert, Daniel

2018-01-01

Payment for hydrological services (PHS) are popular tools for conserving ecosystems and their water-related services. However, improving the spatial targeting and impacts of PHS, as well as their ability to foster synergies with other ecosystem services (ES), remain challenging. We aimed at using spatial analyses to evaluate the targeting performance of México’s National PHS program in central Veracruz. We quantified the effectiveness of areas targeted for PHS in actually covering areas of high HS provision and social priority during 2003–2013. First, we quantified provisioning and spatial distributions of two target (water yield and soil retention), and one non-target ES (carbon storage) using InVEST. Subsequently, pairwise relationships among ES were quantified by using spatial correlation and overlap analyses. Finally, we evaluated targeting by: (i) prioritizing areas of individual and overlapping ES; (ii) quantifying spatial co-occurrences of these priority areas with those targeted by PHS; (iii) evaluating the extent to which PHS directly contribute to HS delivery; and (iv), testing if PHS targeted areas disproportionately covered areas with high ecological and social priority. We found that modelled priority areas exhibited non-random distributions and distinct spatial patterns. Our results show significant pairwise correlations between all ES suggesting synergistic relationships. However, our analysis showed a significantly lower overlap than expected and thus significant mismatches between PHS targeted areas and all types of priority areas. These findings suggest that the targeting of areas with high HS provisioning and social priority by Mexico’s PHS program could be improved significantly. This study underscores: (1) the importance of using maps of HS provisioning as main targeting criteria in PHS design to channel payments towards areas that require future conservation, and (2) the need for future research that helps balance ecological and socioeconomic targeting criteria. PMID:29462205

Past, present and future challenges in health care priority setting.

PubMed

Hall, William; Williams, Iestyn; Smith, Neale; Gold, Marthe; Coast, Joanna; Kapiriri, Lydia; Danis, M; Mitton, Craig

2018-05-21

Purpose Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a "magic bullet" is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues. Design/methodology/approach An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015. Findings "Decision-making frameworks" and "Engagement" were the two most frequently mentioned notable achievements. "Priority setting in practice" and "Awareness and education" were the two most frequently mentioned policy and practical challenges. "Priority setting in practice" and "Engagement" were the two most frequently mentioned areas in need of future research. Research limitations/implications Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly. Practical implications Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area. Originality/value Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges.

HPLC-PFD determination of priority pollutant PAHs in water, sediment, and semipermeable membrane devices

USGS Publications Warehouse

Williamson, K.S.; Petty, J.D.; Huckins, J.N.; Lebo, J.A.; Kaiser, E.M.

2002-01-01

High performance liquid chromatography coupled with programmable fluorescence detection was employed for the determination of 15 priority pollutant polycyclic aromatic hydrocarbons (PPPAHs) in water, sediment, and semipermeable membrane devices (SPMDs). Chromatographic separation using this analytical method facilitates selectivity, sensitivity (ppt levels), and can serve as a non-destructive technique for subsequent analysis by other chromatographic and spectroscopic techniques. Extraction and sample cleanup procedures were also developed for water, sediment, and SPMDs using various chromatographic and wet chemical methods. The focus of this publication is to examine the enrichment techniques and the analytical methodologies used in the isolation, characterization, and quantitation of 15 PPPAHs in different sample matrices.

34 CFR 656.23 - What priorities may the Secretary establish?

Code of Federal Regulations, 2010 CFR

2010-07-01

... POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION NATIONAL RESOURCE CENTERS PROGRAM FOR FOREIGN LANGUAGE AND AREA... priorities: (1) Specific countries or world areas, such as, for example, East Asia, Africa, or the Middle East. (2) Specific focus of a Center, such as, for example, a single world area; international studies...

A Fair Contention Access Scheme for Low-Priority Traffic in Wireless Body Area Networks

PubMed Central

Sajeel, Muhammad; Bashir, Faisal; Asfand-e-yar, Muhammad; Tauqir, Muhammad

2017-01-01

Recently, wireless body area networks (WBANs) have attracted significant consideration in ubiquitous healthcare. A number of medium access control (MAC) protocols, primarily derived from the superframe structure of the IEEE 802.15.4, have been proposed in literature. These MAC protocols aim to provide quality of service (QoS) by prioritizing different traffic types in WBANs. A contention access period (CAP)with high contention in priority-based MAC protocols can result in higher number of collisions and retransmissions. During CAP, traffic classes with higher priority are dominant over low-priority traffic; this has led to starvation of low-priority traffic, thus adversely affecting WBAN throughput, delay, and energy consumption. Hence, this paper proposes a traffic-adaptive priority-based superframe structure that is able to reduce contention in the CAP period, and provides a fair chance for low-priority traffic. Simulation results in ns-3 demonstrate that the proposed MAC protocol, called traffic- adaptive priority-based MAC (TAP-MAC), achieves low energy consumption, high throughput, and low latency compared to the IEEE 802.15.4 standard, and the most recent priority-based MAC protocol, called priority-based MAC protocol (PA-MAC). PMID:28832495

Research priorities in mental health occupational therapy: A study of clinician perspectives.

PubMed

Hitch, Danielle; Lhuede, Kate

2015-10-01

The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. This study provides an updated indication of research priorities for mental health occupational therapy in Australia. © 2015 Occupational Therapy Australia.

Landscape level reforestation priorities for forest breeding landbirds in the Mississippi Alluvial Valley

USGS Publications Warehouse

Twedt, D.J.; Uihlein, W.B.; Fredrickson, L.H.; King, S.L.; Kaminski, R.M.

2005-01-01

Thousands of ha of cleared wetlands are being reforested annually in the Mississippi Alluvial Valley (MAV). Despite the expansive and long-term impacts of reforestation on the biological communities of the MAV, there is generally a lack of landscape level planning in its implementation. To address this deficiency we used raster-based digital data to assess the value of forest restoration to migratory landbirds for each ha within the MAV. Raster themes were developed that reflected distance from 3 existing forest cover parameters: (1) extant forest, (2) contiguous forest patches between 1,012 and 40,000 ha, and (3) forest cores with contiguous area 1 km from an agricultural, urban, or pastoral edge. Two additional raster themes were developed that combined information on the proportion of forest cover and average size of forest patches, respectively, within landscapes of 50,000, 100,000, 150,000, and 200,000 ha. Data from these 5 themes were amalgamated into a single raster using a weighting system that gave increased emphasis to existing forest cores, larger forest patches, and moderately forested landscapes while deemphasizing reforestation near small or isolated forest fragments and within largely agricultural landscapes. This amalgamated raster was then modified by the geographic location of historical forest cover and the current extent of public land ownership to assign a reforestation priority score to each ha in the MAV. However, because reforestation is not required on areas with extant forest cover and because restoration is unlikely on areas of open water and urban communities, these lands were not assigned a reforestation priority score. These spatially explicit reforestation priority scores were used to simulate reforestation of 368,000 ha (5%) of the highest priority lands in the MAV. Targeting restoration to these high priority areas resulted in a 54% increase in forest core - an area of forest core that exceeded the area of simulated reforestation. Bird Conservation Regions, developed within the framework of the Partners in Flight: Mississippi Alluvial Valley Bird Conservation Plan, encompassed a large proportion (circa 70%) of the area with highest priority for reforestation. Similarly, lands with high reforestation priority often were enrolled in the Wetland Reserve Program.

The effectiveness of surrogate taxa to conserve freshwater biodiversity.

PubMed

Stewart, David R; Underwood, Zachary E; Rahel, Frank J; Walters, Annika W

2018-02-01

Establishing protected areas has long been an effective conservation strategy and is often based on readily surveyed species. The potential of any freshwater taxa to be a surrogate for other aquatic groups has not been explored fully. We compiled occurrence data on 72 species of freshwater fishes, amphibians, mussels, and aquatic reptiles for the Great Plains, Wyoming (U.S.A.). We used hierarchical Bayesian multispecies mixture models and MaxEnt models to describe species' distributions and the program Zonation to identify areas of conservation priority for each aquatic group. The landscape-scale factors that best characterized aquatic species' distributions differed among groups. There was low agreement and congruence among taxa-specific conservation priorities (<20%), meaning no surrogate priority areas would include or protect the best habitats of other aquatic taxa. Common, wideranging aquatic species were included in taxa-specific priority areas, but rare freshwater species were not included. Thus, the development of conservation priorities based on a single freshwater aquatic group would not protect all species in the other aquatic groups. © 2017 Society for Conservation Biology.

Accreditation of Engineering Programmes: European Perspectives and Challenges in a Global Context

ERIC Educational Resources Information Center

Augusti, Giuliano

2007-01-01

The EUR-ACE Socrates-Tempus project (September 2004/March 2006) proposed a decentralized European system for accreditation of engineering programmes in the "Bologna process" area (European Higher Education Area) at the First and Second Cycle (FC and SC) level (but including "Integrated Programmes", i.e. programmes leading…

The Rise and Fall of Workplace Basic Skills Programmes: Lessons for Policy and Practice

ERIC Educational Resources Information Center

Wolf, Alison; Aspin, Liam; Waite, Edmund; Ananiadou, Katerina

2010-01-01

Since the publication of the Moser Report in 1999, improving the basic skills of adults has been a major priority for all of the UK's governments. There has been a particular interest in building up workplace provision, because of the assumed relationship between the basic skills of the employed population and productivity. A longitudinal study…

What Tanzanian Young People Want to Know about Sexual Health; Implications for School-Based Sex and Relationships Education

ERIC Educational Resources Information Center

Mkumbo, Kitila A. K.

2010-01-01

It is very important that sex and relationships education (SRE) programme developers attempt to elicit, understand and incorporate young people's views in the SRE development and implementation processes. This paper reports the findings of a study that sought to identify young people's self-identified learning needs and priorities regarding sexual…

Community College Baccalaureate: A Fixed Effects, Multi-Year Study of the Influence of State Policy on Nursing Degree Production

ERIC Educational Resources Information Center

Daun-Barnett, Nathan

2011-01-01

For the past 10 years, a growing number of community colleges in the US have begun to offer baccalaureate degrees across a range of targeted programmes including business, education, and nursing. This study examines whether community college baccalaureate policies result in an increased production of nurses--currently a policy priority in nearly…

Identifying needs and barriers to diabetes education in patients with diabetes.

PubMed

Rafique, Ghazala; Shaikh, Furqan

2006-08-01

To assess the needs, awareness and barriers to diabetes education for self management and to facilitate the initiation of an education programme promoting self care among diabetics and their families. A qualitative study was conducted among adult diabetics attending outpatient clinics in a tertiary care teaching hospital in Karachi, Pakistan. Semi-structured interviews were conducted on 27 subjects (11 men; 16 women) to identify dominant themes and priority issues. Participants displayed great deal of variation with respect to level of knowledge and motivation for education. Most believed that diabetes was caused by stress. Family was perceived to be a source of positive support. Relative ease of adherence to pharmacological regimens as compared to diet and exercise was reported. Participants expressed frustration at chronicity of disease and fear of developing certain specific complications and inheritance by their children. Barriers to enhancing knowledge included 'No need for further information', distance from training institutions and other priorities. Knowledge, beliefs and fears about diabetes, family influence and accessibility of healthcare, affects management behaviours and learning. Understanding needs and expectations of people with diabetes is essential in initiating and improving the outcomes of education programme for diabetes self care.

The delivery of injury prevention exercise programmes in professional youth soccer: Comparison to the FIFA 11.

PubMed

O'Brien, James; Young, Warren; Finch, Caroline F

2017-01-01

Injury prevention exercise programmes for amateur soccer have gained considerable attention, but little is known about their relevance and adaptability to professional soccer settings. The first aim of this study was to evaluate the delivery and content of injury prevention exercise programmes used by professional youth soccer teams, compared to the industry standard injury prevention exercise programme for soccer, the Fédération Internationale de Football Association's FIFA 11+. The second aim was to document specific challenges to implementing injury prevention exercise programmes in this context. Prospective observational study. The participants were soccer coaches, fitness coaches and physiotherapists (n=18) from four teams in a professional youth soccer academy. Each team's chosen injury prevention exercise programmes were observed weekly across an entire soccer season (160 sessions). The delivery and content of the programmes were documented on a standardised worksheet and compared to the FIFA 11+. Specific implementation challenges were recorded. Fitness coaches were the primary deliverers of injury prevention exercise programmes, with support from physiotherapists. Multiple delivery formats and locations were employed, along with the extensive use of equipment. Across all injury prevention exercise programme sessions, a median of one FIFA 11+ exercise was performed in its original form and a further four in a modified form. Implementation challenges included poor staff communication, competing training priorities and heavy game schedules. Although the basic components of the FIFA 11+ hold relevance for professional youth male teams, the delivery and content of injury prevention exercise programmes require considerable tailoring for this context. Recognising this will inform the development of improved, context-specific injury prevention exercise programmes, along with corresponding strategies to enhance their implementation. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

[The general criteria and recommendations for the elaboration of programs for the early detection of breast cancer and cervical cancer in Spain. The Working Group for the Early Detection of Breast Cancer and Cervical Cancer].

PubMed

Ascunze Elizaga, N; González Enríquez, J; González Navarro, A; Herranz Fernández, C; Marqués Bravo, A; Martín Pérez, J

1993-01-01

Cancer screening and primary prevention of cancer are effective strategies to reduce cancer morbidity and mortality. The experience gained in several European countries about breast and cervical cancer has been growing in the last decades. This fact facilitates the adoption of the most convenient strategies to implement screening programmes in Spain. The Spanish Ministry of Health and Consumer Affairs set up a work group of experts and health managers to make recommendations and to define the basic criteria to take into account when planning and implementing these programmes. The article describes those recommendations as well as the priorities to be established regarding the target population, and the strategies to increase efficiency of those programmes. Recommendations were made according with scientific evidences and the current situation and resources in Spain.

Integrating economic costs and biological traits into global conservation priorities for carnivores.

PubMed

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-08-27

Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy.

Exclusion of agricultural lands in spatial conservation prioritization strategies: consequences for biodiversity and ecosystem service representation.

PubMed

Durán, América P; Duffy, James P; Gaston, Kevin J

2014-10-07

Agroecosystems have traditionally been considered incompatible with biological conservation goals, and often been excluded from spatial conservation prioritization strategies. The consequences for the representativeness of identified priority areas have been little explored. Here, we evaluate these for biodiversity and carbon storage representation when agricultural land areas are excluded from a spatial prioritization strategy for South America. Comparing different prioritization approaches, we also assess how the spatial overlap of priority areas changes. The exclusion of agricultural lands was detrimental to biodiversity representation, indicating that priority areas for agricultural production overlap with areas of relatively high occurrence of species. By contrast, exclusion of agricultural lands benefits representation of carbon storage within priority areas, as lands of high value for agriculture and carbon storage overlap little. When agricultural lands were included and equally weighted with biodiversity and carbon storage, a balanced representation resulted. Our findings suggest that with appropriate management, South American agroecosystems can significantly contribute to biodiversity conservation. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

7 CFR 3430.309 - Priority areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agriculture and Food Research Initiative § 3430.309 Priority areas. NIFA will award competitive grants in the...) Conventional breeding, including cultivar and breed development, selection theory, applied quantitative... development, selection theory, applied quantitative genetics, breeding for improved food quality, breeding for...

7 CFR 3430.309 - Priority areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture and Food Research Initiative § 3430.309 Priority areas. NIFA will award competitive grants in the...) Conventional breeding, including cultivar and breed development, selection theory, applied quantitative... development, selection theory, applied quantitative genetics, breeding for improved food quality, breeding for...

7 CFR 3430.309 - Priority areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agriculture and Food Research Initiative § 3430.309 Priority areas. NIFA will award competitive grants in the...) Conventional breeding, including cultivar and breed development, selection theory, applied quantitative... development, selection theory, applied quantitative genetics, breeding for improved food quality, breeding for...

7 CFR 3430.309 - Priority areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agriculture and Food Research Initiative § 3430.309 Priority areas. NIFA will award competitive grants in the...) Conventional breeding, including cultivar and breed development, selection theory, applied quantitative... development, selection theory, applied quantitative genetics, breeding for improved food quality, breeding for...

7 CFR 4284.603 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... provide assistance to businesses located in rural areas. Economic development. The industrial, business... development of rural areas. Priority communities. Communities targeted for Agency assistance as determined by the USDA Under Secretary for Rural Development. Priority communities are those that are experiencing...

An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya.

PubMed

Nyandieka, Lilian Nyamusi; Kombe, Yeri; Ng'ang'a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

2015-01-01

In spite of the critical role of Emergency Obstetric Care in treating complications arising from pregnancy and childbirth, very few facilities are equipped in Kenya to offer this service. In Malindi, availability of EmOC services does not meet the UN recommended levels of at least one comprehensive and four basic EmOC facilities per 500,000 populations. This study was conducted to assess priority setting process and its implication on availability, access and use of EmOC services at the district level. A qualitative study was conducted both at health facility and community levels. Triangulation of data sources and methods was employed, where document reviews, in-depth interviews and focus group discussions were conducted with health personnel, facility committee members, stakeholders who offer and/ or support maternal health services and programmes; and the community members as end users. Data was thematically analysed. Limitations in the extent to which priorities in regard to maternal health services can be set at the district level were observed. The priority setting process was greatly restricted by guidelines and limited resources from the national level. Relevant stakeholders including community members are not involved in the priority setting process, thereby denying them the opportunity to contribute in the process. The findings illuminate that consideration of all local plans in national planning and budgeting as well as the involvement of all relevant stakeholders in the priority setting exercise is essential in order to achieve a consensus on the provision of emergency obstetric care services among other health service priorities.

The development of a national nutrition and mental health research agenda with comparison of priorities among diverse stakeholders.

PubMed

Davison, Karen M; D'Andreamatteo, Carla; Mitchell, Scott; Vanderkooy, Pat

2017-03-01

To develop a national nutrition and mental health research agenda based on the engagement of diverse stakeholders and to assess research priorities by stakeholder groups. A staged, integrated and participatory initiative was implemented to structure a national nutrition and mental health research agenda that included: (i) national stakeholder consultations to prioritize research questions; (ii) a workshop involving national representatives from research, policy and practice to further define priorities; (iii) triangulation of data to formulate the agenda; and (iv) test hypotheses about stakeholder influences on decision making. Canada. Diverse stakeholders including researchers, academics, administrators, service providers, policy makers, practitioners, non-profit, industry and funding agency representatives, front-line workers, individuals with lived experience of a mental health condition and those who provide care for them. This first-of-its-kind research priority-setting initiative showed points of agreement among diverse stakeholders (n 899) on research priorities aimed at service provision; however, respondents with lived experience of a mental health condition (themselves or a family member) placed emphasis on prevention and mental health promotion-based research. The final integrated agenda identified four research priorities, including programmes and services, service provider roles, the determinants of health and knowledge translation and exchange. These research priorities aim to identify effective models of care, enhance collaboration, inform policy makers and foster knowledge dissemination. Since a predictor of research uptake is the involvement of relevant stakeholders, a sustained and deliberate effort must continue to engage collaboration that will lead to the optimization of nutrition and mental health-related outcomes.

An Implementation of Wireless Body Area Networks for Improving Priority Data Transmission Delay.

PubMed

Gündoğdu, Köksal; Çalhan, Ali

2016-03-01

The rapid growth of wireless sensor networks has enabled the human health monitoring of patients using body sensor nodes that gather and evaluate human body parameters and movements. This study describes both simulation model and implementation of a new traffic sensitive wireless body area network by using non-preemptive priority queue discipline. A wireless body area network implementation employing TDMA is designed with three different priorities of data traffics. Besides, a coordinator node having the non-preemptive priority queue is performed in this study. We have also developed, modeled and simulated example network scenarios by using the Riverbed Modeler simulation software with the purpose of verifying the implementation results. The simulation results obtained under various network load conditions are consistent with the implementation results.

Ecosystem Services Modeling as a Tool for Defining Priority Areas for Conservation.

PubMed

Duarte, Gabriela Teixeira; Ribeiro, Milton Cezar; Paglia, Adriano Pereira

2016-01-01

Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services-carbon stock and sediment retention-and a biodiversity proxy-habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention distribution.

Ecosystem Services Modeling as a Tool for Defining Priority Areas for Conservation

PubMed Central

Duarte, Gabriela Teixeira; Ribeiro, Milton Cezar; Paglia, Adriano Pereira

2016-01-01

Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services—carbon stock and sediment retention—and a biodiversity proxy–habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention distribution. PMID:27145031

Sentinel-1A - Launching the first satellite and launching the operational Copernicus programme

NASA Astrophysics Data System (ADS)

Aschbacher, Josef; Milagro Perez, Maria Pilar

2014-05-01

The first Copernicus satellite, Sentinel-1A, is prepared for launch in April 2014. It will provide continuous, systematic and highly reliable radar images of the Earth. Sentinel-1B will follow around 18 months later to increase observation frequency and establish an operational system. Sentinel-1 is designed to work in a pre-programmed conflict-free operation mode ensuring the reliability required by operational services and creating a consistent long-term data archive for applications based on long time series. This mission will ensure the continuation and improvement of SAR operational services and applications addressing primarily medium- to high-resolution applications through a main mode of operation that features both a wide swath (250 km) and high geometric (5 × 20 m) and radiometric resolution, allowing imaging of global landmasses, coastal zones, sea ice, polar areas, and shipping routes at high resolution. The Sentinel-1 main operational mode (Interferometric Wide Swath) will allow to have a complete coverage of the Earth in 6 days in the operational configuration when the two Sentinel-1 spacecraft will be in orbit simultaneously. High priority areas like Europe, Canada and some shipping routes will be covered almost daily. This high global observation frequency is unprecedented and cannot be reached with any other current radar mission. Envisat, for example, which was the 'workhorse' in this domain up to April 2012, reached global coverage every 35 days. Sentinel-1 data products will be made available systematically and free of charge to all users including institutional users, the general public, scientific and commercial users. The transition of the Copernicus programme from the development to operational phase will take place at about the same time when the first Sentinel-1 satellite will be launched. During the operational phase, funding of the programme will come from the European Union Multiannual Financial Framework (MFF) for the years 2014-2020. The EU Copernicus Regulation, laying down the legal basis for the EU operational Copernicus programme, is currently in its final phase of approval by the European Parliament and Council. Based on this, the future EU-ESA Copernicus Agreement will define the modalities for the cooperation between ESA and the EU for the period 2014-2020 and will regulate the budget implementation tasks entrusted to ESA by the EU for the accomplishment of the space segment and the programme operations phase. The agreement, once signed, will pave the way for important procurements over the next seven years in the Earth observation domain.

A Roadmap for HEP Software and Computing R&D for the 2020s

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alves, Antonio Augusto, Jr; et al.

Particle physics has an ambitious and broad experimental programme for the coming decades. This programme requires large investments in detector hardware, either to build new facilities and experiments, or to upgrade existing ones. Similarly, it requires commensurate investment in the R&D of software to acquire, manage, process, and analyse the shear amounts of data to be recorded. In planning for the HL-LHC in particular, it is critical that all of the collaborating stakeholders agree on the software goals and priorities, and that the efforts complement each other. In this spirit, this white paper describes the R&D activities required to preparemore » for this software upgrade.« less

Aiding priority setting in health care: is there a role for the contingent valuation method?

PubMed

Olsen, J A

1997-01-01

The paper discusses some methodological and measurement aspects with the contingent valuation (CV) method which appear to create problems when eliciting preferences for the relative social valuation of alternative health care programmes. After pointing to biases which tend to exaggerate the true valuations, emphasis is placed on framing issues when applied to health care. Thereafter the paper discusses the extent to which preferences elicited through one's willingness to pay can be used to infer how the respondent would prioritize between the health care programmes in question. New empirical evidence is presented which suggest discrepancies between a CV ranking and the ranking expressed when making a direct ordinal comparison.

Consensus document on European brain research.

PubMed

Olesen, Jes; Baker, Mary G; Freund, Tamas; di Luca, Monica; Mendlewicz, Julien; Ragan, Ian; Westphal, Manfred

2006-08-01

Brain disease psychiatric and neurologic disease combined represents a considerable social and economic burden in Europe. Data collected by the World Health Organization (WHO) suggest that brain diseases are responsible for 35% of Europe's total disease burden. An analysis of all health economic studies of brain diseases in Europe, published by the European Brain Council (EBC) in June 2005, estimated the total cost of brain disease in Europe in 2004 to be Euro 386 billion. That burden is set to grow, mainly due to the fact that the European population is ageing. Investment in brain sciences does not match that burden now, let alone in the future. Brain research received only 8% of the life science budget in the European Commission's Fifth Framework Programme, which represents less than 0.01% of the annual cost of brain disorders for that period. Over the last decade, Europe has been losing ground to the USA and Japan in terms of both basic and clinical research. Many of Europe's young researchers are taking up posts in the USA and staying there. Big pharmaceutical companies are fleeing Europe for the USA, taking their drug development programmes with them. Research in the brain sciences now holds the promise of therapies that halt and even reverse neurodegeneration, of better diagnostic tools, neural prostheses for the paralysed and drugs for depression and anxiety that are tailored to the individual, thereby eliminating or reducing side effects. Our growing understanding of the normal brain could lead to better prevention of brain disease and to more effective teaching methods. The need for innovative treatments has never been greater, and Europe boasts clusters of excellent researchers in biotechnology who could collaborate with brain scientists and the pharmaceutical industry to realise this promise. But if Europe is to seize these opportunities and meet the challenge of brain disease, it needs to go forward on the basis of greater collaboration between countries, greater collaboration between industry, academia and patient organisations, and increased investment in the brain sciences. The EBC was formed in 2002 to bring together scientists, clinicians, the pharmaceutical industry, charities and patient organisations from all over Europe to campaign for these goals. It takes a novel, bottom-up approach to research policy, and in developing this consensus document, it aims to promote a greater and more focused effort in this area, to improve public understanding of the brain sciences and above all, to support brain research as a priority under the European Commission's Seventh Framework Programme (FP7, 2007-2013). The research programme outlined here was first conceived by the EBC board. An outline was sent to all member organisations and a number of individual experts for comments. Following that, a table of contents was developed. The 45 research themes were written by groups of experts from across Europe who represent a wide range of disciplines. Each one contains a proposal for future research on a specific brain-related theme which the EBC believes could form the basis of one or more integrated projects or strategic targeted research projects (STREP) funded under FP7. The EBC has deliberately focused on the major diseases and then described the basic research needed to understand and treat or perhaps even cure those diseases. The programme is therefore constructed "from man to molecule" and not the other way round, with equal importance attached to basic and clinical research. The EBC suggests that each of the proposed integrated projects or STREP should be awarded a budget in the order of Euro 10 to 15 million. In addition, brain research should be treated as an important element of many other parts of FP7, such as the European Research Council and research programmes on information technology and the causes of violence. Any research programme that concerns human behaviour should, by definition, take account of brain research. The EBC envisages that the priority for brain research it proposes at the European level will translate into higher priority for brain research at the national level, and this document may also serve as a starting point for the development of national consensus programmes. It seems likely that consensus conferences on brain research in Europe may further develop the themes and ideas discussed here. An EBC task force may also be established to further the consensus process. In general, increasing funding in the brain sciences would bring enormous economic returns by lightening the burden on healthcare systems and increasing the productivity of affected individuals-and might easily pay for itself. The human and social returns of such an investment are inestimable. And the time to act is now.

Attention Priority Map of Face Images in Human Early Visual Cortex.

PubMed

Mo, Ce; He, Dongjun; Fang, Fang

2018-01-03

Attention priority maps are topographic representations that are used for attention selection and guidance of task-related behavior during visual processing. Previous studies have identified attention priority maps of simple artificial stimuli in multiple cortical and subcortical areas, but investigating neural correlates of priority maps of natural stimuli is complicated by the complexity of their spatial structure and the difficulty of behaviorally characterizing their priority map. To overcome these challenges, we reconstructed the topographic representations of upright/inverted face images from fMRI BOLD signals in human early visual areas primary visual cortex (V1) and the extrastriate cortex (V2 and V3) based on a voxelwise population receptive field model. We characterized the priority map behaviorally as the first saccadic eye movement pattern when subjects performed a face-matching task relative to the condition in which subjects performed a phase-scrambled face-matching task. We found that the differential first saccadic eye movement pattern between upright/inverted and scrambled faces could be predicted from the reconstructed topographic representations in V1-V3 in humans of either sex. The coupling between the reconstructed representation and the eye movement pattern increased from V1 to V2/3 for the upright faces, whereas no such effect was found for the inverted faces. Moreover, face inversion modulated the coupling in V2/3, but not in V1. Our findings provide new evidence for priority maps of natural stimuli in early visual areas and extend traditional attention priority map theories by revealing another critical factor that affects priority maps in extrastriate cortex in addition to physical salience and task goal relevance: image configuration. SIGNIFICANCE STATEMENT Prominent theories of attention posit that attention sampling of visual information is mediated by a series of interacting topographic representations of visual space known as attention priority maps. Until now, neural evidence of attention priority maps has been limited to studies involving simple artificial stimuli and much remains unknown about the neural correlates of priority maps of natural stimuli. Here, we show that attention priority maps of face stimuli could be found in primary visual cortex (V1) and the extrastriate cortex (V2 and V3). Moreover, representations in extrastriate visual areas are strongly modulated by image configuration. These findings extend our understanding of attention priority maps significantly by showing that they are modulated, not only by physical salience and task-goal relevance, but also by the configuration of stimuli images. Copyright © 2018 the authors 0270-6474/18/380149-09$15.00/0.

Priority setting in HIV/AIDS control in West Java Indonesia: an evaluation based on the accountability for reasonableness framework.

PubMed

Tromp, Noor; Prawiranegara, Rozar; Subhan Riparev, Harris; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

2015-04-01

Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four conditions of the accountability for reasonableness (A4R) framework: relevance, publicity, appeals and revision, and enforcement. We reviewed government documents and conducted semi-structured qualitative interviews based on the A4R framework with 22 participants of the 5-year HIV/AIDS strategy development for 2008-13 (West Java province) and 2007-11 (Bandung). We found that criteria for priority setting were used implicitly and that the strategies included a wide range of programmes. Many stakeholders were involved in the process but their contribution could be improved and particularly the public and people living with HIV/AIDS could be better engaged. The use of appeal and publicity mechanisms could be more transparent and formally stated. Public regulations are not yet installed to ensure fair priority setting. To increase fairness in HIV/AIDS priority setting, West Java should make improvements on all four conditions of the A4R framework. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Cardiovascular Nursing Science Priorities: A Statement from the American Heart Association Council on Cardiovascular and Stroke Nursing.

PubMed

Piano, Mariann R; Artinian, Nancy T; DeVon, Holli A; Pressler, Susan T; Hickey, Kathleen T; Chyun, Deborah A

2018-04-26

The American Heart Association's (AHA) Council on Cardiovascular and Stroke Nursing (CVSN) plays a critical role in advancing the mission of the AHA in the discovery of new scientific knowledge. The aim was to identify priority research topics that would promote and improve cardiovascular (CV) health, provide direction for the education of future nurse scientists, and serve as a resource and catalyst for federal and organizational funding priorities. A Qualtrics survey, which included 3 questions about priorities for CVSN nurse researchers, was sent to the CVSN Leadership Committee and all CVSN Fellows of the AHA (n = 208). Responses to the questions were reviewed for word repetitions, patterns, and concepts and were then organized into thematic areas. The thematic areas were reviewed within small groups at the November (2016) in-person CVSN leadership meeting. Seventy-three surveys were completed. Five thematic areas were identified and included (1) developing and testing interventions, (2) assessment and monitoring, (3) precision CV nursing care, (4) translational and implementation science, and (5) big data. Topic areas noted were stroke, research methods, prevention of stroke and CV disease, self-management, and care and health disparities. Five thematic areas and 24 topic areas were identified as priorities for CV nursing research. These findings can provide a guide for CV nurse scientists and for federal and foundational funders to use in developing funding initiatives. We believe additional research and discovery in these thematic areas will help reduce the rising global burden of CV disease.

Measuring vaccine confidence: analysis of data obtained by a media surveillance system used to analyse public concerns about vaccines.

PubMed

Larson, Heidi J; Smith, David M D; Paterson, Pauline; Cumming, Melissa; Eckersberger, Elisabeth; Freifeld, Clark C; Ghinai, Isaac; Jarrett, Caitlin; Paushter, Louisa; Brownstein, John S; Madoff, Lawrence C

2013-07-01

The intensity, spread, and effects of public opinion about vaccines are growing as new modes of communication speed up information sharing, contributing to vaccine hesitancy, refusals, and disease outbreaks. We aimed to develop a new application of existing surveillance systems to detect and characterise early signs of vaccine issues. We also aimed to develop a typology of concerns and a way to assess the priority of each concern. Following preliminary research by The Vaccine Confidence Project, media reports (eg, online articles, blogs, government reports) were obtained using the HealthMap automated data collection system, adapted to monitor online reports about vaccines, vaccination programmes, and vaccine-preventable diseases. Any reports that did not meet the inclusion criteria--any reference to a human vaccine or vaccination campaign or programme that was accessible online--were removed from analysis. Reports were manually analysed for content and categorised by concerns, vaccine, disease, location, and source of report, and overall positive or negative sentiment towards vaccines. They were then given a priority level depending on the seriousness of the reported event and time of event occurrence. We used descriptive statistics to analyse the data collected during a period of 1 year, after refinements to the search terms and processes had been made. We analysed data from 10,380 reports (from 144 countries) obtained between May 1, 2011, and April 30, 2012. 7171 (69%) contained positive or neutral content and 3209 (31%) contained negative content. Of the negative reports, 1977 (24%) were associated with impacts on vaccine programmes and disease outbreaks; 1726 (21%) with beliefs, awareness, and perceptions; 1371 (16%) with vaccine safety; and 1336 (16%) with vaccine delivery programmes. We were able to disaggregate the data by country and vaccine type, and monitor evolution of events over time and location in specific regions where vaccine concerns were high. Real-time monitoring and analysis of vaccine concerns over time and location could help immunisation programmes to tailor more effective and timely strategies to address specific public concerns. Bill & Melinda Gates Foundation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Balancing student/trainee learning with the delivery of patient care in the healthcare workplace: a protocol for realist synthesis.

PubMed

Sholl, Sarah; Ajjawi, Rola; Allbutt, Helen; Butler, Jane; Jindal-Snape, Divya; Morrison, Jill; Rees, Charlotte

2016-04-26

A national survey was recently conducted to explore medical education research priorities in Scotland. The identified themes and underlying priority areas can be linked to current medical education drivers in the UK. The top priority area rated by stakeholders was: 'Understanding how to balance service and training conflicts'. Despite its perceived importance, a preliminary scoping exercise revealed the least activity with respect to published literature reviews. This protocol has therefore been developed so as to understand how patient care, other service demands and student/trainee learning can be simultaneously facilitated within the healthcare workplace. The review will identify key interventions designed to balance patient care and student/trainee learning, to understand how and why such interventions produce their effects. Our research questions seek to address how identified interventions enable balanced patient care-trainee learning within the healthcare workplace, for whom, why and under what circumstances. Pawson's five stages for undertaking a realist review underpin this protocol. These stages may progress in a non-linear fashion due to the iterative nature of the review process. We will: (1) clarify the scope of the review, identifying relevant interventions and existing programme theories, understanding how interventions act to produce their intended outcomes; (2) search journal articles and grey literature for empirical evidence from 1998 (introduction of the European Working Time Directive) on the UK multidisciplinary team working concerning these interventions, theories and outcomes, using databases such as ERIC, Scopus and CINAHL; (3) assess study quality; (4) extract data; and (5) synthesise data, drawing conclusions. A formal ethical review is not required. These findings should provide an important understanding of how workplace-based interventions influence the balance of trainee learning and service provision. They should benefit various stakeholders involved in workplace-based learning interventions, and inform the medical education research agenda in the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A pan-European survey of research in end-of-life cancer care.

PubMed

Sigurdardottir, Katrin Ruth; Haugen, Dagny Faksvåg; Bausewein, Claudia; Higginson, Irene J; Harding, Richard; Rosland, Jan Henrik; Kaasa, Stein

2012-01-01

To date, there is no coordinated strategy for end-of-life (EOL) cancer care research in Europe. The PRISMA (Reflecting the Positive Diversities of European Priorities for Research and Measurement in End-of-life Care) project is aiming to develop a programme integrating research and measurement in EOL care. This survey aimed to map and describe present EOL cancer care research in Europe and to identify priorities and barriers. A questionnaire of 62 questions was developed and 201 researchers in 41 European countries were invited to complete it online in May 2009. An open invitation to participate was posted on the internet. Invited contacts in 36 countries sent 127 replies; eight additional responses came through websites. A total of 127 responses were eligible for analysis. Respondents were 69 male and 58 female, mean age 49 (28-74) years; 85% of the scientific team leaders were physicians. Seventy-one of 127 research groups were located in a teaching hospital or cancer centre. Forty-five percent of the groups had only one to five members and 28% six to ten members. Sixty-three of 92 groups reported specific funding for EOL care research. Seventy-five percent of the groups had published papers in journals with impact factor ≤ 5 in the last 3 years; 8% had published in journals with impact factor >10. Forty-four out of 90 groups reported at least one completed Ph.D. in the last 3 years. The most frequently reported active research areas were pain, assessment and measurement tools, and last days of life and quality of death. Very similar areas--last days of life and quality of death, pain, fatigue and cachexia, and assessment and measurement tools--were ranked as the most important research priorities. The most important research barriers were lack of funding, lack of time, and insufficient knowledge/expertise. Most research groups in EOL care are small. The few large groups (14%) had almost half of the reported publications, and more than half of the current Ph.D. students. There is a lack of a common strategy and coordination in EOL cancer care research and a great need for international collaboration.

The Community Connection Model: implementation of best evidence into practice for self-management of chronic diseases.

PubMed

Liddy, C; Johnston, S; Irving, H; Nash, K

2013-06-01

With chronic diseases becoming an increasing burden for healthcare systems worldwide, self-management support has gained traction in many health regions and organizations. However, the real-world application of the findings from clinical trials into actual community programming is not self-evident. The aim of this study was to present a model of programme implementation, namely the Community Connection Model. The process of implementing a chronic disease self-management programme has been documented in detail from its initial inception through to a sustainable programme. This account includes a description of the strategic activities undertaken (e.g. alignment with local policy and the formation of community partnerships) and the specific steps taken on the path to programme implementation (e.g. a scoping literature review, an environmental scan and a pilot programme with an evaluation component). Reflection on this case example suggests that a cognizance of the interactions between policy, partnership, planning and programme could act as a useful tool to guide programme implementation, evaluation and sustainability. Multiple types of self-management support have been implemented (as part of the Living Health Champlain programme), and are being evaluated and adapted in response to new evidence, shifting priorities and direction from more partners. The widespread access means that self-management support programmes are becoming part of the culture of care in the study region. Establishing a connection around an important health problem, ensuring active partnerships, adequate planning and early implementation of a programme grounded on the principles of applying best-available evidence can lead to successful solutions. The Community Connection Model is proposed as a way of conceptualizing these processes. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Institutional considerations in priority setting: transactions cost perspective on PBMA.

PubMed

Jan, S

2000-10-01

Programme budgeting and marginal analysis (PBMA) is increasingly being used as a method of priority setting in the health care sector. Despite this, PBMA has, on occasions, been subject to problems in its application which can be seen as being 'institutional' in nature. This paper examines the extent to which the institutional setting of PBMA affects the way in which it can be conducted. In particular, a transactions costs perspective is taken to analyse the extent to which variation in such costs can alter the incentives of the individual participants. A number of recommendations for improving the sustainability of such projects is then provided. Following this, the implications which this 'institutional' approach has for the evaluation of PBMA are set out.

