Analysis of misoprostol and chlorhexidine policy gains in Pakistan: the advocacy experience of Mercy Corps Pakistan.

PubMed

Sarwar, Zahida; Cutherell, Andrea; Noor, Arif; Naureen, Farah; Norman, Jennifer

2015-11-25

While Pakistan has made progress toward achieving Millennium Development Goal 5 for maternal health, it is unlikely to achieve the target; further, it is also not on track for Millennium Development Goal 4 regarding child health. Two low-cost, temperature stable and life-saving drugs, misoprostol and chlorhexidine, can respectively avert maternal and newborn deaths, and are particularly pertinent for poor and marginalized areas which bear the brunt of maternal and newborn deaths in Pakistan. In response, Mercy Corps led focused advocacy efforts to promote changes in policies, protocols, and regulatory environments for misoprostol (2012-2014) and for chlorhexidine (2014). These short-duration advocacy projects facilitated significant policy gains, such as inclusion of misoprostol and chlorhexidine into province-specific essential drug lists, development and endorsement of clinical protocols for the two drugs by provincial health departments, inclusion of misoprostol into pre-service training curriculum for several health cadres, and application for registration of chlorhexidine (at the concentration required for newborn care) by two pharmaceutical companies. These results were achieved by a consultative and evidence-based process which generated feedback from community members, program implementers, and policymakers, and ultimately put the government in the driver's seat to facilitate change. Community Action Dialogue forums were linked with provincial-level Technical Working Groups and Provincial Steering Committees, who passed on endorsed recommendations to the Health Secretary. The key factors which facilitated change were the identification of champions within the provincial health departments, prioritization of relationship building and follow-up, focus on concrete advocacy aims rather than broad objectives, and the use of multi-stakeholder forums to secure an enabling environment for the policy changes to take root. While these advocacy initiatives resulted in significant policy changes in Pakistan's devolved health system, to ensure these policy changes have an impact on health outcomes, Pakistan should focus on the scale-up of appropriate use of chlorhexidine and misoprostol. Further, future policy initiatives in Pakistan should make use of similar multi-stakeholder policy forums, while ensuring a third party to facilitate the process so that civil society and community voices are not lost in the policy development discussion.

Habsburg Austria: Experiments in Non-Territorial Autonomy

PubMed Central

Kuzmany, Börries

2016-01-01

Abstract In the early twentieth century, three provinces of the Austrian half of the Habsburg Empire enacted national compromises in their legislation that had elements of non-territorial autonomy provisions. Czech and German politicians in Moravia reached an agreement in 1905. In the heavily mixed Bukovina, Romanian, Ukrainian, German, Jewish and Polish representatives agreed on a new provincial constitution in 1909. Last but not least, Polish and Ukrainian nationalists compromised in spring 1914, just a few months before the outbreak of the First World War vitiated the new provisions. Even though the provisions of these agreements varied substantially, new electoral laws introducing national registers were at their heart. These were designed to ensure a fairer representation of national groups in the provincial assemblies and to keep national agitation out of electoral campaigns. The earliest compromise in Moravia went furthest in consociational power sharing. However, the national bodies within the provincial assembly had no right to tax their respective national communities, and the provisions of the provincial constitutions kept the non-nationally defined nobility as an important counterbalance. The compromises in Bukovina and Galicia, even if they categorised all inhabitants nationally, contented themselves with even less autonomous agency for the national bodies in the provincial assemblies and rather emphasised the symbolic elements of national autonomy. The non-territorial approach in all three crownlands, however, was an instrument to reorganise multi-ethnic provinces that increasingly became the model for national compromises in other Austrian provinces. PMID:27499799

The current capacity and future development of economic evaluation for policy decision-making: a survey among researchers and decision-makers in Thailand.

PubMed

Chaikledkaew, Usa; Lertpitakpong, Chanida; Teerawattananon, Yot; Thavorncharoensap, Montarat; Tangcharoensathien, Viroj

2009-01-01

This study aims to explore the knowledge, experience, and attitudes toward economic evaluation (EE) among decision-makers and researchers in Thailand. Researchers were purposively selected from Thai academics and both public and private research organizations related to EE. Decision-makers at the provincial level were purposively selected from the members of the Management Committees of Provincial Health Offices, and those at hospital level were randomly selected from members of the public and private hospital formulary drug committees throughout Thailand. The self-administered postal questionnaires were distributed. Univariate and bivariate analyses were applied. Of the total 2575 questionnaires distributed, 758 (29.4% response rate) were completed and sent back. The majority of researchers and decision-makers were not familiar with technical terms commonly used in health EE, e.g., incremental cost-effectiveness ratio, discounting, and sensitivity analysis. More decision-makers (70.6%) had never had EE training compared to researchers (50.0%). Both roles indicated that value for money was one of the important issues to consider for health technology adoption. An extensive unmet demand for EE training among Thai researchers and decision-makers still exists. Findings from this study contribute to the short- and long-term plans for research capacity building.

From Teachers to Teacher-Leaders: A Case Study

ERIC Educational Resources Information Center

Riveros, Augusto; Newton, Paul; da Costa, José

2013-01-01

This paper reports on a study of teacher leadership conducted in Alberta, Canada. Twenty-one school teachers and administrators were interviewed about their experiences with a provincial teacher-leader program in which they participated from 1997 to 2007. The participants were asked questions related to their experience in the program and how…

Integrated clinical and quality improvement coaching in Son La Province, Vietnam: a model of building public sector capacity for sustainable HIV care delivery.