New perspectives for European climate services: HORIZON2020

NASA Astrophysics Data System (ADS)

Bruning, Claus; Tilche, Andrea

2014-05-01

The developing of new end-to-end climate services was one of the core priorities of 7th Framework for Research and Technological Development of the European Commission and will become one of the key strategic priorities of Societal Challenge 5 of HORIZON2020 (the new EU Framework Programme for Research and Innovation 2014-2020). Results should increase the competitiveness of European businesses, and the ability of regional and national authorities to make effective decisions in climate-sensitive sectors. In parallel, the production of new tailored climate information should strengthen the resilience of the European society to climate change. In this perspective the strategy to support and foster the underpinning science for climate services in HORIZON2020 will be presented.

Overview of the HFM-181 Symposium Programme, Medical Technology Repurposed to Enhance Human Performance

DTIC Science & Technology

2009-10-01

BIO -INSPIRED HUMAN PERFORMANCE ENHANCEMENT 3.1 Biological performance currently outside of the bounds of the human species HPE opportunities may...strategies to preferentially burn fat in weight reduction (85). 3.2 Bio -inspired opportunities for human performance There are many interesting...solutions to assist human performance Nonmedical applications of bio -inspired engineering and computing technologies are a recognized priority in

"Visions" for Children's Health and Wellbeing: Exploring the Complex and Arbitrary Processes of Putting Theory into Practice

ERIC Educational Resources Information Center

Wellard, Ian; Secker, Michelle

2017-01-01

It could be claimed that the priority of any Government should be to look after the interests of the public it serves. Much of this role includes attempting to actively develop and implement policies and programmes that best contribute to or enhance general standards of living. Addressing health and wellbeing, it follows, is a reasonable vision…

Using Formative Research to Develop a Nutrition Education Resource Aimed at Assisting Low-Income Households in South Africa Adopt a Healthier Diet

ERIC Educational Resources Information Center

Everett-Murphy, K.; De Villiers, A.; Ketterer, E.; Steyn, K.

2015-01-01

As part of a comprehensive programme to prevent non-communicable disease in South Africa, there is a need to develop public education campaigns on healthy eating. Urban populations of lower socioeconomic status are a priority target population. This study involved formative research to guide the development of a nutrition resource appropriate to…

Research priority setting in childhood chronic disease: a systematic review.

PubMed

Odgers, Harrison Lindsay; Tong, Allison; Lopez-Vargas, Pamela; Davidson, Andrew; Jaffe, Adam; McKenzie, Anne; Pinkerton, Ross; Wake, Melissa; Richmond, Peter; Crowe, Sally; Caldwell, Patrina Ha Yuen; Hill, Sophie; Couper, Jennifer; Haddad, Suzy; Kassai, Behrouz; Craig, Jonathan C

2018-04-11

To evaluate research priority setting approaches in childhood chronic diseases and to describe the priorities of stakeholders including patients, caregivers/families and health professionals. We conducted a systematic review of MEDLINE, Embase, PsycINFO and CINAHL from inception to 16 October 2016. Studies that elicited stakeholder priorities for paediatric chronic disease research were eligible for inclusion. Data on the prioritisation process were extracted using an appraisal checklist. Generated priorities were collated into common topic areas. We identified 83 studies (n=15 722). Twenty (24%) studies involved parents/caregivers and four (5%) children. The top three health areas were cancer (11%), neurology (8%) and endocrine/metabolism (8%). Priority topic areas were treatment (78%), disease trajectory (48%), quality of life/psychosocial impact (48%), disease onset/prevention (43%), knowledge/self-management (33%), prevalence (30%), diagnostic methods (28%), access to healthcare (25%) and transition to adulthood (12%). The methods included workshops, Delphi techniques, surveys and focus groups/interviews. Specific methods for collecting and prioritising research topics were described in only 60% of studies. Most reviewed studies were conducted in high-income nations. Research priority setting activities in paediatric chronic disease cover many discipline areas and have elicited a broad range of topics. However, child/caregiver involvement is uncommon, and the methods often lack clarity. A systematic and explicit process that involves patients and families in partnership may help to inform a more patient and family-relevant research agenda in paediatric chronic disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Integrating Economic Costs and Biological Traits into Global Conservation Priorities for Carnivores

PubMed Central

Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael

2009-01-01

Background Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. Methodology/Principal Findings We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Conclusions/Significance Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy. PMID:19710911

Factors affecting the attrition of community-directed distributors of ivermectin, in an onchocerciasis-control programme in the Imo and Abia states of south-eastern Nigeria.

PubMed

Emukah, E C; Enyinnaya, U; Olaniran, N S; Akpan, E A; Hopkins, D R; Miri, E S; Amazigo, U; Okoronkwo, C; Stanley, A; Rakers, L; Richards, F O; Katabarwa, M N

2008-01-01

In areas of Nigeria where onchocerciasis is endemic, community-directed distributors (CDD) distribute ivermectin annually, as part of the effort to control the disease. Unfortunately, it has been reported that at least 35% of the distributors who have been trained in Nigeria are unwilling to participate further as CDD. The selection and training of new CDD, to replace those unwilling to continue, leads to annual expense that the national onchocerciasis-programme is finding difficult to meet, given other programme priorities and the limited resources. If the reported levels of attrition are true, they seriously threaten the sustainability of community-directed treatment with ivermectin (CDTI) in Nigeria. In 2002, interviews were held with 101 people who had been trained as CDD, including those who had stopped serving their communities, from 12 communities in south-eastern Nigeria that had high rates of CDD attrition. The results showed that, although the overall reported CDD attrition was 40.6%, the actual rate was only 10.9%. The CDD who had ceased participating in the annual rounds of ivermectin blamed a lack of incentives (65.9%), the demands of other employment (14.6%), the long distances involved in the house-to-house distribution (12.2%) or marital duties (7.3%). Analysis of the data obtained from all the interviewed CDD showed that inadequate supplies of ivermectin (P<0.01), lack of supervision (P<0.05) and a lack of monetary incentives (P<0.001) led to significant increases in attrition. Conversely, CDD retention was significantly enhanced when the distributors were selected by their community members (P<0.001), supervised (P<0.001), supplied with adequate ivermectin tablets (P<0.05), involved in educating their community members (P<0.05), and/or involved in other health programmes (P<0.001). Although CDD who were involved in other health programmes were relatively unlikely to cease participating in the distributions, they were more likely to take longer than 14 days to complete ivermectin distribution than other CDD, who only distributed ivermectin. Data obtained in interviews with present and past CDD appear vital for informing, directing, protecting and enhancing the performance of CDTI programmes, in Nigeria and elsewhere.

Kids just wanna have fun: Children's experiences of a weight management programme.

PubMed

Watson, Libby A; Baker, Martyn C; Chadwick, Paul M

2016-05-01

To explore children's accounts of their experiences of the UK's largest childhood obesity programme, MEND (Mind, Exercise, Nutrition...Do it!) (See www.mendprogramme.org). Semi-structured interviews were conducted with children who had completed the MEND obesity programme. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (IPA). Fourteen children spanning diverse areas of London comprised this study (eight male, six female), aged between 11 and 14 years and in secondary school. Participants were interviewed a year after completing one of the London-based MEND obesity programmes. This article focuses on the most common and striking theme to emerge from the original dataset (The complete analysis may be found in L. Watson, Unpublished doctoral thesis): Fun. Subthemes were: 'going with the flow'; active participation in activities that led to new experiences ('actually doing it' - seeing the fun side); the importance of others in the experience of fun ('you do games in unity' - 'it's not as fun on your own'). Children have fun when engaged in interactive and varied activities with opportunity for individual feedback and improvement. When designing childhood obesity programmes, conditions that optimise children's experience of fun should be emphasised over didactic and risk-heavy information pertaining to childhood obesity. What is already known on this subject? Continued growth in childhood obesity and its associated health problems, psychological effects, and economic burden make tackling childhood obesity a public health priority. Multicomponent lifestyle interventions to treat childhood obesity within the community have been shown to reduce overweight and obesity from pre- to post-treatment, increase self-esteem, and are found to be acceptable by parents. MEND is the most widely disseminated evidence-based programme of this kind in the United Kingdom. What does this study add? This study is the first qualitative study to explore the child's experience of attending MEND. The post-treatment maintenance period, where most behaviour change is consolidated (or not), is also captured in this study, with children interviewed at least 1 year post-treatment. Findings unearthed an unexpected and strong theme - that of 'fun' - integral to their experience during their time at MEND. Optimizing conditions for fun is imperative to children's (and adults'?) engagement with, and maintenance of, healthy lifestyle activities. © 2015 The British Psychological Society.

A Community Jury on PSA screening: what do well-informed men want the government to do about prostate cancer screening--a qualitative analysis.

PubMed

Rychetnik, Lucie; Doust, Jenny; Thomas, Rae; Gardiner, Robert; Mackenzie, Geraldine; Glasziou, Paul

2014-04-30

Cancer screening policies and programmes should take account of public values and concerns. This study sought to determine the priorities, values and concerns of men who were 'fully informed' about the benefits and harms of prostate-specific antigen (PSA) screening; and empirically examine the value of a community jury in eliciting public values on PSA screening. Community jury was convened on the Gold Coast, Queensland (Australia) to consider PSA screening benefits and harms, and whether government campaigns on PSA screening should be conducted. 27 men (volunteers) aged 50-70 with no personal history of prostate cancer and willing to attend jury 6-7 April 2013: 12 were randomly allocated to jury (11 attended). A qualitative analysis was conducted of the jury deliberations (audio-recorded and transcribed) to elicit the jury's views and recommendations. A survey determined the impact of the jury process on participants' individual testing decisions compared with control group. The jury concluded governments should not invest in programmes focused on PSA screening directed at the public because the PSA test did not offer sufficient reassurance or benefit and could raise unnecessary alarm. It recommended an alternative programme to support general practitioners to provide patients with better quality and more consistent information about PSA screening. After the jury, participants were less likely to be tested in the future compared with the controls, but around half said they would still consider doing so. The jury's unanimous verdict about government programmes was notable in the light of their divergent views on whether or not they would be screened themselves in the future. Community juries provide valuable insights into the priorities and concerns of men weighing up the benefits and harms of PSA screening. It will be important to assess the degree to which the findings are generalisable to other settings.

A Community Jury on PSA screening: what do well-informed men want the government to do about prostate cancer screening—a qualitative analysis

PubMed Central

Rychetnik, Lucie; Doust, Jenny; Thomas, Rae; Gardiner, Robert; MacKenzie, Geraldine; Glasziou, Paul

2014-01-01

Objective Cancer screening policies and programmes should take account of public values and concerns. This study sought to determine the priorities, values and concerns of men who were ‘fully informed’ about the benefits and harms of prostate-specific antigen (PSA) screening; and empirically examine the value of a community jury in eliciting public values on PSA screening. Setting Community jury was convened on the Gold Coast, Queensland (Australia) to consider PSA screening benefits and harms, and whether government campaigns on PSA screening should be conducted. Participants 27 men (volunteers) aged 50–70 with no personal history of prostate cancer and willing to attend jury 6–7 April 2013: 12 were randomly allocated to jury (11 attended). Outcome measures A qualitative analysis was conducted of the jury deliberations (audio-recorded and transcribed) to elicit the jury's views and recommendations. A survey determined the impact of the jury process on participants’ individual testing decisions compared with control group. Results The jury concluded governments should not invest in programmes focused on PSA screening directed at the public because the PSA test did not offer sufficient reassurance or benefit and could raise unnecessary alarm. It recommended an alternative programme to support general practitioners to provide patients with better quality and more consistent information about PSA screening. After the jury, participants were less likely to be tested in the future compared with the controls, but around half said they would still consider doing so. Conclusions The jury's unanimous verdict about government programmes was notable in the light of their divergent views on whether or not they would be screened themselves in the future. Community juries provide valuable insights into the priorities and concerns of men weighing up the benefits and harms of PSA screening. It will be important to assess the degree to which the findings are generalisable to other settings. PMID:24785399

Representation of critical natural capital in China.

PubMed

Lü, Yihe; Zhang, Liwei; Zeng, Yuan; Fu, Bojie; Whitham, Charlotte; Liu, Shuguang; Wu, Bingfang

2017-08-01

Traditional means of assessing representativeness of conservation value in protected areas depend on measures of structural biodiversity. The effectiveness of priority conservation areas at representing critical natural capital (CNC) (i.e., an essential and renewable subset of natural capital) remains largely unknown. We analyzed the representativeness of CNC-conservation priority areas in national nature reserves (i.e., nature reserves under jurisdiction of the central government with large spatial distribution across the provinces) in China with a new biophysical-based composite indicator approach. With this approach, we integrated the net primary production of vegetation, topography, soil, and climate variables to map and rank terrestrial ecosystems capacities to generate CNC. National nature reserves accounted for 6.7% of CNC-conservation priority areas across China. Considerable gaps (35.2%) existed between overall (or potential) CNC representativeness nationally and CNC representation in national reserves, and there was significant spatial heterogeneity of representativeness in CNC-conservation priority areas at the regional and provincial levels. For example, the best and worst representations were, respectively, 13.0% and 1.6% regionally and 28.9% and 0.0% provincially. Policy in China is transitioning toward the goal of an ecologically sustainable civilization. We identified CNC-conservation priority areas and conservation gaps and thus contribute to the policy goals of optimization of the national nature reserve network and the demarcation of areas critical to improving the representativeness and conservation of highly functioning areas of natural capital. Moreover, our method for assessing representation of CNC can be easily adapted to other large-scale networks of conservation areas because few data are needed, and our model is relatively simple. © 2017 Society for Conservation Biology.

Global policy and programme guidance on maternal nutrition: what exists, the mechanisms for providing it, and how to improve them?

PubMed

Shrimpton, Roger

2012-07-01

Undernutrition in one form or another affects the majority of women of reproductive age in most developing countries. However, there are few or no effective programmes trying to solve maternal undernutrition problems. The purpose of the paper is to examine global policy and programme guidance mechanisms for nutrition, what their content is with regard to maternal nutrition in particular, as well as how these might be improved. Almost all countries have committed themselves politically to ensuring the right of pregnant and lactating women to good nutrition through the Convention on the Elimination of all Forms of Discrimination Against Women. Despite this, the World Health Organization (WHO) has not endorsed any policy commitments with regard to maternal nutrition. The only policy guidance coming from the various technical departments of WHO relates to the control of maternal anaemia. There is no policy or programme guidance concerning issues of maternal thinness, weight gain during pregnancy and/or low birthweight prevention. Few if any countries have maternal nutrition programmes beyond those for maternal anaemia, and most of those are not effective. The lack of importance given to maternal nutrition is related in part to a weakness of evidence, related to the difficulty of getting ethical clearance, as well as a generalised tendency to downplay the importance of those interventions found to be efficacious. No priority has been given to implementing existing policy and programme guidance for the control of maternal anaemia largely because of a lack of any dedicated funding, linked to a lack of Millennium Development Goals indicator status. This is partly due to the poor evidence base, as well as to the common belief that maternal anaemia programmes were not effective, even if efficacious. The process of providing evidence-based policy and programme guidance to member states is currently being revamped and strengthened by the Department of Nutrition for Health and Development of WHO through the Nutrition Guidance Expert Advisory Group processes. How and if programme guidance, as well as policy commitment for improved maternal nutrition, will be strengthened through the Nutrition Guidance Expert Advisory Group process is as yet unclear. The global movement to increase investment in programmes aimed at maternal and child undernutrition called Scaling Up Nutrition offers an opportunity to build developing country experience with efforts to improve nutrition during pregnancy and lactation. All member states are being encouraged by the World Health Assembly to scale-up efforts to improve maternal infant and young child nutrition. Hopefully Ministries of Health in countries most affected by maternal and child undernutrition will take leadership in the development of such plans, and ensure that the control of anaemia during pregnancy is given a great priority among these actions, as well as building programme experience with improved nutrition during pregnancy and lactation. For this to happen it is essential that donor support is assured, even if only to spearhead a few flagship countries. © 2012 Blackwell Publishing Ltd.

Effective stakeholder participation in setting research priorities using a Global Evidence Mapping approach.

PubMed

Clavisi, Ornella; Bragge, Peter; Tavender, Emma; Turner, Tari; Gruen, Russell L

2013-05-01

We present a multistep process for identifying priority research areas in rehabilitation and long-term care of traumatic brain-injured (TBI) patients. In particular, we aimed to (1) identify which stakeholders should be involved; (2) identify what methods are appropriate; (3) examine different criteria for the generation of research priority areas; and (4) test the feasibility of linkage and exchange among researchers, decision makers, and other potential users of the research. Potential research questions were identified and developed using an initial scoping meeting and preliminary literature search, followed by a facilitated mapping workshop and an online survey. Identified research questions were then prioritized against specific criteria (clinical importance, novelty, and controversy). Existing evidence was then mapped to the high-priority questions using usual processes for search, screening, and selection. A broad range of stakeholders were then brought together at a forum to identify priority research themes for future research investment. Using clinical and research leaders, smaller targeted planning workshops prioritized specific research projects for each of the identified themes. Twenty-six specific questions about TBI rehabilitation were generated, 14 of which were high priority. No one method identified all high-priority questions. Methods that relied solely on the views of clinicians and researchers identified fewer high-priority questions compared with methods that used broader stakeholder engagement. Evidence maps of these high-priority questions yielded a number of evidence gaps. Priority questions and evidence maps were then used to inform a research forum, which identified 12 priority themes for future research. Our research demonstrates the value of a multistep and multimethod process involving many different types of stakeholders for prioritizing research to improve the rehabilitation outcomes of people who have suffered TBI. Enhancing stakeholder representation can be augmented using a combination of methods and a process of linkage and exchange. This process can inform decisions about prioritization of research areas. Copyright © 2013 Elsevier Inc. All rights reserved.

Communicable Diseases Prioritized According to Their Public Health Relevance, Sweden, 2013

PubMed Central

Dahl, Viktor; Tegnell, Anders; Wallensten, Anders

2015-01-01

To establish strategic priorities for the Public Health Agency of Sweden we prioritized pathogens according to their public health relevance in Sweden in order to guide resource allocation. We then compared the outcome to ongoing surveillance. We used a modified prioritization method developed at the Robert Koch Institute in Germany. In a Delphi process experts scored pathogens according to ten variables. We ranked the pathogens according to the total score and divided them into four priority groups. We then compared the priority groups to self-reported time spent on surveillance by epidemiologists and ongoing programmes for surveillance through mandatory and/or voluntary notifications and for surveillance of typing results. 106 pathogens were scored. The result of the prioritization process was similar to the outcome of the prioritization in Germany. Common pathogens such as calicivirus and Influenza virus as well as blood-borne pathogens such as human immunodeficiency virus, hepatitis B and C virus, gastro-intestinal infections such as Campylobacter and Salmonella and vector-borne pathogens such as Borrelia were all in the highest priority group. 63% of time spent by epidemiologists on surveillance was spent on pathogens in the highest priority group and all pathogens in the highest priority group, except for Borrelia and varicella-zoster virus, were under surveillance through notifications. Ten pathogens in the highest priority group (Borrelia, calicivirus, Campylobacter, Echinococcus multilocularis, hepatitis C virus, HIV, respiratory syncytial virus, SARS- and MERS coronavirus, tick-borne encephalitis virus and varicella-zoster virus) did not have any surveillance of typing results. We will evaluate the possibilities of surveillance for the pathogens in the highest priority group where we currently do not have any ongoing surveillance and evaluate the need of surveillance for the pathogens from the low priority group where there is ongoing surveillance in order to focus our work on the pathogens with the highest relevance. PMID:26397699

Hospital accreditation: staff experiences and perceptions.

PubMed

Bogh, Søren Bie; Blom, Ane; Raben, Ditte Caroline; Braithwaite, Jeffrey; Thude, Bettina; Hollnagel, Erik; Plessen, Christian von

2018-06-11

Purpose The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI) specifically. Design/methodology/approach In a newly accredited Danish hospital, the authors conducted semi-structured interviews to capture broad ranging experiences. Medical doctors, nurses, a quality coordinator and a quality department employee participated. Interviews were audio recorded and subjected to framework analysis. Findings Staff reported that The Danish Healthcare Quality Programme affected management priorities: office time and working on documentation, which reduced time with patients and on improvement activities. Organisational structures were improved during preparation for accreditation. Staff perceived that the hospital was better prepared for new QI initiatives after accreditation; staff found disease specific requirements unnecessary. Other areas benefited from accreditation. Interviewees expected that organisational changes, owing to accreditation, would be sustained and that the QI focus would continue. Practical implications Accreditation is a critical and complete hospital review, including areas that often are neglected. Accreditation dominates hospital agendas during preparation and surveyor visits, potentially reducing patient care and other QI initiatives. Improvements are less likely to occur in areas that other QI initiatives addressed. Yet, accreditation creates organisational foundations for future QI initiatives. Originality/value The authors study contributes new insights into how hospital staff at different organisational levels perceive and understand accreditation.

Investments in tuberculosis research - what are the gaps?

PubMed

Khan, Mishal S; Fletcher, Helen; Coker, Richard

2016-08-25

Through decades of research, numerous studies have generated robust evidence about effective interventions for tuberculosis control. Yet, the global annual decline in incidence of approximately 1 % is evidence that current approaches and investment strategies are not sufficient. In this article, we assess recent tuberculosis research funding and discuss two critical gaps in funding and in scientific evidence from topics that have been left off the research priority agenda.We first examine research and development funding goals in the 2011-2015 Global Plan to Stop Tuberculosis and analyze disbursements to different research areas by funders worldwide in 2014. We then summarize, through a compilation of published literature and consultation with 35 researchers across multiple disciplines in the London School of Hygiene and Tropical Medicine TB Centre, priorities identified by the tuberculosis research community. Finally, we compare researchers' priority areas to the global funding agendas and activities.Our analysis shows that, among the five key research areas defined in the 2011-2015 Global Plan - namely drugs, basic science, vaccines, diagnostics and operational research - drug discovery and basic science on Mycobacterium tuberculosis accounted for 60 % of the $2 billion annual funding target. None of the research areas received the recommended level of funding. Operational research, which had the lowest target, received 66 % of its target funding, whereas new diagnostics received only 19 %. Although many of the priority research questions identified by researchers fell within the Global Plan categories, our analysis highlights important areas that are not explicitly mentioned in the current plan. These priority research areas included improved understanding of tuberculosis transmission dynamics, the role of social protection and social determinants, and health systems and policy research.While research priorities are increasingly important in light of the limited funding for tuberculosis, there is a risk that we neglect important research areas and encourage the formation of research silos. To ensure that funding priorities, researchers' agendas and national tuberculosis control policies are better coordinated, there should be more, and wider, dialogue between stakeholders in high tuberculosis burden countries, researchers, international policymakers and funders.

Identifying appropriate protected areas for endangered fern species under climate change.

PubMed

Wang, Chun-Jing; Wan, Ji-Zhong; Zhang, Zhi-Xiang; Zhang, Gang-Min

2016-01-01

The management of protected areas (PAs) is widely used in the conservation of endangered plant species under climate change. However, studies that have identified appropriate PAs for endangered fern species are rare. To address this gap, we must develop a workflow to plan appropriate PAs for endangered fern species that will be further impacted by climate change. Here, we used endangered fern species in China as a case study, and we applied conservation planning software coupled with endangered fern species distribution data and distribution modeling to plan conservation areas with high priority protection needs under climate change. We identified appropriate PAs for endangered fern species under climate change based on the IUCN protected area categories (from Ia to VI) and planned additional PAs for endangered fern species. The high priority regions for protecting the endangered fern species were distributed throughout southern China. With decreasing temperature seasonality, the priority ranking of all endangered fern species is projected to increase in existing PAs. Accordingly, we need to establish conservation areas with low climate vulnerability in existing PAs and expand the conservation areas for endangered fern species in the high priority conservation regions.

Rehabilitation priorities for individuals with Prader-Willi Syndrome.

PubMed

Pituch, Keenan A; Green, Vanessa A; Didden, Robert; Lang, Russell; O'Reilly, Mark F; Lancioni, Giulio E; Whittle, Lisa; Hodis, Flaviu; Sigafoos, Jeff

2010-01-01

To identify rehabilitation priorities that parents have for their children, including their adult-aged children, with Prader-Willi Syndrome (PWS) and to determine the relation between these priorities and the child's levels of adaptive behaviour functioning. Parents involved in organisations related to PWS were invited to complete an online survey. The survey listed 54 skills/behaviours (e.g. toileting, expresses wants and needs and tantrums) representing 10 adaptive functioning domains (e.g. self-care, communication and problem behaviour). Parents rated their child's current level of ability/performance with respect to each skill/behaviour and indicated the extent to which training/treatment was a priority. Fifty-eight surveys were completed during the 4-month data collection period. Parents identified nine high-priority skills/behaviours from five different adaptive functioning domains. For most domains, parent priorities showed a significant linear relation to the children's adaptive behaviour deficits, in that priorities reflected areas where the child had the greatest deficits and the most problematic behaviours. Rehabilitation professionals should focus on the eating issues that arise in PWS and identify the adaptive functioning deficits of these individuals because such deficits are high-priority areas for parents.

Does community-wide chronic kidney disease management improve patient outcomes?

PubMed

Rayner, Hugh C; Baharani, Jyoti; Dasgupta, Indranil; Suresh, Vijayan; Temple, Robert M; Thomas, Mark E; Smith, Steve A

2014-03-01

The number of patients starting renal replacement therapy (RRT) is increasing in England, as it is worldwide. Improvements in the management of chronic kidney disease (CKD) across communities to alter this trend are a public health priority. We have prospectively studied changes in the incidence and modality of treatment for end-stage renal disease following the introduction of a CKD management programme in the West Midlands region of England. Nephrology service to approximately 700 000 adult population of mixed ethnicity in urban and suburban areas, many with social deprivation. The programme was introduced in stages between 2003 and 2006 and comprised primary care education and financial incentives, personal clinical reports written directly to patients following every consultation, routine laboratory estimated glomerular filtration rate (eGFR) reporting, eGFR graph surveillance to identify and monitor patients at risk, multidisciplinary pre-RRT care and conservative care. Prevalent patients: 10 552 with CKD and 8509 without CKD with diabetes. access to nephrology care, trends in RRT incidence and starting modality, place of death without RRT. Incident count was adjusted for changes in the local adult population recorded in national censuses. Ninety-one per cent of patients aged ≥75 years with incident CKD stage 5 were known to a nephrologist. The population-adjusted incident RRT rate peaked in 2005 and then declined; the proportion starting with transplant, peritoneal dialysis or haemodialysis by arterio-venous fistula increased to 63% by 2012 (P = 0.001 versus 2005). Fifty-two per cent of patients receiving planned conservative care without dialysis died out of hospital. Following the introduction of a community-wide systematic CKD management programme, the population-adjusted incidence of RRT reduced, modality of initiation of RRT improved and a majority of patients receiving planned conservative care without dialysis died out of hospital.

Global Foot-and-Mouth Disease Research Update and Gap Analysis: 2 - Epidemiology, Wildlife and Economics.

PubMed

Knight-Jones, T J D; Robinson, L; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

2016-06-01

We assessed knowledge gaps in foot-and-mouth disease (FMD) research, and in this study, we consider (i) epidemiology, (ii) wildlife and (iii) economics. The study took the form of a literature review (2011-2015) combined with research updates collected in 2014 from 33 institutes from across the world. Findings were used to identify priority areas for future FMD research. During 2011-2015, modelling studies were dominant in the broad field of epidemiology; however, continued efforts are required to develop robust models for use during outbreaks in FMD-free countries, linking epidemiologic and economics models. More guidance is needed for both the evaluation and the setting of targets for vaccine coverage, population immunity and vaccine field efficacy. Similarly, methods for seroprevalence studies need to be improved to obtain more meaningful outputs that allow comparison across studies. To inform control programmes in endemic countries, field trials assessing the effectiveness of vaccination in extensive smallholder systems should be performed to determine whether FMD can be controlled with quality vaccines in settings where implementing effective biosecurity is challenging. Studies need to go beyond measuring only vaccine effects and should extend our knowledge of the impact of FMD and increase our understanding of how to maximize farmer participation in disease control. Where wildlife reservoirs of virus exist, particularly African Buffalo, we need to better understand when and under what circumstances transmission to domestic animals occurs in order to manage this risk appropriately, considering the impact of control measures on livelihoods and wildlife. For settings where FMD eradication is unfeasible, further ground testing of commodity-based trade is recommended. A thorough review of global FMD control programmes, covering successes and failures, would be extremely valuable and could be used to guide other control programmes. © 2016 Blackwell Verlag GmbH.

Seven key actions to eradicate rheumatic heart disease in Africa: the Addis Ababa communiqué.

PubMed

Watkins, David; Zuhlke, Liesl; Engel, Mark; Daniels, Rezeen; Francis, Veronica; Shaboodien, Gasnat; Kango, Mabvuto; Abul-Fadl, Azza; Adeoye, Abiodun; Ali, Sulafa; Al-Kebsi, Mohammed; Bode-Thomas, Fidelia; Bukhman, Gene; Damasceno, Albertino; Goshu, Dejuma Yadeta; Elghamrawy, Alaa; Gitura, Bernard; Haileamlak, Abraham; Hailu, Abraha; Hugo-Hamman, Christopher; Justus, Steve; Karthikeyan, Ganesan; Kennedy, Neil; Lwabi, Peter; Mamo, Yoseph; Mntla, Pindile; Sutton, Chris; Mocumbi, Ana Olga; Mondo, Charles; Mtaja, Agnes; Musuku, John; Mucumbitsi, Joseph; Murango, Louis; Nel, George; Ogendo, Stephen; Ogola, Elijah; Ojji, Dike; Olunuga, Taiwo Olabisi; Redi, Mekia Mohammed; Rusingiza, Kamanzi Emmanuel; Sani, Mahmoud; Sheta, Sahar; Shongwe, Steven; van Dam, Joris; Gamra, Habib; Carapetis, Jonathan; Lennon, Diana; Mayosi, Bongani M

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a 'roadmap' of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa. Seven priority areas for action were adopted: (1) create prospective disease registers at sentinel sites in affected countries to measure disease burden and track progress towards the reduction of mortality by 25% by the year 2025, (2) ensure an adequate supply of high-quality benzathine penicillin for the primary and secondary prevention of ARF/RHD, (3) improve access to reproductive health services for women with RHD and other non-communicable diseases (NCD), (4) decentralise technical expertise and technology for diagnosing and managing ARF and RHD (including ultrasound of the heart), (5) establish national and regional centres of excellence for essential cardiac surgery for the treatment of affected patients and training of cardiovascular practitioners of the future, (6) initiate national multi-sectoral RHD programmes within NCD control programmes of affected countries, and (7) foster international partnerships with multinational organisations for resource mobilisation, monitoring and evaluation of the programme to end RHD in Africa. This Addis Ababa communiqué has since been endorsed by African Union heads of state, and plans are underway to implement the roadmap in order to end ARF and RHD in Africa in our lifetime.

Probabilistic Priority Message Checking Modeling Based on Controller Area Networks

NASA Astrophysics Data System (ADS)

Lin, Cheng-Min

Although the probabilistic model checking tool called PRISM has been applied in many communication systems, such as wireless local area network, Bluetooth, and ZigBee, the technique is not used in a controller area network (CAN). In this paper, we use PRISM to model the mechanism of priority messages for CAN because the mechanism has allowed CAN to become the leader in serial communication for automobile and industry control. Through modeling CAN, it is easy to analyze the characteristic of CAN for further improving the security and efficiency of automobiles. The Markov chain model helps us to model the behaviour of priority messages.

Studying the nutritional beliefs and food practices of Malagasy school children parents. A contribution to the understanding of malnutrition in Madagascar.

PubMed

Ramaroson Rakotosamimanana, Vonimihaingo; Arvisenet, Gaëlle; Valentin, Dominique

2014-10-01

Madagascar is severely affected by the problem of children malnutrition. The present study aimed at exploring school children Malagasy parents' food practices and beliefs structures about the nutritional value of foods, to better understand the causes of this malnutrition. A combination of Focus Groups (72 participants), and questionnaires (1000 interviewees) was used to evaluate the food beliefs and the nutritional habits of low income parents of school age children in urban and rural areas of Antananarivo and Antsiranana. The respondents' beliefs were shown to focus not only on the nutrient and energetic composition of food, but also to involve more general relations between food and health and particularly the sanitary properties of food. Compared with such sanitary properties, nutrient content was not considered to be the priority in food choice and food preparation. The food category considered to be the most nutritive was cereals, ahead of protein foods, or vegetables and fruit. Nutritional beliefs were not the same in the Antananarivo and Antsiranana areas, nor between urban and rural areas of Antsiranana. Different socio-economic contexts, food availability and information may explain these differences. This study could guide actors involved in nutrition promotion to adapt to specific areas their nutrition programmes in the fight against malnutrition. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Cancer, Educate to Prevent Model-the Potential of School Environment for Primary Prevention of Cancer.

PubMed

Barros, A; Santos, H; Moreira, L; Ribeiro, N; Silva, L; Santos-Silva, F

2016-12-01

Cancer represents one of the main causes of death worldwide; consequently, preventive interventions are of utmost importance in public health education. The leading model of cancer prevention campaigns is based on general and undifferentiated actions mediated by health professionals, focusing on the technical and scientific information but rather ineffective in changing the symbolic, cognitive and practical relationship with the disease. New intervention models are thus required to address cancer literacy, being early interventions targeted to specific groups an elective counterpoint to contribute to positive and durable changes in cancer prevention. Our aim is to evaluate the feasibility and impact of cancer prevention programmes planned as focused interventions in restricted targets and mediated by non-healthcare professionals to increase cancer literacy and promote preventive behaviours. This pilot study evaluates schools' potential as a vehicle for cancer prevention education in a reality shaped by traditional health prevention campaigns. We developed a protocol of systematic surveying in order to review and, in the future, optimize and replicate this ecological model of intervention to other groups and contexts. The implementation of this model has been successful in which concerns to the effectiveness of the training programme for teachers. This led to the development of impactful cancer prevention education projects by trainees targeted to their students, allowing us to argue that it contributes to knowledge and practice in this complex as consensual priority area of intervention.

EDITORIAL: Ultrafast magnetization processes

NASA Astrophysics Data System (ADS)

Hillebrands, Burkard

2008-09-01

This Cluster Issue of Journal of Physics D: Applied Physics is devoted to ultrafast magnetization processes. It reports on the scientific yield of the Priority Programme 1133 'Ultrafast Magnetization Processes' which was funded by the Deutsche Forschungsgemeinschaft in the period 2002-2008 in three successive two-year funding periods, supporting research of 17-18 groups in Germany. Now, at the end of this Priority Programme, the members feel that the achievements made in the course of the programme merit communication to the international scientific community in a concerted way. Therefore, each of the projects of the last funding period presents a key result in a published contribution to this Cluster Issue. The purpose of the funding by a Priority Programme is to advance knowledge in an emerging field of research through collaborative networked support over several locations. Priority Programmes are characterized by their enhanced quality of research through the use of new methods and forms of collaboration in emerging fields, by added value through interdisciplinary cooperation, and by networking. The aim of the Priority Programme 1133 'Ultrafast Magnetization Processes' may be well characterized by the call for projects in June 2001 after the programme was approved by the Deutsche Forschungsgemeinschaft: 'The aim of the priority programme is the achievement of a basic understanding of the temporal evolution of fast magnetization processes in magnetically ordered films, multilayers and micro-structured systems. The challenge lies in the advancement of the field of ultrafast magnetization processes into the regime of a few femtoseconds to nanoseconds, a topic not yet well explored. A general aim is to understand the fundamental mechanisms needed for applications in ultrafast magneto-electronic devices. The fundamental topic to be addressed is the response of the magnetization of small structures upon the application of pulsed magnetic fields, laser pulses or injected spin-polarized electron pulses on short time scales, ranging from a small disturbance of the system up to the reversal of the magnetization direction.' Now, seven years later, the subject of ultrafast magnetization processes has grown into a mainstream research direction in modern magnetism. The major international conferences on magnetism, such as the Annual Conference on Magnetism and Magnetic Materials (MMM), the INTERMAG, the International Conference of Magnetism, as well as many regional conferences, schedule dedicated sessions to ultrafast magnetization processes, very often several of them. The large share in research in this field from German scientists has been made possible by this Priority Programme. Since its beginning, new developments have been picked up by the Priority Programme 1133 and addressed by projects. Spin torque phenomena in spin dynamics, although foreseen at the time of establishing the Priority Programme, have been taken up. The field of dissipation has been addressed and extended by several groups, with contributions both from theoretical and experimental groups. A first set of contributions addresses ultrafast dynamics and materials. T Roth et al [article 164001] in this issue] study the dynamics of coercivity in ultrafast pump-probe experiments on the femtosecond time scale. They show that an all optical pump-probe technique is, in general, not suitable for gaining access to the time-dependent behaviour of the coercivity, since the switching in a fixed external field is an irreversible process. They comment on the possible mechanisms leading to the observed reduction of the coercivity with increasing pump power and propose a potential solution to clarify the origin of such a behaviour. B Heitkamp et al [164002] discuss the femtosecond spin dynamics of ferromagnetic CoPt thin films and nanodots, which they probe using spin-polarized photoemission electron microscopy. They show by photoelectron spin analysis, that enhanced optical near fields can be used to induce a local demagnetization of the sample following femtosecond laser excitation. A B Schmidt et al [164003] report a new access to the surface electronic structure of fcc Co films combining spin-resolved one- and two-photon photoemission. The knowledge of surface states is important for interpreting time-resolved measurements of ultrafast magnetization dynamics in this material. An extension of ultrafast dynamics has been made by several groups. A Melnikov et al [164004] report on the ultrafast dynamics at lanthanide surfaces such as Gd(0001) and Tb(0001) using time-resolved second-harmonic generation and photoelectron spectroscopy. These surfaces exhibit a rich dynamics including a collective response of the crystal lattice and the magnetization. Effects of phonon-magnon scattering are discussed. M Fiebig et al [164005] report on experiments of ultrafast magnetization dynamics in antiferromagnetic compounds, and show that the magnetization dynamics in these systems differs noticeably from that of ferromagnetic compounds. They use optical second-harmonic generation and linear reflection to monitor the evolution of the antiferromagnetic order parameter subsequent to an intense optical excitation. In a theory paper, the local light-induced spin manipulation in two-magnetic-centre metallic chains is studied by T Hardenstein et al [164006] using highly correlational ab initio calculations. They show that, as an example of local spin manipulation, the spin on the iron side of a Co-Na-Fe cluster can be switched. S Halm et al [164007] present evidence to manipulate spin states in a diluted magnetic semiconductor on a submicrometer length scale via the magnetic fringe fields of micro-structured magnets. By optically switching the magnetization of the ferromagnet, the magnetization in the semiconductor is manipulated and the limits of a dynamical interaction between the spin states in the ferromagnet and the magnetic semiconductor are discussed. A second set of contributions addresses the field of spin waves and dynamic spin torque phenomena. C W Sandweg et al [164008] discuss the modification of the thermal spin wave spectrum by a domain wall in a narrow stripe and report the observation of a localized mode near the domain wall using the new technique of Brillouin light scattering microscopy. Time-resolved measurements are often made using a stroboscopic approach, thus missing non-periodic responses. P Möhrke et al [164009] report single-shot Kerr magnetometer measurements to observe the real time-domain wall motion in permalloy nanowires. The dynamics in magnetic disks is studied by I Neudecker et al [164010] using in-plane magnetic microwave fields for excitation. The effect of current-induced magnetization dynamics in single and double layer magnetic nanopillars is reported by N Müsgens et al [164011]. A spin-polarized charge current can modify the damping properties of spin waves in magnetic nanostructures. This is reported by V E Demidov et al [164012] using space-resolved Brillouin light scattering. They also present results regarding nonlinear spin-wave propagation and mode coupling in magnetic stripes and squares. D V Berkov and N L Gorn [164013] report on their results of nonlinear magnetization dynamics in nanodevices induced by a spin-polarized current using micromagnetic simulation. A third set of contributions focuses on dissipation phenomena ranging from a phenomenological description to the investigation of the microscopic origin(s). In a theory paper, M Fähnle et al [164014] revisit the Gilbert equation and discuss anisotropic and non-local damping of the magnetization dynamics. They derive their results by a combination of the breathing Fermi surface model with a variant of the ab initio density functional electron theory given by the magnetic force theorem. On the experimental side, S Serrano-Guisan et al [164015] address Gilbert damping in Ni81Fe19 thin films and microstructures using anisotropic magnetoresistance and pulsed inductive microwave magnetometry to measure the time-resolved precessional magnetization dynamics. The intrinsic and non-local Gilbert damping in polycrystalline Ni films is also addressed by J Walowski et al [164016] using femtosecond laser pulses. Several spin-wave modes are observed and their dissipation is studied. Non-local damping by spin currents emitted into a non-magnetic metallic layer of either vanadium, palladium or dysprosium is studied. Dissipation in small magnetic Ni81Fe19 rings is studied using Brillouin light scattering microscopy by H Schultheiss et al [164017]. They investigate the spatial profiles and the decay constants of spin-wave quasi-eigenmodes. We hope that this cluster of papers will help to stimulate and advance a better understanding of this very interesting field of ultrafast magnetization processes.

Global Priorities for Marine Biodiversity Conservation

PubMed Central

Selig, Elizabeth R.; Turner, Will R.; Troëng, Sebastian; Wallace, Bryan P.; Halpern, Benjamin S.; Kaschner, Kristin; Lascelles, Ben G.; Carpenter, Kent E.; Mittermeier, Russell A.

2014-01-01

In recent decades, many marine populations have experienced major declines in abundance, but we still know little about where management interventions may help protect the highest levels of marine biodiversity. We used modeled spatial distribution data for nearly 12,500 species to quantify global patterns of species richness and two measures of endemism. By combining these data with spatial information on cumulative human impacts, we identified priority areas where marine biodiversity is most and least impacted by human activities, both within Exclusive Economic Zones (EEZs) and Areas Beyond National Jurisdiction (ABNJ). Our analyses highlighted places that are both accepted priorities for marine conservation like the Coral Triangle, as well as less well-known locations in the southwest Indian Ocean, western Pacific Ocean, Arctic and Antarctic Oceans, and within semi-enclosed seas like the Mediterranean and Baltic Seas. Within highly impacted priority areas, climate and fishing were the biggest stressors. Although new priorities may arise as we continue to improve marine species range datasets, results from this work are an essential first step in guiding limited resources to regions where investment could best sustain marine biodiversity. PMID:24416151

Global priorities for marine biodiversity conservation.

PubMed

Selig, Elizabeth R; Turner, Will R; Troëng, Sebastian; Wallace, Bryan P; Halpern, Benjamin S; Kaschner, Kristin; Lascelles, Ben G; Carpenter, Kent E; Mittermeier, Russell A

2014-01-01

In recent decades, many marine populations have experienced major declines in abundance, but we still know little about where management interventions may help protect the highest levels of marine biodiversity. We used modeled spatial distribution data for nearly 12,500 species to quantify global patterns of species richness and two measures of endemism. By combining these data with spatial information on cumulative human impacts, we identified priority areas where marine biodiversity is most and least impacted by human activities, both within Exclusive Economic Zones (EEZs) and Areas Beyond National Jurisdiction (ABNJ). Our analyses highlighted places that are both accepted priorities for marine conservation like the Coral Triangle, as well as less well-known locations in the southwest Indian Ocean, western Pacific Ocean, Arctic and Antarctic Oceans, and within semi-enclosed seas like the Mediterranean and Baltic Seas. Within highly impacted priority areas, climate and fishing were the biggest stressors. Although new priorities may arise as we continue to improve marine species range datasets, results from this work are an essential first step in guiding limited resources to regions where investment could best sustain marine biodiversity.

42 CFR 57.2205 - Priority for selection of scholarship recipients.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Priority for selection of scholarship recipients... GRANTS GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Physician Shortage Area Scholarship Grants § 57.2205 Priority for selection of scholarship...

42 CFR 57.2205 - Priority for selection of scholarship recipients.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Priority for selection of scholarship recipients... GRANTS GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Physician Shortage Area Scholarship Grants § 57.2205 Priority for selection of scholarship...

42 CFR 57.2205 - Priority for selection of scholarship recipients.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Priority for selection of scholarship recipients... GRANTS GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Physician Shortage Area Scholarship Grants § 57.2205 Priority for selection of scholarship...

42 CFR 57.2205 - Priority for selection of scholarship recipients.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Priority for selection of scholarship recipients... GRANTS GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Physician Shortage Area Scholarship Grants § 57.2205 Priority for selection of scholarship...

42 CFR 57.2205 - Priority for selection of scholarship recipients.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Priority for selection of scholarship recipients... GRANTS GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Physician Shortage Area Scholarship Grants § 57.2205 Priority for selection of scholarship...

78 FR 66344 - Applications for New Awards; Rehabilitation Training: Rehabilitation Long-Term Training Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

...-Term Training Program--Vocational Rehabilitation Counseling AGENCY: Office of Special Education and...: Rehabilitation Long- Term Training Program--Vocational Rehabilitation Counseling Notice inviting applications for... in the priority area of rehabilitation counseling. Absolute Priority 2: This priority is from the...

Monitoring Natural World Heritage Sites: optimization of the monitoring system in Bogda with GIS-based multi-criteria decision analysis.

PubMed

Wang, Zhaoguo; Du, Xishihui

2016-07-01

Natural World Heritage Sites (NWHSs) are invaluable treasure due to the uniqueness of each site. Proper monitoring and management can guarantee their protection from multiple threats. In this study, geographic information system (GIS)-based multi-criteria decision analysis (GIS-MCDA) was used to assess criteria layers acquired from the data available in the literature. A conceptual model for determining the priority area for monitoring in Bogda, China, was created based on outstanding universal values (OUV) and expert knowledge. Weights were assigned to each layer using the analytic hierarchy process (AHP) based on group decisions, encompassing three experts: one being a heritage site expert, another a forest ranger, and the other a heritage site manager. Subsequently, evaluation layers and constraint layers were used to generate a priority map and to determine the feasibility of monitoring in Bogda. Finally, a monitoring suitability map of Bogda was obtained by referencing priority and feasibility maps.The high-priority monitoring area is located in the montane forest belt, which exhibits high biodiversity and is the main tourist area of Bogda. The northern buffer zone of Bogda comprises the concentrated feasible monitoring areas, and the area closest to roads and monitoring facilities is highly feasible for NWHS monitoring. The suitability of an area in terms of monitoring is largely determined by the monitoring priority in that particular area. The majority of planned monitoring facilities are well distributed in both suitable and less suitable areas. Analysis results indicate that the protection of Bogda will be more scientifically based due to its effective and all-around planned monitoring system proposed by the declaration text of Xinjiang Tianshan, which is the essential file submitted to World Heritage Centre to inscribe as a NWHS.

Community mobilization for malaria elimination: application of an open space methodology in Ruhuha sector, Rwanda

PubMed Central

2014-01-01

Background Despite the significant reduction of malaria transmission in Rwanda, Ruhuha sector is still a highly endemic area for malaria. The objective of this activity was to explore and brainstorm the potential roles of various community stakeholders in malaria elimination. Methods Horizontal participatory approaches such as ‘open space’ have been deployed to explore local priorities, stimulate community contribution to project planning, and to promote local capacity to manage programmes. Two open space meetings were conducted with 62 and 82 participants in years 1 and 2, respectively. Participants included purposively selected community and local organizations’ representatives. Results Malaria was perceived as a health concern by the respondents despite the reported reduction in prevalence from 60 to 20% for cases at the local health centre. Some misconceptions of the cause of malaria and misuse of preventive strategies were noted. Poverty was deemed to be a contributing factor to malaria transmission, with suggestions that improvement of living conditions for poor families might help malaria reduction. Participants expressed willingness to contribute to malaria elimination and underscored the need for constant education, sensitization and mobilization towards malaria control in general. Active diagnosis, preventative strategies and prompt treatment of malaria cases were all mentioned by participants as ways to reduce malaria. Participants suggested that partnership of stakeholders at various levels could speed up programme activities. A community rewards system was deemed important to motivate engaged participants, i.e., community health workers and households. Establishment of malaria clubs in schools settings was also suggested as crucial to speed up community awareness and increase skills towards further malaria reduction. Conclusions This bottom-up approach was found useful in engaging the local community, enabling them to explore issues related to malaria in the area and suggest solutions for sustainable malaria elimination gains. PMID:24886145

malERA: An updated research agenda for characterising the reservoir and measuring transmission in malaria elimination and eradication

PubMed Central

2017-01-01

This paper summarises key advances in defining the infectious reservoir for malaria and the measurement of transmission for research and programmatic use since the Malaria Eradication Research Agenda (malERA) publication in 2011. Rapid and effective progress towards elimination requires an improved understanding of the sources of transmission as well as those at risk of infection. Characterising the transmission reservoir in different settings will enable the most appropriate choice, delivery, and evaluation of interventions. Since 2011, progress has been made in a number of areas. The extent of submicroscopic and asymptomatic infections is better understood, as are the biological parameters governing transmission of sexual stage parasites. Limitations of existing transmission measures have been documented, and proof-of-concept has been established for new innovative serological and molecular methods to better characterise transmission. Finally, there now exists a concerted effort towards the use of ensemble datasets across the spectrum of metrics, from passive and active sources, to develop more accurate risk maps of transmission. These can be used to better target interventions and effectively monitor progress toward elimination. The success of interventions depends not only on the level of endemicity but also on how rapidly or recently an area has undergone changes in transmission. Improved understanding of the biology of mosquito–human and human–mosquito transmission is needed particularly in low-endemic settings, where heterogeneity of infection is pronounced and local vector ecology is variable. New and improved measures of transmission need to be operationally feasible for the malaria programmes. Outputs from these research priorities should allow the development of a set of approaches (applicable to both research and control programmes) that address the unique challenges of measuring and monitoring transmission in near-elimination settings and defining the absence of transmission. PMID:29190279

Indirect effects of bioinsecticides on the nontarget fauna: The Camargue experiment calls for future research

NASA Astrophysics Data System (ADS)

Poulin, Brigitte

2012-10-01

Following its high selectivity and low toxicity to nontarget organisms, Bacillus thuringiensis var. israelensis (Bti) has become the most commonly used microbial agent to control mosquitoes worldwide. Considered non-toxic to mammals, birds, fish, plants and most aquatic organisms, Bti direct effects on the nontarget fauna are largely limited to non-biting midges (Chironomidae). Studies addressing the indirect effects of Bti through food web perturbations are scanty and showed no significant results. Mosquito-control in southern France was implemented in 1965 using various insecticides over 400 km of coast. In spite of a high mosquito nuisance, the Camargue wetlands were excluded from this control programme to preserve biodiversity. The expanding use of Bti has prompted the implementation of an experimental mosquito control in 2006 involving 2500 of the 25,000 ha of larval biotopes of the Camargue, accompanied by impact studies on the nontarget fauna. Using birds from natural and human-inhabited areas as model species, we assessed trophic perturbations caused by three years of Bti applications. The preliminary results of this 5-yr programme revealed significant effects of Bti spraying on abundance of reed-dwelling invertebrates serving as food to passerines, as well as on the diet and breeding success of house martins nesting in rural estates and small towns. Very few studies (if any) have provided such compelling evidence of an insecticide affecting vertebrate populations, putting into question the environmental-friendly character of Bti, at least in some areas. The significance of these results are discussed within a wider context and completed with an analysis of the current Bti bibliography to highlight and orient priorities for future research on this topic.

Occurrence and removal of pharmaceuticals in wastewater treatment plants at the Spanish Mediterranean area of Valencia.

PubMed

Gracia-Lor, Emma; Sancho, Juan V; Serrano, Roque; Hernández, Félix

2012-04-01

A survey on the presence of pharmaceuticals in urban wastewater of a Spanish Mediterranean area (Castellon province) was carried out. The scope of the study included a wide variety of pharmaceuticals belonging to different therapeutical classes. For this purpose, 112 samples, including influent and effluent wastewater, from different conventional wastewater treatment plants were collected. Two monitoring programmes were carried out along several seasons. The first was in June 2008 and January 2009, and the second in April and October 2009. During the first monitoring, the occurrence of 20 analytes in 84 urban wastewater samples (influent and effluent) was studied. The selection of these pharmaceuticals was mainly based on consumption. From these, 17 compounds were detected in the samples, with analgesics and anti-inflammatories, cholesterol lowering statin drugs and lipid regulators being the most frequently detected groups. 4-Aminoantipyrine, bezafibrate, diclofenac, gemfibrozil, ketoprofen, naproxen and venlafaxine were the compounds most frequently found. In the highlight of these results, the number of analytes was increased up to around 50. A lot of antibiotic compounds were added to the target list as they were considered "priority pharmaceuticals" due to their more potential hazardous effects in the aquatic environment. Data obtained during the second monitoring programme (spring and autumn) corroborated the results from the first one (summer and winter). Analgesics and anti-inflammatories, lipid regulators together with quinolone and macrolide antibiotics were the most abundant pharmaceuticals. Similar median concentrations were found over the year and seasonal variation was not clearly observed. The removal efficiency of pharmaceuticals in the wastewater treatment plants was roughly evaluated. Our results indicated that elimination of most of the selected compounds occurred during the treatment process of influent wastewater, although it was incomplete. Copyright © 2011 Elsevier Ltd. All rights reserved.

Genetic educational needs and the role of genetics in primary care: a focus group study with multiple perspectives

PubMed Central

2011-01-01

Background Available evidence suggests that improvements in genetics education are needed to prepare primary care providers for the impact of ongoing rapid advances in genomics. Postgraduate (physician training) and master (midwifery training) programmes in primary care and public health are failing to meet these perceived educational needs. The aim of this study was to explore the role of genetics in primary care (i.e. family medicine and midwifery care) and the need for education in this area as perceived by primary care providers, patient advocacy groups and clinical genetics professionals. Methods Forty-four participants took part in three types of focus groups: mono-disciplinary groups of general practitioners and midwives, respectively and multidisciplinary groups composed of a diverse set of experts. The focus group sessions were audio-taped, transcribed verbatim and analysed using content analysis. Recurrent themes were identified. Results Four themes emerged regarding the educational needs and the role of genetics in primary care: (1) genetics knowledge, (2) family history, (3) ethical dilemmas and psychosocial effects in relation to genetics and (4) insight into the organisation and role of clinical genetics services. These themes reflect a shift in the role of genetics in primary care with implications for education. Although all focus group participants acknowledged the importance of genetics education, general practitioners felt this need more urgently than midwives and more strongly emphasized their perceived knowledge deficiencies. Conclusion The responsibilities of primary care providers with regard to genetics require further study. The results of this study will help to develop effective genetics education strategies to improve primary care providers' competencies in this area. More research into the educational priorities in genetics is needed to design courses that are suitable for postgraduate and master programmes for general practitioners and midwives. PMID:21329524

Communication strategy for implementing community IMCI.

PubMed

Ford, Neil; Williams, Abimbola; Renshaw, Melanie; Nkum, John

2005-01-01

In resource-poor developing countries, significant improvements in child survival, growth, and development can be made by: (a) shifting from sectoral programmes (for example, in nutrition or immunization) to holistic strategies such as the Integrated Management of Childhood Illnesses (IMCI) and (b) improving household and community care and health-seeking practices as a priority, while concurrently strengthening health systems and the skills of health professionals. This article focuses on household and community learning, and proposes a communication strategy for implementing community IMCI (c-IMCI) that is based on human rights principles such as inclusion, participation, and self-determination. Rather than attempt to change the care practices and health-seeking behaviour of individuals through the design and delivery of messages alone, it proposes an approach that is based on community engagement and discussion to create the social conditions in which individual change is possible. The strategy advocates for the integration of sectoral programmes rather than the development of new holistic programmes, so that integrated programmes are created from "multiple entry points". As integration occurs, the participatory communication processes that are used in sectoral programmes can be enriched and combined, improving the capacity of governments and agencies to engage community members effectively in a process of learning and action related to child health and development.

International identification of research priorities for postgraduate theses in musculoskeletal physiotherapy using a modified Delphi technique.

PubMed

Rushton, Alison; Moore, Ann

2010-04-01

Research priorities are established to identify gaps and maximise opportunities in developing an evidence base. Numerous postgraduate research theses are undertaken each year within the specialist area of musculoskeletal physiotherapy, and although some are published, greater potential for influence exists. This paper identifies international research priorities for postgraduate theses developed using a consensual Delphi process. A purposive sample included course tutors and expert clinicians nominated by Member Organisations of the International Federation of Orthopaedic Manipulative Physical Therapists (N=91). Round 1 requested >10 priorities for theses, and content analysis identified research themes. Round 2 requested participants rank the importance of each theme on a 1-5 scale, and round 3 requested ranking the importance and feasibility of the research question areas within each agreed theme. Descriptive analysis and use of Kendall's coefficient of concordance enabled interpretation of consensus. The response rate of 68% was good, identifying 23 research themes in round 1. Round 2 identified 14 research themes as important. Participant rating of the importance and feasibility of research question areas in round 3 supported 43 agreed priorities demonstrating good measurement validity. Establishing priorities provides a vision of how postgraduate theses can contribute to the developing evidence base and offer a focus for international collaboration. Copyright 2009 Elsevier Ltd. All rights reserved.

Hr Quality Improvement Strategy of Education in Indonesia-Based Systems and Broad Based Education High Based Education: Perspective of 21st Century Challenges

ERIC Educational Resources Information Center

Subandi

2017-01-01

Although the educational programme had been on going process since 68 years ago in Indonesia, but this state did not has provided qualified human resources. Since 32 years ago of the New Order Government authority, educational sector development has never been placed as a prime priority of development. The effect of Indonesian educational quality…

Volunteered Geographic Information: Interpretation, Visualisation and Social Computing (VGIscience)

NASA Astrophysics Data System (ADS)

Burghardt, Dirk; Nejdl, Wolfgang; Schiewe, Jochen; Sester, Monika

2018-05-01

In the past years Volunteered Geographic Information (VGI) has emerged as a novel form of user-generated content, which involves active generation of geo-data for example in citizen science projects or during crisis mapping as well as the passive collection of data via the user's location-enabled mobile devices. In addition there are more and more sensors available that detect our environment with ever greater detail and dynamics. These data can be used for a variety of applications, not only for the solution of societal tasks such as in environment, health or transport fields, but also for the development of commercial products and services. The interpretation, visualisation and usage of such multi-source data is challenging because of the large heterogeneity, the differences in quality, the high update frequencies, the varying spatial-temporal resolution, subjective characteristics and low semantic structuring. Therefore the German Research Foundation has launched a priority programme for the next 3-6 years which will support interdisciplinary research projects. This priority programme aims to provide a scientific basis for raising the potential of VGI- and sensor data. Research questions described more in detail in this short paper span from the extraction of spatial information, to the visual analysis and knowledge presentation, taking into account the social context while collecting and using VGI.

Zika virus infection-the next wave after dengue?

PubMed

Wong, Samson Sai-Yin; Poon, Rosana Wing-Shan; Wong, Sally Cheuk-Ying

2016-04-01

Zika virus was initially discovered in east Africa about 70 years ago and remained a neglected arboviral disease in Africa and Southeast Asia. The virus first came into the limelight in 2007 when it caused an outbreak in Micronesia. In the ensuing decade, it spread widely in other Pacific islands, after which its incursion into Brazil in 2015 led to a widespread epidemic in Latin America. In most infected patients the disease is relatively benign. Serious complications include Guillain-Barré syndrome and congenital infection which may lead to microcephaly and maculopathy. Aedes mosquitoes are the main vectors, in particular, Ae. aegypti. Ae. albopictus is another potential vector. Since the competent mosquito vectors are highly prevalent in most tropical and subtropical countries, introduction of the virus to these areas could readily result in endemic transmission of the disease. The priorities of control include reinforcing education of travellers to and residents of endemic areas, preventing further local transmission by vectors, and an integrated vector management programme. The container habitats of Ae. aegypti and Ae. albopictus means engagement of the community and citizens is of utmost importance to the success of vector control. Copyright © 2016. Published by Elsevier B.V.

Research Priorities in Networking and Communications.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC.

A workshop focused on major research issues in networking and communications. This report defines the context for research priorities and initiatives and deals with issues in networking and communications. Fifteen major research priorities and four research specific initiatives were identified by participants as areas that should be pursued over…

76 FR 17396 - Proposed Priorities: Disability and Rehabilitation Research Projects and Centers Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

...-science conference on its designated priority research area in the fourth year of the project period, and... Rehabilitation Research Projects and Centers Program AGENCY: Office of Special Education and Rehabilitative... and Rehabilitative Services proposes two priorities for the Disability and Rehabilitation Research...

Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

PubMed

2013-06-11

The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

Diversity and distribution of aquatic insects in Southern Brazil wetlands: implications for biodiversity conservation in a Neotropical region.

PubMed

Maltchik, Leonardo; Dalzochio, Marina Schmidt; Stenert, Cristina; Rolon, Ana Silvia

2012-03-01

The selection of priority areas is an enormous challenge for biodiversity conservation. Some biogeographic methods have been used to identify the priority areas to conservation, and panbiogeography is one of them. This study aimed at the utilization of panbiogeographic tools, to identify the distribution patterns of aquatic insect genera, in wetland systems of an extensive area in the Neotropical region (approximately 280 000km2), and to compare the distribution of the biogeographic units identified by the aquatic insects, with the conservation units of Southern Brazil. We analyzed the distribution pattern of 82 genera distributed in four orders of aquatic insects (Diptera, Odonata, Ephemeroptera and Trichoptera) in Southern Brazil wetlands. Therefore, 32 biogeographic nodes corresponded to the priority areas for conservation of the aquatic insect diversity. Among this total, 13 were located in the Atlantic Rainforest, 16 in the Pampa and three amongst both biomes. The distribution of nodes showed that only 15% of the dispersion centers of insects were inserted in conservation units. The four priority areas pointed by node cluster criterion must be considered in further inclusions of areas for biodiversity conservation in Southern Brazil wetlands, since such areas present species from different ancestral biota. The inclusion of such areas into the conservation units would be a strong way to conserve the aquatic biodiversity in this region.

Optimized spatial priorities for biodiversity conservation in China: a systematic conservation planning perspective.

PubMed

Wu, Ruidong; Long, Yongcheng; Malanson, George P; Garber, Paul A; Zhang, Shuang; Li, Diqiang; Zhao, Peng; Wang, Longzhu; Duo, Hairui

2014-01-01

By addressing several key features overlooked in previous studies, i.e. human disturbance, integration of ecosystem- and species-level conservation features, and principles of complementarity and representativeness, we present the first national-scale systematic conservation planning for China to determine the optimized spatial priorities for biodiversity conservation. We compiled a spatial database on the distributions of ecosystem- and species-level conservation features, and modeled a human disturbance index (HDI) by aggregating information using several socioeconomic proxies. We ran Marxan with two scenarios (HDI-ignored and HDI-considered) to investigate the effects of human disturbance, and explored the geographic patterns of the optimized spatial conservation priorities. Compared to when HDI was ignored, the HDI-considered scenario resulted in (1) a marked reduction (∼9%) in the total HDI score and a slight increase (∼7%) in the total area of the portfolio of priority units, (2) a significant increase (∼43%) in the total irreplaceable area and (3) more irreplaceable units being identified in almost all environmental zones and highly-disturbed provinces. Thus the inclusion of human disturbance is essential for cost-effective priority-setting. Attention should be targeted to the areas that are characterized as moderately-disturbed, <2,000 m in altitude, and/or intermediately- to extremely-rugged in terrain to identify potentially important regions for implementing cost-effective conservation. We delineated 23 primary large-scale priority areas that are significant for conserving China's biodiversity, but those isolated priority units in disturbed regions are in more urgent need of conservation actions so as to prevent immediate and severe biodiversity loss. This study presents a spatially optimized national-scale portfolio of conservation priorities--effectively representing the overall biodiversity of China while minimizing conflicts with economic development. Our results offer critical insights for current conservation and strategic land-use planning in China. The approach is transferable and easy to implement by end-users, and applicable for national- and local-scale systematic conservation prioritization practices.

Optimized Spatial Priorities for Biodiversity Conservation in China: A Systematic Conservation Planning Perspective

PubMed Central

Wu, Ruidong; Long, Yongcheng; Malanson, George P.; Garber, Paul A.; Zhang, Shuang; Li, Diqiang; Zhao, Peng; Wang, Longzhu; Duo, Hairui

2014-01-01

By addressing several key features overlooked in previous studies, i.e. human disturbance, integration of ecosystem- and species-level conservation features, and principles of complementarity and representativeness, we present the first national-scale systematic conservation planning for China to determine the optimized spatial priorities for biodiversity conservation. We compiled a spatial database on the distributions of ecosystem- and species-level conservation features, and modeled a human disturbance index (HDI) by aggregating information using several socioeconomic proxies. We ran Marxan with two scenarios (HDI-ignored and HDI-considered) to investigate the effects of human disturbance, and explored the geographic patterns of the optimized spatial conservation priorities. Compared to when HDI was ignored, the HDI-considered scenario resulted in (1) a marked reduction (∼9%) in the total HDI score and a slight increase (∼7%) in the total area of the portfolio of priority units, (2) a significant increase (∼43%) in the total irreplaceable area and (3) more irreplaceable units being identified in almost all environmental zones and highly-disturbed provinces. Thus the inclusion of human disturbance is essential for cost-effective priority-setting. Attention should be targeted to the areas that are characterized as moderately-disturbed, <2,000 m in altitude, and/or intermediately- to extremely-rugged in terrain to identify potentially important regions for implementing cost-effective conservation. We delineated 23 primary large-scale priority areas that are significant for conserving China's biodiversity, but those isolated priority units in disturbed regions are in more urgent need of conservation actions so as to prevent immediate and severe biodiversity loss. This study presents a spatially optimized national-scale portfolio of conservation priorities – effectively representing the overall biodiversity of China while minimizing conflicts with economic development. Our results offer critical insights for current conservation and strategic land-use planning in China. The approach is transferable and easy to implement by end-users, and applicable for national- and local-scale systematic conservation prioritization practices. PMID:25072933

Regional scale prioritisation for key ecosystem services, renewable energy production and urban development.

PubMed

Casalegno, Stefano; Bennie, Jonathan J; Inger, Richard; Gaston, Kevin J

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services.

Regional Scale Prioritisation for Key Ecosystem Services, Renewable Energy Production and Urban Development

PubMed Central

Casalegno, Stefano; Bennie, Jonathan J.; Inger, Richard; Gaston, Kevin J.

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services. PMID:25250775

Managing a monotown as a priority social and economic development area

NASA Astrophysics Data System (ADS)

Trifonov, Vladimir; Loyko, Olga; Nesteruk, Dmitriy; Zhironkin, Sergey; Strekovtsova, Ekaterina

2017-01-01

The goal of the study is studying the specific features of organizing a priority social and economic development area (PSEDA) on the example of PSEDA "Yurga" in Kemerovo region (Russia). The problem is formulated as the question: which institutes, ideas, resources and management technologies may fuel transition to the new stage of the monotown development. The practical task is to determine the promising trends of development of single-industry municipalities on the example of the town of Yurga in Kemerovo region. In the paper we formulate the trends of developing sustainable urban environment of the monotown as of priority social and economic development area for further synergetic integration into higher order structures.

European research priorities for intracerebral haemorrhage.

PubMed

Steiner, Thorsten; Petersson, Jesper; Al-Shahi Salman, Rustam; Christensen, Hanne; Cordonnier, Charlotte; Csiba, Laszlo; Harnof, Sagi; Krieger, Derk; Mendelow, David; Molina, Carlos; Montaner, Joan; Overgaard, Karsten; Roine, Risto O; Schmutzhard, Erich; Tatlisumak, Turgut; Toni, Danilo; Stapf, Christian

2011-01-01

Over 2 million people are affected by intracerebral haemorrhage (ICH) worldwide every year, one third of them dying within 1 month, and many survivors being left with permanent disability. Unlike most other stroke types, the incidence, morbidity and mortality of ICH have not declined over time. No standardised diagnostic workup for the detection of the various underlying causes of ICH currently exists, and the evidence for medical or surgical therapeutic interventions remains limited. A dedicated European research programme for ICH is needed to identify ways to reduce the burden of ICH-related death and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH. Copyright © 2011 S. Karger AG, Basel.

National nursing science priorities: Creating a shared vision.

PubMed

Eckardt, Patricia; Culley, Joan M; Corwin, Elizabeth; Richmond, Therese; Dougherty, Cynthia; Pickler, Rita H; Krause-Parello, Cheryl A; Roye, Carol F; Rainbow, Jessica G; DeVon, Holli A

Nursing science is essential to advance population health through contributions at all phases of scientific inquiry. Multiple scientific initiatives important to nursing science overlap in aims and population focus. This article focused on providing the American Academy of Nursing and nurse scientists in the Unites States with a blueprint of nursing science priorities to inform a shared vision for future collaborations, areas of scientific inquiry, and resource allocation. The Science Committee convened four times and using Delphi methods identified priorities with empirical evidence and expert opinion for prioritization, state of the science, expert interest, and potential target stakeholders. Nursing science priorities for 2017 were categorized into four themes including: (a) precision science, (b) big data and data analytics, (c) determinants of health, and (d) global health. Nurse scientists can generate new knowledge in priority areas that advances the health of the world's populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Implementing the NHS information technology programme: qualitative study of progress in acute trusts.

PubMed

Hendy, Jane; Fulop, Naomi; Reeves, Barnaby C; Hutchings, Andrew; Collin, Simon

2007-06-30

To describe progress and perceived challenges in implementing the NHS information and technology (IT) programme in England. Case studies and in-depth interviews, with themes identified using a framework developed from grounded theory. We interviewed personnel who had been interviewed 18 months earlier, or new personnel in the same posts. Four NHS acute hospital trusts in England. Senior trust managers and clinicians, including chief executives, directors of IT, medical directors, and directors of nursing. Interviewees unreservedly supported the goals of the programme but had several serious concerns. As before, implementation is hampered by local financial deficits, delays in implementing patient administration systems that are compliant with the programme, and poor communication between Connecting for Health (the agency responsible for the programme) and local managers. New issues were raised. Local managers cannot prioritise implementing the programme because of competing financial priorities and uncertainties about the programme. They perceive a growing risk to patients' safety associated with delays and a loss of integration of components of the programme, and are discontented with Choose and Book (electronic booking for referrals from primary care). We recommend that the programme sets realistic timetables for individual trusts and advises managers about interim IT systems they have to purchase because of delays outside their control. Advice needs to be mindful of the need for trusts to ensure longer term compatibility with the programme and value for money. Trusts need assistance in prioritising modernisation of IT by, for example, including implementation of the programme in the performance management framework. Even with Connecting for Health adopting a different approach of setting central standards with local implementation, these issues will still need to be addressed. Lessons learnt in the NHS have wider relevance as healthcare systems, such as in France and Australia, look to realise the potential of large scale IT modernisation.

Combining endangered plants and animals as surrogates to identify priority conservation areas in Yunnan, China

NASA Astrophysics Data System (ADS)

Yang, Feiling; Hu, Jinming; Wu, Ruidong

2016-08-01

Suitable surrogates are critical for identifying optimal priority conservation areas (PCAs) to protect regional biodiversity. This study explored the efficiency of using endangered plants and animals as surrogates for identifying PCAs at the county level in Yunnan, southwest China. We ran the Dobson algorithm under three surrogate scenarios at 75% and 100% conservation levels and identified four types of PCAs. Assessment of the protection efficiencies of the four types of PCAs showed that endangered plants had higher surrogacy values than endangered animals but that the two were not substitutable; coupled endangered plants and animals as surrogates yielded a higher surrogacy value than endangered plants or animals as surrogates; the plant-animal priority areas (PAPAs) was the optimal among the four types of PCAs for conserving both endangered plants and animals in Yunnan. PAPAs could well represent overall species diversity distribution patterns and overlap with critical biogeographical regions in Yunnan. Fourteen priority units in PAPAs should be urgently considered as optimizing Yunnan’s protected area system. The spatial pattern of PAPAs at the 100% conservation level could be conceptualized into three connected conservation belts, providing a valuable reference for optimizing the layout of the in situ protected area system in Yunnan.

Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

PubMed

Turner, S; Ollerhead, E; Cook, A

2017-10-09

In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others contributed further potential topic areas instead. Delphi-like survey methods are practical and productive as a means of obtaining opinions from a wide number of relevant experts identifying potential priority topic areas for research; however, this method is less appropriate for framing tractable research questions.

76 FR 17400 - Proposed Priorities: Interventions To Promote Community Living Among Individuals With Disabilities

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... and Rehabilitative Services proposes a funding priority for the Disability and Rehabilitation Research... action to focus research attention on areas of national need. We intend this priority to improve... disability and rehabilitation research; (2) foster an exchange of expertise, information, and [[Page 17401...

Michigan's Infrastructure: Priorities for the Future. Capital Investment Needs 1985-1995.

ERIC Educational Resources Information Center

Michigan Infrastructure Coalition, Lansing.

The Michigan Infrastructure Coalition was formed to review needs and make judgments concerning priorities for future infrastructure investments in Michigan. This report describes the coalition's findings and is intended to serve as the guidelines for state elected officials. Contents include: (1) an introduction (specifying priority areas); (2)…

Variation in community intervention programmes and consequences for children and families: the example of Sure Start Local Programmes.

PubMed

Melhuish, Edward; Belsky, Jay; Anning, Angela; Ball, Mog; Barnes, Jacqueline; Romaniuk, Helena; Leyland, Alastair

2007-06-01

An area-based initiative, Sure Start Local Programmes (SSLPs), was established by the UK government to reduce social exclusion through improving the well-being of children aged 0-3 years and their families in disadvantaged communities; a true community intervention in that all children under four and their families in specified areas served as targets of universal services. A national evaluation examined the links between variation in programme implementation and effectiveness. Data gathered from multiple sources produced measures of implementation in terms of proficiency, services and staffing. Measures of programme impact on child/parenting outcomes derived from multilevel models, controlling for child, family and area characteristics, were identified to demonstrate programme effectiveness. Some modest linkage between programme implementation (e.g., proficiency, empowerment of parents and staff, identification of users) and effectiveness for child and parenting outcomes. Overall proficiency and specific aspects of implementation may influence effectiveness, which should guide the design of other child, family and community services.

The impact of a nutrition education programme on the anthropometric nutritional status of low-income children in South Africa.

PubMed

Walsh, C M; Dannhauser, A; Joubert, G

2002-02-01

The study determined the impact of a community-based nutrition education programme, using trained community nutrition advisors, on the anthropometric nutritional status of mixed-race children aged between 2 and 5 years. The programme was implemented over two years in four study areas in the Free State and Northern Cape Provinces. Two control areas were included to differentiate between the effect of the education programme and a food aid programme that were implemented simultaneously. Weight-for-age, height-for-age and weight-for-height were summarised using standard deviations from the NCHS reference median. For each of the indicators, the difference in the percentage of children below minus two standard deviations from the reference NCHS median in the initial and follow-up surveys was determined. Initially 536 children were measured and, after two years of intervention, 815. Weight-for-age improved in all areas, but only significantly in boys and girls in the urban study area, and in boys in one rural study area. No significant improvement in height-for-age occurred in any area. Weight-for-height improved significantly in the urban study area. The education programme in combination with food aid succeeded in improving the weight status of children, but was unable to facilitate catch-up growth in stunted children after two years of intervention.

Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002-2012.

PubMed

Reveiz, Ludovic; Elias, Vanessa; Terry, Robert F; Alger, Jackeline; Becerra-Posada, Francisco

2013-07-01

To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012. This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG). Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

Smoking cessation after 12 months with multi-component therapy.

PubMed

Raich, Antònia; Martínez-Sánchez, Jose Maria; Marquilles, Emili; Rubio, Lídia; Fu, Marcela; Fernández, Esteve

2015-03-01

Smoking is one of the most important causes of morbidity and mortality in developed countries. One of the priorities of public health programmes is the reduction of its prevalence, which would involve millions of people quitting smoking, but cessation programs often have modest results, especially within certain population groups. The aim of this study was to analyze the variables determining the success of a multicomponent therapy programme for smoking cessation. We conducted the study in the Smoking Addiction Unit at the Hospital of Manresa, with 314 patients (91.4% of whom had medium or high-level dependency). We observed that higher educational level, not living with a smoker, following a multimodal programme or smoking cessation with psychological therapy, and pharmacological treatment are relevant factors for quitting smoking. Abstinence rates are not associated with other factors, such as sex, age, smoking behaviour characteristics or psychiatric history. The combination of pharmacological and psychological treatment increased success rates in multicomponent therapy. Psychological therapy only also obtained positive results, though somewhat more modest.

Audiology in Latin America: hearing impairment, resources and services.

PubMed

Madriz, J J

2001-01-01

Evidence is presented about the limitation of information available on prevalence/incidence of deafness and hearing impairment in the developing world; particularly in Latin America. Two questionnaires on audiological resources and services were mailed to Latin American and Caribbean countries in general and to Central American nations in particular. The information returned by Argentina, Chile, Colombia, Costa Rica, Cuba, Belize, El Salvador, Grenada, Guatemala, Honduras, Mexico, Nicaragua, Panama, Puerto Rico and Uruguay was analysed. Data was gathered about epidemiological studies on hearing impairment, about specific programmes, such as early identification of hearing impairment, national registers on deafness and programmes on hearing screening. Training programmes and availability of professionals in the field of hearing and deafness is also shown. Hearing services, hearing aids provision, hearing testing equipment, professional organization and legislation in audiology is also documented. It is our conclusion that hearing impairment is a low priority for health systems in the developing world, technology continues to be excessively costly and material and human resources are limited, and services are poor and restricted.

Population and reproductive health in National Adaptation Programmes of Action (NAPAs) for climate change in Africa.

PubMed

Mutunga, Clive; Hardee, Karen

2010-12-01

This paper reviews 44 National Adaptation Programmes of Action (NAPAs) to assess the NAPA process and identify the range of interventions included in countries' priority adaptation actions and highlight how population issues and reproductive health/family planning (RH/FP) are addressed as part of the adaptation agenda. A majority of the 44 NAPAs identify rapid population growth as a key component of vulnerability to climate change impacts. However, few chose to prioritise NAPA funds for family planning/reproductive health programmes. The paper emphasizes the need to translate the recognition of population pressure as a factor related to countries' ability to adapt to climate change into relevant project activities. Such projects should include access to RH/FP, in addition to other strategies such as girls' education and women's empowerment that lead to lower fertility. Attention to population and integrated strategies should be central and aligned to longer-term national adaptation plans and strategies.

Civil society organizations: capacity to address the needs of the urban poor in Nairobi.