PubMed

Cosimi, Lisa A; Dam, Huong V; Nguyen, Thai Q; Ho, Huyen T; Do, Phuong T; Duc, Duat N; Nguyen, Huong T; Gardner, Bridget; Libman, Howard; Pollack, Todd; Hirschhorn, Lisa R

2015-07-17

The global scale-up of antiretroviral therapy included extensive training and onsite support to build the capacity of HIV health care workers. However, traditional efforts aimed at strengthening knowledge and skills often are not successful at improving gaps in the key health systems required for sustaining high quality care. We trained and mentored existing staff of the Son La provincial health department and provincial HIV clinic to work as a provincial coaching team (PCT) to provide integrated coaching in clinical HIV skills and quality improvement (QI) to the HIV clinics in the province. Nine core indicators were measured through chart extraction by clinic and provincial staff at baseline and at 6 month intervals thereafter. Coaching from the team to each of the clinics, in both QI and clinical skills, was guided by results of performance measurements, gap analyses, and resulting QI plans. After 18 months, the PCT had successfully spread QI activities, and was independently providing regular coaching to the provincial general hospital clinic and six of the eight district clinics in the province. The frequency and type of coaching was determined by performance measurement results. Clinics completed a mean of five QI projects. Quality of HIV care was improved throughout all clinics with significant increases in seven of the indicators. Overall both the PCT activities and clinic performance were sustained after integration of the model into the Vietnam National QI Program. We successfully built capacity of a team of public sector health care workers to provide integrated coaching in both clinical skills and QI across a province. The PCT is a feasible and effective model to spread and sustain quality activities and improve HIV care services in a decentralized rural setting.

Snakes or Ladders? An Examination of the Experiences of Two Teacher Leaders Returning to Classroom Teaching

ERIC Educational Resources Information Center

Munroe, Elizabeth

2014-01-01

Teachers who have held leadership roles at the school, district, or provincial level have the potential to contribute to student and school success when they return to classroom teaching. The contrasting experiences of two teacher leaders who returned voluntarily to classroom teaching are analyzed using Owens's (2004) social constructivist theory…

Mapping South African allied health primary care clinical guideline activity: establishing a stakeholder reference sample.

PubMed

Dizon, Janine Margarita; Grimmer, Karen; Machingaidze, Shingai; McLaren, Pam; Louw, Quinette

2016-10-10

Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant. South African government websites were searched for structures of departments and portfolios, and available CPGs. Professional AH association websites were searched for CPGs, purposively-identified key informants were interviewed, and CPGs previously identified for priority South African primary care conditions were critiqued for AH therapy involvement. Key informants described potentially complex relationships between players who may be engaged in South African AH CPGs, in both public and private sectors. There were disability/rehabilitation portfolios at national and provincial governments, but no uniformity in provincial government organisation of, or support for, PHC AH services. There were no AH primary care therapy CPGs on government websites, although there was 'clinical guidance' in various forms on professional association websites. Only two CPGs of priority South African PHC conditions included mention of any AH therapy (physiotherapy for adult asthma and chronic obstructive pulmonary disease). A comprehensive and wide-reaching stakeholder reference framework would be required in order to capture the heterogeneity of AH primary care CPG activity in South Africa. This should involve the voices of national and purposively-selected provincial governments, academic institutions, consultants, public sector managers and clinicians, private practitioners, professional associations, and private sector insurers. Provincial governments should be selected to reflect heterogeneity in local economics, population demographics and availability of university AH training programs. This investigation should aim to determine the areas of PHC in which AH are engaged.

A novel image encryption scheme based on Kepler’s third law and random Hadamard transform

NASA Astrophysics Data System (ADS)

Luo, Yu-Ling; Zhou, Rong-Long; Liu, Jun-Xiu; Qiu, Sen-Hui; Cao, Yi

2017-12-01

Not Available Project supported by the National Natural Science Foundation of China (Grant Nos. 61661008 and 61603104), the Natural Science Foundation of Guangxi Zhuang Autonomous Region, China (Grant Nos. 2015GXNSFBA139256 and 2016GXNSFCA380017), the Funding of Overseas 100 Talents Program of Guangxi Provincial Higher Education, China, the Research Project of Guangxi University of China (Grant No. KY2016YB059), the Guangxi Key Laboratory of Multi-source Information Mining & Security, China (Grant No. MIMS15-07), the Doctoral Research Foundation of Guangxi Normal University, the Guangxi Provincial Experiment Center of Information Science, and the Innovation Project of Guangxi Graduate Education (Grant No. YCSZ2017055).

77 FR 18786 - Eastern Washington Cascades Provincial Advisory Committee and the Yakima Provincial Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... DEPARTMENT OF AGRICULTURE Forest Service Eastern Washington Cascades Provincial Advisory Committee and the Yakima Provincial Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting... Chief's 10-Year Stewardship Challenge, Upper Yakima Basin Water Enhancement Project, Holden Mine...

Investor sentiment and stock returns: Evidence from provincial TV audience rating in China

NASA Astrophysics Data System (ADS)

Zhang, Yongjie; Zhang, Yuzhao; Shen, Dehua; Zhang, Wei

2017-01-01

In this paper, we advocate the provincial TV audience rating as the novel proxy for the provincial investor sentiment (PIS) and investigate its relation with stock returns. The empirical results firstly show that the PIS is positively related to stock returns. Secondly, we provide direct evidence on the existence of home bias in China by observing that the provincial correlation coefficient is significantly larger than the cross-provincial correlation coefficient. Finally, the PIS can explain a large proportion of provincial comovement. To sum up, all these findings support the role of the non-traditional information sources in understanding the ;anomalies; in stock market.

Poster - 27: Incident Learning Practices in Ontario

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

Angers, Crystal; Medlam, Gaylene; Liszewski, Brian

Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharingmore » incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.« less

75 FR 7440 - Eastern Washington Cascades Provincial Advisory Committee and the Yakima Provincial Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-19

... DEPARTMENT OF AGRICULTURE Forest Service Eastern Washington Cascades Provincial Advisory Committee and the Yakima Provincial Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting... Committee will meet on March 9, 2010 at the Sunnyslope Fire Station, 206 Easy Street, Wenatchee, WA. During...

Is Ontario Moving to Provincial Negotiation of Teaching Contracts?

ERIC Educational Resources Information Center

Jefferson, Anne L.

2008-01-01

In Canada, the statutes governing public school teachers' collective bargaining are a combination of the provincial Labour Relations Act or Code and the respective provincial Education/School/Public Schools Act. As education is within the provincial, not federal, domain of legal responsibility, the specifics of each act or code can vary.…

Life Interference Due to Gambling in Three Canadian Provinces.

PubMed

Afifi, Tracie O; Sareen, Jitender; Taillieu, Tamara; Turner, Sarah; Fortier, Janique

2018-03-28

The gambling landscape among provinces in Canada is diverse. Yet, few studies have investigated provincial differences related to life interference due to gambling. The objectives of the current study were to examine: (1) provincial differences with regard to gambling types and (2) if gender, family history of gambling, and alcohol or drug use while gambling were related to an increased likelihood of life interference in three Canadian provinces. Data were drawn from the 2013 and 2014 cycles of the Canadian Community Health Survey from Manitoba, Saskatchewan, and British Columbia (n = 30,150). Analyses were conducted stratified by provinces and also combined using logistic regression models. Provincial differences were noted with individuals from British Columbia compared to Manitoba being less likely to play VLTs outside of casinos, play live horse racing at a track or off track, and participate in sports gambling. Those in Saskatchewan compared to Manitoba were more likely to play VLTs inside a casino. When examining all provinces combined, family history of gambling was associated with increased odds of life interference. Gender was not associated with life interference. Provincial differences were noted, which may be in part related to differences in gambling landscapes. Family history of gambling may have clinical relevance for understanding which individuals may be more likely to experience life interference due to gambling. Further research is needed to clarify the link between alcohol and drug use while gambling and life interference due to gambling as the models in the current research were likely underpowered.

The Third Indochina Conflict: Cambodia’s Total War

DTIC Science & Technology

2014-12-12

Military Region. NR National Road. OMZ Operational Military Zone. PAVN People’s Army of Vietnam. PMC Provincial Military Command. PRK People’s......of the Khmer Rouge regime escaped to the Cambodian-Thai border and started a resistance movement aimed at deposing the PRK and driving out the

A survey of radiation treatment planning peer-review activities in a provincial radiation oncology programme: current practice and future directions

PubMed Central

Brundage, Michael; Foxcroft, Sophie; McGowan, Tom; Gutierrez, Eric; Sharpe, Michael; Warde, Padraig

2013-01-01

Objectives To describe current patterns of practice of radiation oncology peer review within a provincial cancer system, identifying barriers and facilitators to its use with the ultimate aim of process improvement. Design A survey of radiation oncology programmes at provincial cancer centres. Setting All cancer centres within the province of Ontario, Canada (n=14). These are community-based outpatient facilities overseen by Cancer Care Ontario, the provincial cancer agency. Participants A delegate from each radiation oncology programme filled out a single survey based on input from their multidisciplinary team. Outcome measures Rated importance of peer review; current utilisation; format of the peer-review process; organisation and timing; case attributes; outcomes of the peer-review process and perceived barriers and facilitators to expanding peer-review processes. Results 14 (100%) centres responded. All rated the importance of peer review as at least 8/10 (10=extremely important). Detection of medical error and improvement of planning processes were the highest rated perceived benefits of peer review (each median 9/10). Six centres (43%) reviewed at least 50% of curative cases; four of these centres (29%) conducted peer review in more than 80% of cases treated with curative intent. Fewer than 20% of cases treated with palliative intent were reviewed in most centres. Five centres (36%) reported usually conducting peer review prior to the initiation of treatment. Five centres (36%) recorded the outcomes of peer review on the medical record. Thirteen centres (93%) planned to expand peer-review activities; a critical mass of radiation oncologists was the most important limiting factor (median 6/10). Conclusions Radiation oncology peer-review practices can vary even within a cancer system with provincial oversight. The application of guidelines and standards for peer-review processes, and monitoring of implementation and outcomes, will require effective knowledge translation activities. PMID:23903814

[Assessment of a supervision grid being used in the laboratories of cutaneous leishmaniasis in Morocco].

PubMed

El Mansouri, Bouchra; Amarir, Fatima; Hajli, Yamina; Fellah, Hajiba; Sebti, Faiza; Delouane, Bouchra; Sadak, Abderrahim; Adlaoui, El Bachir; Rhajaoui, Mohammed

2017-01-01

The aim of our study was to assess a standardized supervisory grid as a new supervision tool being used in the laboratories of leishmaniasis. We conducted a pilot trial to evaluate the ongoing performances of seven provincial laboratories, in four provinces in Morocco, over a period of two years, between 2006 and 2014. This study detailed the situation in provincial laboratories before and after the implementation of the supervisory grid. A total of twenty-one grids were analyzed. In 2006, the results clearly showed a poor performance of laboratories: need for training (41.6%), staff performing skin biopsy (25%), shortage of materials and reagents (65%), non-compliant document and local management (85%). Several corrective actions were conducted by the National Reference Laboratory (LNRL) of Leishmaniasis during the study period. In 2014, the LNRL recorded a net improvement of the performances of the laboratories. The need for training, the quality of the biopsy, the supply of tools and reagents were met and an effective coordination activity was established between the LNRL and the provincial laboratories. This trial shows the effectiveness of the grid as a high quality supervisory tool and as a cornerstone of making progress on fight programs against leishmaniases.