PubMed

Ekirapa, Akaco; Mgomella, George S; Kyobutungi, Catherine

2012-11-01

We conducted a needs assessment that describes the landscape of civil society organizations (CSOs) in three informal settlements around Nairobi, Kenya. The numbers of CSOs have rapidly increased in areas underserved by governments including poor urban neighbourhoods but little is known about CSOs capacity to meet the priority health needs of the urban poor. It is also unclear why, despite a proliferation of CSOs, residents still experience unimproved health outcomes. We collected data on core activities, financial management, and governance structures. Of the 952 CSOs assessed, 47 per cent reported HIV/AIDS counselling, prevention, and treatment as their core activity. Most CSOs reported good financial management systems and governance structures but responses were not validated. Representation in district health stakeholder fora was low; most CSOs did not have the capacity to effectively deliver services that would have impact. For CSOs to realize the desired goal to improve the well-being of low-income populations, programmes to build their management capacity are essential.

The Parliamentarian, NGO and Youth Fora.

PubMed

1999-01-01

Three fora, namely, the Parliamentarian's Forum, the Nongovernmental Organization (NGO) Forum, and the Youth Forum, immediately preceded the Hague Forum. Each of the forums assessed achievements in implementing the International Conference on Population and Development Programme of Action (ICPD-PA) and formulated recommendations that provided valuable input to the International Forum. The Parliamentarian's Forum, attended by 210 parliamentarians from 103 countries, evaluated the progress in development of the parliamentarians' movement after the ICPD. The parliamentarians focused their discussions on the following priority areas: reproductive health and rights; gender and population; adolescents, youth, the elderly, and persons with disabilities; population, environment, and food security; resource mobilization; economic crises; and parliamentarian networks. The NGO Forum, on the other hand, emphasized the need to achieve consensus on policy formulation that includes NGOs as partners; establish permanent mechanisms for ICPD-PA implementation; and mobilize financial resources for sexual and reproductive health initiatives. Lastly, the Youth Forum highlighted the central role that youth can play in the development of policies and programs for ICPD-PA implementation.

Modern design of a fast front-end computer

NASA Astrophysics Data System (ADS)

Šoštarić, Z.; Anic̈ić, D.; Sekolec, L.; Su, J.

1994-12-01

Front-end computers (FEC) at Paul Scherrer Institut provide access to accelerator CAMAC-based sensors and actuators by way of a local area network. In the scope of the new generation FEC project, a front-end is regarded as a collection of services. The functionality of one such service is described in terms of Yourdon's environment, behaviour, processor and task models. The computational model (software representation of the environment) of the service is defined separately, using the information model of the Shlaer-Mellor method, and Sather OO language. In parallel with the analysis and later with the design, a suite of test programmes was developed to evaluate the feasibility of different computing platforms for the project and a set of rapid prototypes was produced to resolve different implementation issues. The past and future aspects of the project and its driving forces are presented. Justification of the choice of methodology, platform and requirement, is given. We conclude with a description of the present state, priorities and limitations of our project.

A National Effort to Integrate Math and Science with CTE

ERIC Educational Resources Information Center

Hyslop, Alisha

2008-01-01

National activities focus on priority areas and are often designed to develop, improve and identify the most successful methods and techniques for providing career and technical education (CTE) programs under Perkins. One of these priority areas under the 2006 Perkins Act is the integration of academic and technical education. Since the early…

41 CFR 102-74.285 - How must Federal agencies assign priority to parking spaces in controlled areas?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false How must Federal... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL....285 How must Federal agencies assign priority to parking spaces in controlled areas? Federal agencies...

41 CFR 102-74.285 - How must Federal agencies assign priority to parking spaces in controlled areas?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false How must Federal... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL....285 How must Federal agencies assign priority to parking spaces in controlled areas? Federal agencies...

Analyzing international clinical education practices for Canadian rehabilitation students.

PubMed

Ahluwalia, Puja; Cameron, Debra; Cockburn, Lynn; Ellwood, Lynn; Mori, Brenda; Nixon, Stephanie A

2014-09-09

Clinical training in low-income countries has become increasingly popular among pre-licensure trainees from high-income countries. The Working Group on Ethics Guidelines for Global Health Training ("WEIGHT Guidelines") were designed to identify and inform the complex and contentious field of international clinical education. The purpose of this study was to use the WEIGHT Guidelines to evaluate an international clinical internship programme for Master's-level rehabilitation students at a Canadian university. In-depth, semi-structured interviews were conducted with eight Canadian rehabilitation researchers, educations and/or clinicians responsible for administering international internships across three clinical training programmes. Interview questions were informed by the WEIGHT Guidelines. Directed content analysis was used to identify priorities for policy, practice and research. Five themes relating to strengthening international clinical education were identified: (1) from one-time internships to long-term partnerships, (2) starting a discussion about "costs", (3) a more informed approach to student selection, (4) expanding and harmonizing pre-departure training across disciplines, and (5) investing in post-internship debriefing. International clinical education is fraught with ethical, pedagogical and logistical issues that require recognition and ongoing management. This is the first study to use the WEIGHT Guidelines as a qualitative research tool for assessing an existing global health education programme. Results highlight new priorities for action at the Canadian "sending institution", including more explicit attention to the costs (broadly defined) borne by all parties. A crucial next step is deepened engagement with educational partners at the "receiving organizations" based in low-income countries to nurture dialogue regarding reciprocity, trust and sustainability of the partnership. Education research is also needed that evaluates models of pre-departure training and post-internship debriefing for trainees.

Neglected tropical diseases: exploring long term practical approaches to achieve sustainable disease elimination and beyond.

PubMed

Ortu, Giuseppina; Williams, Oliver

2017-09-27

Remarkable progress has been made in the fight against neglected tropical diseases, but new challenges have emerged. Innovative diagnostics, better drugs and new insecticides are often identified as the priority; however, access to these new tools may not be sufficient to achieve and sustain disease elimination, if certain challenges and priorities are not considered. The authors summarise key operational challenges, and based on these, identify two major priorities: strengthening the capacity of the primary health care health system in correctly diagnosing and managing neglected tropical diseases; and establishing an effective disease surveillance process. Five steps are proposed as concrete actions to build an effective primary health care service for neglected tropical diseases, and a health management information system capable of accurately reporting these diseases. Community engagement and formalization of community health workers role are proposed as essential components of these steps. Shift of financial support from disease oriented programmes to disease integrated interventions, improved access to international guidelines for primary health care staff, and availability of donated drugs in health care structures are also suggested as key elements of the proposed process. The authors conclude that failure to address these priorities now may lead to further challenges on the long path towards neglected tropical disease elimination and beyond.

Ecoregion-Based Conservation Planning in the Mediterranean: Dealing with Large-Scale Heterogeneity

PubMed Central

Giakoumi, Sylvaine; Sini, Maria; Gerovasileiou, Vasilis; Mazor, Tessa; Beher, Jutta; Possingham, Hugh P.; Abdulla, Ameer; Çinar, Melih Ertan; Dendrinos, Panagiotis; Gucu, Ali Cemal; Karamanlidis, Alexandros A.; Rodic, Petra; Panayotidis, Panayotis; Taskin, Ergun; Jaklin, Andrej; Voultsiadou, Eleni; Webster, Chloë; Zenetos, Argyro; Katsanevakis, Stelios

2013-01-01

Spatial priorities for the conservation of three key Mediterranean habitats, i.e. seagrass Posidonia oceanica meadows, coralligenous formations, and marine caves, were determined through a systematic planning approach. Available information on the distribution of these habitats across the entire Mediterranean Sea was compiled to produce basin-scale distribution maps. Conservation targets for each habitat type were set according to European Union guidelines. Surrogates were used to estimate the spatial variation of opportunity cost for commercial, non-commercial fishing, and aquaculture. Marxan conservation planning software was used to evaluate the comparative utility of two planning scenarios: (a) a whole-basin scenario, referring to selection of priority areas across the whole Mediterranean Sea, and (b) an ecoregional scenario, in which priority areas were selected within eight predefined ecoregions. Although both scenarios required approximately the same total area to be protected in order to achieve conservation targets, the opportunity cost differed between them. The whole-basin scenario yielded a lower opportunity cost, but the Alboran Sea ecoregion was not represented and priority areas were predominantly located in the Ionian, Aegean, and Adriatic Seas. In comparison, the ecoregional scenario resulted in a higher representation of ecoregions and a more even distribution of priority areas, albeit with a higher opportunity cost. We suggest that planning at the ecoregional level ensures better representativeness of the selected conservation features and adequate protection of species, functional, and genetic diversity across the basin. While there are several initiatives that identify priority areas in the Mediterranean Sea, our approach is novel as it combines three issues: (a) it is based on the distribution of habitats and not species, which was rarely the case in previous efforts, (b) it considers spatial variability of cost throughout this socioeconomically heterogeneous basin, and (c) it adopts ecoregions as the most appropriate level for large-scale planning. PMID:24155901

Hypertension management research priorities from patients, caregivers, and healthcare providers: A report from the Hypertension Canada Priority Setting Partnership Group.

PubMed

Khan, Nadia; Bacon, Simon L; Khan, Samia; Perlmutter, Sara; Gerlinsky, Carline; Dermer, Mark; Johnson, Lonni; Alves, Finderson; McLean, Donna; Laupacis, Andreas; Pui, Mandy; Berg, Angelique; Flowitt, Felicia

2017-11-01

Patient- and stakeholder-oriented research is vital to improving the relevance of research. The authors aimed to identify the 10 most important research priorities of patients, caregivers, and healthcare providers (family physicians, nurses, nurse practitioners, pharmacists, and dietitians) for hypertension management. Using the James Lind Alliance approach, a national web-based survey asked patients, caregivers, and care providers to submit their unanswered questions on hypertension management. Questions already answered from randomized controlled trial evidence were removed. A priority setting process of patient, caregiver, and healthcare providers then ranked the final top 10 research priorities in an in-person meeting. There were 386 respondents who submitted 598 questions after exclusions. Of the respondents, 78% were patients or caregivers, 29% lived in rural areas, 78% were aged 50 to 80 years, and 75% were women. The 598 questions were distilled to 42 unique questions and from this list, the top 10 research questions prioritized included determining the combinations of healthy lifestyle modifications to reduce the need for antihypertensive medications, stress management interventions, evaluating treatment strategies based on out-of-office blood pressure compared with conventional (office) blood pressure, education tools and technologies to improve patient motivation and health behavior change, management strategies for ethnic groups, evaluating natural and alternative treatments, and the optimal role of different healthcare providers and caregivers in supporting patients with hypertension. These priorities can be used to guide clinicians, researchers, and funding bodies on areas that are a high priority for hypertension management research for patients, caregivers, and healthcare providers. This also highlights priority areas for improved knowledge translation and delivering patient-centered care. ©2017 Wiley Periodicals, Inc.

The Australian tar derby: the origins and fate of a low tar harm reduction programme

PubMed Central

King, W; Carter, S; Borland, R; Chapman, S; Gray, N

2003-01-01

Objective: To document the development of the low tar harm reduction programme in Australia, including tobacco industry responses. Data sources: Tobacco industry documents, retail tobacco journals, newspapers, medical journals, and Anti-Cancer Council of Victoria (ACCV) newsletters and archival records. Study selection: Documents on the strategies and knowledge bases of the ACCV, other Australian health authorities, and the tobacco industry. Results: The ACCV built a durable system for measuring and publicising the tar and nicotine yields of Australian cigarettes and influencing their development. The tobacco industry initially sought to block the development of this system but later appeared to cooperate with it, as is evidenced by the current market dominance of low tar brands. However, behind the scenes, the industry used its substantial knowledge advantage regarding compensatory smoking and its ability to re-engineer cigarettes to gain effective control of the system and subvert the ACCV's objectives. Conclusions: Replacement of the low tar programme with new means of minimising the harms from cigarette smoking should be a policy priority for the Australian government. This will require regulation, rather than further voluntary agreements, and stringent monitoring of successor programmes will be necessary. PMID:14645950

Towards good practice for health statistics: lessons from the Millennium Development Goal health indicators.

PubMed

Murray, Christopher J L

2007-03-10

Health statistics are at the centre of an increasing number of worldwide health controversies. Several factors are sharpening the tension between the supply and demand for high quality health information, and the health-related Millennium Development Goals (MDGs) provide a high-profile example. With thousands of indicators recommended but few measured well, the worldwide health community needs to focus its efforts on improving measurement of a small set of priority areas. Priority indicators should be selected on the basis of public-health significance and several dimensions of measurability. Health statistics can be divided into three types: crude, corrected, and predicted. Health statistics are necessary inputs to planning and strategic decision making, programme implementation, monitoring progress towards targets, and assessment of what works and what does not. Crude statistics that are biased have no role in any of these steps; corrected statistics are preferred. For strategic decision making, when corrected statistics are unavailable, predicted statistics can play an important part. For monitoring progress towards agreed targets and assessment of what works and what does not, however, predicted statistics should not be used. Perhaps the most effective method to decrease controversy over health statistics and to encourage better primary data collection and the development of better analytical methods is a strong commitment to provision of an explicit data audit trail. This initiative would make available the primary data, all post-data collection adjustments, models including covariates used for farcasting and forecasting, and necessary documentation to the public.

“It means you are grounded” – caregivers’ perspectives on the rehabilitation of children with neurodisability in Malawi

PubMed Central

Paget, Amelia; Mallewa, Macpherson; Chinguo, Dorothy; Mahebere-Chirambo, Chawanangwa; Gladstone, Melissa

2016-01-01

Abstract Purpose: Rates of childhood disability are estimated to be high in African settings; however, services to provide information and support are limited. This study aims to explore perspectives and experiences of caregivers of children with disabilities (CWD) from acquired brain injury to inform the development of training packages for health-workers (HW) in hospital settings. Methods: The study was conducted in a tertiary hospital using qualitative methods. Fourteen in-depth interviews (IDIs) were conducted with parents/carers (PC), and 10 IDIs and 4 focus-group discussions (FGDs) with HW. Data were audio-recorded, transcribed, translated and analysed using thematic approaches. Results: HWs and PCs held varying perspectives on aetiology and prognosis for CWD. HWs raised concerns about impact on families, risks of neglect and abuse. Barriers to care and support included prioritisation of acute illness, lack of HW knowledge and confidence, stigma, poor communication, focus on physical disability, and poor availability of services. Among ideas for improvement, good communication and counselling was seen as a priority but not often achieved. Conclusion: A range of family, health service and wider contextual factors affect care for CWD. Training for HW should emphasise disability rights, access to services, a range of disabilities and specific training on counselling.Implications for RehabilitationTo create good training programmes for workers who manage children with neurodisability, workers’ views on their training needs, as well parents’ views of what feel they need to know most, must be taken into account.The need for training regarding communication skills is a priority for health-workers (HW), who manage children with neurodisability in Malawi and confidence in this area is likely to be vital in providing support for these families.Disability rights and inclusion should be imperative in any training programme for managing children with neurodisability in hospital settings.Even in low-resource settings such as Malawi, it is vital that the links between hospital management and the limited resources in the community are updated and maintained.

Cave Conservation Priority Index to Adopt a Rapid Protection Strategy: A Case Study in Brazilian Atlantic Rain Forest

NASA Astrophysics Data System (ADS)

Souza Silva, Marconi; Martins, Rogério Parentoni; Ferreira, Rodrigo Lopes

2015-02-01

Cave environments are characterized by possessing specialized fauna living in high environmental stability with limited food conditions. These fauna are highly vulnerable to impacts, because this condition can frequently be easily altered. Moreover, environmental determinants of the biodiversity patterns of caves remain poorly understood and protected. Therefore, the main goal of this work is to propose a cave conservation priority index (CCPi) for a rapid assessment for troglobiotic and troglophile protection. Furthermore, the troglobiotic diversity, distribution and threats have been mapped in the Brazilian Atlantic forest. To propose the CCPi, the human impacts and richness of troglobiotic and troglophile species of 100 caves were associated. Data related to troglomorphic/troglobiotic fauna from another 200 caves were used to map the troglobiotic diversity and distribution. The CCPi reveals extremely high conservation priority for 15 % of the caves, high for 36 % and average for 46 % of the caves. Fourteen caves with extremely high priorities should have urgent conservation and management actions. The geographical distribution of the 221 known troglobiotic/troglomorphic species allowed us to select 19 karst areas that need conservation actions. Seven areas were considered to have urgent priority for conservation actions. The two richest areas correspond to the "iron quadrangle" with iron ore caves (67 spp.) and the "Açungui limestone group" (56 spp.). Both areas have several caves and are important aquifers. The use of the CCPi can prevent future losses because it helps assessors to select caves with priorities for conservation which should receive emergency attention in relation to protection, management and conservation actions.

Horizontal schools-based health programme in rural Kenya.

PubMed

Bogie, James; Eder, Ben; Magnus, Dan; Amonje, Onguko David; Gant, Martina

2017-09-01

Primary school children in low-income countries are at risk of many diseases and poor health affects attendance, cognition and ability to learn. Developing school health and nutrition strategies has been extensively highlighted as a global priority, with a particular focus on complex programme design. However, such programmes are relatively untested in low-income settings. We implemented a complex school health and nutrition programme in two schools in Western Kenya over 3 years. There were numerous elements covering health policy, skills-based health education, infrastructure and disease prevention. A local non-governmental organisation, with involvement from local government and the community, performed programme implementation. Height-for-age, weight-for-age,height-for-weight, anaemia prevalence, academic performance and school attendance were the primary outcome measures. The programme improved nutrition, academic performance and anaemia prevalence. The number of underweight children fell from 20% to 11% (OR 0.51 95% CI 0.39 to 0.68 p=<0.01) and stunting prevalence fell from 29.9% to 20% (OR 0.59 95% CI 0.50 to 0.68 p=<0.01). Academic performance improved with a 74% reduction in odds of failing assessments (OR 0.26 95% CI 0.22 to 0.29 p=<0.01). Anaemia prevalence fell from 17.2% to 11%. The programme showed an increase in low body mass index prevalence and no effect on school attendance, the reasons for which are unclear. These results are encouraging and demonstrate that complex schools health programmes can lead to positive gains in health, nutrition and importantly academic performance. There is a need for further evaluation of comprehensive school health interventions in poor communities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A pilot quality assurance scheme for diabetic retinopathy risk reduction programmes.

PubMed

Garvican, L; Scanlon, P H

2004-10-01

We describe a pilot study of measurement of quality assurance targets for diabetic retinopathy screening and performance comparison between 10 existing services, in preparation for the roll-out of the national programme. In 1999 the UK National Screening Committee approved proposals for a national diabetic retinopathy risk reduction programme, including recommendations for quality assurance, but implementation was held pending publication of the National Service Framework for Diabetes. Existing services requested the authors to perform a pilot study of a QA scheme, indicating willingness to contribute data for comparison. Objectives and quality standards were developed, following consultation with diabetologists, ophthalmologists and retinal screeners. Services submitted 2001/2 performance data, in response to a questionnaire, for anonymization, central analysis and comparison. The 17 quality standards encompass all aspects of the programme from identification of patients to timeliness of treatment. Ten programmes took part, submitting all the data available. All returns were incomplete, but especially so from the optometry-based schemes. Eight or more services demonstrated they could reach the minimum level in only five of the 17 standards. Thirty per cent could not provide coverage data. All were running behind. Reasons for difficulties in obtaining data and/or failing to achieve standards included severe under-funding and little previous experience of QA. Information systems were limited and incompatible between diabetes and eye units, and there was a lack of co-ordinated management of the whole programme. Quality assurance is time-consuming, expensive and inadequately resourced. The pilot study identified priorities for local action. National programme implementation must involve integral quality assurance mechanisms from the outset.

Conservation priorities of Iberoamerican pig breeds and their ancestors based on microsatellite information.

PubMed

Cortés, O; Martinez, A M; Cañon, J; Sevane, N; Gama, L T; Ginja, C; Landi, V; Zaragoza, P; Carolino, N; Vicente, A; Sponenberg, P; Delgado, J V

2016-07-01

Criollo pig breeds are descendants from pigs brought to the American continent starting with Columbus second trip in 1493. Pigs currently play a key role in social economy and community cultural identity in Latin America. The aim of this study was to establish conservation priorities among a comprehensive group of Criollo pig breeds based on a set of 24 microsatellite markers and using different criteria. Spain and Portugal pig breeds, wild boar populations of different European geographic origins and commercial pig breeds were included in the analysis as potential genetic influences in the development of Criollo pig breeds. Different methods, differing in the weight given to within- and between-breed genetic variability, were used in order to estimate the contribution of each breed to global genetic diversity. As expected, the partial contribution to total heterozygosity gave high priority to Criollo pig breeds, whereas Weitzman procedures prioritized Iberian Peninsula breeds. With the combined within- and between-breed approaches, different conservation priorities were achieved. The Core Set methodologies highly prioritized Criollo pig breeds (Cr. Boliviano, Cr. Pacifico, Cr. Cubano and Cr. Guadalupe). However, weighing the between- and within-breed components with FST and 1-FST, respectively, resulted in higher contributions of Iberian breeds. In spite of the different conservation priorities according to the methodology used, other factors in addition to genetic information also need to be considered in conservation programmes, such as the economic, cultural or historical value of the breeds involved.

Conservation priorities of Iberoamerican pig breeds and their ancestors based on microsatellite information

PubMed Central

Cortés, O; Martinez, A M; Cañon, J; Sevane, N; Gama, L T; Ginja, C; Landi, V; Zaragoza, P; Carolino, N; Vicente, A; Sponenberg, P; Delgado, J V

2016-01-01

Criollo pig breeds are descendants from pigs brought to the American continent starting with Columbus second trip in 1493. Pigs currently play a key role in social economy and community cultural identity in Latin America. The aim of this study was to establish conservation priorities among a comprehensive group of Criollo pig breeds based on a set of 24 microsatellite markers and using different criteria. Spain and Portugal pig breeds, wild boar populations of different European geographic origins and commercial pig breeds were included in the analysis as potential genetic influences in the development of Criollo pig breeds. Different methods, differing in the weight given to within- and between-breed genetic variability, were used in order to estimate the contribution of each breed to global genetic diversity. As expected, the partial contribution to total heterozygosity gave high priority to Criollo pig breeds, whereas Weitzman procedures prioritized Iberian Peninsula breeds. With the combined within- and between-breed approaches, different conservation priorities were achieved. The Core Set methodologies highly prioritized Criollo pig breeds (Cr. Boliviano, Cr. Pacifico, Cr. Cubano and Cr. Guadalupe). However, weighing the between- and within-breed components with FST and 1-FST, respectively, resulted in higher contributions of Iberian breeds. In spite of the different conservation priorities according to the methodology used, other factors in addition to genetic information also need to be considered in conservation programmes, such as the economic, cultural or historical value of the breeds involved. PMID:27025169

Simulation of Regionally Ecological Land Based on a Cellular Automation Model: A Case Study of Beijing, China

PubMed Central

Xie, Hualin; Kung, Chih-Chun; Zhang, Yanting; Li, Xiubin

2012-01-01

Ecological land is like the “liver” of a city and is very useful to public health. Ecological land change is a spatially dynamic non-linear process under the interaction between natural and anthropogenic factors at different scales. In this study, by setting up natural development scenario, object orientation scenario and ecosystem priority scenario, a Cellular Automation (CA) model has been established to simulate the evolution pattern of ecological land in Beijing in the year 2020. Under the natural development scenario, most of ecological land will be replaced by construction land and crop land. But under the scenarios of object orientation and ecosystem priority, the ecological land area will increase, especially under the scenario of ecosystem priority. When considering the factors such as total area of ecological land, loss of key ecological land and spatial patterns of land use, the scenarios from priority to inferiority are ecosystem priority, object orientation and natural development, so future land management policies in Beijing should be focused on conversion of cropland to forest, wetland protection and prohibition of exploitation of natural protection zones, water source areas and forest parks to maintain the safety of the regional ecosystem. PMID:23066410

Simulation of regionally ecological land based on a cellular automation model: a case study of Beijing, China.

PubMed

Xie, Hualin; Kung, Chih-Chun; Zhang, Yanting; Li, Xiubin

2012-08-01

Ecological land is like the "liver" of a city and is very useful to public health. Ecological land change is a spatially dynamic non-linear process under the interaction between natural and anthropogenic factors at different scales. In this study, by setting up natural development scenario, object orientation scenario and ecosystem priority scenario, a Cellular Automation (CA) model has been established to simulate the evolution pattern of ecological land in Beijing in the year 2020. Under the natural development scenario, most of ecological land will be replaced by construction land and crop land. But under the scenarios of object orientation and ecosystem priority, the ecological land area will increase, especially under the scenario of ecosystem priority. When considering the factors such as total area of ecological land, loss of key ecological land and spatial patterns of land use, the scenarios from priority to inferiority are ecosystem priority, object orientation and natural development, so future land management policies in Beijing should be focused on conversion of cropland to forest, wetland protection and prohibition of exploitation of natural protection zones, water source areas and forest parks to maintain the safety of the regional ecosystem.

Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey.

PubMed

Sardanelli, Francesco; Aase, Hildegunn S; Álvarez, Marina; Azavedo, Edward; Baarslag, Henk J; Balleyguier, Corinne; Baltzer, Pascal A; Beslagic, Vanesa; Bick, Ulrich; Bogdanovic-Stojanovic, Dragana; Briediene, Ruta; Brkljacic, Boris; Camps Herrero, Julia; Colin, Catherine; Cornford, Eleanor; Danes, Jan; de Geer, Gérard; Esen, Gul; Evans, Andrew; Fuchsjaeger, Michael H; Gilbert, Fiona J; Graf, Oswald; Hargaden, Gormlaith; Helbich, Thomas H; Heywang-Köbrunner, Sylvia H; Ivanov, Valentin; Jónsson, Ásbjörn; Kuhl, Christiane K; Lisencu, Eugenia C; Luczynska, Elzbieta; Mann, Ritse M; Marques, Jose C; Martincich, Laura; Mortier, Margarete; Müller-Schimpfle, Markus; Ormandi, Katalin; Panizza, Pietro; Pediconi, Federica; Pijnappel, Ruud M; Pinker, Katja; Rissanen, Tarja; Rotaru, Natalia; Saguatti, Gianni; Sella, Tamar; Slobodníková, Jana; Talk, Maret; Taourel, Patrice; Trimboli, Rubina M; Vejborg, Ilse; Vourtsis, Athina; Forrai, Gabor

2017-07-01

EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 % for women aged 50-69 years taking up the invitation while the probability of false-positive needle biopsy is <1 % per round and overdiagnosis is only 1-10 % for a 20-year screening. Mortality reduction was also observed for the age groups 40-49 years and 70-74 years, although with "limited evidence". Thus, we firstly recommend biennial screening mammography for average-risk women aged 50-69 years; extension up to 73 or 75 years, biennially, is a second priority, from 40-45 to 49 years, annually, a third priority. Screening with thermography or other optical tools as alternatives to mammography is discouraged. Preference should be given to population screening programmes on a territorial basis, with double reading. Adoption of digital mammography (not film-screen or phosphor-plate computer radiography) is a priority, which also improves sensitivity in dense breasts. Radiologists qualified as screening readers should be involved in programmes. Digital breast tomosynthesis is also set to become "routine mammography" in the screening setting in the next future. Dedicated pathways for high-risk women offering breast MRI according to national or international guidelines and recommendations are encouraged. • EUSOBI and 30 national breast radiology bodies support screening mammography. • A first priority is double-reading biennial mammography for women aged 50-69 years. • Extension to 73-75 and from 40-45 to 49 years is also encouraged. • Digital mammography (not film-screen or computer radiography) should be used. • DBT is set to become "routine mammography" in the screening setting in the next future.

75 FR 27625 - Announcement of the Priority Grant Competition for Immediate Release

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... specific themes for each priority area may be found at our Web site at: http://www.usip.org/grants....usip.org/grants-fellowships/priority-grant-competition for specific information on the competition as...) (202) 457-1719 (TTY) E-mail: [email protected]org . FOR FURTHER INFORMATION CONTACT: The Grant Program...

Impact of conditional cash transfers on maternal and newborn health.

PubMed

Glassman, Amanda; Duran, Denizhan; Fleisher, Lisa; Singer, Daniel; Sturke, Rachel; Angeles, Gustavo; Charles, Jodi; Emrey, Bob; Gleason, Joanne; Mwebsa, Winnie; Saldana, Kelly; Yarrow, Kristina; Koblinsky, Marge

2013-12-01

Maternal and newborn health (MNH) is a high priority for global health and is included among the Millennium Development Goals (MDGs). However, the slow decline in maternal and newborn mortality jeopardizes achievements of the targets of MDGs. According to UNICEF, 60 million women give birth outside of health facilities, and family planning needs are satisfied for only 50%. Further, skilled birth attendance and the use of antenatal care are most inequitably distributed in maternal and newborn health interventions in low- and middle-income countries. Conditional cash transfer (CCT) programmes have been shown to increase health service utilization among the poorest but little is written on the effects of such programmes on maternal and newborn health. We carried out a systematic review of studies on CCT that report maternal and newborn health outcomes, including studies from 8 countries. The CCT programmes have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers and reduced the incidence of low birthweight. The programmes have not had a significant impact on fertility while the impact on maternal and newborn mortality has not been well-documented thus far. Given these positive effects, we make the case for further investment in CCT programmes for maternal and newborn health, noting gaps in knowledge and providing recommendations for better design and evaluation of such programmes. We recommend more rigorous impact evaluations that document impact pathways and take factors, such as cost-effectiveness, into account.

Identifying Corridors among Large Protected Areas in the United States

PubMed Central

Belote, R. Travis; Dietz, Matthew S.; McRae, Brad H.; Theobald, David M.; McClure, Meredith L.; Irwin, G. Hugh; McKinley, Peter S.; Gage, Josh A.; Aplet, Gregory H.

2016-01-01

Conservation scientists emphasize the importance of maintaining a connected network of protected areas to prevent ecosystems and populations from becoming isolated, reduce the risk of extinction, and ultimately sustain biodiversity. Keeping protected areas connected in a network is increasingly recognized as a conservation priority in the current era of rapid climate change. Models that identify suitable linkages between core areas have been used to prioritize potentially important corridors for maintaining functional connectivity. Here, we identify the most “natural” (i.e., least human-modified) corridors between large protected areas in the contiguous Unites States. We aggregated results from multiple connectivity models to develop a composite map of corridors reflecting agreement of models run under different assumptions about how human modification of land may influence connectivity. To identify which land units are most important for sustaining structural connectivity, we used the composite map of corridors to evaluate connectivity priorities in two ways: (1) among land units outside of our pool of large core protected areas and (2) among units administratively protected as Inventoried Roadless (IRAs) or Wilderness Study Areas (WSAs). Corridor values varied substantially among classes of “unprotected” non-core land units, and land units of high connectivity value and priority represent diverse ownerships and existing levels of protections. We provide a ranking of IRAs and WSAs that should be prioritized for additional protection to maintain minimal human modification. Our results provide a coarse-scale assessment of connectivity priorities for maintaining a connected network of protected areas. PMID:27104683

Identifying Corridors among Large Protected Areas in the United States.

PubMed

Belote, R Travis; Dietz, Matthew S; McRae, Brad H; Theobald, David M; McClure, Meredith L; Irwin, G Hugh; McKinley, Peter S; Gage, Josh A; Aplet, Gregory H

2016-01-01

Conservation scientists emphasize the importance of maintaining a connected network of protected areas to prevent ecosystems and populations from becoming isolated, reduce the risk of extinction, and ultimately sustain biodiversity. Keeping protected areas connected in a network is increasingly recognized as a conservation priority in the current era of rapid climate change. Models that identify suitable linkages between core areas have been used to prioritize potentially important corridors for maintaining functional connectivity. Here, we identify the most "natural" (i.e., least human-modified) corridors between large protected areas in the contiguous Unites States. We aggregated results from multiple connectivity models to develop a composite map of corridors reflecting agreement of models run under different assumptions about how human modification of land may influence connectivity. To identify which land units are most important for sustaining structural connectivity, we used the composite map of corridors to evaluate connectivity priorities in two ways: (1) among land units outside of our pool of large core protected areas and (2) among units administratively protected as Inventoried Roadless (IRAs) or Wilderness Study Areas (WSAs). Corridor values varied substantially among classes of "unprotected" non-core land units, and land units of high connectivity value and priority represent diverse ownerships and existing levels of protections. We provide a ranking of IRAs and WSAs that should be prioritized for additional protection to maintain minimal human modification. Our results provide a coarse-scale assessment of connectivity priorities for maintaining a connected network of protected areas.

Addressing the social determinants of health: a case study from the Mitanin (community health worker) programme in India

PubMed Central

Schneider, Helen

2014-01-01

The Mitanin Programme, a government community health worker (CHW) programme, was started in Chhattisgarh State of India in 2002. The CHWs (Mitanins) have consistently adopted roles that go beyond health programme-specific interventions to embrace community mobilization and action on local priorities. The aim of this research was to document how and why the Mitanins have been able to act on the social determinants of health, describing the catalysts and processes involved and the enabling programmatic and organizational factors. A qualitative comparative case study of successful action by Mitanin was conducted in two ‘blocks’, purposefully selected as positive exemplars in two districts of Chhattisgarh. One case focused on malnutrition and the other on gender-based violence. Data collection involved 17 in-depth interviews and 10 group interviews with the full range of stakeholders in both blocks, including community members and programme team. Thematic analysis was done using a broad conceptual framework that was further refined. Action on social determinants involved raising awareness on rights, mobilizing women’s collectives, revitalizing local political structures and social action targeting both the community and government service providers. Through these processes, the Mitanins developed identities as agents of change and advocates for the community, both with respect to local cultural and gender norms and in ensuring accountability of service providers. The factors underpinning successful action on social determinants were identified as the significance of the original intent and vision of the programme, and how this was carried through into all aspects of programme design, the role of the Mitanins and their identification with village women, ongoing training and support, and the relative autonomy of the programme. Although the results are not narrowly generalizable and do not necessarily represent the situation of the Mitanin Programme as a whole, the explanatory framework may provide general lessons for programmes in similar contexts. PMID:25274643

Future initiatives to reduce lung cancer incidence in the United Kingdom: smoking cessation, radon remediation and the impact of social change.

PubMed

Denman, Antony R; Rogers, Stephen; Timson, Karen; Phillips, Paul S; Crockett, Robin Gm; Groves-Kirkby, Christopher J

2015-03-01

Smoking and radon cause lung cancer, with smoking being the more significant risk factor. Although programmes to identify UK houses with raised radon levels and to encourage remedial action started in 1990, uptake has been limited and those most at risk, smokers and young families, are not being reached. The risks from smoking and radon are multiplicative. Public health campaigns have reduced smoking prevalence significantly. Since most radon-induced lung cancers occur in smokers, reducing the number of smokers will reduce the number of radon-induced lung cancers. This article considers the impact of reducing smoking prevalence on the effectiveness of radon remediation programmes, combining this with demographic trends and regional variations to assess implications for future public health. Results on cost-effectiveness of smoking cessation and radon remediation programmes were combined with government figures for smoking prevalence to estimate the number of cancers averted and the cost-effectiveness of such programmes, taking into account demographic changes, including increasing life expectancy. Regional variations in smoking prevalence and smoking cessation programmes were reviewed, comparing these to the geographic variation of radon. The continuing impact of smoking cessation programmes in reducing smoking prevalence will reduce the number of radon-induced lung cancers, but with a lag. Smoking cessation programmes are more cost-effective than radon remediation programmes, presenting an additional opportunity to reduce radon risk to smokers. Regional data show no correlation between smoking prevalence and radon levels. Reduced smoking prevalence reduces the effectiveness of radon remediation programmes. This, coupled with limited uptake of radon remediation, suggests that radon remediation programmes should be targeted, and that an integrated public health policy for smoking and radon is appropriate. Lack of correlation between smoking prevalence and radon suggests that local assessment of relative priorities for public health strategies, such as the 'Total Place' initiative, is appropriate. © Royal Society for Public Health 2014.

A public health e-learning master's programme with a focus on health workforce development targeting francophone Africa: the University of Geneva experience.

PubMed

Chastonay, Philippe; Zesiger, Véronique; Moretti, Roberto; Cremaschini, Marco; Bailey, Rebecca; Wheeler, Erika; Mattig, Thomas; Avocksouma, Djona Atchenemou; Mpinga, Emmanuel Kabengele

2015-08-13

Shortage of a competent public health workforce is as a worldwide problem. The situation is especially bad in sub-Saharan Africa. In 2008, the World Health Organization and the Global Health Workforce Alliance launched a call for proposals for a public health training programme with an emphasis on health workforce development specifically targeting Africa. Our article presents the development, implementation and evaluation of an e-learning Master of Advanced Studies in Public Health on Workforce Development. The project was developed in collaboration with academic partner institutions of 10 French-speaking African countries and local/regional/HQ WHO offices. A five-step approach was adopted. First, a needs assessment study was done in the target countries, with identification of priority health issues. Second, student and tutor selection was done in collaboration with local WHO offices, health authorities and partner universities. Third, the e-platform was developed and a training workshop for tutors was organized. Fourth, the learning objectives were derived from the needs assessment study and an interactive educational approach was adopted. Fifth, the participation of students, their perception of the programme, their performance on assignments and community outcomes were monitored. The needs assessment allowed the identification of 12 priority health issues (trauma related to road accidents, maternal and child health, HIV/AIDS, mental heath, food and malnutrition, health resource management, infectious diseases, access to essential drugs, chronic diseases, health promotion, ageing and violence/conflicts) of which 10 were studied through the lens of the key public health disciplines (epidemiology, human resources, health project/service planning, health policy, communication, health economics/management, informatics and ethics/human rights), each validated through a certifying examination. Student participation, measured through connection hits (total: 58 256; mean: 168/student/module) and posted messages (total: 5994; mean: 18/student/module), was good, and global satisfaction was high (7.7/10). Twenty-nine students out of 37 obtained their master's degree from the University of Geneva. Outcomes reported include career development, strengthening of inter-country networks and common projects. Keys to the success of the programme were the enthusiasm and commitment of students, the availability of the coordination team, the simplicity of the electronic platform and the support of local/regional/WHO offices. Yet, the sustainability of the programme is not assured.

An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries.

PubMed

Rehfuess, Eva A; Durão, Solange; Kyamanywa, Patrick; Meerpohl, Joerg J; Young, Taryn; Rohwer, Anke

2016-04-01

To derive evidence-based and stakeholder-informed research priorities for implementation in African settings, the international research consortium Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) developed and applied a pragmatic approach. First, an online survey and face-to-face consultation between CEBHA+ partners and policy-makers generated priority research areas. Second, evidence maps for these priority research areas identified gaps and related priority research questions. Finally, study protocols were developed for inclusion within a grant proposal. Policy and practice representatives were involved throughout the process. Tuberculosis, diabetes, hypertension and road traffic injuries were selected as priority research areas. Evidence maps covered screening and models of care for diabetes and hypertension, population-level prevention of diabetes and hypertension and their risk factors, and prevention and management of road traffic injuries. Analysis of these maps yielded three priority research questions on hypertension and diabetes and one on road traffic injuries. The four resulting study protocols employ a broad range of primary and secondary research methods; a fifth promotes an integrated methodological approach across all research activities. The CEBHA+ approach, in particular evidence mapping, helped to formulate research questions and study protocols that would be owned by African partners, fill gaps in the evidence base, address policy and practice needs and be feasible given the existing research infrastructure and expertise. The consortium believes that the continuous involvement of decision-makers throughout the research process is an important means of ensuring that studies are relevant to the African context and that findings are rapidly implemented.

Optimizing farm landscape by two decision-support tools for present and future: A case study in a mountainous farm of Taiwan

NASA Astrophysics Data System (ADS)

Chou, S.; Lin, Y.