Application of local policy to prevent alcohol problems: experiences from a community trial.

PubMed

Holder, H D; Reynolds, R I

1997-06-01

Alcohol policy conventionally has been established at the national or regional, state and provincial levels. Alcohol policy at any level is not actually limited to the regulation and control of alcohol production, wholesale distribution, and retail sales. There are a number of alternatives for setting alcohol policies within a local community. Building upon existing national and state/provincial laws, policy makers at the community level can set priorities for allocating resources and enforcing laws related to drinking and driving, underage alcohol sales, alcohol serving practices of bars and restaurants and geographical density of alcohol outlets in the community. This paper concludes from the Community Trials Project that policies established at the local level can reduce alcohol problems.

Preface

Treesearch

David DeYoe

1999-01-01

The idea for this workshop began in 1996 when the folks in Quebec, faced with some unappealing fiscal realities that promised to devastate their provincial forest research capacity, held a meeting that convened representatives from research organizations around the world to share their experiences under similar circumstances. The meeting gathered senior research...

Chemistry 300. Administration Manual for Supervising Teachers, Provincial Examination, Answer Key--Multiple-Choice and Written-Answer Questions, and Provincial Summary Report = Chimie 300. Guide d'administration a l'intention des surveillants d'examen, Examen provincial, Cle de correction--Questions choix multiple et Questions responses ouvertes, et Rapport sommaire provincial.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This collection of manuals contains the Manitoba Provincial Chemistry Examination for students seeking credit in Senior 4 Chemistry (Chemistry 300) and instructions for its use and grading. The examination is based on the Core Topics of the Senior 4 Chemistry course and accounts for 30% of the student's final grade in the course. The examination…

Culture Trading on the Old Silk Road.

ERIC Educational Resources Information Center

Murray, Donald M.

1981-01-01

An American professor of English on an exchange trip to a provincial Chinese university describes his experiences. His Chinese students are diligent, polite, studious, and eager for any opportunity to practice their English. Culture trading is sometimes difficult but can have great rewards for an American teacher. (JN)

Anesthesia for Cesarean Delivery: A Cross-Sectional Survey of Provincial, District, and Mission Hospitals in Zimbabwe.

PubMed

Lonnée, Herman A; Madzimbamuto, Farai; Erlandsen, Ole R M; Vassenden, Astrid; Chikumba, Edson; Dimba, Rutenda; Myhre, Arne K; Ray, Sunanda

2018-06-01

Cesarean delivery is the most common surgical procedure in low- and middle-income countries, so provision of anesthesia services can be measured in relation to it. This study aimed to assess the type of anesthesia used for cesarean delivery, the level of training of anesthesia providers, and to document the availability of essential anesthetic drugs and equipment in provincial, district, and mission hospitals in Zimbabwe. In this cross-sectional survey of 8 provincial, 21 district, and 13 mission hospitals, anesthetic providers were interviewed on site using a structured questionnaire adapted from standard instruments developed by the World Federation of Societies of Anaesthesiologists and the World Health Organization. The anesthetic workforce for the hospitals in this survey constituted 22% who were medical officers and 77% nurse anesthetists (NAs); 55% of NAs were recognized independent anesthetic providers, while 26% were qualified as assistants to anesthetic providers and 19% had no formal training in anesthesia. The only specialist physician anesthetist was part time in a provincial hospital. Spinal anesthesia was the most commonly used method for cesarean delivery (81%) in the 3 months before interview, with 19% general anesthesia of which 4% was ketamine without airway intubation. The mean institutional cesarean delivery rate was 13.6% of live births, although 5 district hospitals were <5%. The estimated institutional maternal mortality ratio was 573 (provincial), 251 (district), and 211 (mission hospitals) per 100,000 live births. Basic monitoring equipment (oximeters, electrocardiograms, sphygmomanometers) was reported available in theatres. Several unsafe practices continue: general anesthesia without a secure airway, shortage of essential drugs for spinal anesthesia, inconsistent use of recovery area or use of table tilt or wedge, and insufficient blood supplies. Postoperative analgesia management was reported inadequate. This study identified areas where anesthetic provision and care could be improved. Provincial hospitals, where district/mission hospitals refer difficult cases, did not have the higher level anesthesia expertise required to manage these cases. More intensive mentorship and supervision from senior clinicians is essential to address the shortcomings identified in this survey, such as the implementation of evidence-based safe practices, supply chain failures, high maternal morbidity, and mortality. Training of medical officers and NAs should be strengthened in leadership, team work, and management of complications.

Decentralization and human resource management in the health sector: a case study (1996-1998) from Nampula province, Mozambique.

PubMed

Saide, M A; Stewart, D E

2001-01-01

Despite political, cultural and geographical diversity, health care reforms implemented in many developing countries share a number of common features regarding management and structural issues. Decentralization of decision-making from the central authority to local and provincial levels is generally regarded in the literature to be an important way of achieving a more equitable distribution of health care and better management practices, aligned with local priorities and needs. However, in the absence of clear guidelines, continuous monitoring and an adequate supply of financial and human resources, decentralization processes are more likely to have a low impact on the process of health care reform and can, to a certain extent, provoke inequalities between regions in the same country. This qualitative study in Nampula province, Mozambique, was conducted to assess the impact of decentralization, through an analysis of the viewpoints of provincial health managers regarding their perceptions of the process, particularly with regard to the management of basic and elementary nurses. Secondary data from Nampula provincial reports and documents from the Mozambican Health Ministry were also reviewed and comparisons made with the experiences of other developing countries.

Public Education and Multicultural Policy in Canada: The Special Case of Quebec

ERIC Educational Resources Information Center

Ghosh, Ratna

2004-01-01

Education is a provincial responsibility in Canada, but there is a sharing of expenditure and strong support of public education, health and other welfare programs between the provinces and the federal government. Although the federal policy of multiculturalism has been aimed at making Canada a "just" society, the implementation of this…

Jane Austen and Imperialism--A Rereading of "Pride and Prejudice"

ERIC Educational Resources Information Center

Xu, Runjiang; Li, Yucheng

2009-01-01

This thesis attempts to search for the clues related to British domestic exploitation of the peasant labors and overseas colonization of other countries after rereading the novel "Pride and Prejudice," with an aim to bring out Austen's intimacy with Imperialism. It will offer some insights into a better understanding of provincial world…

Forest gene conservation programs in Alberta, Canada

Treesearch

Jodie Krakowski

2017-01-01

Provincial tree improvement programs in Alberta began in 1976. Early gene conservation focused on ex situ measures such as seed and clone banking, and research trials of commercial species with tree improvement programs. The gene conservation program now encompasses representative and unique populations of all native tree species in situ. The ex situ program aims to...

Decentralization of Education in Indonesia--A Study on Education Development Gaps in the Provincial Areas

ERIC Educational Resources Information Center

Winardi

2017-01-01

Decentralization is acknowledged as the handover of government from central government to local government, including giving broader authority to local governments to manage education. This study aims to discovering education development gap between regions in Indonesia as a result of decentralization. This research method uses descriptive…

Canada's experience in applying C&I to measure progress towards SFM - perspectives from the National, Regional and local levels

Treesearch

John E. Hall; S. R. J. Bridge; Brian D. Haddon

2006-01-01

This paper will provide perspectives of Canada’s experiences in applying Criteria and Indicators (C&I) to measure progress towards Sustainable Forest Management (SFM) at the National, Regional (Provincial) and local levels. SFM is rooted in Bruntland’s concept of Sustainable Development and is about providing for present forest-based needs without compromising...

Same Same but Different: Curriculum Representations of Health Education

ERIC Educational Resources Information Center

Renwick, Kerry

2017-01-01

The development of curriculum for health education in schools is an area of contestation. Drawing on the provincial curriculum of British Columbia and the Australian national curriculum, this article explores both common and different approaches to school-based health education and promotion. Students experience the impacts of the social…

State-Owned Enterprise Director Training: A Review of Canadian Experiences

ERIC Educational Resources Information Center

O'Neill, Michael A.

2015-01-01

This article surveys state-owned enterprise director training programmes in Canada at both the national and provincial levels. In Canada director training programmes have emerged to enable good private-sector corporate governance. This trend has been embraced by governments seeking to improve corporate governance among their state-owned…

Legitimacy and Penetration in Stability Operations; Setting the Conditions for Perpetual Failure

DTIC Science & Technology

2011-12-02

District or Provincial level. Taking the lessons from Vietnam and 124 Michael Crawshaw , Running a Country: The British Colonial Experience and its Relevance...Metrics of the Afghan War. CSIS presentation, Washington DC: Center for Strategic and International Studies, 2010. Crawshaw , Michael. Running a Country

Effective Programmatic Tutor Training for Interprofessional Problem-Based Learning

ERIC Educational Resources Information Center

D'Eon, Marcel; Proctor, Peggy; Bassendowski, Sandra; Dobson, Roy; Udahl, Brenda

2010-01-01

A provincial initiative to encourage interprofessional education and research resulted in the implementation of three interprofessional PBL (iPBL) modules at the University of Saskatchewan. The ambitious target of 1200 student iPBL experiences over three years presented a substantial teaching development challenge. Training incorporated many of…

The Quality Assurance Project assists the vitamin A capsule program in Antique Province, Philippines.

PubMed

Blumenfeld, S

1994-01-01

Vitamin A deficiency remains an important problem in some parts of the Philippines. The Department of Health, with assistance from the Helen Keller Institute (HKI), established a vitamin A supplementation program in Antique Province providing for the administration of vitamin A capsules to malnourished children. Although the HKI cut off its assistance in 1992, continuation of the capsule supplementation program was an element of the National Nutrition Plan for 1992-96, and remains an element of the Antique Provincial health services program under the Philippines' devolved health services scheme. The Quality Assurance Program (QAP) in May 1993 began helping the Provincial Health Office improve the quality of the vitamin A program. A systems analysis was first undertaken to identify significant deviations from provider performance standards which had been adapted by the province from Nutrition Service guidelines. Many problems were observed, including lack of knowledge of the high-priority categories of children, incomplete counseling, and frequent mistakes in determining children's nutritional status. The provincial health office staff recommended that six of the province's seventeen municipalities participate in the quality improvement effort. The intent of the QAP staff was not only to help the provincial staff improve the quality of its vitamin A program by resolving some immediate operational problems, but to provide the health care workers with a quality improvement experience that they would intuitively transfer to other programs for which they were responsible. The coaching/facilitating approach of modern quality management allowed health workers to explore their own approaches to solving the problems chosen.