2013-12-01

Rapid expansion of agricultural land-use has been identified as the main factor degrading biodiversity. Many studies have indicated that habitat quality and connectivity for multiple species can be preserved by applying the systematic conservation planning and software programs for spatial conservation prioritizations are usually used by planners to solve conservation problems for present and future. However, each conservation software program uses different algorithms and may not be suitable or efficient for all case studies. Therefore, in this study we compared the performance of two commonly used decision-support tools, Marxan and Zonation, on identifying priority areas as reserve region for 16 bird species in the mountain area of Taiwan. The priority areas are considered as the results of the tradeoff between bird presence (biological factor) and agricultural products (economic factor). Marxan uses the minimum set approach to identify priority areas for meeting specific targets while Zonation uses the maximum coverage approach to identify priority areas given a fixed budget. Therefore, we design the scenario with the most comparable setting, which selects target-based planning as the removal rule and boundary length penalty option in zonation. The landscape composition and configuration of the simulated priority areas were further evaluated by using landscape metrics and their similarity were examined by using Spearman's rank tests. The results showed that Marxan performed more efficiently while Zonation generated the priority areas in better connectivity. As the selection of conservation programs depends on users objectives and needs for present and future, this study provides useful information on determining suitable and efficient decision-support tools for future bird conservation. Conservation maps for Zonation based on different BLP parameter. The conservation value for Zonation is based on the hierarchical solution output. (a)BLP =1000 (b)BLP =3000 (c)BLP =5000 (d)BLP =7000 Conservation maps for Marxan based on different BMP parameter. The conservation value for Marxan is based on the selection frequency. (a)BMP =2500 (b)BMP =5000 (c)BMP =7500 (d)BMP =10000

Scale-dependent complementarity of climatic velocity and environmental diversity for identifying priority areas for conservation under climate change.

PubMed

Carroll, Carlos; Roberts, David R; Michalak, Julia L; Lawler, Joshua J; Nielsen, Scott E; Stralberg, Diana; Hamann, Andreas; Mcrae, Brad H; Wang, Tongli

2017-11-01

As most regions of the earth transition to altered climatic conditions, new methods are needed to identify refugia and other areas whose conservation would facilitate persistence of biodiversity under climate change. We compared several common approaches to conservation planning focused on climate resilience over a broad range of ecological settings across North America and evaluated how commonalities in the priority areas identified by different methods varied with regional context and spatial scale. Our results indicate that priority areas based on different environmental diversity metrics differed substantially from each other and from priorities based on spatiotemporal metrics such as climatic velocity. Refugia identified by diversity or velocity metrics were not strongly associated with the current protected area system, suggesting the need for additional conservation measures including protection of refugia. Despite the inherent uncertainties in predicting future climate, we found that variation among climatic velocities derived from different general circulation models and emissions pathways was less than the variation among the suite of environmental diversity metrics. To address uncertainty created by this variation, planners can combine priorities identified by alternative metrics at a single resolution and downweight areas of high variation between metrics. Alternately, coarse-resolution velocity metrics can be combined with fine-resolution diversity metrics in order to leverage the respective strengths of the two groups of metrics as tools for identification of potential macro- and microrefugia that in combination maximize both transient and long-term resilience to climate change. Planners should compare and integrate approaches that span a range of model complexity and spatial scale to match the range of ecological and physical processes influencing persistence of biodiversity and identify a conservation network resilient to threats operating at multiple scales. © 2017 The Authors. Global Change Biology Published by John Wiley & Sons Ltd.

Accountable priority setting for trust in health systems--the need for research into a new approach for strengthening sustainable health action in developing countries.

PubMed

Byskov, Jens; Bloch, Paul; Blystad, Astrid; Hurtig, Anna-Karin; Fylkesnes, Knut; Kamuzora, Peter; Kombe, Yeri; Kvåle, Gunnar; Marchal, Bruno; Martin, Douglas K; Michelo, Charles; Ndawi, Benedict; Ngulube, Thabale J; Nyamongo, Isaac; Olsen, Oystein E; Onyango-Ouma, Washington; Sandøy, Ingvild F; Shayo, Elizabeth H; Silwamba, Gavin; Songstad, Nils Gunnar; Tuba, Mary

2009-10-24

Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed.Accountability for Reasonableness (AFR) is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i) relevance to the local setting, decided by agreed criteria; ii) publicizing priority-setting decisions and the reasons behind them; iii) the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv) the provision of leadership to ensure that the first three conditions are met.REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being applied in an action research framework to examine the potential of AFR to support sustainable improvements to health systems performance.This paper reports on the project design and progress and argues that there is a high need for research into legitimate and fair priority setting to improve the knowledge base for achieving sustainable improvements in health outcomes.

Use of the Community College Goals Inventory in Assessing Institutional Success in Allocating Appropriate Priorities to Its Goals and to Estimate the Change of Priorities Needed to Achieve Its Intended Outcomes. AIR Forum 1980 Paper.

ERIC Educational Resources Information Center

Capoor, Madan

The use of the Community College Goals Inventory (CCGI) to assess priorities assigned to institutional goals and to estimate priority changes required to reach intended outcomes was studied. The CCGI consists of goal statements that mainly cover outcome and process goal areas. Respondents indicate their perceptions of how much importance is…

Combining endangered plants and animals as surrogates to identify priority conservation areas in Yunnan, China

PubMed Central

Yang, Feiling; Hu, Jinming; Wu, Ruidong

2016-01-01

Suitable surrogates are critical for identifying optimal priority conservation areas (PCAs) to protect regional biodiversity. This study explored the efficiency of using endangered plants and animals as surrogates for identifying PCAs at the county level in Yunnan, southwest China. We ran the Dobson algorithm under three surrogate scenarios at 75% and 100% conservation levels and identified four types of PCAs. Assessment of the protection efficiencies of the four types of PCAs showed that endangered plants had higher surrogacy values than endangered animals but that the two were not substitutable; coupled endangered plants and animals as surrogates yielded a higher surrogacy value than endangered plants or animals as surrogates; the plant-animal priority areas (PAPAs) was the optimal among the four types of PCAs for conserving both endangered plants and animals in Yunnan. PAPAs could well represent overall species diversity distribution patterns and overlap with critical biogeographical regions in Yunnan. Fourteen priority units in PAPAs should be urgently considered as optimizing Yunnan’s protected area system. The spatial pattern of PAPAs at the 100% conservation level could be conceptualized into three connected conservation belts, providing a valuable reference for optimizing the layout of the in situ protected area system in Yunnan. PMID:27538537

Identifying priorities to improve paediatric in-hospital antimicrobial use by cross-sectional evaluation of prevalence and appropriateness of prescription.

PubMed

Goycochea-Valdivia, Walter Alfredo; Moreno-Ramos, Francisco; Paño-Pardo, José Ramón; Aracil-Santos, Francisco Javier; Baquero-Artigao, Fernando; Del Rosal-Rabes, Teresa; Mellado-Peña, María José; Escosa-García, Luis

2017-11-01

Information about paediatric in-hospital antimicrobial usage and prescribing patterns to guide improvement strategies is scant. We aim to use an evaluation of the prevalence and appropriateness of antimicrobial prescription to identify antimicrobial stewardship priorities in children. A cross-sectional point study was performed on hospitalised paediatric patients in a Spanish tertiary hospital, assessing the prevalence of antimicrobial prescription (PAP) and appropriateness of antimicrobial prescription (AAP). AAP was defined as a correct indication plus an appropriate prescribing pattern (dose, spectrum and interval). Evaluation was performed using established antimicrobial guidelines. Other factors that may have a bearing on antimicrobial prescription were also analysed. A total of 171 patients were included. PAP was 49.7% (85/171) and AAP was 60.9% (91/161). The most common indications for antimicrobial use were antimicrobial prophylaxis (28.3%, 32/113) and pneumonia (8.2%, 8/113). Overall, 161 antimicrobials were prescribed (1.9 antimicrobials per patient): 55.3% (89/161) were empiric, 16.1% (26/161) were targeted and 28.6% (46/161) were prophylactic. Amoxicillin/clavulanate (8.2%, 14/171) and sulfamethoxazole/trimethoprim (8.2%, 14/171) were the most prescribed antimicrobials. The prescription of antifungals (11.7%, 20/171) and antivirals (1.8%, 3/171) was analysed. Major causes of inappropriate antibiotic use were prolonged prescriptions (21.7%, 35/161) and use of agents with an excessively broad coverage spectrum (21.1%, 34/161). PAP and AAP varied between wards and antimicrobials. Measurement of PAP and AAP offers valuable information for detecting priorities in hospital settings and monitoring antimicrobial usage prior to the development of antimicrobial stewardship programmes. In our setting, the main areas for improvement are duration of therapy and proper use of broad-spectrum antimicrobials. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Domestic Violence and Pregnancy: A CBPR Coalition Approach to Identifying Needs and Informing Policy.

PubMed

Bright, Candace Forbes; Bagley, Braden; Pulliam, Ivie; Newton, Amy Swetha

2018-01-01

Community engagement-the collaborative process of addressing issues that impact the well-being of a community-is a strategic effort to address community issues. The Gulf States Health Policy Center (GS-HPC) formed the Hattiesburg Area Health Coalition (HAHC) in November 2014 for the purpose of addressing policies impacting the health of Forrest and Lamar counties in Mississippi. To chronicle the community-based participatory research (CBPR) process used by HAHC's identification of infant and maternal health as a policy area, domestic violence in pregnancy as a priority area within infant and maternal health, and a community action plan (CAP) regarding this priority area. HAHC reviewed data and identified infant and maternal health as a priority area. They then conducted a policy scan of local prenatal health care to determine the policy area of domestic violence in pregnancy. HAHC developed a CAP identifying three goals with regard to domestic violence and pregnancy that together informed policy. Changes included the development of materials specific to resources available in the area. The materials and recommended changes will first be implemented by Southeast Mississippi Rural Health Initiative (SeMRHI) through a screening question for all pregnant patients, and the adoption of policies for providing information and referrals. The lack of community-level data was a challenge to HAHC in identifying focus and priority areas, but this was overcome by shared leadership and community engagement. After completion of the CAP, 100% of expecting mothers receiving prenatal care in the area will be screened for domestic violence.

Incentivising innovation in antibiotic drug discovery and development: progress, challenges and next steps

PubMed Central

Simpkin, Victoria L; Renwick, Matthew J; Kelly, Ruth; Mossialos, Elias

2017-01-01

Political momentum and funding for combatting antimicrobial resistance (AMR) continues to build. Numerous major international and national initiatives aimed at financially incentivising the research and development (R&D) of antibiotics have been implemented. However, it remains unclear how to effectively strengthen the current set of incentive programmes to further accelerate antibiotic innovation. Based on a literature review and expert input, this study first identifies and assesses the major international, European Union, US and UK antibiotic R&D funding programmes. These programmes are then evaluated across market and public health criteria necessary for comprehensively improving the antibiotic market. The current set of incentive programmes are an important initial step to improving the economic feasibility of antibiotic development. However, there appears to be a lack of global coordination across all initiatives, which risks duplicating efforts, leaving funding gaps in the value chain and overlooking important AMR goals. This study finds that incentive programmes are overly committed to early-stage push funding of basic science and preclinical research, while there is limited late-stage push funding of clinical development. Moreover, there are almost no pull incentives to facilitate transition of antibiotic products from early clinical phases to commercialisation, focus developer concentration on the highest priority antibiotics and attract large pharmaceutical companies to invest in the market. Finally, it seems that antibiotic sustainability and patient access requirements are poorly integrated into the array of incentive mechanisms. PMID:29089600

Incentivising innovation in antibiotic drug discovery and development: progress, challenges and next steps.

PubMed

Simpkin, Victoria L; Renwick, Matthew J; Kelly, Ruth; Mossialos, Elias

2017-12-01

Political momentum and funding for combatting antimicrobial resistance (AMR) continues to build. Numerous major international and national initiatives aimed at financially incentivising the research and development (R&D) of antibiotics have been implemented. However, it remains unclear how to effectively strengthen the current set of incentive programmes to further accelerate antibiotic innovation. Based on a literature review and expert input, this study first identifies and assesses the major international, European Union, US and UK antibiotic R&D funding programmes. These programmes are then evaluated across market and public health criteria necessary for comprehensively improving the antibiotic market. The current set of incentive programmes are an important initial step to improving the economic feasibility of antibiotic development. However, there appears to be a lack of global coordination across all initiatives, which risks duplicating efforts, leaving funding gaps in the value chain and overlooking important AMR goals. This study finds that incentive programmes are overly committed to early-stage push funding of basic science and preclinical research, while there is limited late-stage push funding of clinical development. Moreover, there are almost no pull incentives to facilitate transition of antibiotic products from early clinical phases to commercialisation, focus developer concentration on the highest priority antibiotics and attract large pharmaceutical companies to invest in the market. Finally, it seems that antibiotic sustainability and patient access requirements are poorly integrated into the array of incentive mechanisms.

78 FR 28292 - Announcement of the Priority Grant Competition For Immediate Release

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... area may be found at our Web site at: http://www.usip.org/grants-fellowships/priority-grant-competition... announced throughout the year. Please visit our Web site at: http://www.usip.org/grants-fellowships/priority..., (202) 429-3842 (phone), (202) 833-1018 (fax), (202) 457-1719 (TTY), Email: [email protected]org . FOR...

Commentary: the value of PrEP for people who inject drugs.

PubMed

Coleman, Rosalind L; McLean, Susie

2016-01-01

The offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection. What does this recommendation mean in terms of the diverse range of HIV prevention needs of key populations, some of whom are so discriminated against that they exist essentially outside formal systems such as national public health services, and for whom a substantial risk of HIV is part of a larger adverse and hostile situation? We discuss this question with reference to people who inject drugs, informed by concerns and comments that emerged from a series of consultations. HIV prevention is part of a spectrum of injecting drug users' priorities, and their access and uptake of HIV prevention services is contingent on their wider "risk environment." The need to address structural barriers to services and human rights violations, and to improve access to comprehensive harm reduction programmes are of prime importance and would have higher value than a mono-focus on HIV prevention. Where existing harm reduction activities are inadequate, fragile or dependent on external donors, shifts in funding priorities, including, for example, towards PrEP, could threaten investment in the broader programmes. For these reasons, it cannot be assumed that PrEP promotion will always be supported by people who inject drugs.The sexual partners of people who inject drugs, non-opioid users who also inject and for whom there is no established substitution treatment, as well as drug users who are unable to negotiate safe sex may value PrEP. As for all key populations, the involvement of people who inject drugs in shaping services for their consumption is vital and too often ignored. For people who inject drugs and who experience discrimination, violence or harassment, implementation of PrEP should be guided by understanding and engaging with their interconnected range of needs, risk practices, priorities and options. The differentiated needs of sub-populations that inject a range of drugs, and their sexual partners, require further exploration.

Patient needs and research priorities in the enteral nutrition market - a quantitative prioritization analysis.

PubMed

Weenen, T C; Jentink, A; Pronker, E S; Commandeur, H R; Claassen, E; Boirie, Y; Singer, P

2014-10-01

A quantitative systematic identification and prioritization of unmet needs and research opportunities in relation to enteral nutrition was conducted by means of a tailor-made health research prioritization process. The research objectives were reached by conducting qualitative interviews followed by quantitative questionnaires targeting enteral nutrition key opinion leaders (KOLs). (1) Define disease areas that deserve more research attention; (2) Rank importance of product characteristics of tube feeding (TF) and oral nutritional supplements (ONS); (3) Assess involvement of KOLs in enteral nutrition R&D process. KOLs ranked three product characteristics and three disease areas that deserve additional research attention. From these, overall priority scores were calculated by multiplying ranks for both product characteristics and disease areas. 17 qualitative interviews were conducted and 77 questionnaires (response rate 35%) were completed and returned. (1) Disease areas in ONS and TF with highest priorities are: ONS: general malnutrition & geriatrics, TF: intensive care. (2) TF product characteristics with highest priorities are: composition and clinical evidence from a KOL perspective; tolerance and ease of use from a patient perspective. ONS product characteristics with highest priorities are: composition, clinical evidence and taste from a KOL perspective; taste from a patient perspective. We find a high discrepancy between product characteristic prioritization from a KOL and patient perspective. (3) Although 62% of all KOLs give advice to enteral nutrition companies on patient needs, they under-influence the setting of research priorities by enteral nutrition companies. This study provides a systematic approach to achieve research prioritization in enteral nutrition. In addition to providing new directions for enteral nutrition research and development, this study highlights the relevance of involving KOLs in the identification of research priorities as they have the ability to provide a balanced view of the unmet patient needs. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Ten years (2004-2014) of Chagas disease surveillance and vector control in Ecuador: successes and challenges.

PubMed

Quinde-Calderón, Leonardo; Rios-Quituizaca, Paulina; Solorzano, Luis; Dumonteil, Eric

2016-01-01

To describe the current situation of Chagas disease in Ecuador and to evaluate the impact of vector control for the period 2004-2014. Since 2004, the Ministry of Public Health has formalized activities for the surveillance and control of Chagas disease and we analyzed here available records. More than 200 000 houses were surveyed, and 2.6% were found to be infested (95% CI: 2.6-2.7), and more than 51 000 houses were sprayed with residual insecticide, with important yearly variations. A total of 915 cases of T. cruzi infection were registered. The Amazon region is emerging as a high priority area, where nearly half of T. cruzi infection cases originate. The costal region and the southern highland valleys remain important high-risk area. Vector control efforts over the past 10 years have been effective in the coastal region, where T. dimidiata predominates, and resulted in important reductions in house infestation indices in many areas, even reaching negligible levels in some parishes. Vector efforts need to be sustained and expanded for the elimination of T. dimidiata to be feasible. Novel vector control interventions need to be designed to reduce intrusion by several triatomine species present in the Amazon region and southern Ecuador. Strong political commitment is needed to sustain current achievements and improve the national coverage of these programmes. © 2015 John Wiley & Sons Ltd.

Identifying research priorities for health care priority setting: a collaborative effort between managers and researchers

PubMed Central

Smith, Neale; Mitton, Craig; Peacock, Stuart; Cornelissen, Evelyn; MacLeod, Stuart

2009-01-01

Background To date there has been relatively little published about how research priorities are set, and even less about methods by which decision-makers can be engaged in defining a relevant and appropriate research agenda. We report on a recent effort in British Columbia to have researchers and decision-makers jointly establish an agenda for future research into questions of resource allocation. Methods The researchers enlisted decision-maker partners from each of British Columbia's six health authorities. Three forums were held, at which researchers and decision-makers from various levels in the health authorities considered possible research areas related to three key focus areas: (1) generation and use of decision criteria and measurement of 'benefit' against such criteria; (2) identification of so-called 'disinvestment' opportunities; and (3) evaluation of the effectiveness of priority setting procedures. Detailed notes were taken from each forum and synthesized into a set of qualitative themes. Results Forum participants suggested that future research into healthcare priority setting would benefit from studies that were longitudinal, comparative, and/or interdisciplinary. As well, participants identified two broad theme areas in which specific research projects were deemed desirable. First, future research might usefully consider how formal priority setting and resource allocation projects are situated within a larger organizational and political context. Second, additional research efforts should be devoted to better understanding and improving the actual implementation of priority setting frameworks, particularly with respect to issues of change management and the resolution of impediments to action on recommendations for resource allocation. Conclusion We were able to validate the importance of initial areas posed to the group and observed emergence of additional concerns and directions of critical importance to these decision-makers at this time. It is likely that the results are broadly applicable to other healthcare contexts. The implementation of this research agenda in British Columbia will depend upon the ability of the researchers and decision-makers to develop particular projects that fit within the constraints of existing funding opportunities. The process of engagement itself had benefits in terms of connecting decision-makers with their peers and sparking increased interest in the use and refinement of priority setting frameworks. PMID:19754969

Sustenance and sustainability: maximizing the impact of school gardens on health outcomes.

PubMed

Davis, Jaimie N; Spaniol, Mackenzie R; Somerset, Shawn

2015-09-01

School garden programmes have become popular action-oriented learning environments in many countries, often driven by converging priorities of environmental sustainability and healthful diets. Many of these programmes have assessed the impact on dietary intake, specifically fruit and vegetable intake, and related dietary behaviours, such as knowledge, preference, motivation, intention and self-efficacy to eat and prepare fruit and vegetables. The objective of the present study was twofold: (i) to review published garden-based programmes conducted in schools targeting dietary intake and/or determinants of dietary behaviour in children; and (ii) to identify similar strategies and components employed by these garden-based programmes. The review included thirteen studies that have examined the impact of garden-based programmes conducted in school, either during school hours or in after-school settings, on dietary behaviours in children (kindergarten through 8th grade students). Three of the reviewed studies did not have a comparison or control group and simply evaluated within-group changes after a garden intervention. None of the reviewed studies were randomized, but were assigned based on school's interest and timing of new school gardens being built. Out of the eleven programmes that examined dietary intake, six found that the programme resulted in increased vegetable intake, whereas four showed no effect. Seven of the eight studies that measured preference found that the programmes resulted in increased preference for vegetables. Gardening programmes also resulted in improved attitudes towards, willingness to taste, identification of and self-efficacy to prepare/cook fruit and vegetables. Similar strategies/components employed by the majority of the programmes included: 'hands on' curriculum, incorporation of a cooking component, providing the instructors, parental and stakeholder support, food provision and using the garden as the focal point for media promotion. Some of the garden programmes resulted in increased vegetable intake, which has positive implications for both environment sustainability and health-related outcomes. Further, the majority resulted in some improvement in behaviour determinants more generally. However, more research is warranted to understand how to achieve long-term improvements in dietary behaviours and how to sustain the garden-based programmes in schools.

Spatial analysis on school environment characteristics in mangrove management based on local wisdom (Case study at Lhokseumawe, Aceh)

NASA Astrophysics Data System (ADS)

Susiloningtyas, Dewi; Handayani, Tuty; Amalia, Naila; Nadhira, Arum Ira

2017-01-01

After 2004 tsunami, lots of efforts have been made, such as building school and distributing mangrove forests. This study examines the perception of teachers and students about mangrove management which spread in the administrative area of Lhokseumawe to become a reference then applied as local education regarding mangrove after tsunami disaster. This paper was based on primary data taken using questionnaire with a predetermined analysis unit to interview teachers and students in the study area. The result presented with quantitative and descriptive analysis. The result is of the total number of junior high schools in the city of Lhokseumawe as many as 41 Public Schools, Private and Religious School, there are 31 schools with priority for local wisdom education implemented mangrove. The result is classified with 3 class. The school’s first priority is schools with a melee, with mangroves mangrove poor condition. Educational priority 2 is schools with close proximity to the mangrove and mangrove condition with moderate levels of damage. Schools with third priority are school with a close range, and mangrove good condition. Priority I as many as 18 schools, 10 schools priority II and 3 school for priority with learning competency standards that differ from each other.

Professional Development Programmes for Teachers in the Northern Territory of Australia: Enablers and Inhibiters for Success in Two Aspirant Leadership Programmes

ERIC Educational Resources Information Center

Speering, Glen

2016-01-01

Professional development programmes for teachers have become an increasing focus in the quest to improve teacher quality. In regional and remote areas of Australia the delivery of professional development programmes can become problematic. This study compares and contrasts the two separate professional development programmes evaluated (Programme A…

What do doctors and nurses think about development of clinical leadership?

PubMed

Lo, David; Till, Alex; McKimm, Judy

2017-09-02

Leadership development for health-care professionals is a priority within the NHS. Training is generally targeted at individual staff groups in isolation, even though contemporary leadership thinking recognizes the benefits of collaborative leadership between different clinical disciplines. Focussing on the attitudes and perceived training needs of undergraduate and qualified medical and nursing professionals, this article highlights the similarities and differences and will help to inform the design of existing and future leadership programmes.

Measurement Uncertainty Within the Uniform Engine Test Programme

DTIC Science & Technology

1989-05-01

Design to Cost and l.ifc (.cle Cost to Aircraft Engines AGARD LS 107 (May 1980) Microcomputer Applications in Power and Propulsion Systems AGARD LS...Flows in Propulsion Systems AGARD LS 140 (June 1985) Engine Airframe Integration for Rotorcraft AGARD LS 148 (June 1986) Design Methods Used in Solid...modest nero-thermodynamic design was of no consequence. Two engines were loaned to the proeram by the U.S. Air Force. Due to higher priority test workload

Cairo conference affirms CEDPA priorities.

PubMed

1995-01-01

The International Conference on Population and Development (ICPD) that was held in Cairo during September adopted a 20-year Programme of Action endorsing the empowerment of women as the foundation of sustainable development. 178 countries and more than a 1000 nongovernmental organizations (NGOs), including the Centre for Development and Population Activities (CEDPA), from 100 countries attended the conference and the parallel NGO forum. The final document sets out specific steps for achievement of universal access to a full range of voluntary, quality family planning and reproductive health services for women and men; provision of services for the special needs of adolescents; closure of the gender gap in education; and empowerment of women via education, health care, and economic options. The CEDPA network of alumnae from 30 countries had worked over the 3 years prior to the conference for the inclusion of women's priorities in policies and to achieve consensus among the government and NGO caucuses. 14 alumnae, including Peggy Curlin (CEDPA President and US delegate), were appointed to their countries' delegations and directly influenced the Programme of Action. The NGO Forum provided a place to exchange experiences and expertise; CEDPA mounted an exhibit, "Empowering Women." The network's theme was "Access, Choice, and Participation." With support from the United Nations Population Fund, CEDPA developed a manual, "After Cairo: A Handbook on Advocacy for Women Leaders," which has been distributed at training sessions and workshops and was translated into French (with support from the US Agency for International Development in Mali) for distribution at the Dakar conference in November in preparation for the World Conference on Women. CEDPA and The Global Committee for Cairo honored the secretary-general of the conference, Dr. Nafis Sadik, for her leadership of the ICPD and UNFPA, and Aziza Hussein, co-chair of the NGO steering committee, at a luncheon; Dr. Sadik received the Global Committee for Cairo Award. Planning the implementation of the Programme of Action has already begun among CEDPA partners and network NGOs. Advocacy networks have already been organized in India and Kenya, with support from CEDPA, to monitor and promote the Programme of Action.

A comparison of global conservation prioritization models with spatial spending patterns of conservation nongovernmental organizations.

PubMed

Holmes, George; Scholfield, Katherine; Brockington, Dan

2012-08-01

In recent decades, various conservation organizations have developed models to prioritize locations for conservation. Through a survey of the spending patterns of 281 conservation nongovernmental organizations (NGOs), we examined the relation between 2 such models and spatial patterns of spending by conservation NGOs in 44 countries in sub-Saharan Africa. We tested whether, at the country level, the proportion of a country designated as a conservation priority was correlated with where NGOs spent money. For one model (the combination of Conservation International's hotspots and High Biodiversity Wilderness Areas, which are areas of high endemism with high or low levels of vegetation loss respectively), there was no relation between the proportion of a country designated as a priority and levels of NGO spending, including by the NGO associated with the model. In the second model (Global 200), the proportion of a country designated as a priority and the amount of money spent by NGOs were significantly and positively related. Less money was spent in countries in northern and western sub-Saharan Africa than countries in southern and eastern Africa, relative to the proportion of the country designated as a conservation priority. We suggest that on the basis of our results some NGOs consider increasing their spending on the areas designated as of conservation priority which are currently relatively underfunded, although there are economic, political, cultural, historical, biological, and practical reasons why current spending patterns may not align with priority sites. ©2012 Society for Conservation Biology.

Phase IV: Deploying ESE Pilot Information Programs for State and Local Government in the Northeast, the Education Community and the Commercial Sector

NASA Technical Reports Server (NTRS)

Brower, Robert N.

2004-01-01

This Summary of Research report is a final report which summarizes significant accomplishments achieved during NASA grant NAG 13-00044 entitled Phase IV: Deploying ESE Pilot Information Programs for State and Local Government in the Northeast, the Education Community and the Commercial Sector , for the period of September 27,2000 through September 26,2004. All activities under this grant have been successfully completed. It has been requested by NASA reviewers that the material contained herein also be considered in $iew of NASA s twelve national priority areas. During the grant period, the nature of the Earth Science Enterprise (ESE) Application Program has been significantly amended (two major restructurings). These amendments have been reviewed at several meetings, including a national gathering held in Washington DC. Additional meetings have occurred with NASA officials at headquarters and at IAGT offices as the newly emerging programs have become defined. The work described herein is considered "cross-cutting", meaning that it has relevancy to several of the national priority areas. The time period covered requires that the twelve national priority areas initially articulated by NASA be considered. (Subsequent NASA revision has eliminated "community growth" as a focus area. It is not clear how this area might be treated in the future NASA organizational structure, but it is noted that the work reported herein includes clear potential for application to the previously defined community growth area, as well as most of the other application areas.) As indicated in the accompanying figure, activity reports throughout this report can be "mapped" to the priority areas.

What are your priorities right now? Identifying service needs across recovery stages to inform service development.

PubMed

Laudet, Alexandre B; White, William

2010-01-01

Substance use disorders (SUD) are, for many, chronic conditions that are typically associated with severe impairments in multiple areas of functioning. "Recovery" from SUD is, for most, a lengthy process; improvements in other areas of functioning do not necessarily follow the attainment of abstinence. The current SUD service model providing intense, short-term, symptom-focused services is ill-suited to address these issues. A recovery-oriented model of care is emerging, which provides coordinated recovery-support services using a chronic-care model of sustained recovery management. Information is needed about substance users' priorities, particularly persons in recovery who are not currently enrolled in treatment, to guide the development of recovery-oriented systems. As a first step in filling this gap, we present qualitative data on current life priorities among a sample of individuals that collectively represent successive recovery stages (N = 356). Findings suggest that many areas of functioning remain challenging long after abstinence is attained, most notably employment and education, family/social relations, and housing. Although the ranking of priorities changes somewhat across recovery stages, employment is consistently the second most important priority, behind working on one's recovery. Study limitations are noted, and the implications of findings for the development and evaluation of recovery-oriented services are discussed.

Identifying research priorities for patient safety in mental health: an international expert Delphi study

PubMed Central

Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie

2018-01-01

Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Main outcome measures Agreement in research priorities on a five-point scale. Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. PMID:29502096

[Wetlands of priority restoration in Northeast China based on spatial analysis].

PubMed

Dong, Zhang-Yu; Liu, Dian-Wei; Wang, Zong-Ming; Ren, Chun-Ying; Tang, Xu-Guang; Jia, Ming-Ming; Wang, Yan

2013-01-01

By using GIS/RS technology, and from the aspects of landscape structure, river- and road densities, wetness index, geomorphology, and cultivated land productivity, a spatial analysis was made on the potentiality of wetland restoration in Northeast China, with the regions of priority and secondary priority restoration wetlands determined. Then, by using the coordinated development index of crop production and wetland as well as the landscape indices, the wetland restoration effect was verified. In Northeast China, the wetland area of priority restoration was 1.78 x 10(6) hm2, among which, farmland and grassland were the main types for restoration, accounting for 96.7% of the total, and mainly located in the Sanjiang Plain in the northeastern part and the Songnen Plain in the central part of Northeast China. The wetland area of secondary priority restoration was 1.03 x 10(6) hm2. After the restoration of the wetlands, the wetland area in Northeast China would be increased by 37.4%, compared with the present wetland area, and the value of the coordinated development index of crop production and wetland would increase from 0.539 before restoration to 0.733 after restoration. The landscape pattern would be more benefit to the performance of the ecological functions of the wetlands. This study revealed that the restoration scheme of the wetlands in Northeast China based on spatial analysis was practicable, which could provide data support for the implement of wetland restoration and the improvement of ecological environment in Northeast China.

Compulsory service programmes for recruiting health workers in remote and rural areas: do they work?

PubMed Central

Mullan, Fitzhugh; Payne, Perry W; Ross, Heather

2010-01-01

Abstract Compulsory service programmes have been used worldwide as a way to deploy and retain a professional health workforce within countries. Other names for these programmes include ”obligatory”, ”mandatory”, ”required” and ”requisite.” All these different programme names refer to a country’s law or policy that governs the mandatory deployment and retention of a heath worker in the underserved and/or rural areas of the country for a certain period of time. This study identified three different types of compulsory service programmes in 70 countries. These programmes are all governed by some type of regulation, ranging from a parliamentary law to a policy within the ministry of health. Depending on the country, doctors, nurses, midwives and all types of professional allied health workers are required to participate in the programme. Some of the compliance-enforcement measures include withholding full registration until obligations are completed, withholding degree and salary, or imposing large fines. This paper aims to explain these programmes more clearly, to identify countries that have or had such programmes, to develop a typology for the different kinds and to discuss the programmes in the light of important issues that are related to policy concepts and implementation. As governments consider the cost of investment in health professionals’ education, the loss of health professionals to emigration and the lack of health workers in many geographic areas, they are using compulsory service requirements as a way to deploy and retain the health workforce. PMID:20461136

State-of-the-Art: Research Priorities in Deaf-Blindness. Proceedings of a Conference (Washington, D.C., November 2-5, 1984).

ERIC Educational Resources Information Center

Stahlecker, James E., Ed.; And Others

Ten papers are presented from a 1984 conference on research priorities in deaf-blindness. Each of five areas is examined first with a review of the literature and second with priorities for future research, summarizing the recommendations of the 10-member group. Responses to questionnaires sent to rehabilitation counselors, university affiliated…

Prioritising in situ conservation of crop resources: A case study of African cowpea (Vigna unguiculata)

PubMed Central

Moray, C.; Game, E. T.; Maxted, N.

2014-01-01

Conserving crop wild relatives (CWR) is critical for maintaining food security. However, CWR-focused conservation plans are lacking, and are often based on the entire genus, even though only a few taxa are useful for crop improvement. We used taxonomic and geographic prioritisation to identify the best locations for in situ conservation of the most important (priority) CWR, using African cowpea (Vigna unguiculata (L.) Walp.) as a case study. Cowpea is an important crop for subsistence farmers in sub-Saharan Africa, yet its CWR are under-collected, under-conserved and under-utilised in breeding. We identified the most efficient sites to focus in situ cowpea CWR conservation and assessed whether priority CWR would be adequately represented in a genus-based conservation plan. We also investigated whether priority cowpea CWR are likely to be found in existing conservation areas and in areas important for mammal conservation. The genus-based method captured most priority CWR, and the distributions of many priority CWR overlapped with established conservation reserves and targets. These results suggest that priority cowpea CWR can be conserved by building on conservation initiatives established for other species. PMID:24936740

Prioritising in situ conservation of crop resources: a case study of African cowpea (Vigna unguiculata).

PubMed

Moray, C; Game, E T; Maxted, N

2014-06-17

Conserving crop wild relatives (CWR) is critical for maintaining food security. However, CWR-focused conservation plans are lacking, and are often based on the entire genus, even though only a few taxa are useful for crop improvement. We used taxonomic and geographic prioritisation to identify the best locations for in situ conservation of the most important (priority) CWR, using African cowpea (Vigna unguiculata (L.) Walp.) as a case study. Cowpea is an important crop for subsistence farmers in sub-Saharan Africa, yet its CWR are under-collected, under-conserved and under-utilised in breeding. We identified the most efficient sites to focus in situ cowpea CWR conservation and assessed whether priority CWR would be adequately represented in a genus-based conservation plan. We also investigated whether priority cowpea CWR are likely to be found in existing conservation areas and in areas important for mammal conservation. The genus-based method captured most priority CWR, and the distributions of many priority CWR overlapped with established conservation reserves and targets. These results suggest that priority cowpea CWR can be conserved by building on conservation initiatives established for other species.

The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)--a sentinel approach in the European Union (EU)/European Economic Area (EEA).

PubMed

Spiteri, Gianfranco; Cole, Michelle; Unemo, Magnus; Hoffmann, Steen; Ison, Catherine; van de Laar, Marita

2013-12-01

Antimicrobial resistance in Neisseria gonorrhoeae is monitored in the European Union/European Economic Area through the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) coordinated by the European Centre for Disease Prevention and Control. Euro-GASP includes a sentinel surveillance programme which aims to detect in a timely manner changes in resistance patterns and inform treatment guidelines. The programme aims to test a representative number of isolates from each European Union/European Economic Area member state per year for a range of therapeutically relevant antimicrobials through a biannual hybrid centralised/decentralised system. Testing is supported by an External Quality Assurance programme and a laboratory training programme. Participation in the programme has increased to 21 countries in 2012. Euro-GASP has been able to detect the rapid spread of isolates with decreased susceptibility to cefixime across Europe in 2010 and 2011. Results from the programme have informed changes in European treatment guidelines for gonorrhoea and led to the development of the 'Response plan to control and manage the threat of multidrug resistant gonorrhoea in Europe'. Future challenges for Euro-GASP include supporting countries to participate in Euro-GASP through decentralised testing, improving timeliness and epidemiological data quality, and increasing participation from Eastern Europe.

HIV and Alcohol Research Priorities of City, State, and Federal Policymakers: Results of a Delphi Study

PubMed Central

Li, Lingfeng; Braithwaite, Ronald Scott

2015-01-01

We identified the research areas related to HIV and alcohol consumption that were of highest priority to city, state, and federal policymakers. From June to July 2014, we conducted a 3-round Delphi study to elicit from experts a list of alcohol- and HIV-related clinical trial research questions that were important to fund and rank order the list to identify questions of highest priority. Translating evidence into practice must be improved because some questions that have been extensively studied with results published in peer-reviewed journals were identified by the panel as areas needing additional research. PMID:26180968

HIV and Alcohol Research Priorities of City, State, and Federal Policymakers: Results of a Delphi Study.

PubMed

Uyei, Jennifer; Li, Lingfeng; Braithwaite, Ronald Scott

2015-09-01

We identified the research areas related to HIV and alcohol consumption that were of highest priority to city, state, and federal policymakers. From June to July 2014, we conducted a 3-round Delphi study to elicit from experts a list of alcohol- and HIV-related clinical trial research questions that were important to fund and rank order the list to identify questions of highest priority. Translating evidence into practice must be improved because some questions that have been extensively studied with results published in peer-reviewed journals were identified by the panel as areas needing additional research.

If it works there, will it work here? The effect of a multi-component responsible beverage service (RBS) programme on violence in Oslo.

PubMed

Skardhamar, Torbjørn; Fekjær, Silje Bringsrud; Pedersen, Willy

2016-12-01

The Stockholm Prevents Alcohol and Drug Problems (STAD) programme has been regarded as one of the most successful programmes to date, in reducing alcohol-related violence. This multi-component Responsible Beverage Service (RBS) programme was implemented in Stockholm, Sweden, and has been documented to be extremely effective in reducing alcohol-related nightlife violence. The SALUTT programme in Oslo, Norway was carefully modelled on the STAD project. We investigate whether the results from STAD were replicated in the SALUTT intervention. Using geocoded data, the level of violence in the intervention area was compared with different control areas before and after the intervention. Autoregressive moving average models (ARIMA). The SALUTT programme had no statistically significant effect on violence. However, the level of violence in the different potential control areas of Oslo fluctuated without a clear common trend. Hence, it was difficult to establish proper control areas. The results from the Swedish STAD-intervention were not replicated in Oslo. Successful interventions are not necessarily replicated in other contexts, and the current literature does not shed sufficient light on the conditions under which such interventions actually work. Moreover, more attention should be devoted to the identification of adequate control areas in future research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Climate Change and the Distribution of Neotropical Red-Bellied Toads (Melanophryniscus, Anura, Amphibia): How to Prioritize Species and Populations?