Transmission Challenges and Best Practices for Cost-Effective Renewable Energy Delivery across State and Provincial Boundaries

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

Zhou, Shengru; Hurlbut, David J.; Bird, Lori A.

A strategically planned transmission network is an important source of flexibility for the integration of large-scale renewable energy (RE). Such a network can offer access to a broad geographic diversity of resources, which can reduce flexibility needs and facilitate sharing between neighboring balancing areas. This report builds on two previous NREL technical reports - Advancing System Flexibility for High Penetration Renewable Integration (Milligan et al. 2015) and 'Renewables-Friendly' Grid Development Strategies (Hurlbut et al. 2015) - which discuss various flexibility options and provide an overview of U.S. market models and grid planning. This report focuses on addressing issues with cross-regional/provincialmore » transmission in China with the aim of integrating renewable resources that are concentrated in remote areas and require inter-regional/provincial power exchange.« less

Federal, provincial and territorial public health response plan for biological events.

PubMed

McNeill, R; Topping, J

2018-01-04

The Federal/Provincial/Territorial (FPT) Public Health Response Plan for Biological Events was developed for the Public Health Network Council (PHNC). This plan outlines how the national response to public health events caused by biological agents will be conducted and coordinated, with a focus on implementation of responses led by senior-level FPT public health decision-makers. The plan was developed by an expert task group and was approved by PHNC in October, 2017. The plan describes roles, responsibilities and authorities of FPT governments for public health and emergency management, a concept of operations outlining four scalable response levels and a governance structure that aims to facilitate an efficient, timely, evidence-informed and consistent approach across jurisdictions. Improving effective engagement amongst public health, health care delivery and health emergency management authorities is a key objective of the plan.

Federal, provincial and territorial public health response plan for biological events

PubMed Central

McNeill, R; Topping, J

2018-01-01

The Federal/Provincial/Territorial (FPT) Public Health Response Plan for Biological Events was developed for the Public Health Network Council (PHNC). This plan outlines how the national response to public health events caused by biological agents will be conducted and coordinated, with a focus on implementation of responses led by senior-level FPT public health decision-makers. The plan was developed by an expert task group and was approved by PHNC in October, 2017. The plan describes roles, responsibilities and authorities of FPT governments for public health and emergency management, a concept of operations outlining four scalable response levels and a governance structure that aims to facilitate an efficient, timely, evidence-informed and consistent approach across jurisdictions. Improving effective engagement amongst public health, health care delivery and health emergency management authorities is a key objective of the plan. PMID:29770090

Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam

PubMed Central

Harris, Jody; Nguyen, Phuong H.; To, Quyen; Frongillo, Edward A.; Menon, Purnima

2016-01-01

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009–2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. PMID:27198978

Adolescents' Attitudes toward Wheelchair Users: A Provincial Survey

ERIC Educational Resources Information Center

Arbour-Nicitopoulos, Kelly P.

2010-01-01

The study aims were to examine (i) adolescents' attitudes towards family members who use a wheelchair in relation to other health problems and conditions, and (ii) the association between perceived wheelchair stigma and socio-demographic factors. Data were based on surveys from 2790 seventh to 12th grade students derived from the 2007 cycle of the…

The Language Teaching Methods Scale: Reliability and Validity Studies

ERIC Educational Resources Information Center

Okmen, Burcu; Kilic, Abdurrahman

2016-01-01

The aim of this research is to develop a scale to determine the language teaching methods used by English teachers. The research sample consisted of 300 English teachers who taught at Duzce University and in primary schools, secondary schools and high schools in the Provincial Management of National Education in the city of Duzce in 2013-2014…

Domestic Violence against Married Women in Edirne

ERIC Educational Resources Information Center

Tokuc, Burcu; Ekuklu, Galip; Avcioglu, Serap

2010-01-01

The aim of this study is to assess the prevalence and risk factors of domestic violence against married women in Edirne, Turkey. This is a cross-sectional study which included a representative sample of the married women living in the Provincial Center of Edirne. The total past year prevalence of some forms of physical domestic violence is 34% in…

Province/Ministry-Coordinated Industry-University-Institute Cooperation and University Development: Based on the Experiences of Guangdong Province

ERIC Educational Resources Information Center

Yang, Liu

2016-01-01

The industry S&T missioners, industry-university-institute innovation alliances, industry-university-institute regional model bases, and other provincial-level industry-university-institute cooperation mechanisms that Guangdong Province has formed through its practical efforts play an important role in training a large batch of practical…

Threats and Aggression Directed at Soccer Referees: An Empirical Phenomenological Psychological Study

ERIC Educational Resources Information Center

Friman, Margareta; Nyberg, Claes; Norlander, Torsten

2004-01-01

A descriptive qualitative analysis of in-depth interviews involving seven provincial Soccer Association referees was carried out in order to find out how referees experience threats and aggression directed to soccer referees. The Empirical Phenomenological Psychological method (EPP-method) was used. The analysis resulted in thirty categories which…

A Naturalistic Alcohol Availability Experiment: Effects on Crime.

ERIC Educational Resources Information Center

Kraushaar, Kevin; Alsop, Brent

Previous investigators have looked at many types of criminal offenses in order to determine alcohol involvement in crime. This longitudinal (4-year) naturalistic experimental and control designed study examined the effects of change in alcohol availability on rates of offending in a small provincial region of New Zealand following the closure of…

Democratic Dialogue as a Process to Inform Public Policy: Reconceptualizing a Supervisory Officer's Qualification Program

ERIC Educational Resources Information Center

Smith, Deirdre M.; Qua-Hiansen, Jessica

2015-01-01

An exploration of the collaborative reconceptualization of a provincial Supervisory Officer's Qualification Program (SOQP) through the use of dialogic approaches is the focus of this inquiry. The stories, perspectives, and lived experiences of supervisory officers, principals, teachers, parents, students, and members of the public in Ontario were…

Central-provincial relations for anti-schistosomiasis policy in china.

PubMed

Fan, Ka-Wai

2012-01-01

This paper discusses central-local relations for healthcare policy in China from a principal-agent perspective, based on schistosomiasis control. In order to control the disease, the central government produced the Outline of the Mid-Long-Term National Plan for Schistosomiasis Prevention and Control (2004-2015) in 2004. By discussing the implementation of the National Outline at the provincial level, the author uses principal-agent theory to examine conflict and coordination between the central and provincial governments. The documents were collected from the Internet. Although the central and provincial governments all want to eliminate schistosomiasis, allocating funding among them creates conflict and forms an obstacle to achieving the goal. This paper extensively discusses the topics related to central-provincial relation and schistosomiasis control program. Further case study on a single province may be needed to intensify the discussion from a micro perspective. The conflict between central and provincial relations needs to be resolved in order to implement the national policy.

Central-Provincial Relations for Anti-Schistosomiasis Policy in China

PubMed Central

FAN, Ka-wai

2012-01-01

This paper discusses central-local relations for healthcare policy in China from a principal-agent perspective, based on schistosomiasis control. In order to control the disease, the central government produced the Outline of the Mid-Long-Term National Plan for Schistosomiasis Prevention and Control (2004–2015) in 2004. By discussing the implementation of the National Outline at the provincial level, the author uses principal-agent theory to examine conflict and coordination between the central and provincial governments. The documents were collected from the Internet. Although the central and provincial governments all want to eliminate schistosomiasis, allocating funding among them creates conflict and forms an obstacle to achieving the goal. This paper extensively discusses the topics related to central-provincial relation and schistosomiasis control program. Further case study on a single province may be needed to intensify the discussion from a micro perspective. The conflict between central and provincial relations needs to be resolved in order to implement the national policy. PMID:23113188

The BC Glomerulonephritis Network: Improving Access and Reducing the Cost of Immunosuppressive Treatments for Glomerular Diseases

PubMed Central

Barbour, Sean; Lo, Clifford; Espino-Hernandez, Gabriela; Gill, Jagbir; Levin, Adeera

2018-01-01

Glomerulonephritis (GN) is a common cause of end-stage renal disease in Canada and worldwide, and results in significant health care resource utilization and patient morbidity. However, GN has not been a traditional priority of provincial renal health care organizations, despite the known benefits to health services delivery and patient outcomes from integrated provincial care in other types of chronic kidney disease. To address this deficiency, the British Columbia (BC) Provincial Renal Agency created the BC GN Network in 2013 to coordinate provincial GN health services delivery informed by robust population-level data capture on all GN patients in the province via the BC GN Registry. This report describes the use of the BC GN Network infrastructure to systematically develop and evaluate a provincial GN drug formulary to improve patient and physician access to evidence-based immunosuppressive treatments for GN in a cost-efficient manner that successfully halted historical trends of increasing medication costs. An example is provided of using the provincial infrastructure to implement and subsequently evaluate an evidence-informed health policy of converting brand to generic tacrolimus for the treatment of GN. The BC GN Network, including the provincial drug formulary and data infrastructure, is an example of the benefits of expanding the mandate of provincial renal health administrative organizations to include the care of patients with GN, and constitutes a viable health delivery model that can be implemented in other Canadian provinces to achieve similar goals. PMID:29581884

Physics 300 Provincial Examination.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This document consists of the physics 300 provincial examination (English version), a separate "provincial summary report" on the results of giving the test, and a separate French language version of the examination. This physics examination contains a 53-item multiple choice section and an 12 item free response section. Subsections of…

An Example of Decentralized Management in Education: Provincial Directory Model

ERIC Educational Resources Information Center

Ada, Sefer; Baysal, Z. Nurdan; Erkan, Senem Seda Sahenk

2016-01-01

In Turkey, two types of administrative structures existed in the fields of National Education: "the central" and "provincial" institutions. However, between 1926-1931, the Locality model was implemented. Locality can be considered as a local administration formed in the provincial organization of the Ministry of Education by…

Research on carbon emission driving factors of China’s provincial construction industry

NASA Astrophysics Data System (ADS)

Shang, Mei; Dong, Rui; Fu, Yujie; Hao, Wentao

2018-03-01

As a pillar industry of the national economy, the damage to the environment by construction industry can not be ignored. In the context of low carbon development, identifying the main driving factors for the carbon emission of the provincial construction industry are the key for the local government to formulate the development strategy for construction. In the paper, based on the Kaya factor decomposition method, the carbon intensity of the energy structure, energy intensity and the impact of the construction output on the carbon emission of provincial construction industry are studied, and relevant suggestions for low carbon development of provincial construction industry are proposed. The conclusion of this paper provides a theoretical basis for the early realization of low-carbon development in China’s provincial construction industry.

Teledermatology: an experience in Tucumán

NASA Astrophysics Data System (ADS)

Rotger, V. I.; Solarz, P. F.; Ruiz, L. M.; Salas, A.; García Mena, M. C.; Olivera, J. M.