PubMed Central

Zank, Caroline; Becker, Fernando Gertum; Abadie, Michelle; Baldo, Diego; Maneyro, Raúl; Borges-Martins, Márcio

2014-01-01

We used species distribution modeling to investigate the potential effects of climate change on 24 species of Neotropical anurans of the genus Melanophryniscus. These toads are small, have limited mobility, and a high percentage are endangered or present restricted geographical distributions. We looked at the changes in the size of suitable climatic regions and in the numbers of known occurrence sites within the distribution limits of all species. We used the MaxEnt algorithm to project current and future suitable climatic areas (a consensus of IPCC scenarios A2a and B2a for 2020 and 2080) for each species. 40% of the species may lose over 50% of their potential distribution area by 2080, whereas 28% of species may lose less than 10%. Four species had over 40% of the currently known occurrence sites outside the predicted 2080 areas. The effect of climate change (decrease in climatic suitable areas) did not differ according to the present distribution area, major habitat type or phylogenetic group of the studied species. We used the estimated decrease in specific suitable climatic range to set a conservation priority rank for Melanophryniscus species. Four species were set to high conservation priority: M. montevidensis, (100% of its original suitable range and all known occurrence points potentially lost by 2080), M. sp.2, M. cambaraensis, and M. tumifrons. Three species (M. spectabilis, M. stelzneri, and M. sp.3) were set between high to intermediate priority (more than 60% decrease in area predicted by 2080); nine species were ranked as intermediate priority, while eight species were ranked as low conservation priority. We suggest that monitoring and conservation actions should be focused primarily on those species and populations that are likely to lose the largest area of suitable climate and the largest number of known populations in the short-term. PMID:24755937

Priorities for Investments in Children and Families in Caddo and Bossier Parishes: Application of a Unique Framework for Identifying Priorities. Technical Report

ERIC Educational Resources Information Center

Kilburn, M. Rebecca; Maloney, Shannon I.

2010-01-01

After an initial inventory of community indicators in its 2008 Shreveport-Bossier City "Community Counts" annual report, the Community Foundation of Shreveport-Bossier decided to focus existing funding related to children and families on the areas of education, health, and poverty, as well as develop new funds in these areas. These focal…

Required competencies of occupational physicians: a Delphi survey of UK customers.

PubMed

Reetoo, K N; Harrington, J M; Macdonald, E B

2005-06-01

Occupational physicians can contribute to good management in healthy enterprises. The requirement to take into account the needs of the customers when planning occupational health services is well established. To establish the priorities of UK employers, employees, and their representatives regarding the competencies they require from occupational physicians; to explore the reasons for variations of the priorities in different groups; and to make recommendations for occupational medicine training curricula in consideration of these findings. This study involved a Delphi survey of employers and employees from public and private organisations of varying business sizes, and health and safety specialists as well as trade union representatives throughout the UK. It was conducted in two rounds by a combination of computer assisted telephone interview (CATI) and postal survey techniques, using a questionnaire based on the list of competencies described by UK and European medical training bodies. There was broad consensus about the required competencies of occupational physicians among the respondent subgroups. All the competencies in which occupational physicians are trained were considered important by the customers. In the order of decreasing importance, the competencies were: Law and Ethics, Occupational Hazards, Disability and Fitness for Work, Communication, Environmental Exposures, Research Methods, Health Promotion, and Management. The priorities of customers differed from previously published occupational physicians' priorities. Existing training programmes for occupational physicians should be regularly reviewed and where necessary, modified to ensure that the emphasis of training meets customer requirements.

In eHealth in India today, the nature of work, the challenges and the finances: an interview-based study

PubMed Central

2014-01-01

Background India is a country with vast unmet medical needs. eHealth has the potential to improve the quality of health care and reach the unreached. We have sought to understand the kinds of eHealth programmes being offered in India today, the challenges they face and the nature of their financing. Methods We have adopted an interview-based methodology. The 30 interviews represent 28 organizations, and include designers, implementers, evaluators and technology providers for eHealth programmes. Results A range of programmes is being run, including point-of-care in rural and urban areas, treatment compliance, data collection and disease surveillance, and distant medical education. Most programmes provide point-of-care to patients or other beneficiaries in rural areas. Technology is not a limiting factor but the unavailability of suitable health personnel is a major challenge, especially in rural areas. We have identified a few factors that help this situation. Financial sustainability is also a concern for most programmes, which have rarely been scaled up. There are recent for-profit efforts in urban areas, but no reliable business model has been identified yet. Government facilities have not been very effective in eHealth on their own, but collaborations between the government and non-profit (in particular) and for-profit organisations have led to impactful programmes. Conclusions It is unlikely that eHealth will have widespread and sustainable impact without government involvement, especially in rural areas. Nevertheless, programmes run solely by the government are unlikely to be the most effective. PMID:24387627

Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India.

PubMed

Mohanan, Manoj; Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

2017-05-01

To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme - the World Health Partners' Sky Program. We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers' performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. The programme did not significantly improve health-care providers' knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up.

Process factors explaining the ineffectiveness of a multidisciplinary fall prevention programme: A process evaluation

PubMed Central

Bleijlevens, Michel HC; Hendriks, Marike RC; van Haastregt, Jolanda CM; van Rossum, Erik; Kempen, Gertrudis IJM; Diederiks, Joseph PM; Crebolder, Harry FJM; van Eijk, Jacques ThM

2008-01-01

Background Falls are a major health threat to older community-living people, and initiatives to prevent falls should be a public health priority. We evaluated a Dutch version of a successful British fall prevention programme. Results of this Dutch study showed no effects on falls or daily functioning. In parallel to the effect evaluation, we carried out a detailed process evaluation to assess the feasibility of our multidisciplinary fall prevention programme. The present study reports on the results of this process evaluation. Methods Our fall prevention programme comprised a medical and occupational-therapy assessment, resulting in recommendations and/or referrals to other services if indicated. We used self-administered questionnaires, structured telephone interviews, structured recording forms, structured face-to-face interviews and a plenary group discussion to collect data from participants allocated to the intervention group (n = 166) and from all practitioners who performed the assessments (n = 8). The following outcomes were assessed: the extent to which the multidisciplinary fall prevention programme was performed according to protocol, the nature of the recommendations and referrals provided to the participants, participants' self-reported compliance and participants' and practitioners' opinions about the programme. Results Both participants and practitioners judged the programme to be feasible. The programme was largely performed according to protocol. The number of referrals and recommendations ensuing from the medical assessment was relatively small. Participants' self-reported compliance as regards contacting their GP to be informed of the recommendations and/or referrals was low to moderate. However, self-reported compliance with such referrals and recommendations was reasonable to good. A large majority of participants reported they had benefited from the programme. Conclusion The results of the present study show that the programme was feasible for both practitioners and participants. Main factors that seem to be responsible for the lack of effectiveness are the relatively low number of referrals and recommendations ensuing from the medical assessments and participants' low compliance as regards contacting their GP about the results of the medical assessment. We do not recommend implementing the programme in its present form in regular care. Trial registration ISRCTN64716113 PMID:18816381

Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Engineering Research Centers. Final priority.

PubMed

2014-06-05

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Technologies to Enhance Independence in Daily Living for Adults with Cognitive Impairments. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improved outcomes related to independence in daily activities in the home, community, or workplace setting for adults with cognitive impairments.

Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Engineering Research Centers. Final priority.

PubMed

2014-07-09

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Improving the Accessibility, Usability, and Performance of Technology for Individuals who are Deaf or Hard of Hearing. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improving the accessibility, usability, and performance of technology for individuals who are deaf or hard of hearing.

Integrating habitat status, human population pressure, and protection status into biodiversity conservation priority setting

USGS Publications Warehouse

Shi, Hua; Singh, Ashbindu; Kant, S.; Zhu, Zhiliang; Waller, E.

2005-01-01

Priority setting is an essential component of biodiversity conservation. Existing methods to identify priority areas for conservation have focused almost entirely on biological factors. We suggest a new relative ranking method for identifying priority conservation areas that integrates both biological and social aspects. It is based on the following criteria: the habitat's status, human population pressure, human efforts to protect habitat, and number of endemic plant and vertebrate species. We used this method to rank 25 hotspots, 17 megadiverse countries, and the hotspots within each megadiverse country. We used consistent, comprehensive, georeferenced, and multiband data sets and analytical remote sensing and geographic information system tools to quantify habitat status, human population pressure, and protection status. The ranking suggests that the Philippines, Atlantic Forest, Mediterranean Basin, Caribbean Islands, Caucasus, and Indo-Burma are the hottest hotspots and that China, the Philippines, and India are the hottest megadiverse countries. The great variation in terms of habitat, protected areas, and population pressure among the hotspots, the megadiverse countries, and the hotspots within the same country suggests the need for hotspot- and country-specific conservation policies.

Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

PubMed

2013-06-19

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Technologies to Support Successful Aging with Disability under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

PubMed

2013-06-14

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Universal Interfaces and Information Technology Access under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

A Research Agenda for Helminth Diseases of Humans: Social Ecology, Environmental Determinants, and Health Systems

PubMed Central

Gazzinelli, Andrea; Correa-Oliveira, Rodrigo; Yang, Guo-Jing; Boatin, Boakye A.; Kloos, Helmut

2012-01-01

In this paper, the Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), with the mandate to review helminthiases research and identify research priorities and gaps, focuses on the environmental, social, behavioural, and political determinants of human helminth infections and outlines a research and development agenda for the socioeconomic and health systems research required for the development of sustainable control programmes. Using Stockols' social-ecological approach, we describe the role of various social (poverty, policy, stigma, culture, and migration) and environmental determinants (the home environment, water resources development, and climate change) in the perpetuation of helminthic diseases, as well as their impact as contextual factors on health promotion interventions through both the regular and community-based health systems. We examine these interactions in regard to community participation, intersectoral collaboration, gender, and possibilities for upscaling helminthic disease control and elimination programmes within the context of integrated and interdisciplinary approaches. The research agenda summarises major gaps that need to be addressed. PMID:22545168

Usability-driven evolution of a space instrument

NASA Astrophysics Data System (ADS)

McCalden, Alec

2012-09-01

The use of resources in the cradle-to-grave timeline of a space instrument might be significantly improved by considering the concept of usability from the start of the mission. The methodology proposed here includes giving early priority in a programme to the iterative development of a simulator that models instrument operation, and allowing this to evolve ahead of the actual instrument specification and fabrication. The advantages include reduction of risk in software development by shifting much of it to earlier in a programme than is typical, plus a test programme that uses and thereby proves the same support systems that may be used for flight. A new development flow for an instrument is suggested, showing how the system engineering phases used by the space agencies could be reworked in line with these ideas. This methodology is also likely to contribute to a better understanding between the various disciplines involved in the creation of a new instrument. The result should better capture the science needs, implement them more accurately with less wasted effort, and more fully allow the best ideas from all team members to be considered.

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed Central

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-01-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-07-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.

Cost-benefit analysis of the polypill in the primary prevention of myocardial infarction and stroke.

PubMed

Wald, Nicholas J; Luteijn, Johannes Michiel; Morris, Joan K; Taylor, David; Oppenheimer, Peter

2016-04-01

The primary prevention of cardiovascular disease is a public health priority. To assess the costs and benefits of a Polypill Prevention Programme using a daily 4-component polypill from age 50 in the UK, we determined the life years gained without a first myocardial infarction (MI) or stroke, together with the total service cost (or saving) and the net cost (or saving) per year of life gained without a first MI or stroke. This was estimated on the basis of a 50 % uptake and a previously published 83 % treatment adherence. The total years of life gained without a first MI or stroke in a mature programme is 990,000 each year in the UK. If the cost of the Polypill Prevention Programme were £1 per person per day, the total cost would be £4.76 bn and, given the savings (at 2014 prices) of £2.65 bn arising from the disease prevented, there would be a net cost of £2.11 bn representing a net cost per year of life gained without a first MI or stroke of £2120. The results are robust to sensitivity analyses. A national Polypill Prevention Programme would have a substantial effect in preventing MIs and strokes and be cost-effective.

Priority strategies for India's family planning programme

PubMed Central

Pachauri, Saroj

2014-01-01

Strategies to accelerate progress of India's family planning programme are discussed and the importance of improving the quality and reach of services to address unmet contraceptive need by providing method choice is emphasized. Although there is a growing demand for both limiting and spacing births, female sterilisation, is the dominant method in the national programme and use of spacing methods remains very limited. Fertility decline has been slower in the empowered action group (EAG) States which contribute about 40 per cent of population growth to the country and also depict gloomy statistics for other socio-development indicators. It is, therefore, important to intensify efforts to reduce both fertility and mortality in these States. A rationale has been provided for implementing integrated programmes using a gender lens because the lack of women's autonomy in reproductive decision-making, compounded by poor male involvement in sexual and reproductive health matters, is a fundamental issue yet to be addressed. The need for collaboration between scientists developing contraceptive technologies and those implementing family planning services is underscored. If contraceptive technologies are developed with an understanding of the contexts in which they will be delivered and an appreciation of end-users’ needs and perspectives, they are more likely to be accepted by service providers and used by clients. PMID:25673535

Integrated control programmes for schistosomiasis and other helminth infections in P.R. China.

PubMed

Xu, Jing; Xu, Jun-Fang; Li, Shi-Zhu; Zhang, Li-Juan; Wang, Qiang; Zhu, Hui-Hui; Zhou, Xiao-Nong

2015-01-01

The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon. Copyright © 2013 Elsevier B.V. All rights reserved.

Coverage gap in maternal and child health services in India: assessing trends and regional deprivation during 1992-2006.

PubMed

Kumar, Chandan; Singh, Prashant Kumar; Rai, Rajesh Kumar

2013-12-01

Increasing the coverage of key maternal, newborn and child health interventions is essential, if India has to attain Millennium Development Goals 4 and 5. This study assesses the coverage gap in maternal and child health services across states in India during 1992-2006 emphasizing the rural-urban disparities. Additionally, association between the coverage gap and under-5 mortality rate across states are illustrated. The three waves of National Family Health Survey (NFHS) conducted during 1992-1993 (NFHS-1), 1998-1999 (NFHS-2) and 2005-2006 (NFHS-3) were used to construct a composite index of coverage gap in four areas of health-care interventions: family planning, maternal and newborn care, immunization and treatment of sick children. The central, eastern and northeastern regions of India reported a higher coverage gap in maternal and child health care services during 1992-2006, while the rural-urban difference in the coverage gap has increased in Gujarat, Haryana, Rajasthan and Kerala over the period. The analysis also shows a significant positive relationship between the coverage gap index and under-five mortality rate across states. Region or area-specific focus in order to increase the coverage of maternal and child health care services in India should be the priority of the policy-makers and programme executors.

Profile: Manhiça Health Research Centre (Manhiça HDSS).

PubMed

Sacoor, Charfudin; Nhacolo, Ariel; Nhalungo, Delino; Aponte, John J; Bassat, Quique; Augusto, Orvalho; Mandomando, Inácio; Sacarlal, Jahit; Lauchande, Natu; Sigaúque, Betuel; Alonso, Pedro; Macete, Eusébio; Munguambe, Khátia; Guinovart, Caterina; Aide, Pedro; Menendez, Clara; Acácio, Sozinho; Quelhas, Diana; Sevene, Esperança; Nhampossa, Tacilta

2013-10-01

The Manhiça Health Research Centre, established in 1996 in a rural area of southern Mozambique, currently follows around 92 000 individuals living in approximately 20 000 enumerated and geo-positioned households. Its main strength is the possibility of linking demographic data and clinical data to promote and conduct biomedical research in priority health areas. Socio-demographic data are updated twice a year and clinical data are collected on a daily basis. The data collected in Manhiça HDSS comprises household and individual characteristics, household socio-economic assets, vital data, migration, individual health history and cause of death, among others. Studies conducted in this HDSS contributed to guide the health authorities and decision-making bodies to define or adjust health policies such as the introduction of Mozambique's expanded programme of immunization with different vaccines (Haemophilus influenzae type b, Pneumococcus) or the development of the concept of Intermittent Preventive Treatment for Infants (IPTi) that led to the World Health Organization recommendation of this method as best practice for the control of malaria among infants. Manhiça's data can be accessed through a formal request to Diana Quelhas (diana.quelhas@manhica.net) accompanied by a proposal that will be analysed by the Manhiça HDSS internal scientific and ethics committees.

The Chilean Rural Practitioner Programme: a multidimensional strategy to attract and retain doctors in rural areas

PubMed Central

Peña, Sebastian; Ramirez, Jorge; Becerra, Carlos; Carabantes, Jorge

2010-01-01

Abstract Developing countries currently face internal and external migration of their health workforce and interventions are needed to attract and retain health professionals in rural areas. Evidence of multidimensional interventions, however, is scarce. This study explores a long-standing strategy to attract and retain doctors to rural areas in Chile: the Rural Practitioner Programme. The main objective is to describe the programme, characterize its multidimensional set of incentives and appraise preliminary programme outcomes. Retrospective national data were employed to examine recruitment, retention and incentives provided to extend the length of stay and motivate non-clinical work. The programme has successfully recruited a large number of applicants, with acceptance rates close to 100%. Retention rates are nearly 100% (drop-outs are exceptional), but only 58% of participants stay for the maximum period. Areas with greater work difficulty are attracting the best-ranked applicants, but incentives to engage in community projects, management responsibilities, continuous medical education and research have achieved mixed results. Rural doctors are satisfied with their experience and 70% plan to practise as specialists in a referral hospital. The programme has successfully matched the interests of physicians in specialization with the country’s need for rural doctors. However, a gap might be forming between the demand for certain specialties and what the programme can offer. There is a need to conciliate both parties, which will require a more refined strategy than before. This should be grounded in robust knowledge based on programme outcomes and evidence of the interests and motivations of health professionals. PMID:20461139

Evaluation of a pilot oral health promotion programme 'Keep Smiling': perspectives from GDPs, health champions and school staff.

PubMed

Yusuf, H; Wright, K; Robertson, C

2015-04-24

To evaluate a pilot oral health promotion programme (fluoride varnish and tooth brushing), targeting 3-7-year-olds in primary schools in a deprived area of London. A pilot programme was conducted among five primary schools targeting 3-7-year-old children in a deprived area of London. The programme consisted of a fluoride varnish application and tooth brushing sessions. Outcome (participation rates) and process evaluations were carried out using semi-structured interviews with school staff, health champions and dentists. Overall, 79.2% of the targeted children participated in tooth brushing and 68.6% of children received fluoride varnish. The programme received positive feedback from school staff, dental teams and health champions. It raised awareness of dental health among all stakeholders and provided children with a unique experience, creating a positive image of dental teams. Community engagement and collaboration between health, education and the voluntary sector is feasible and integral in developing oral health promotion programmes aimed at children attending primary schools in a deprived area of London.

The Cockcroft difference: an analysis of the impact of a nursing leadership development programme.

PubMed

Chappell, Kate K; Willis, Leah

2013-03-01

Identifying impact areas of nursing leadership development programmes is needed to determine if there are measureable effects on participants. These impact areas help to identify measures to substantiate the benefits of nursing leadership programmes for organization leaders making decisions about support and implementation of such opportunities for their emerging leaders. Using mixed qualitative/quantitative methods, the impact of a nursing leadership development programme, the Amy V. Cockcroft Fellowship, is examined to determine if there are measureable influences. Themes of four areas of impact: improved conflict resolution/negotiation skills, communication skills, personal development and career action or change were identified through content analysis. These themes provide the basis for creating measureable indicators for nursing organizations to use in determining the value of nursing leadership development programmes such as the Amy V. Cockcroft Fellowship. Based on the findings established in this research article, nurse managers can focus on developing themselves and their peer groups through nursing leadership development programmes to prepare for leading in the present and future healthcare environment. © 2012 Blackwell Publishing Ltd.

Attention, Intention, and Priority in the Parietal Lobe

PubMed Central

Bisley, James W.; Goldberg, Michael E.

2013-01-01

For many years there has been a debate about the role of the parietal lobe in the generation of behavior. Does it generate movement plans (intention) or choose objects in the environment for further processing? To answer this, we focus on the lateral intraparietal area (LIP), an area that has been shown to play independent roles in target selection for saccades and the generation of visual attention. Based on results from a variety of tasks, we propose that LIP acts as a priority map in which objects are represented by activity proportional to their behavioral priority. We present evidence to show that the priority map combines bottom-up inputs like a rapid visual response with an array of top-down signals like a saccade plan. The spatial location representing the peak of the map is used by the oculomotor system to target saccades and by the visual system to guide visual attention. PMID:20192813

Identifying research priorities with nurses at a tertiary children's hospital in the United Kingdom.

PubMed

Williams, A; Sell, D; Oulton, K; Wilson, N; Wray, J; Gibson, F

2017-03-01

The objective of this study was to undertake a research priority setting exercise with the aim of maximizing efficiency and impact in research activity undertaken by nurses at one children's tertiary healthcare institution by ensuring the clinical staff directly shaped a coherent, transparent and consensus driven nurse-led research agenda. In Round 1, the research topics of 147 nurses were elicited using a modified nominal group technique as the consensus method. The number of participants in the 24 separate discussions ranged from 3 to 21, generating lists of between 6 and 23 topics. In Round 2, nurses from the clinical areas ranked topics of importance resulting in a set of four to five priorities. In Round 3, the divisional heads of nursing consulted with staff in all of their clinical areas to each finalize their five divisional priorities. The Nursing Research Working Group discussed and refined the divisions' priorities and voted on the final list to agree the top five research priorities for the organization. A total of 269 research topics were initially generated. Following three rounds of ranking and prioritizing, five priorities were agreed at Divisional level, and from these, the five top organizational priorities were selected. These were (i) understanding and improving all aspects of the patient journey through the hospital system; (ii) play; (iii) staff wellbeing, patient care and productivity; (iv) team work - linking to a more efficient service; and (v) supporting parents/parent pathway. Divisional priorities have been disseminated widely to clinical teams to inform a patient-specific nurse-led research agenda. Organizational priorities agreed upon have been disseminated through management structures and processes to ensure engagement at all levels. A subgroup of the Nursing Research Working Group has been delegated to take this work forward so that the agreed priorities continue to contribute towards shaping nurse-led research activity, thereby going some way to inform and embed an evidence-based culture of inquiry. © 2016 John Wiley & Sons Ltd.

C3 EVAL Model Development and Test. Volume 2. Programmers Manual.

DTIC Science & Technology

1985-10-01

requests for CAS (message types 2900, 3000, 3400) and has a non- 61 - ~~.t -o-5. Sd% NODE MESSAGE DEST DEST PLINK LINKI ALT1 LINK2 ALT2 . LINKP • LINKA1...LINKA2 LINKn ALTi PLINK LINKI LINK2 LINKn ALT2 PLINK LINKI LINK2 * LINKn Figure 13: PARAMETERS IN COMMUNICATIONS ALLOCATION null pointer to its...SUBROUTINE HOLDQ1 (IPASS) * MOVE PRIORITY MESSAGES FROM HOLD QUEUE TO ALTERNATE * COMMUNICATIONS LINKI SEND QUEUE * CALLS - SNAP, FIND

ESA's Earth observation priority research objectives and satellite instrument requirements

NASA Astrophysics Data System (ADS)

Reynolds, M. L.

2018-04-01

Since 1996 the European Space Agency has been pursuing an Earth Observation strategy based on a resolution endorsed by European Minister at a meeting in Toulouse. This resolution recognised a broad distinction between purely research objectives, on the one hand, and purely application objectives on the other. However, this is not to be understood as an absolute separation, but rather as an identification of the major driving emphasis for the definition of mission requirement. Indeed, application satellites can provide a wealth of data for research objectives and scientific earth observation programmes can equally provide an important source of data to develop and demonstrate new applications. It is sufficient to look at the data utilisation of Meteosat and ERS to find very many examples of this. This paper identifies the priority research objectives defined for scientific Earth Explorer missions and the resulting instrument needs. It then outlines the requirements for optical instruments.

Eradication of tephritid fruit fly pest populations: outcomes and prospects.

PubMed

Suckling, David Maxwell; Kean, John M; Stringer, Lloyd D; Cáceres-Barrios, Carlos; Hendrichs, Jorge; Reyes-Flores, Jesus; Dominiak, Bernard C

2016-03-01

The number of insect eradication programmes is rising in response to globalisation. A database of arthropod and plant pathogen eradications covers 1050 incursion responses, with 928 eradication programmes on 299 pest and disease taxa in 104 countries (global eradication database b3.net.nz/gerda). A subset of the database was assembled with 211 eradication or response programmes against 17 species of fruit flies (Tephritidae) in 31 countries, in order to investigate factors affecting the outcome. The failure rate for fruit fly eradication programmes was about 7%, with 0% for Ceratitis capitata (n = 85 programmes) and 0% for two Anastrepha species (n = 12 programmes), but 12% for 13 Bactrocera species (n = 108 programmes). A number of intended eradication programmes against long-established populations were not initiated because of cost and other considerations, or evolved during the planning phase into suppression programmes. Cost was dependent on area, ranged from $US 0.1 million to $US 240 million and averaged about $US 12 million (normalised to $US in 2012). In addition to the routine use of surveillance networks, quarantine and fruit destruction, the key tactics used in eradication programmes were male annihilation, protein bait sprays (which can attract both sexes), fruit destruction and the sterile insect technique. Eradication success generally required the combination of several tactics applied on an area-wide basis. Because the likelihood of eradication declines with an increase in the area infested, it pays to invest in effective surveillance networks that allow early detection and delimitation while invading populations are small, thereby greatly favouring eradication success. © 2014 Society of Chemical Industry.

A model for Southern Mediterranean research institute self-assessment: a SWOT analysis-based approach to promote capacity building at Theodor Bilharz Research Institute in Cairo (Egypt).

PubMed

Ghinolfi, Davide; El Baz, Hanan G; Borgonovi, Elio; Radwan, Amr; Laurence, Ola; Sayed, Hanan A; De Simone, Paolo; Abdelwadoud, Moaz; Stefani, Alessandro; Botros, Sanaa S; Filipponi, Franco

2014-01-01

THEBERA is a project funded by the European Union (EU), as an ERA-WIDE FP7 project, aiming to strengthen the Theodor Bilharz Research Institute (TBRI) capacities. A SWOT (strength/weakness/opportunities/threats) analysis of human, structural and organisational existing resources was performed in light of an extensive analysis of liver disease research and clinical management in Egypt, for a full understanding of TBRI needs. Strength and weakness features were identified and analysed, so were actions to be implemented and targets to be accomplished, to develop a business plan gathering the required critical mass (political, scientific, industrial, social) to select investment priorities, to sacrifice non-strategic areas of research, to promote national and international connections and industrial innovations, to update diagnostics and research device technologies and clinical management processes at European levels, to implement fundraising activities, to organise and properly assess training activities for young researchers, physicians, nurses, and technicians. Research institute self assessment is a priority need for sustainable capacity building and for future build-up of a competent health care research institute. Sustainable capacity building strategies must be designed on needs assessment, involving salient requirements: clear strategy, leverage of administrative capacities, industrial support and connections, systematised training programmes and enhancement of mobility of health care staff implemented within ill-defined boundaries and continuously re-evaluated with multiple feedback loops in order to build a complex, adaptable and reliable system based on value. Copyright © 2014 Arab Journal of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Foresight Infectious Diseases China Project--a novel approach to anticipating future trends in risk of infectious diseases in China: methodology and results from an initial application.

PubMed

Nicoll, A; Huang, J; Xie, Z

2009-07-09

The project devised a simple but novel methodology for identifying possible future trends in infectious diseases in animals and humans in China, of priority concern to the Chinese authorities. It used a model of disease drivers (social, economic, biological or environmental factors that affect disease outcomes, by changing the behaviour of diseases, sources or pathways) devised for the Foresight Programme in the United Kingdom. Nine families of drivers were adapted to Chinese circumstances and matrices were constructed to identify the likely relationship of single infectious diseases or families of diseases to the drivers. The likely future trends in those drivers in China were determined by interviews with 36 independent Chinese experts. These trends included not only potentially adverse animal and human movements but also opportunities for innovative surveillance methods, more use of hospitals, antimicrobials and vaccines. Some human behaviours and social trends were expected to increase the risk of infections (in particular sexually transmitted and healthcare-associated infections) while at the same time the experts thought the awareness of risk in the Chinese population would increase. The results suggested a number of areas where the Chinese authorities may experience difficulties in the future, such as rising numbers of healthcare-associated infections, zoonoses and other emerging diseases and sexually transmitted infections (including HIV). Not making firm predictions, this work identifies priority disease groups requiring surveillance and consideration of countermeasures as well as recommending strengthening basic surveillance and response mechanisms for unanticipatable zoonoses and other emerging disease threats.

Evaluation of a nationally funded state-based programme to reduce fatal occupational injuries

PubMed Central

Menendez, Cammie Chaumont; Castillo, Dawn; Rosenman, Kenneth; Harrison, Robert; Hendricks, Scott

2015-01-01

Background The Fatality Assessment and Control Evaluation (FACE) programme was established by the National Institute for Occupational Safety and Health to help prevent occupational traumatic fatalities by funding states to conduct targeted fatality investigations within cause-specific focus areas and associated prevention efforts. Purpose To investigate the impact of the state-based FACE programme on two previous focus areas. Methods A longitudinal time-series analysis spanning 22 years compared state fatality rates for occupational falls and electrocutions before and after FACE programme funding with states not receiving FACE programme funding. Lag periods were utilised to allow time for the programme to have an effect, and rates were adjusted for a variety of covariates. Separate analyses were conducted for each injury outcome. Results A reduction in fall fatality rates that was of borderline significance (1-year lag adjRR=0.92 (0.84 to 1.00)) and a non-significant reduction in electrocution fatality rates (3-year lag adjRR=0.92 (0.82 to 1.03)) were observed in states with FACE programme funding, Best-fit models presented two separate lag periods. Conclusions While it is challenging to quantitatively evaluate effectiveness of programmes such as FACE, the data suggest the FACE programme may be effective in preventing occupational injury deaths within its outcome focus areas throughout the state. It is important to look for ways to measure intermediate effects more precisely, as well as ways to maintain effects over time. PMID:22864251

Implementing accountability for reasonableness framework at district level in Tanzania: a realist evaluation.

PubMed

Maluka, Stephen; Kamuzora, Peter; Sansebastián, Miguel; Byskov, Jens; Ndawi, Benedict; Olsen, Øystein E; Hurtig, Anna-Karin

2011-02-10

Despite the growing importance of the Accountability for Reasonableness (A4R) framework in priority setting worldwide, there is still an inadequate understanding of the processes and mechanisms underlying its influence on legitimacy and fairness, as conceived and reflected in service management processes and outcomes. As a result, the ability to draw scientifically sound lessons for the application of the framework to services and interventions is limited. This paper evaluates the experiences of implementing the A4R approach in Mbarali District, Tanzania, in order to find out how the innovation was shaped, enabled, and constrained by the interaction between contexts, mechanisms and outcomes. This study draws on the principles of realist evaluation -- a largely qualitative approach, chiefly concerned with testing and refining programme theories by exploring the complex interactions of contexts, mechanisms, and outcomes. Mixed methods were used in data collection, including individual interviews, non-participant observation, and document reviews. A thematic framework approach was adopted for the data analysis. The study found that while the A4R approach to priority setting was helpful in strengthening transparency, accountability, stakeholder engagement, and fairness, the efforts at integrating it into the current district health system were challenging. Participatory structures under the decentralisation framework, central government's call for partnership in district-level planning and priority setting, perceived needs of stakeholders, as well as active engagement between researchers and decision makers all facilitated the adoption and implementation of the innovation. In contrast, however, limited local autonomy, low level of public awareness, unreliable and untimely funding, inadequate accountability mechanisms, and limited local resources were the major contextual factors that hampered the full implementation. This study documents an important first step in the effort to introduce the ethical framework A4R into district planning processes. This study supports the idea that a greater involvement and accountability among local actors through the A4R process may increase the legitimacy and fairness of priority-setting decisions. Support from researchers in providing a broader and more detailed analysis of health system elements, and the socio-cultural context, could lead to better prediction of the effects of the innovation and pinpoint stakeholders' concerns, thereby illuminating areas that require special attention to promote sustainability.

'Communicate to vaccinate' (COMMVAC). building evidence for improving communication about childhood vaccinations in low- and middle-income countries: protocol for a programme of research.

PubMed

Lewin, Simon; Hill, Sophie; Abdullahi, Leyla H; de Castro Freire, Sara Bensaude; Bosch-Capblanch, Xavier; Glenton, Claire; Hussey, Gregory D; Jones, Catherine M; Kaufman, Jessica; Lin, Vivian; Mahomed, Hassan; Rhoda, Linda; Robinson, Priscilla; Waggie, Zainab; Willis, Natalie; Wiysonge, Charles S

2011-12-02

Effective provider-parent communication can improve childhood vaccination uptake and strengthen immunisation services in low- and middle-income countries (LMICs). Building capacity to improve communication strategies has been neglected. Rigorous research exists but is not readily found or applicable to LMICs, making it difficult for policy makers to use it to inform vaccination policies and practice.The aim of this project is to build research knowledge and capacity to use evidence-based strategies for improving communication about childhood vaccinations with parents and communities in LMICs. This project is a mixed methods study with six sub-studies. In sub-study one, we will develop a systematic map of provider-parent communication interventions for childhood vaccinations by screening and extracting data from relevant literature. This map will inform sub-study two, in which we will develop a taxonomy of interventions to improve provider-parent communication around childhood vaccination. In sub-study three, the taxonomy will be populated with trial citations to create an evidence map, which will also identify how evidence is linked to communication barriers regarding vaccination. In the project's fourth sub-study, we will present the interventions map, taxonomy, and evidence map to international stakeholders to identify high-priority topics for systematic reviews of interventions to improve parent-provider communication for childhood vaccination. We will produce systematic reviews of the effects of high-priority interventions in the fifth sub-study. In the sixth and final sub-study of the project, evidence from the systematic reviews will be translated into accessible formats and messages for dissemination to LMICs. This project combines evidence mapping, conceptual and taxonomy development, priority setting, systematic reviews, and knowledge transfer. It will build and share concepts, terms, evidence, and resources to aid the development of communication strategies for effective vaccination programmes in LMICs.

Research priorities for conservation and natural resource management in Oceania's small-island developing states.

PubMed

Weeks, R; Adams, V M

2018-02-01

For conservation science to effectively inform management, research must focus on creating the scientific knowledge required to solve conservation problems. We identified research questions that, if answered, would increase the effectiveness of conservation and natural resource management practice and policy in Oceania's small-island developing states. We asked conservation professionals from academia, governmental, and nongovernmental organizations across the region to propose such questions and then identify which were of high priority in an online survey. We compared the high-priority questions with research questions identified globally and for other regions. Of 270 questions proposed by respondents, 38 were considered high priority, including: What are the highest priority areas for conservation in the face of increasing resource demand and climate change? How should marine protected areas be networked to account for connectivity and climate change? What are the most effective fisheries management policies that contribute to sustainable coral reef fisheries? High-priority questions related to the particular challenges of undertaking conservation on small-island developing states and the need for a research agenda that is responsive to the sociocultural context of Oceania. Research priorities for Oceania relative to elsewhere were broadly similar but differed in specific issues relevant to particular conservation contexts. These differences emphasize the importance of involving local practitioners in the identification of research priorities. Priorities were reasonably well aligned among sectoral groups. Only a few questions were widely considered answered, which may indicate a smaller-than-expected knowledge-action gap. We believe these questions can be used to strengthen research collaborations between scientists and practitioners working to further conservation and natural resource management in this region. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Postgraduate training for trauma prevention, injury surveillance and research, Uganda.

PubMed

Bachani, Abdulgafoor M; Paichadze, Nino; Bentley, Jacob A; Tumwesigye, Nazarius Mbona; Bishai, David; Atuyambe, Lynn; Wegener, Stephen; Guwatudde, David; Kobusingye, Olive C; Hyder, Adnan A

2018-06-01

The burden of trauma and injuries in Uganda is substantial and growing. Two important gaps that need addressing are the shortage of trained people and a lack of national data on noncommunicable diseases and their risk factors in Uganda. We developed and implemented a new track within an existing master of public health programme, aimed at developing graduate-level capacity and promoting research on key national priorities for trauma and injuries. We also offered training opportunities to a wider audience and set up a high-level national injury forum to foster national dialogue on addressing the burden of trauma, injuries and disability. The Chronic Consequences of Trauma, Injuries and Disability in Uganda programme was implemented in 2012 at Makerere University School of Public Health in Kampala, Uganda, in conjunction with Johns Hopkins Bloomberg School of Public Health in Baltimore, United States of America. Over the years 2012 to 2017 we supported four cohorts of master's students, with a total of 14 students (9 females and 5 males; mean age 30 years). Over 1300 individuals participated in workshops and seminars of the short-term training component of the programme. The forum hosted three research symposia and two national injury forums. Institutional support and collaborative engagement is important for developing and implementing successful capacity development programmes. Integration of training components within existing academic structures is key to sustainability. Appropriate mentorship for highly motivated and talented students is valuable for guiding students through the programme.

Shaping ESO2020+ Together: Feedback from the Community Poll

NASA Astrophysics Data System (ADS)

Primas, F.; Ivison, R.; Berger, J.-P.; Caselli, P.; De Gregorio-Monsalvo, I.; Alonso Herrero, A.; Knudsen, K. K.; Leibundgut, B.; Moitinho, A.; Saviane, I.; Spyromilio, J.; Testi, L.; Vennes, S.

2015-09-01

A thorough evaluation and prioritisation of the ESO science programme into the 2020+ timeframe took place under the auspices of a working group, comprising astronomers drawn from ESO’s advisory structure and from within ESO. This group reported to ESO’s Scientific Technical Committee, and to ESO Council, concluding the exercise with the publication of a report, “Science Priorities at ESO”. A community poll and a dedicated workshop, held in January 2015, formed part of the information gathering process. The community poll was designed to probe the demographics of the user community, its scientific interests, use of observing facilities and plans for use of future telescopes and instruments, its views on types of observing programmes and on the provision of data processing and archiving. A total of 1775 full responses to the poll were received and an analysis of the results is presented here. Foremost is the importance of regular observing programmes on all ESO observing facilities, in addition to Large Programmes and Public Surveys. There was also a strong community requirement for ESO to process and archive data obtained at ESO facilities. Other aspects, especially those related to future facilities, are more challenging to interpret because of biases related to the distribution of science expertise and favoured wavelength regime amongst the targeted audience. The results of the poll formed a fundamental component of the report and pro-vide useful data to guide the evolution of ESO’s science programme.

Long Term Control of Scabies Fifteen Years after an Intensive Treatment Programme

PubMed Central

Marks, Michael; Taotao-Wini, Betty; Satorara, Lorraine; Engelman, Daniel; Nasi, Titus; Mabey, David C.; Steer, Andrew C.

2015-01-01

Introduction Scabies is a major public health problem in the Pacific and is associated with an increased risk of bacterial skin infections, glomerulonephritis and rheumatic fever. Mass drug administration with ivermectin is a promising strategy for the control of scabies. Mass treatment with ivermectin followed by active case finding was conducted in five communities in the Solomon Islands between 1997 and 2000 and resulted in a significant reduction in the prevalence of both scabies and bacterial skin infections. Methods We conducted a prospective follow-up study of the communities where the original scabies control programme had been undertaken. All residents underwent a standardised examination for the detection of scabies and impetigo. Results Three hundred and thirty eight residents were examined, representing 69% of the total population of the five communities. Only 1 case of scabies was found, in an adult who had recently returned from the mainland. The prevalence of active impetigo was 8.8% overall and 12.4% in children aged 12 years or less. Discussion We found an extremely low prevalence of scabies 15 years after the cessation of a scabies control programme. The prevalence of impetigo had also declined further since the end of the control programme. Our results suggest that a combination of mass treatment with ivermectin and intensive active case finding may result in long term control of scabies. Larger scale studies and integration with other neglected tropical disease control programmes should be priorities for scabies control efforts. PMID:26624616

Long Term Control of Scabies Fifteen Years after an Intensive Treatment Programme.

PubMed

Marks, Michael; Taotao-Wini, Betty; Satorara, Lorraine; Engelman, Daniel; Nasi, Titus; Mabey, David C; Steer, Andrew C

2015-12-01

Scabies is a major public health problem in the Pacific and is associated with an increased risk of bacterial skin infections, glomerulonephritis and rheumatic fever. Mass drug administration with ivermectin is a promising strategy for the control of scabies. Mass treatment with ivermectin followed by active case finding was conducted in five communities in the Solomon Islands between 1997 and 2000 and resulted in a significant reduction in the prevalence of both scabies and bacterial skin infections. We conducted a prospective follow-up study of the communities where the original scabies control programme had been undertaken. All residents underwent a standardised examination for the detection of scabies and impetigo. Three hundred and thirty eight residents were examined, representing 69% of the total population of the five communities. Only 1 case of scabies was found, in an adult who had recently returned from the mainland. The prevalence of active impetigo was 8.8% overall and 12.4% in children aged 12 years or less. We found an extremely low prevalence of scabies 15 years after the cessation of a scabies control programme. The prevalence of impetigo had also declined further since the end of the control programme. Our results suggest that a combination of mass treatment with ivermectin and intensive active case finding may result in long term control of scabies. Larger scale studies and integration with other neglected tropical disease control programmes should be priorities for scabies control efforts.

Two approaches to physics tutoring

NASA Astrophysics Data System (ADS)

Solomaniuck, Tania

One in two first-year students at science or biomedical faculties fail in basic subjects such as mathematics, chemistry or physics. Course-specific tutoring is one of the available means for improving their performance. In the present research, two tutoring models are developed. Both incorporate independent learning, but from different perspectives and priorities. A pragmatic tutoring approach. The first part of the thesis describes the search process for an optimal course-specific tutoring strategy for a standard first-year physics course in life sciences curricula. After a number of empirical research rounds, a pragmatic compromise emerged as the most suitable form of tutoring. The approach is characterised by: (1) priority to questions from students; (2) a high degree of interactivity with the tutor and among students; (3) due consideration to the number of questions to be dealt with and the depth in which they should be discussed. Most students participating in the tutoring sessions expressed their satisfaction and performed sufficiently well in their exams. However, there was still a problem: the students' insight into the course material was restricted to first-order processing of the syllabus. While this would be satisfactory in non-scientific study programmes, it is deemed insufficient in programmes where deeper insight is required in order that students be able to deal adequately with new conceptual questions or problems. In-depth tutoring. In science programmes, the core objective is for students to acquire in-depth knowledge. Therefore, science educators are designing and studying teaching methods that are geared not only to the acquisition of in-depth knowledge as such, but also to the motivation of students to take a more in-depth approach to learning. Some of the crucial notions in their research are: the extent to which the course content ties in with students' prior knowledge, problem-setting strategies and concept-context linking. 'In-depth tutoring' integrates these crucial notions into a didactical structure that deviates from the classical course structure proposed in reference works. Chapters and learning activities begin with key questions in an area of application that ties in with the interests of the students. In the case of biology students, they are invited to answer biomechanical questions on the basis of their ready knowledge of dynamics, to compare their answers with those from their fellow-students, and to evaluate. However, the questions are formulated in such a way that the students will encounter a problem: lack of knowledge, contradictions, ... This problem creates a need for new information and thus provides a motivation for the knowledge expansion foreseen in the curriculum. Through carefully designed assignments, the students acquire the knowledge and skills they need in order to be able to reach consensus on a scientifically substantiated answer to the initial question.

Climatotherapy in Japan: a pilot study

NASA Astrophysics Data System (ADS)

Kanayama, Hitomi; Kusaka, Yukinori; Hirai, Takayoshi; Inoue, Hiroyuki; Agishi, Yuko; Schuh, Angela

2017-12-01

Twenty-nine urban inhabitants participated in a half-day climatotherapy programme at the moderate mountain area and lowland area in the northwest part of the main island of Japan. The current study was aimed to investigate physically and mentally the objective and subjective influence of our short programme, which was a prospective pilot study of single intervention. Blood pressure was significantly descended during terrain cure at the uphill mountain path and returned after fresh-air rest cure, while there was no significant change throughout the programme at lowland flat path. Heart rate was significantly ascended and descended at both area, and more clearly changed at the mountain path. Profile of Mood Status brief form Japanese version administered before and after our half-day programme. Age adjusted T score of negative subscales, `tension-anxiety', `depression', `anger-hostility', `fatigue' and `confusion' were significantly lower after climatotherapy at both sites. Whereas, there was no significant change concerning `vigour' score. This short-version climatotherapy programme has been designed for people without enough time for long stay at health resort. It turned out our half-day climatotherapy programme contribute to mood status improvement. In addition, repeated practice of our short-version programme including endurance exercise with cool body shell using uphill path can be expected that blood pressure will go toward the normal range and heart rate will decrease both in usual time and during exercise. Therefore, health benefits can be expected of this climatotherapy programme.

Research priorities of the Canadian chiropractic profession: a consensus study using a modified Delphi technique.

PubMed

French, Simon D; Beliveau, Peter J H; Bruno, Paul; Passmore, Steven R; Hayden, Jill A; Srbely, John; Kawchuk, Greg N

2017-01-01

Research funds are limited and a healthcare profession that supports research activity should establish research priority areas. The study objective was to identify research priority areas for the Canadian chiropractic profession, and for stakeholders in the chiropractic profession to rank these in order of importance. We conducted a modified Delphi consensus study between August 2015 and May 2017 to determine the views of Canadian chiropractic organisations (e.g. Canadian Chiropractic Association; provincial associations) and stakeholder groups (e.g. chiropractic educational institutions; researchers). Participants completed three online Delphi survey rounds. In Round 1, participants suggested research areas within four broad research themes: 1) Basic science; 2) Clinical; 3) Health services; and 4) Population health. In Round 2, researchers created sub-themes by categorising the areas suggested in Round 1, and participants judged the importance of the research sub-themes. We defined consensus as at least 70% of participants agreeing that a research area was "essential" or "very important". In Round 3, results from Round 2 were presented to the participants to re-evaluate the importance of sub-themes. Finally, participants completed an online pairwise ranking activity to determine the rank order of the list of important research sub-themes. Fifty-seven participants, of 85 people invited, completed Round 1 (response rate 67%). Fifty-six participants completed Round 2, 55 completed Round 3, and 53 completed the ranking activity. After three Delphi rounds and the pairwise ranking activity was completed, the ranked list of research sub-themes considered important were: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services; 4) Effects of chiropractic care; 5) Safety/side effects of chiropractic care; 6) Chiropractic care for older adults; 7) Neurophysiological mechanisms and effects of spinal manipulative therapy; 8) General mechanisms and effects of spinal manipulative therapy. This project identified research priority areas for the Canadian chiropractic profession. The top three priority areas were all in the area of health services research: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services.

Addressing the social determinants of health: a case study from the Mitanin (community health worker) programme in India.

PubMed

Nandi, Sulakshana; Schneider, Helen

2014-09-01

The Mitanin Programme, a government community health worker (CHW) programme, was started in Chhattisgarh State of India in 2002. The CHWs (Mitanins) have consistently adopted roles that go beyond health programme-specific interventions to embrace community mobilization and action on local priorities. The aim of this research was to document how and why the Mitanins have been able to act on the social determinants of health, describing the catalysts and processes involved and the enabling programmatic and organizational factors. A qualitative comparative case study of successful action by Mitanin was conducted in two 'blocks', purposefully selected as positive exemplars in two districts of Chhattisgarh. One case focused on malnutrition and the other on gender-based violence. Data collection involved 17 in-depth interviews and 10 group interviews with the full range of stakeholders in both blocks, including community members and programme team. Thematic analysis was done using a broad conceptual framework that was further refined. Action on social determinants involved raising awareness on rights, mobilizing women's collectives, revitalizing local political structures and social action targeting both the community and government service providers. Through these processes, the Mitanins developed identities as agents of change and advocates for the community, both with respect to local cultural and gender norms and in ensuring accountability of service providers. The factors underpinning successful action on social determinants were identified as the significance of the original intent and vision of the programme, and how this was carried through into all aspects of programme design, the role of the Mitanins and their identification with village women, ongoing training and support, and the relative autonomy of the programme. Although the results are not narrowly generalizable and do not necessarily represent the situation of the Mitanin Programme as a whole, the explanatory framework may provide general lessons for programmes in similar contexts. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Selection and Evaluation of Priority Domains in Global Energy Internet Standard Development Based on Technology Foresight

NASA Astrophysics Data System (ADS)

Jin, Yang; Ciwei, Gao; Jing, Zhang; Min, Sun; Jie, Yu

2017-05-01

The selection and evaluation of priority domains in Global Energy Internet standard development will help to break through limits of national investment, thus priority will be given to standardizing technical areas with highest urgency and feasibility. Therefore, in this paper, the process of Delphi survey based on technology foresight is put forward, the evaluation index system of priority domains is established, and the index calculation method is determined. Afterwards, statistical method is used to evaluate the alternative domains. Finally the top four priority domains are determined as follows: Interconnected Network Planning and Simulation Analysis, Interconnected Network Safety Control and Protection, Intelligent Power Transmission and Transformation, and Internet of Things.

What Are the Top 10 Research Questions in the Treatment of Inflammatory Bowel Disease? A Priority Setting Partnership with the James Lind Alliance.

PubMed

Hart, Ailsa L; Lomer, Miranda; Verjee, Azmina; Kemp, Karen; Faiz, Omar; Daly, Ann; Solomon, Julie; McLaughlin, John

2017-02-01

Many uncertainties remain regarding optimal therapies and strategies for the treatment of inflammatory bowel disease. Setting research priorities addressing therapies requires a partnership between health care professionals, patients and organisations supporting patients. We aimed to use the structure of the James Lind Alliance Priority Setting Partnership, which has been used in other disease areas, to identify and prioritise unanswered questions about treatments for inflammatory bowel disease. The James Lind Priority Setting Partnership uses methods agreed and adopted in other disease areas to work with patients and clinicians: to identify uncertainties about treatments; to agree by consensus a prioritised list of uncertainties for research; then to translate these uncertainties into research questions which are amenable to hypothesis testing; and finally to take results to research commissioning bodies to be considered for funding. A total of 1636 uncertainties were collected in the initial survey from 531 respondents, which included 22% health care professionals and 78% patients and carers. Using the rigorously applied processes of the priority setting partnership, this list was distilled down to the top 10 research priorities for inflammatory bowel disease. The top priorities were: identifying treatment strategies to optimise efficacy, safety and cost-effectiveness; and stratifying patients with regard to their disease course and treatment response. Diet and symptom control [pain, incontinence and fatigue] were also topics which were prioritised. A partnership involving multidisciplinary clinicians, patients and organisations supporting patients has identified the top 10 research priorities in the treatment of patients with inflammatory bowel disease. © European Crohn’s and Colitis Organisation 2016.

Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India

PubMed Central

Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

2017-01-01

Abstract Objective To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme – the World Health Partners’ Sky Program. Methods We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers’ performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. Findings The programme did not significantly improve health-care providers’ knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Conclusion Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up. PMID:28479635

Development situation and prospecting division of geothermal resources in Yangshan county, Guangdong Province

NASA Astrophysics Data System (ADS)

Yin, Lijun; Luo, Yizhen; Ma, Huiying; Xie, Yanxiao; Liu, Zhenzhen

2017-03-01

Yangshan County has abundant low-geothermal resources in its northeast, southwest, and midwest regions. These low-temperature geothermal resources in Yangshan County can prove to be beneficial for different purposes such as tourism, recuperation, sauna, and agriculture. Thirteen geothermal hot springs (spots) and seven geothermal anomalies have been discovered till now in this area. The geothermal resources are grouped on the basis of their conditions as follows: The Chengjia-Dianzhan and Dongguan-Jietan geothermal areas are classified as priority development zones, the Huangben-Mazishui and Qigongyuntankeng areas as sub-priority development zones, the Jiangying geothermal area as a general development zone, the Yangshan geothermal area as a potential development zone, and the Chengjia and Longfeng geothermal areas as restricted development zones.

A literature review exploring how healthcare professionals contribute to the assessment and control of postoperative pain in older people.

PubMed

Brown, Donna

2004-09-01

Little research has examined the care older people receive in the acute surgical setting. Although pain assessment and management are judged to be a priority in nursing, often pain, in older people, is undermanaged for a variety of reasons. Factors such as stoicism, communication and ageism can shape both the patients' and nurses' attitude towards the perception of pain which subsequently affects pain management. Through a review of the literature, this paper aims to: (i) identify how healthcare professionals contribute to the assessment and control of postoperative pain in older people and (ii) explore potential barriers to achieving more advantageous pain control in this group. It is suggested that to improve pain management there is a need to individualize pain assessment for older people and to assist clinicians with enhancing their education and decision-making abilities in this field. This may best be achieved by supporting a programme of change to develop the skills of staff and encouraging learning through reflective practice. There is however a need for further research in this area.

An implementation plan for priorities in solar-system space physics

NASA Technical Reports Server (NTRS)

Krimigis, Stamatios M.; Athay, R. Grant; Baker, Daniel; Fisk, Lennard A.; Fredricks, Robert W.; Harvey, John W.; Jokipii, Jack R.; Kivelson, Margaret; Mendillo, Michael; Nagy, Andrew F.

1985-01-01

The scientific objectives and implementation plans and priorities of the Space Science Board in areas of solar physics, heliospheric physics, magnetospheric physics, upper atmosphere physics, solar-terrestrial coupling, and comparative planetary studies are discussed and recommended programs are summarized. Accomplishments of Skylab, Solar Maximum Mission, Nimbus-7, and 11 other programs are highlighted. Detailed mission plans in areas of solar and heliospheric physics, plasma physics, and upper atmospheric physics are also described.

Using Baltimore HIV behavioral surveillance data for local HIV prevention planning.

PubMed

German, Danielle; Linton, Sabriya; Cassidy-Stewart, Hope; Flynn, Colin

2014-04-01

In response to the National HIV/AIDS Strategy (NHAS) and as part of CDC's Enhanced Comprehensive HIV Prevention Plan (ECHPP) project, Maryland developed a comprehensive local HIV prevention plan for the Baltimore-Towson Metropolitan Statistical Area and identified a series of priority HIV prevention and service goals. The current project sought to: (1) determine how well National HIV Behavioral Surveillance (NHBS) indicators were aligned with NHAS/ECHPP-informed local HIV prevention goals (2) facilitate on-going NHBS data utilization to inform on-going local HIV prevention and service planning, and (3) build a foundation for future NHBS data utilization in local HIV decision-making. Project activities identified key HIV-related indicators in NHBS that are directly or indirectly related to local HIV priorities as informed by NHAS/ECHPP, which can be used for HIV prevention planning in the Baltimore area. Areas for enhancing NHBS and local data collection to further inform HIV prevention priorities are highlighted.

Region 6's 2016 Strategic Plan and 2015 Accomplishment Report

EPA Pesticide Factsheets

The EPA Region 6 Strategic Plan highlights the goals we have set out to accomplish in 2016 based on each of our priorities. areas. Our Accomplishment Report summarizes our work in meeting these priorities during the prior year.

75 FR 21600 - Groundfish Fisheries of the Bering Sea and Aleutian Islands Area and the Gulf of Alaska; King and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

... (Magnuson-Stevens Act). The Council has identified skate nurseries as a priority for consideration during... meet the Council's identified priority for this proposal cycle, which is skate nurseries. Proposal...

SPECIES RICHNESS AND BIODIVERSITY CONSERVATION PRIORITIES IN BRITISH COLUMBIA

EPA Science Inventory

Patterns in the geographic distribution of seven species groups were used to identify important areas for conservation in British Columbia, Canada. Potential priority sites for conservation were determined using an integer programming algorithm that maximized the number of speci...

Applying the Ottawa Charter to inform health promotion programme design.

PubMed

Fry, Denise; Zask, Avigdor

2017-10-01

There is evidence of a correlation between adoption of the Ottawa Charter's framework of five action areas and health promotion programme effectiveness, but the Charter's framework has not been as fully implemented as hoped, nor is generally used by formal programme design models. In response, we aimed to translate the Charter's framework into a method to inform programme design. Our resulting design process uses detailed definitions of the Charter's action areas and evidence of predicted effectiveness to prompt greater consideration and use of the Charter's framework. We piloted the process by applying it to the design of four programmes of the Healthy Children's Initiative in New South Wales, Australia; refined the criteria via consensus; and made consensus decisions on the extent to which programme designs reflected the Charter's framework. The design process has broad potential applicability to health promotion programmes; facilitating greater use of the Ottawa Charter framework, which evidence indicates can increase programme effectiveness. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population.

PubMed

Lung, F-W; Liao, S-C; Wu, C-Y; Lee, M-B

2017-06-01

The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. Observational study. A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Addressing basic resource needs to improve primary care quality: a community collaboration programme.

PubMed

Berkowitz, Seth A; Hulberg, A Catherine; Hong, Clemens; Stowell, Brian J; Tirozzi, Karen J; Traore, Carine Y; Atlas, Steven J

2016-03-01

Unmet basic resource needs, such as difficulty affording healthcare, medications, food and housing, may contribute to worse healthcare quality indicators, but interventions are hampered by lack of specific knowledge regarding the distribution of unmet basic resource needs and their association with priority clinical conditions and health service use patterns. Cross-sectional study of primary care patients in two urban academic practices from 1 October 2013 to 30 April 2014. Patients were screened for unmet needs and enrolled in a programme to link them with community resources. Key measures included patient report of unmet basic resource needs, clinical conditions prioritised by quality improvement programmes (hypertension, diabetes and depression), and health service use patterns such as frequent emergency department (ED) visits (>2 in the preceding year) and frequent clinic 'no-shows' (>1 in the preceding year). 416 patients with unmet needs were included, and compared with 2750 patients who did not report needs. The most common types of needs reported were: difficulties affording healthcare (46.5%), food (40.1%) and utilities (36.3%). Patients who reported unmet needs were more likely to have depression (17.8% vs 9.5%, p<0.0001), diabetes (32.7% vs 20.4%, p<0.0001), hypertension (54.3% vs 46.3%, p=0.002), be frequent ED users (11.3% vs 5.4%, p<0.0001), and have frequent 'no-shows' to clinic (21.6% vs 11.9%, p<0.0001). Difficulty affording healthcare and food are particularly common needs among patients with priority conditions. Strategies to identify and address unmet needs as part of routine care may be an important way to improve healthcare quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The European initiative on low-dose risk research: from the HLEG to MELODI.

PubMed

Belli, Mauro; Tabocchini, Maria Antonella; Jourdain, Jean-René; Salomaa, Sisko; Repussard, Jacques

2015-09-01

The importance of low-dose risk research for radiation protection is now widely recognised. The European Commission (EC) and five European Union (EU) Member States involved in the Euratom Programme set up in 2008 a 'High Level and Expert Group on European Low Dose Risk Research' (HLEG) aimed at identifying research needs and proposing a better integration of European efforts in the field. The HLEG revised the research challenges and proposed a European research strategy based on a 'Multidisciplinary European LOw Dose Initiative' (MELODI). In April 2009, five national organisations, with the support of the EC, created the initial core of MELODI (http://www.melodi-online.eu) with a view to integrate the EU institutions with significant programmes in the field, while being open to other scientific organisations and stakeholders, and to develop an agreed strategic research agenda (SRA) and roadmap. Since then, open workshops have been organised yearly, exploring ideas for SRA implementation. As of October 2014, 31 institutions have been included as members of MELODI. HLEG recommendations and MELODI SRA have become important reference points in the radiation protection part of the Euratom Research Programme. MELODI has established close interactions through Memorandum of Understanding with other European platforms involved in radiation protection (Alliance, NERIS and EURADOS) and, together with EURADOS, with the relevant medical European Associations. The role of Joint Programming in priority setting, foreseen in the forthcoming EU Horizon 2020, calls for keeping MELODI an open, inclusive and transparent initiative, able to avoid redundancies and possible conflicts of interest, while promoting common initiatives in radiation protection research. An important issue is the establishment of a proper methodology for managing these initiatives, and this includes the set-up of an independent MELODI Scientific Committee recently extended to Alliance, NERIS and EURADOS, with the aim of identifying research priorities to suggest for the forthcoming Euratom research calls. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Residents' perceived needs in communication skills training across in- and outpatient clinical settings.

PubMed

Junod Perron, Noelle; Sommer, Johanna; Hudelson, Patricia; Demaurex, Florence; Luthy, Christophe; Louis-Simonet, Martine; Nendaz, Mathieu; De Grave, Willem; Dolmans, Diana; Van der Vleuten, Cees

2009-05-01

Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics and amount of prior training in communication skills. In focus groups, outpatient residents felt that communication skills were especially useful in addressing chronic diseases and social issues. In contrast, inpatient residents emphasized the importance of good communication skills for dealing with family conflicts and end-of-life issues. Felt needs reflected residents' differing service priorities: outpatient residents saw the need for skills to structure the consultation and explore patients' perspectives in order to build therapeutic alliances, whereas inpatient residents wanted techniques to help them break bad news, provide information and increase their own well-being. The survey's overall response rate was 56%. Its data showed that outpatient residents received more training in communication skills and more of them than inpatient residents considered communication skills training to be useful (100% vs 74%). Outpatient residents' perceived needs in communication skills were more patient-centered than the needs perceived by inpatient residents. Residents' perceived needs for communication skills may differ not only because of their differing service priorities but also because of differences in their previous experiences with communication skills training. These factors should be taken into account when designing a training programme in communication skills.

The Australasian Antarctic Expedition 2013-2014: Practicing 'Citizen-Science' in a Changing World

NASA Astrophysics Data System (ADS)

Fogwill, C. J.; Turney, C. S.

2014-12-01

Government funding is the cornerstone of modern science. But with declining investment in science across most of the Western World, a major challenge for society is where best to place what little resource we have. Which research questions should have the greatest priority? Nowhere are these issues more pressing than in the Antarctic, where bases have and continue to play host to 'big-science', multi-year programmes of research, locking up logistical support and costs. But in a warming world, the areas with the greatest effects of climate change aren't always near government research stations. With this in mind, in 2012 a plan was formed to visit Commonwealth Bay, a remote area off the East Antarctic Ice Sheet, where in 2010, an iceberg the size of Rhode Island, known as B09B, dramatically knocked a 60-mile long tongue of ice off the Mertz Glacier into the Southern Ocean, setting off a cascade of change. Inspired by the expeditions of the past, we advertised berths for sale to take citizen scientists south with us, harnessing their interest, experience and investment. People responded far and wide. We were oversubscribed, and the Australasian Antarctic Expedition 2013-2014 was born. With the Russian-owned MV Akademik Shokalskiy as the expedition vessel, we set out south from the New Zealand port of Bluff in late November 2013. During our journey south and on the ice we undertook a number of scientific firsts for the region actively engaging the volunteer scientists on board in projects ranging from oceanography, biology, ecology, geology and glaciaology. The expedition demostrated how private funding could support targeted programmes of research and communicate it to the wider world. Small-science research can capture the public's imagination and also reap real scientific outputs. Although it is a funding model developed in the Antarctic a hundred years ago, the beauty is it can applied anywhere in the world.

Building capacity in workplace health promotion: the case of the Healthy Together e-learning project.

PubMed

Hodgins, Margaret; Battel-Kirk, Barbara; Asgeirsdottir, Asa G

2010-03-01

The current global economic crisis poses major challenges for workplace health promotion (WHP). Activities that are not perceived to obviously and directly contribute to profits could be sacrificed. This paper argues that WHP must remain centre-stage because of the rights of workers to a healthy, safe working environment but also because of WHP's beneficial financial implications for enterprises. Capacity building for WHP can be developed even within a recessionary environment, particularly if the focus is on the wider workforce, described here as people for whom workplace health promotion may not be their primary function but who have an important role to play in health improvement in workplaces. There is a strong case for the development of the wider workforce based both on the lack of suitably qualified specialists and on the practicalities of having WHP implemented within organizations, particularly for small and medium-sized enterprises (SMEs). SMEs make up a very significant proportion of the global economy and are identified as a priority area for action internationally. An example of an e-learning course, the Healthy Together programme, developed by a partnership of three countries, is discussed as an approach that has potential to develop capacity for WHP in the current climate. The findings of the evaluation of the Healthy Together programme indicate that there is a real potential in developing e-learning materials for training those with a brief for promoting workplace health and safety in SMEs. Although modifications in some aspects of delivery identified in the evaluation of the pilot course need to be considered, the course was well received, and was reported to be relevant to the learning needs of students, to their workplaces and specifically to small businesses in rural areas. Specific features of the e-learning approach increase its potential to address capacity building for WHP.

Different challenges, different approaches and related expenditures of community-based tuberculosis activities by international non-governmental organizations in Myanmar.

PubMed

Han, Wai Wai; Saw, Saw; Isaakidis, Petros; Khogali, Mohammed; Reid, Anthony; Hoa, Nguyen; Zaw, Ko Ko; Aung, Si Thu

2017-03-24

International non-governmental organizations (INGOs) have been implementing community-based tuberculosis (TB) care (CBTBC) in Myanmar since 2011. Although the National TB Programme (NTP) ultimately plans to take over CBTBC, there have been no evaluations of the models of care or of the costs of providing CBTBC in Myanmar by INGOs. This was a descriptive study using routinely-collected programmatic and financial data from four INGOs during 2013 and 2014, adjusted for inflation. Data analysis was performed from the provider perspective. Costs for sputum examination were not included as it was provided free of charge by NTP. We calculated the average cost per year of each programme and cost per patient completing treatment. Four INGOs assisted the NTP by providing CBTBC in areas where access to TB services was challenging. Each INGO faced different issues in their contexts and responded with a diversity of strategies. The total costs ranged from US$ 140 754 to US$ 550 221 during the study period. The cost per patient completing treatment ranged from US$ 215 to US$ 1 076 for new cases and US$ 354 to US$ 1 215 for retreatment cases, depending on the targeted area and the package of services offered. One INGO appeared less costly, more sustainable and patient oriented than others. This study revealed a wide variety of models of care and associated costs for implementing CBTBC in diverse and challenging populations and contexts in Myanmar. Consequently, we recommend a more comprehensive evaluation, including development of a cost model, to estimate the costs of scaling up CBTBC country-wide, and cost-effectiveness studies, to best inform the NTP as it prepares to takeover CBTBC activities from INGOs. While awaiting evidence from these studies, model of CBTBC that have higher sustainability potential and allocate more resources to patient-centered care should be given priority support.

Developing European guidelines for training care professionals in mental health promotion.

PubMed

Greacen, Tim; Jouet, Emmanuelle; Ryan, Peter; Cserhati, Zoltan; Grebenc, Vera; Griffiths, Chris; Hansen, Bettina; Leahy, Eithne; da Silva, Ksenija Maravic; Sabić, Amra; De Marco, Angela; Flores, Paz

2012-12-27

Although mental health promotion is a priority mental health action area for all European countries, high level training resources and high quality skills acquisition in mental health promotion are still relatively rare. The aim of the current paper is to present the results of the DG SANCO-funded PROMISE project concerning the development of European guidelines for training social and health care professionals in mental health promotion. The PROMISE project brought together a multidisciplinary scientific committee from eight European sites representing a variety of institutions including universities, mental health service providers and public health organisations. The committee used thematic content analysis to filter and analyse European and international policy documents, scientific literature reviews on mental health promotion and existing mental health promotion programmes with regard to identifying quality criteria for training care professionals on this subject. The resulting PROMISE Guidelines quality criteria were then subjected to an iterative feedback procedure with local steering groups and training professionals at all sites with the aim of developing resource kits and evaluation tools for using the PROMISE Guidelines. Scientific committees also collected information from European, national and local stakeholder groups and professional organisations on existing training programmes, policies and projects. The process identified ten quality criteria for training care professionals in mental health promotion: embracing the principle of positive mental health; empowering community stakeholders; adopting an interdisciplinary and intersectoral approach; including people with mental health problems; advocating; consulting the knowledge base; adapting interventions to local contexts; identifying and evaluating risks; using the media; evaluating training, implementation processes and outcomes. The iterative feedback process produced resource kits and evaluation checklists linked with each of these quality criteria in all PROMISE languages. The development of generic guidelines based on key quality criteria for training health and social care professionals in mental health promotion should contribute in a significant way to implementing policy in this important area.

Effects of a community-based nutrition promotion programme on child feeding and hygiene practices among caregivers in rural Eastern Ethiopia.

PubMed

Kang, Yunhee; Suh, Youn Kyoung; Debele, Lemma; Juon, Hee-Soon; Christian, Parul

2017-06-01

To evaluate the effectiveness of a community-based participatory nutrition promotion (CPNP) programme involving a 2-week group nutrition session in improving child feeding and hygiene practices among caregivers. Cluster randomized trial. In the intervention area (six clusters), the CPNP programme was added to the context of government nutrition programmes; the control area (six clusters) received the government programme only. Child feeding practices were assessed every 3 months using a 24 h dietary recall questionnaire, and hand washing with soap was assessed every 6 months, over a period of 12 months. Feeding and hygiene measures at each visit were scored and the scores summed up for the entire follow-up period. Habro and Melka Bello districts, Ethiopia. Randomly selected mothers with a child aged 6-12 months (n 1790). A total of 1199 mothers, 629 in the control and 570 in the intervention areas, were assessed at all visits and included in the analysis. Mothers in the intervention area showed higher scores than those in the control area regarding meal frequency (difference: 1·04, 95 % CI 0·35, 1·73), composite feeding score_1 (difference: 1·25, 95 % CI 0·37, 2·13; a summing score of currently breast-feeding, meal frequency and dietary diversity) and composite feeding score_2 (difference: 1·40, 95 % CI 0·49, 2·32; a summing score of meal frequency and dietary diversity). However, there were no differences in the scores of breast-feeding, dietary diversity and hand washing between the two areas (all P>0·05). The CPNP programme was effective in improving some child feeding behaviours in rural Eastern Ethiopia.

Identifying research priorities for patient safety in mental health: an international expert Delphi study.

PubMed

Dewa, Lindsay H; Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie

2018-03-03

Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Agreement in research priorities on a five-point scale. Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluating Environment, Erosion and Sedimentation Aspects in Coastal Area to Determine Priority Handling (A Case Study in Jepara Regency, northern Central Java, Indonesia)

NASA Astrophysics Data System (ADS)

Wahyudi, S. I.; Adi, H. P.

2018-04-01

Many areas of the northern coastal in Central Java, Indonesia, have been suffering from damage. One of the areas is Jepara, which has been experiencing this kind of damage for 7.6 kilometres from total 72 kilometres long beach. All damages are mostly caused by coastal erosion, sedimentation, environment and tidal flooding. Several efforts have been done, such as replanting mangroves, building revetment and groins, but it still could not mitigated the coastal damage. The purposes of this study are to map the coastal damages, to analyze handling priority and to determine coastal protection model. The method used are by identifying and plotting the coastal damage on the map, assessing score of each variable, and determining the handling priority and suitable coastal protection model. There are five levels of coastal damage used in this study, namely as light damage, medium, heavy, very heavy, and extremely heavy. Based on the priority assessment of coastal damage, it needs to be followed up by designing in detail and implementing through soft structure for example mangrove, sand nourishes and hard structure, such as breakwater, groins and revetment.

Lack of Cost-Effectiveness Analyses to Address Healthy People 2020 Priority Areas.

PubMed

Neumann, Peter J; Farquhar, Megan; Wilkinson, Colby L; Lowry, Mackenzie; Gold, Marthe

2016-12-01

To examine the extent to which recently published cost-utility analyses (cost-effectiveness analyses using quality-adjusted life-years to measure health benefits) have covered the leading health concerns in the US Department of Health and Human Services Healthy People 2020 report. We examined data in the Tufts Medical Center Cost-Effectiveness Analysis Registry, a database containing 5000 published cost-utility analyses published in the MEDLINE literature through 2014. We focused on US-based cost-utility analyses published from 2011 through 2014 (n = 687). Two reviewers scanned abstracts and met for a consensus on categorization of cost-utility analyses that addressed the specific priorities listed in the 12 Healthy People 2020 areas (n = 120). Although 7.3% of recently published cost-utility analyses addressed key clinical preventive services, only about 2% of recently published cost-utility analyses covered each of the following Healthy People 2020 topics: reproductive and sexual health, nutrition/physical activity/obesity, maternal and infant health, and tobacco. Fewer than 1% addressed priorities such as injuries and violence, mental health or substance abuse, environmental quality, and oral health. Few cost-utility analyses have addressed Healthy People 2020 priority areas.

Thinking Beyond the Silos: Emerging Priorities in Workforce Development for State and Local Government Public Health Agencies

PubMed Central

Kaufman, Nancy J.; Castrucci, Brian C.; Pearsol, Jim; Leider, Jonathon P.; Sellers, Katie; Kaufman, Ira R.; Fehrenbach, Lacy M.; Liss-Levinson, Rivka; Lewis, Melissa; Jarris, Paul E.; Sprague, James B.

2014-01-01

Context: Discipline-specific workforce development initiatives have been a focus in recent years. This is due, in part, to competency-based training standards and funding sources that reinforce programmatic silos within state and local health departments. Objective: National leadership groups representing the specific disciplines within public health were asked to look beyond their discipline-specific priorities and collectively assess the priorities, needs, and characteristics of the governmental public health workforce. Design: The challenges and opportunities facing the public health workforce and crosscutting priority training needs of the public health workforce as a whole were evaluated. Key informant interviews were conducted with 31 representatives from public health member organizations and federal agencies. Interviews were coded and analyzed for major themes. Next, 10 content briefs were created on the basis of priority areas within workforce development. Finally, an in-person priority setting meeting was held to identify top workforce development needs and priorities across all disciplines within public health. Participants: Representatives from 31 of 37 invited public health organizations participated, including representatives from discipline-specific member organizations, from national organizations and from federal agencies. Results: Systems thinking, communicating persuasively, change management, information and analytics, problem solving, and working with diverse populations were the major crosscutting areas prioritized. Conclusions: Decades of categorical funding created a highly specialized and knowledgeable workforce that lacks many of the foundational skills now most in demand. The balance between core and specialty training should be reconsidered. PMID:24667228

Thinking beyond the silos: emerging priorities in workforce development for state and local government public health agencies.

PubMed

Kaufman, Nancy J; Castrucci, Brian C; Pearsol, Jim; Leider, Jonathon P; Sellers, Katie; Kaufman, Ira R; Fehrenbach, Lacy M; Liss-Levinson, Rivka; Lewis, Melissa; Jarris, Paul E; Sprague, James B

2014-01-01

Discipline-specific workforce development initiatives have been a focus in recent years. This is due, in part, to competency-based training standards and funding sources that reinforce programmatic silos within state and local health departments. National leadership groups representing the specific disciplines within public health were asked to look beyond their discipline-specific priorities and collectively assess the priorities, needs, and characteristics of the governmental public health workforce. The challenges and opportunities facing the public health workforce and crosscutting priority training needs of the public health workforce as a whole were evaluated. Key informant interviews were conducted with 31 representatives from public health member organizations and federal agencies. Interviews were coded and analyzed for major themes. Next, 10 content briefs were created on the basis of priority areas within workforce development. Finally, an in-person priority setting meeting was held to identify top workforce development needs and priorities across all disciplines within public health. Representatives from 31 of 37 invited public health organizations participated, including representatives from discipline-specific member organizations, from national organizations and from federal agencies. Systems thinking, communicating persuasively, change management, information and analytics, problem solving, and working with diverse populations were the major crosscutting areas prioritized. Decades of categorical funding created a highly specialized and knowledgeable workforce that lacks many of the foundational skills now most in demand. The balance between core and specialty training should be reconsidered.

Principles of haemophilia care: The Asia-Pacific perspective.

PubMed

Dunkley, S; Lam, J C M; John, M J; Wong, R S M; Tran, H; Yang, R; Nair, S C; Shima, M; Street, A; Srivastava, A

2018-02-21

Optimal haemophilia care is best established and implemented through a well-coordinated plan guided by clearly defined principles and priorities. A document which enunciates those details is therefore important. A successful example of this approach is the definition of principles of haemophilia care (PHC) outlined by the European Association for Haemophilia and Associated Disorders (EAHAD) and also the World Federation of Hemophilia. A similar document applicable to the Asia-Pacific region must take into account not only the highly varied healthcare systems but also the tremendous socio-economic and cultural diversities which impact provision of such care. The Asia-Pacific Haemophilia Working Group (APHWG), representing the countries in this region, has prepared this perspective of the PHC. While endorsing the overall framework outlined by EAHAD, this APHWG document emphasizes regional priorities on education and training of healthcare personnel in the diagnosis and management of hereditary bleeding disorders. Central coordinating agencies with wide stakeholder input, networks of haemophilia treatment centres and national registries as well as robust processes for procurement and distribution of safe and effective clotting factor concentrates (CFCs), implementation of prophylaxis programmes and management of patients with inhibitors should also be developed. The implementation of these strategies should lead to establishment of good comprehensive care programmes. This document should also be an advocacy tool to lobby for improved care for people with haemophilia (PWH) in the region. We urge national healthcare policy makers to consider these principles and initiate strong and decisive action to reach these goals. © 2018 John Wiley & Sons Ltd.

Full value documentation in the Czech Food Composition Database.

PubMed

Machackova, M; Holasova, M; Maskova, E

2010-11-01

The aim of this project was to launch a new Food Composition Database (FCDB) Programme in the Czech Republic; to implement a methodology for food description and value documentation according to the standards designed by the European Food Information Resource (EuroFIR) Network of Excellence; and to start the compilation of a pilot FCDB. Foods for the initial data set were selected from the list of foods included in the Czech Food Consumption Basket. Selection of 24 priority components was based on the range of components used in former Czech tables. The priority list was extended with components for which original Czech analytical data or calculated data were available. Values that were input into the compiled database were documented according to the EuroFIR standards within the entities FOOD, COMPONENT, VALUE and REFERENCE using Excel sheets. Foods were described using the LanguaL Thesaurus. A template for documentation of data according to the EuroFIR standards was designed. The initial data set comprised documented data for 162 foods. Values were based on original Czech analytical data (available for traditional and fast foods, milk and milk products, wheat flour types), data derived from literature (for example, fruits, vegetables, nuts, legumes, eggs) and calculated data. The Czech FCDB programme has been successfully relaunched. Inclusion of the Czech data set into the EuroFIR eSearch facility confirmed compliance of the database format with the EuroFIR standards. Excel spreadsheets are applicable for full value documentation in the FCDB.

Contamination by hazardous substances in the Gulf of Naples and nearby coastal areas: a review of sources, environmental levels and potential impacts in the MSFD perspective.

PubMed

Tornero, Victoria; Ribera d'Alcalà, Maurizio

2014-01-01

During the 7th FW EU Programme, a large group of research institutions with a strong tradition in marine science designed PERSEUS, a policy-oriented, marine research project aimed at identifying human-derived pressures and their impacts in the Southern European Seas. PERSEUS is about gathering and analyzing the data on our marine ecosystems and developing recommendations to assist policy makers in the implementation of the Marine Strategy Framework Directive (MSFD). In its initial phase, the project focuses on the analysis and evaluation of human pressures in selected coastal areas across the Mediterranean and Black Seas. This paper reports on the results about the chemical pollution pressure in the Gulf of Naples, one of the sites selected for the analysis, and surrounding waters of the Southern Tyrrhenian Sea. Based on a systematic up-to-date literature review, the paper brings together for the first time the available information on the presence, severity and distribution of contaminants on the site. In spite of methodological and sampling heterogeneity among studies, this review compiles the data in a harmonized and effective way, so that the current status, knowledge gaps and research priorities can be established. Thus, the review wishes not only to provide a contribution to the scientific community, but also to help to extract recommendations for mitigating pollution sources and risks in the area of concern. A similar process of analysis may be carried out for other areas and pressures in order to facilitate policy making at the European level. © 2013.

Decentralized nursing education in Northern Norway: towards a sustainable recruitment and retention model in rural Arctic healthcare services

PubMed Central

Norbye, Bente; Skaalvik, Mari Wolff

2013-01-01

Introduction Decentralized nursing education (DNE) was established at Tromsø University College in 1990 and has since become a part of the bachelor programme in nursing at UiT The Arctic University of Norway. The objective of the study was to investigate whether and to what degree the first DNE programme established in Norway has contributed to recruitment and retention of registered nurses (RNs) in rural healthcare services. Methods The quantitative survey took place in 2012. A questionnaire was distributed to 315 former students who had graduated from the DNE programme from 1994 to 2011. Results The primary finding of this study is that the DNE successfully recruits students from rural areas of Northern Norway. Nearly, 87.5% have their first employment in community healthcare services. They continued to work in the rural areas and 85% still worked as nurses in 2012. The DNE programme has been successful regarding recruitment and retention of RNs to community healthcare services. Fifty-six percent have attended a variety of postgraduate programmes. Conclusion The DNE programme demonstrates itself as a successful study model regarding recruitment and retention of RNs to rural and remote areas. PMID:24286063

Cost-effectiveness of community health workers in tuberculosis control in Bangladesh.

PubMed Central

Islam, Md Akramul; Wakai, Susumu; Ishikawa, Nobukatsu; Chowdhury, A. M. R.; Vaughan, J. Patrick

2002-01-01

OBJECTIVE: To compare the cost-effectiveness of the tuberculosis (TB) programme run by the Bangladesh Rural Advancement Committee (BRAC), which uses community health workers (CHWs), with that of the government TB programme which does not use CHWs. METHODS: TB control statistics and cost data for July 1996 - June 1997 were collected from both government and BRAC thanas (subdistricts) in rural Bangladesh. To measure the cost per patient cured, total costs were divided by the total number of patients cured. FINDINGS: In the BRAC and government areas, respectively, a total of 186 and 185 TB patients were identified over one year, with cure rates among sputum-positive patients of 84% and 82%. However, the cost per patient cured was US$ 64 in the BRAC area compared to US$ 96 in the government area. CONCLUSION: The government programme was 50% more expensive for similar outcomes. Although both the BRAC and government TB control programmes appeared to achieve satisfactory cure rates using DOTS (a five-point strategy), the involvement of CHWs was found to be more cost-effective in rural Bangladesh. With the same budget, the BRAC programme could cure three TB patients for every two in the government programme. PMID:12132000

Decentralized nursing education in Northern Norway: towards a sustainable recruitment and retention model in rural Arctic healthcare services.

PubMed

Norbye, Bente; Skaalvik, Mari Wolff

2013-01-01

Decentralized nursing education (DNE) was established at Tromsø University College in 1990 and has since become a part of the bachelor programme in nursing at UiT The Arctic University of Norway. The objective of the study was to investigate whether and to what degree the first DNE programme established in Norway has contributed to recruitment and retention of registered nurses (RNs) in rural healthcare services. The quantitative survey took place in 2012. A questionnaire was distributed to 315 former students who had graduated from the DNE programme from 1994 to 2011. The primary finding of this study is that the DNE successfully recruits students from rural areas of Northern Norway. Nearly, 87.5% have their first employment in community healthcare services. They continued to work in the rural areas and 85% still worked as nurses in 2012. The DNE programme has been successful regarding recruitment and retention of RNs to community healthcare services. Fifty-six percent have attended a variety of postgraduate programmes. The DNE programme demonstrates itself as a successful study model regarding recruitment and retention of RNs to rural and remote areas.

Improving capacity in ethnicity and health research: report of a tailored programme for NHS Public Health practitioners.

PubMed

Salway, Sarah; Piercy, Hilary; Chowbey, Punita; Brewins, Louise; Dhoot, Permjeet

2013-10-01

To determine whether an intervention designed to enhance research capacity among commissioners in the area of ethnicity and health was feasible and impactful, and to identify programme elements that might usefully be replicated elsewhere. How healthcare commissioners should be equipped to understand and address multiethnic needs has received little attention to-date. Being able to mobilise and apply evidence is a central element of the commissioning process that requires development. Researching ethnicity and health is widely recognised as challenging and several prior interventions have aimed to enhance competence in this area. These have, however, predominantly taken place in North America and have not been evaluated in detail. An innovative research capacity development programme was delivered to public health staff within a large healthcare commissioning organisation in England. Evaluation methodology drew on 'pluralistic' evaluation principles and included formative and summative elements. Participant evaluation forms gave immediate feedback during the programme. Participants also provided feedback at two weeks and 12 months after the programme ended. In addition, one participant and one facilitator provided reflective accounts of the programme's strengths and weaknesses, and programme impact was traced through ongoing partnership work. The programme was well received and had a tangible impact on knowledge, confidence and practice for most participants. Factors important to success included: embedding learning within the participants' work context; ensuring a balance between theory and practical tips to enhance confidence; and having sustained interaction between trainers and participants. Despite positive signs, the challenging nature of the topic was highlighted, as were wider structural and cultural factors that impede progress in this area. Although it is unrealistic to expect such programmes to have a major impact on commissioning practices, they may well make an important contribution to raising the confidence and competence of staff to undertake work in this area.

The impact of HENRY on parenting and family lifestyle: A national service evaluation of a preschool obesity prevention programme.

PubMed

Willis, T A; Roberts, K P J; Berry, T M; Bryant, M; Rudolf, M C J

2016-07-01

One in five children in England are overweight/obese at school entry. Tackling obesity is therefore a priority. Right from the Start with HENRY is a widely-commissioned programme delivered by trained facilitators to small groups of parents over eight weekly sessions. It is designed to provide parents of infants and preschool children with the skills, knowledge and confidence required for a healthier family lifestyle. The aim of this work was to investigate programme impact using data collected routinely for quality control purposes. Analysis of routinely collected pre-post data from programmes delivered in the UK from January 2012 to February 2014. Data were analysed from 144 programmes, including questionnaires relating to parenting, family eating behaviours, dietary intake, and physical activity/screen time. Over 24 months, 1100 parents attended programmes running in 86 locations. 788 (72%) completed >5 sessions of whom 624 (79%) provided baseline and completion questionnaires. Parents reported increases in healthiness of family lifestyle, parenting attributes, and emotional wellbeing following attendance (all P < .001). Both parents and children were reported to have increased their daily fruit/vegetable consumption, and reduced their consumption of high fat/sugar foods (both P < .001). There were also positive changes in eating behaviours, physical activity (P < .001) and children's screen time (P < .001). Significant changes were reported in all domains similar to those reported in a previous, smaller study in locations selected for experience and quality. The HENRY approach appears to have a beneficial impact even when delivered at scale in non-selected locations. Such changes, if maintained, may serve to protect against later obesity. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Reaching older people with PA delivered in football clubs: the reach, adoption and implementation characteristics of the Extra Time Programme.

PubMed

Parnell, Daniel; Pringle, Andy; McKenna, Jim; Zwolinsky, Stephen; Rutherford, Zoe; Hargreaves, Jackie; Trotter, Lizzie; Rigby, Michael; Richardson, David

2015-03-05

Older adults (OA) represent a core priority group for physical activity and Public Health policy. As a result, significant interest is placed on how to optimise adherence to interventions promoting these approaches. Extra Time (ET) is an example of a national programme of physical activity interventions delivered in professional football clubs for OA aged 55+ years. This paper aims to examine the outcomes from ET, and unpick the processes by which these outcomes were achieved. This paper represents a secondary analysis of data collected during the evaluation of ET. From the 985 OA reached by ET, n=486 adopted the programme and completed post-intervention surveys (typically 12 weeks). We also draw on interview data with 18 ET participants, and 7 staff who delivered the programme. Data were subject to thematic analysis to generate overarching and sub themes. Of the 486 participants, the majority 95%, (n= 462) were White British and 59.7% (n=290) were female. Most adopters (65.4%/n=318) had not participated in previous interventions in the host clubs. Social interaction was the most frequently reported benefit of participation (77.2%, n=375). While the reach of the club badge was important in letting people know about the programme, further work enhanced adoption and satisfaction. These factors included (i) listening to participants, (ii) delivering a flexible age-appropriate programme of diverse physical and social activities, (iii) offering activities which satisfy energy drives and needs for learning and (iv) extensive opportunities for social engagement. Findings emerging from this study indicate that physical activity and health interventions delivered through professional football clubs can be effective for engaging OA.

Understanding international postgraduate studies. Drivers from the supply and the demand side.

PubMed

Delgado-Serrano, M M; Gomez-Bruque, J L; Ambrosio-Albala, M J; Llamas-Moreno, B

2010-01-01

Changes in the global political and socioeconomic scenario are fostering the internationalization of master and doctoral programme as one of the current priorities for Universities. Changes in European higher education such as those stimulated by the Bologna process and the introduction of double, multiple or joint Master degree programmes together with the Erasmus Mundus programme are enhancing the competition of European universities in the global education market place. Universities compete to attract the best students, both national and international, to their postgraduate programmes. However, the design and launch of international masters or doctorates imply working with a different logic to the one used in national programmes. Complexity, diversity and differentiation are drivers of international education and as happens in complex systems the properties and features of the final products are different from the existing in the individual components. The aim of this paper is to understand international studies as complex systems and to analyze and identify factors affecting to the different components involved in the implementation of these programmes. The new approaches and the interrelations in aspects such as academic, administrative or economic management, quality assurance and marketing issues are examined and drivers, challenges and good practices where possible are identified. The analysis has been carried out considering the point of view of both Universities (supply-led approach) and students and employers (demand-led approach). From the analysis have emerged important questions that show the interrelation pattern and that can be useful when designing and implementing international postgraduate studies. Universities and students tend to agree about many issues however, some divergences have also been identified which make the results of the research more valuable.

The European New Car Assessment Programme: A historical review.

PubMed

van Ratingen, Michiel; Williams, Aled; Lie, Anders; Seeck, Andre; Castaing, Pierre; Kolke, Reinhard; Adriaenssens, Guido; Miller, Andrew

2016-04-01

Established in 1997, the European New Car Assessment Programme (Euro NCAP) provides consumers with a safety performance assessment for the majority of the most popular cars in Europe. Thanks to its rigorous crash tests, Euro NCAP has rapidly become an important driver safety improvement to new cars. After ten years of rating vehicles, Euro NCAP felt that a change was necessary to stay in tune with rapidly emerging driver assistance and crash avoidance systems and to respond to shifting priorities in road safety. A new overall rating system was introduced that combines the most important aspects of vehicle safety under a single star rating. The overall rating system has allowed Euro NCAP to continue to push for better fitment and higher performance for vehicles sold on the European market. In the coming years, the safety rating is expected to play an important role in the support of the roll-out of highly automated vehicles.

Container contamination as a possible source of a diarrhoea outbreak in Abou Shouk camp, Darfur province, Sudan.

PubMed

Walden, Vivien Margaret; Lamond, Elizabeth-Anne; Field, Sally A

2005-09-01

Diarrhoea is one of the five major causes of death in an emergency setting and one of the three main causes of death in children (Curtis and Cairncross, 2003). In June 2004, an outbreak of shigellosis was confirmed in Abou Shouk camp in the Northern Darfur province of Sudan. As water testing showed no contamination, it was assumed that post-collection contamination was happening. The decision was taken to launch a programme of mass disinfection of all water containers in order to break the contamination cycle. Diarrhoea figures from the clinics showed a fall in cases following the cleaning campaign. It is extremely difficult to obtain good and statistically rigorous data in an emergency setting, the priority being to intervene rapidly to prevent further cases of diarrhoea. However, the results do appear to indicate that the disinfection programme has had an impact on the prevalence of bloody and watery diarrhoea.

Action to address the household economic burden of non-communicable diseases.

PubMed

Jan, Stephen; Laba, Tracey-Lea; Essue, Beverley M; Gheorghe, Adrian; Muhunthan, Janani; Engelgau, Michael; Mahal, Ajay; Griffiths, Ulla; McIntyre, Diane; Meng, Qingyue; Nugent, Rachel; Atun, Rifat

2018-05-19

The economic burden on households of non-communicable diseases (NCDs), including cardiovascular diseases, cancer, respiratory diseases, and diabetes, poses major challenges to global poverty alleviation efforts. For patients with NCDs, being uninsured is associated with 2-7-fold higher odds of catastrophic levels of out-of-pocket costs; however, the protection offered by health insurance is often incomplete. To enable coverage of the predictable and long-term costs of treatment, national programmes to extend financial protection should be based on schemes that entail compulsory enrolment or be financed through taxation. Priority should be given to eliminating financial barriers to the uptake of and adherence to interventions that are cost-effective and are designed to help the poor. In concert with programmes to strengthen national health systems and governance arrangements, comprehensive financial protection against the growing burden of NCDs is crucial in meeting the UN's Sustainable Development Goals. Copyright © 2018 Elsevier Ltd. All rights reserved.

Transit signal priority project, phase II : field and simulation evaluation results.

DOT National Transportation Integrated Search

2006-01-01

Transit Signal Priority (TSP) is recognized as an emerging technology that is capable of enhancing traditional transit services. Basic green-extension TSP was implemented on U.S. Route 1 in the Northern Virginia Area (or Washington, DC metropolitan a...

Environment and health in contaminated sites: the case of Taranto, Italy.

PubMed

Pirastu, Roberta; Comba, Pietro; Iavarone, Ivano; Zona, Amerigo; Conti, Susanna; Minelli, Giada; Manno, Valerio; Mincuzzi, Antonia; Minerba, Sante; Forastiere, Francesco; Mataloni, Francesca; Biggeri, Annibale

2013-01-01

The National Environmental Remediation programme in Italy includes sites with documented contamination and associated potential health impacts (National Priority Contaminated Sites-NPCSs). SENTIERI Project, an extensive investigation of mortality in 44 NPCSs, considered the area of Taranto, a NPCS where a number of polluting sources are present. Health indicators available at municipality level were analyzed, that is, mortality (2003-2009), mortality time trend (1980-2008), and cancer incidence (2006-2007). In addition, the cohort of individuals living in the area was followed up to evaluate mortality (1998-2008) and morbidity (1998-2010) by district of residence. The results of the study consistently showed excess risks for a number of causes of death in both genders, among them: all causes, all cancers, lung cancer, and cardiovascular and respiratory diseases, both acute and chronic. An increased infant mortality was also observed from the time trends analysis. Mortality/morbidity excesses were detected in residents living in districts near the industrial area, for several disorders including cancer, cardiovascular, and respiratory diseases. These coherent findings from different epidemiological approaches corroborate the need to promptly proceed with environmental cleanup interventions. Most diseases showing an increase in Taranto NPCS have a multifactorial etiology, and preventive measures of proven efficacy (e.g., smoking cessation and cardiovascular risk reduction programs, breast cancer screening) should be planned. The study results and public health actions are to be communicated objectively and transparently so that a climate of confidence and trust between citizens and public institutions is maintained.

Residentialization of Public Spaces: Bratislava Example

NASA Astrophysics Data System (ADS)

Bacová, Andrea; Puškár, Branislav; Vráblová, Edita

2017-10-01

The housing estates in Bratislava saturated the housing needs of a large number of inhabitants who come after World War II to the city. Design of public spaces often did not have priority in the process of designing. The solutions for mentioned exterior spaces had been planned after blocks of flat realization, but many of them are not realized to this day. The article analyzes the example of the unrealized public spaces in existing housing estates Devinska Nova Ves and Petržalka (city districts of Bratislava) and offer practical solutions in relation to residencialization method. Residencialization of missing public places is an effective method of adding identities to settlements. It improves the quality of residential environment and public spaces. The main aim is to create better conditions for social activities in public areas, which are missing on the present. The research will be focused on the examination of the urban, cultural and construction potential of the existing residential enviroment in Bratislava. The main aim of residentialization is not only to enhance the quality of spatial and building structures in the selected residential area and maintain long-term sustainability in the pertinent programme area, but mainly to improve the quality of living for the residents. The outputs of the project are proposals and practical procedures developed with regard to planning documents for local municipal authorities and regional organizations. The solutions will have a positive impact on the enhancement of the quality of public spaces, attractive social activities and of a conceptual link - residentialization.

Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania

PubMed Central

Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

2016-01-01

Background: Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. Methods: A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Results: Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual’s area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Conclusions: Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. PMID:26768827

Analysis of the healthcare process of patients with type 2 diabetes mellitus and associated comorbidity treated in Spain's National Health System: A perspective of medical professionals. IMAGINE study.

PubMed

Gómez-Huelgas, R; Artola-Menéndez, S; Menéndez-Torre, E

2016-04-01

To analyse the care received by patients with type 2 diabetes mellitus (DM2) and comorbidity in Spain's National Health System. Cross-sectional study using an online survey. A total of 302 family physicians, internists and endocrinologists participated in the study. The participants were recruited voluntarily by their respective scientific societies and received no remuneration. Patients with DM2 and comorbidity are mostly treated in Primary Care (71.8%). Forty percent are referred to hospital care, mainly due to renal failure, poor glycaemic control and for a retinopathy assessment. Only 52% of those surveyed conducted medication reconciliation in the transition between healthcare levels. Fifty-eight percent reported conducting interconsultations, clinical meetings or consultancies between healthcare levels. The 3 main factors identified for improving the follow-up and control of DM2 with comorbidity were the multidisciplinary study (80.8%), the continuing education of health professionals (72.3%) and therapeutic education programmes (72%). A lack of time, a lack of qualified personnel for lifestyle interventions and organisational shortcomings were mentioned as the main obstacles for improving the care of these patients. Most patients with DM2 and comorbidity are treated in Primary Care. Promoting multidisciplinary care and training programmes for practitioners and patients can help improve the quality of care. Therapy reconciliation represents a priority area for improvement in this population. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Using a geographical information system to plan a malaria control programme in South Africa.

PubMed Central

Booman, M.; Durrheim, D. N.; La Grange, K.; Martin, C.; Mabuza, A. M.; Zitha, A.; Mbokazi, F. M.; Fraser, C.; Sharp, B. L.

2000-01-01

INTRODUCTION: Sustainable control of malaria in sub-Saharan Africa is jeopardized by dwindling public health resources resulting from competing health priorities that include an overwhelming acquired immunodeficiency syndrome (AIDS) epidemic. In Mpumalanga province, South Africa, rational planning has historically been hampered by a case surveillance system for malaria that only provided estimates of risk at the magisterial district level (a subdivision of a province). METHODS: To better map control programme activities to their geographical location, the malaria notification system was overhauled and a geographical information system implemented. The introduction of a simplified notification form used only for malaria and a carefully monitored notification system provided the good quality data necessary to support an effective geographical information system. RESULTS: The geographical information system displays data on malaria cases at a village or town level and has proved valuable in stratifying malaria risk within those magisterial districts at highest risk, Barberton and Nkomazi. The conspicuous west-to-east gradient, in which the risk rises sharply towards the Mozambican border (relative risk = 4.12, 95% confidence interval = 3.88-4.46 when the malaria risk within 5 km of the border was compared with the remaining areas in these two districts), allowed development of a targeted approach to control. DISCUSSION: The geographical information system for malaria was enormously valuable in enabling malaria risk at town and village level to be shown. Matching malaria control measures to specific strata of endemic malaria has provided the opportunity for more efficient malaria control in Mpumalanga province. PMID:11196490

An Example of Large-group Drama and Cross-year Peer Assessment for Teaching Science in Higher Education

NASA Astrophysics Data System (ADS)

Sloman, Katherine; Thompson, Richard

2010-09-01

Undergraduate students pursuing a three-year marine biology degree programme (n = 86) experienced a large-group drama aimed at allowing them to explore how scientific research is funded and the associated links between science and society. In the drama, Year 1 students played the "general public" who decided which environmental research areas should be prioritised for funding, Year 2 students were the "scientists" who had to prepare research proposals which they hoped to get funded, and Year 3 students were the "research panel" who decided which proposals to fund with input from the priorities set by the "general public". The drama, therefore, included an element of cross-year peer assessment where Year 3 students evaluated the research proposals prepared by the Year 2 students. Questionnaires were distributed at the end of the activity to gather: (1) student perceptions on the cross-year nature of the exercise, (2) the use of peer assessment, and (3) their overall views on the drama. The students valued the opportunity to interact with their peers from other years of the degree programme and most were comfortable with the use of cross-year peer assessment. The majority of students felt that they had increased their knowledge of how research proposals are funded and the perceived benefits of the large-group drama included increased critical thinking ability, confidence in presenting work to others, and enhanced communication skills. Only one student did not strongly advocate the use of this large-group drama in subsequent years.

European Network of Bipolar Research Expert Centre (ENBREC): a network to foster research and promote innovative care.

PubMed

Henry, Chantal; Andreassen, Ole A; Barbato, Angelo; Demotes-Mainard, Jacques; Goodwin, Guy; Leboyer, Marion; Vieta, Eduard; Nolen, Willem A; Kessing, Lars Vedel; Scott, Jan; Bauer, Michael

2013-01-01

Bipolar disorders rank as one of the most disabling illnesses in working age adults worldwide. Despite this, the quality of care offered to patients with this disorder is suboptimal, largely due to limitations in our understanding of the pathology. Improving this scenario requires the development of a critical mass of expertise and multicentre collaborative projects. Within the framework of the European FP7 programme, we developed a European Network of Bipolar Research Expert Centres (ENBREC) designed specifically to facilitate EU-wide studies. ENBREC provides an integrated support structure facilitating research on disease mechanisms and clinical outcomes across six European countries (France, Germany, Italy, Norway, Spain and the UK). The centres are adopting a standardised clinical assessment that explores multiple aspects of bipolar disorder through a structured evaluation designed to inform clinical decision-making as well as being applicable to research. Reliable, established measures have been prioritised, and instruments have been translated and validated when necessary. An electronic healthcare record and monitoring system (e-ENBREC©) has been developed to collate the data. Protocols to conduct multicentre clinical observational studies and joint studies on cognitive function, biomarkers, genetics, and neuroimaging are in progress; a pilot study has been completed on strategies for routine implementation of psycho-education. The network demonstrates 'proof of principle' that expert centres across Europe can collaborate on a wide range of basic science and clinical programmes using shared protocols. This paper is to describe the network and how it aims to improve the quality and effectiveness of research in a neglected priority area.

Comparative study on Climate Change Policies in the EU and China

NASA Astrophysics Data System (ADS)

Bray, M.; Han, D.

2012-04-01

Both the EU and China are among the largest CO2 emitters in the world; their climate actions and policies have profound impacts on global climate change and may influence the activities in other countries. Evidence of climate change has been observed across Europe and China. Despite the many differences between the two regions, the European Commission and Chinese government support climate change actions. The EU has three priority areas in climate change: 1) understanding, monitoring and predicting climate change and its impact; 2) providing tools to analyse the effectiveness, cost and benefits of different policy options for mitigating climate change and adapting to its impacts; 3) improving, demonstrating and deploying existing climate friendly technologies and developing the technologies of the future. China is very vulnerable to climate change, because of its vast population, fast economic development, and fragile ecological environment. The priority policies in China are: 1) Carbon Trading Policy; 2) Financing Loan Policy (Special Funds for Renewable Energy Development); 3) Energy Efficiency Labelling Policy; 4) Subsidy Policy. In addition, China has formulated the "Energy Conservation Law", "Renewable Energy Law", "Cleaner Production Promotion Law" and "Circular Economy Promotion Law". Under the present EU Framework Programme FP7 there is a large number of funded research activities linked to climate change research. Current climate change research projects concentrate on the carbon cycle, water quality and availability, climate change predictors, predicting future climate and understanding past climates. Climate change-related scientific and technological projects in China are mostly carried out through national scientific and technological research programs. Areas under investigation include projections and impact of global climate change, the future trends of living environment change in China, countermeasures and supporting technologies of global environment change, formation mechanism and prediction theory of major climate and weather disasters in China, technologies of efficient use of clean energy, energy conservation and improvement of energy efficiency, development and utilisation technology of renewable energy and new energy. The EU recognises that developing countries, such as China and India, need to strengthen their economies through industrialisation. However this needs to be achieved at the same time as protecting the environment and sustainable use of energy. The EU has committed itself to assisting developing countries to achieve their goals in four priority areas: 1) raising the policy profile of climate change; 2) support for adaption to climate change; 3) support for mitigation of climate change; and 4) capacity development. This comparative study is part of the EU funded SPRING project which seeks to understand and assess Chinese and European competencies, with the aim of facilitating greater cooperation in future climate and environment research.

Systematic Review of Real-time Remote Health Monitoring System in Triage and Priority-Based Sensor Technology: Taxonomy, Open Challenges, Motivation and Recommendations.

PubMed

Albahri, O S; Albahri, A S; Mohammed, K I; Zaidan, A A; Zaidan, B B; Hashim, M; Salman, Omar H

2018-03-22

The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.

Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

PubMed

Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

2015-01-01

New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

Final priority. Rehabilitation Training: Job-Driven Vocational Rehabilitation Technical Assistance Center. Final priority.

PubMed

2014-08-19

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Rehabilitation Training program to establish a Job-Driven Vocational Rehabilitation Technical Assistance Center (JDVRTAC). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus on training in an area of national need. Specifically, this priority responds to the Presidential Memorandum to Federal agencies directing them to take action to address job-driven training for the Nation's workers. The JDVRTAC will provide technical assistance (TA) to State vocational rehabilitation (VR) agencies to help them develop for individuals with disabilities training and employment opportunities that meet the needs of today's employers.

Patient-centered priorities for improving medication management and adherence.

PubMed

McMullen, Carmit K; Safford, Monika M; Bosworth, Hayden B; Phansalkar, Shobha; Leong, Amye; Fagan, Maureen B; Trontell, Anne; Rumptz, Maureen; Vandermeer, Meredith L; Brinkman, William B; Burkholder, Rebecca; Frank, Lori; Hommel, Kevin; Mathews, Robin; Hornbrook, Mark C; Seid, Michael; Fordis, Michael; Lambert, Bruce; McElwee, Newell; Singh, Jasvinder A

2015-01-01

The Centers for Education and Research on Therapeutics convened a workshop to examine the scientific evidence on medication adherence interventions from the patient-centered perspective and to explore the potential of patient-centered medication management to improve chronic disease treatment. Patients, providers, researchers, and other stakeholders (N = 28) identified and prioritized ideas for future research and practice. We analyzed stakeholder voting on priorities and reviewed themes in workshop discussions. Ten priority areas emerged. Three areas were highly rated by all stakeholder groups: creating tools and systems to facilitate and evaluate patient-centered medication management plans; developing training on patient-centered prescribing for providers; and increasing patients' knowledge about medication management. However, priorities differed across stakeholder groups. Notably, patients prioritized using peer support to improve medication management while researchers did not. Engaging multiple stakeholders in setting a patient-centered research agenda and broadening the scope of adherence interventions to include other aspects of medication management resulted in priorities outside the traditional scope of adherence research. Workshop participants recognized the potential benefits of patient-centered medication management but also identified many challenges to implementation that require additional research and innovation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The importance of assessing priorities of reproductive health concerns among adolescent and young adult patients with cancer.

PubMed

Murphy, Devin; Klosky, James L; Reed, Damon R; Termuhlen, Amanda M; Shannon, Susan V; Quinn, Gwendolyn P

2015-08-01

Visions for the future are a normal developmental process for adolescents and young adults (AYAs) with and without cancer, and these visions often include expectations of sexual and romantic relationships. AYA cancer survivors indicate reproductive health is an issue of great importance and more attention is needed in the health care setting throughout the cancer experience, beginning at diagnosis. Various practice guidelines are predominately focused on fertility; are intended to influence survivorship care plans; and do not encompass the broad scope of reproductive health that includes romantic partnering, friendships, body image, sexuality, sexual identity, fertility, contraception, and more. Although interventions to reduce reproductive health-related sequelae from treatment are best approached as an evolving process, practitioners are not certain of the priorities of these various reproductive health content areas. Strategies incongruent with the reproductive health priorities of AYAs will likely thwart adequate follow-up care and foster feelings of isolation from the treatment team. Research is needed to identify these priorities and ensure discussions of diverse content areas. This review explored various domains of reproductive health and emphasized how understanding the priorities of the AYA cancer cohort will guide future models of care. © 2015 American Cancer Society.

An analysis of local government health policy against state priorities and a social determinants framework.

PubMed

Browne, Geoffrey R; Davern, Melanie T; Giles-Corti, Billie

2016-04-01

Victorian local governments are required to develop Municipal Public Health and Wellbeing Plans that incorporate state-level health planning priorities and address the social determinants of health. This paper describes a novel method for evaluating councils' performance against these requirements. Deductive content analysis was used to categorise all actions in 14 local government MPHWPs against Victorian state priorities as well as against social determinants of health policy areas. More than 1,000 actions were identified. However, fewer than half directly addressed a state priority, with many actions addressing policy areas known to be broader determinants of health. In particular, there was a marked focus on leisure and culture, and on building social cohesion through changes to living and working conditions. Councils are working beyond state priorities and there was a clear emphasis on addressing the diverse upstream 'causes of the causes' of health, rather than health promotion behaviour change programs. The approach for data analysis and presentation provides a useful method for rapid appraisal of health and wellbeing actions relative to councils', and the State's, responsibility and efficacy in public health. © 2015 Public Health Association of Australia.

Case Definitions, Diagnostic Algorithms, and Priorities in Encephalitis: Consensus Statement of the International Encephalitis Consortium

PubMed Central

Venkatesan, A.; Tunkel, A. R.; Bloch, K. C.; Lauring, A. S.; Sejvar, J.; Bitnun, A.; Stahl, J-P.; Mailles, A.; Drebot, M.; Rupprecht, C. E.; Yoder, J.; Cope, J. R.; Wilson, M. R.; Whitley, R. J.; Sullivan, J.; Granerod, J.; Jones, C.; Eastwood, K.; Ward, K. N.; Durrheim, D. N.; Solbrig, M. V.; Guo-Dong, L.; Glaser, C. A.; Sheriff, Heather; Brown, David; Farnon, Eileen; Messenger, Sharon; Paterson, Beverley; Soldatos, Ariane; Roy, Sharon; Visvesvara, Govinda; Beach, Michael; Nasci, Roger; Pertowski, Carol; Schmid, Scott; Rascoe, Lisa; Montgomery, Joel; Tong, Suxiang; Breiman, Robert; Franka, Richard; Keuhnert, Matt; Angulo, Fred; Cherry, James

2013-01-01

Background.Encephalitis continues to result in substantial morbidity and mortality worldwide. Advances in diagnosis and management have been limited, in part, by a lack of consensus on case definitions, standardized diagnostic approaches, and priorities for research. Methods.In March 2012, the International Encephalitis Consortium, a committee begun in 2010 with members worldwide, held a meeting in Atlanta to discuss recent advances in encephalitis and to set priorities for future study. Results.We present a consensus document that proposes a standardized case definition and diagnostic guidelines for evaluation of adults and children with suspected encephalitis. In addition, areas of research priority, including host genetics and selected emerging infections, are discussed. Conclusions.We anticipate that this document, representing a synthesis of our discussions and supported by literature, will serve as a practical aid to clinicians evaluating patients with suspected encephalitis and will identify key areas and approaches to advance our knowledge of encephalitis. PMID:23861361

[School feeding programmes in Latin America. An analysis].

PubMed

Amigo, H

1997-12-01

Governments in Latin American countries invest large amounts of resources in school feeding programmes, part of educational and social strategies to reach highly vulnerable group within the respective societies. We analysed the criteria used in selecting the beneficiaries of these programmes, the food distributed, management structures and lessons that have been learned from these processes. Differences found among development strategies in each country were also considered. At present, these strategies are centred on the efficient use of resources, focusing interventions on the neediest groups, and leaving aside the idea of universal benefits. In general, countries provide most types of food, such as breakfast lunch, snacks or just a glass of milk, free of charge. Recipients receive up to 1.000 calories and 30 g of selected protein per day. About execution; Latin American States have generally abandoned the integral management of these programmes, a former characteristic that included the purchasing of or production, reparation and delivery of specific food stuffs. Instead, the respective States have only maintained the organisational functions of planning and control of priority actions whilst the private sector has progressively taken an active part in developing strategies. Community participation is restricted to a minimum. We expect that this paper will be taken into consideration by those who bear the responsibility of formulating, executing and evaluating nutritional interventions directed at schoolchildren in selected Latin American regions.

[Memorandum prevention research - research areas and methods].

PubMed

Walter, U; Nöcker, G; Plaumann, M; Linden, S; Pott, E; Koch, U; Pawils, S; Altgeld, T; Dierks, M L; Frahsa, A; Jahn, I; Krauth, C; Pomp, M; Rehaag, R; Robra, B P; Süß, W; Töppich, J; Trojan, A; von Unger, H; Wildner, M; Wright, M

2012-10-01

From 2004 to 2012, the German Ministry of Education and Research (BMBF) established its first funding programme for the promotion of prevention research. 60 projects on primary prevention and health promotion and the meta-project entitled "Cooperation for Sustainable Prevention Research" (KNP) received BMBF grants under this programme during this period. The experience and knowledge gained and recommendations arising from the research funded under this programme are compiled in memorandum format. The "Memorandum on Prevention Research - Research Areas and Methods" highlights 5 research areas that are considered to be especially relevant from the perspective of the involved scientists and practice partners.The promotion of structural development and sustainability enhancement in disease prevention and health promotion are central areas that should branch out from existing nuclei of crystallization. Improving the health competence of the population and of specific subpopulations is another major area. Research in these areas should contribute to the development of theoretical concepts and to the empirical testing of these concepts. The transfer of knowledge for effective use of developed disease prevention and health promotion programmes and measures is still a scarcely researched area. Among other things, studies of the transfer of programmes from one context to another, analyses of the coop-eration between politics and science, and the continued theoretical and conceptual development of transfer research are needed. Long-term data on the effects of intervention studies are also needed for proper evaluation of sustainability. The latter dem-onstrates the importance of method development in disease prevention and health promotion research as an area that should receive separate funding and support. This research should include, in particular, studies of the efficacy of complex interventions, health economic analyses, and participative health research. © Georg Thieme Verlag KG Stuttgart · New York.

2015 Pediatric Research Priorities in Prehospital Care.

PubMed

Browne, Lorin R; Shah, Manish I; Studnek, Jonathan R; Farrell, Brittany M; Mattrisch, Linda M; Reynolds, Stacy; Ostermayer, Daniel G; Brousseau, David C; Lerner, E Brooke

2016-01-01

Pediatric prehospital research has been limited, but work in this area is starting to increase particularly with the growth of pediatric-specific research endeavors. Given the increased interest in pediatric prehospital research, there is a need to identify specific research priorities that incorporate the perspective of prehospital providers and other emergency medical services (EMS) stakeholders. To develop a list of specific research priorities that is relevant, specific, and important to the practice of pediatric prehospital care. Three independent committees of EMS providers and researchers were recruited. Each committee developed a list of research topics. These topics were collated and used to initiate a modified Delphi process for developing consensus on a list of research priorities. Participants were the committee members. Topics approved by 80% were retained as research priorities. Topics that were rejected by more than 50% were eliminated. The remaining topics were modified and included on subsequent surveys. Each survey allowed respondents to add additional topics. The surveys were continued until all topics were either successfully retained or rejected and no new topics were suggested. Fifty topics were identified by the three independent committees. These topics were included on the initial electronic survey. There were 5 subsequent surveys. At the completion of the final survey a total of 29 research priorities were identified. These research priorities covered the following study areas: airway management, asthma, cardiac arrest, pain, patient-family interaction, resource utilization, seizure, sepsis, spinal immobilization, toxicology, trauma, training and competency, and vascular access. The research priorities were very specific. For example, under airway the priorities were: "identify the optimal device for effectively managing the airway in the prehospital setting" and "identify the optimal airway management device for specific disease processes." This project developed a list of relevant, specific, and important research priorities for pediatric prehospital care. Some similarities exist between this project and prior research agendas but this list represents a current, more specific research agenda and reflects the opinions of working EMS providers, researchers, and leaders. emergency medical technician; research; emergency medical services; priorities.

The emergence of maternal health as a political priority in Madhya Pradesh, India: a qualitative study

PubMed Central

2013-01-01

Background Politics plays a critical role in agenda setting in health affairs; therefore, understanding the priorities of the political agenda in health is very important. The political priority for safe motherhood has been investigated at the national level in different countries. The objective of this study was to explore why and how maternal health became a political priority at sub-national level in the state of Madhya Pradesh in India. Methods This study followed a qualitative design. Data were collected by carrying out interviews and review of documents. Semi-structured interviews were carried out with twenty respondents from four stakeholder groups: government officials, development partners, civil society and academics. Data analysis was performed using thematic analysis. The analysis was guided by Kingdon’s multiple streams model. Results The emergence of maternal health as a political priority in Madhya Pradesh was the result of convergence in the developments in different streams: the development of problem definition, policy generation and political change. The factors which influenced this process were: emerging evidence of the high magnitude of maternal mortality, civil society’s positioning of maternal mortality as a human rights violation, increasing media coverage, supportive policy environment and launch of the National Rural Health Mission (NRHM), the availability of effective policy solutions, India’s aspiration of global leadership, international influence, maternal mortality becoming a hot debate topic and political transition at the national and state levels. Most of these factors first became important at national level which then cascaded to the state level. Currently, there is a supportive policy environment in the state for maternal health backed by greater political will and increased resources. However, malnutrition and population stabilization are the competing priorities which may push maternal health off the agenda. Conclusions The influence of the events and factors evolving from international and national levels significantly contributed to the development of maternal health as a priority in Madhya Pradesh. This led to several opportunities in terms of policies, guidelines and programmes for improving maternal health. These efforts were successful to some extent in improving maternal health in the state but several implementation challenges still require special attention. PMID:24079699

The emergence of maternal health as a political priority in Madhya Pradesh, India: a qualitative study.

PubMed

Jat, Tej Ram; Deo, Prakash Ramchandra; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

2013-09-30

Politics plays a critical role in agenda setting in health affairs; therefore, understanding the priorities of the political agenda in health is very important. The political priority for safe motherhood has been investigated at the national level in different countries. The objective of this study was to explore why and how maternal health became a political priority at sub-national level in the state of Madhya Pradesh in India. This study followed a qualitative design. Data were collected by carrying out interviews and review of documents. Semi-structured interviews were carried out with twenty respondents from four stakeholder groups: government officials, development partners, civil society and academics. Data analysis was performed using thematic analysis. The analysis was guided by Kingdon's multiple streams model. The emergence of maternal health as a political priority in Madhya Pradesh was the result of convergence in the developments in different streams: the development of problem definition, policy generation and political change. The factors which influenced this process were: emerging evidence of the high magnitude of maternal mortality, civil society's positioning of maternal mortality as a human rights violation, increasing media coverage, supportive policy environment and launch of the National Rural Health Mission (NRHM), the availability of effective policy solutions, India's aspiration of global leadership, international influence, maternal mortality becoming a hot debate topic and political transition at the national and state levels. Most of these factors first became important at national level which then cascaded to the state level. Currently, there is a supportive policy environment in the state for maternal health backed by greater political will and increased resources. However, malnutrition and population stabilization are the competing priorities which may push maternal health off the agenda. The influence of the events and factors evolving from international and national levels significantly contributed to the development of maternal health as a priority in Madhya Pradesh. This led to several opportunities in terms of policies, guidelines and programmes for improving maternal health. These efforts were successful to some extent in improving maternal health in the state but several implementation challenges still require special attention.