2011-12-01

Since 2006 projects have been carried out in the Universidad Nacional de Tucuman to introduce Telemedicine in the Provincial System of Health (SIPROSA) in Tucuman, Argentina. These projects aim at improving accessibility to remote populations, providing equity and avoiding costly and unnecessary transfers as well as helping early diagnosis and treatments, timely and appropriate referrals. On the other hand, this consultation has already been set up within the SIPROSA with the application of the system of reference and counter-reference for several years. By applying Telemedicine it is possible to accelerate the times and make this more efficient. This paper presents a prototype Web application for performing consultation in dermatology. These were conducted by professionals in Ranchillos, a small town within the Province, together with specialists from the capital city. After the experience, it can be said that the teledermatological application of the platform has been well received by physicians and dermatologists of rural areas, especially because the interfaces could be adjusted to their requirements. The physicians consider it a useful tool to complete the process of referral and counter-referral.

Students with Disabilities in Mainstream Schools: District Level Perspectives on Anti-Bullying Policy and Practice within Schools in Alberta

ERIC Educational Resources Information Center

Gil, Malgorzata; da Costa, Jose

2010-01-01

Many researchers around the world point out that bullying in schools is aimed towards others, in many cases against students with disabilities. Bullying is a serious issue, which involves many students and is, by far, the biggest violence problem in schools in many countries. The researchers investigated how provincial legislation and…

The Relationship between Teachers' Leadership Behaviours and Emotional Labour=Ögretmenlerin Liderlik Davranislari Ile Duygusal Emekleri Arasindaki Iliski

ERIC Educational Resources Information Center

Hosgörür, Tugba; Yorulmaz, Yilmaz Ilker

2015-01-01

In this study, it was aimed to determine the relationship between teachers' leadership and emotional labour behaviours. The study was designed using correlational survey model. The sample of the study consists of 340 teachers working in primary, secondary, high and vocational high schools within the provincial capital of Mugla, Turkey, during the…

Trade-offs Between Socio-economic Development and Ecosystem Health under Changing Water Availability

NASA Astrophysics Data System (ADS)

Nazemi, A.; Hassanzadeh, E.; Elshorbagy, A. A.; Wheater, H. S.; Gober, P.; Jardine, T.; Lindenschmidt, K. E.

2017-12-01

Natural and human water systems at regional scales are often developed around key characteristics of streamflow. As a result, changes in streamflow regime can affect both socio-economic activities and freshwater ecosystems. In addition to natural variability and/or climate change, extensive water resource management to support socio-economic growth has also changed streamflow regimes. This study aims at understanding the trade-offs between agricultural expansion in the province of Saskatchewan, Canada, and alterations in the ecohydrological characteristics of the Saskatchewan River Delta (SRD) located downstream. Changes in climate along with extensive water resource management have altered the upstream flow regime. Moreover, Saskatchewan is investigating the possible expansion of irrigated agriculture to boost the provincial economy. To evaluate trade-offs across a range of possible scenarios for streamflow changes, the potential increase in provincial net benefit versus potential vulnerability of the SRD was assessed using perturbed flow realizations along with scenarios of irrigation expansion as input to an integrated water resource system model. This study sheds light on the potential variability in trade-offs between economic benefits and ecosystem health under a range of streamflow conditions, with the aim of informing decisions that can benefit both natural and human water systems.

Policy, Guidelines, and Procedures for the Selection and Classification of Provincially Authorized Learning Resources. Revised.

ERIC Educational Resources Information Center

Adamson, Martin; And Others

Intended for use by curriculum committees or individuals charged with responsibility for the selection of provincially authorized learning resources, this document contains guidelines and procedures intended to serve as minimum standard requirements for the provincial evaluation and selection of learning resources. Learning resources are defined…

Individuals with Mental Retardation from the Perspective of Turkish People

ERIC Educational Resources Information Center

Güner Yildiz, Nevin

2015-01-01

This descriptive study examined the attitude of Turkish people towards the mentally retarded. The working group was composed of 329 male and female staff in various places of employment in Eskisehir provincial center, 87 non-working women living in Eskisehir provincial center and 49 non-working women living in Mugla provincial center. Research…

Pharmaceutical policies in Canada: another example of federal-provincial discord

PubMed Central

Anis, A H

2000-01-01

Pharmaceutical policy in Canada is set at both the federal and provincial levels of government. The federal government is responsible for intellectual property rights of manufacturers (patents) and the initial approval and labelling of prescription drugs and for ensuring overall market competitiveness. The provincial government has responsibility and jurisdiction over the funding of all health care services, including pharmaceuticals. Various interactions between the pharmaceutical industry, the federal and provincial governments and consumers have shaped the current landscape for prescription drugs in Canada. One key failing of the system is that the federal government is almost completely insulated from the impact of its policies because, although it regulates drug prices, it does not buy any drugs. In contrast, provincial governments have no jurisdiction over market competitiveness or pricing, yet end up paying for most of the drug expenditures incurred. PMID:10701389

New Brunswick hospital system reorganization: a formula for success.

PubMed

McGeorge, R K; Giberson, S

1994-01-01

Propelled by a staggering burden of national and provincial debt, Canada has been overtaken by reform of its health system. New Brunswick's regionalization of hospital services has been a fascinating experience in health care reform, and many of its characteristics have now been emulated by other provinces. The approach has been bold, challenging and exciting.

Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam.

PubMed

Harris, Jody; Nguyen, Phuong H; To, Quyen; Frongillo, Edward A; Menon, Purnima

2016-12-01

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Assessment of temperatures in the vaccine cold chain in two provinces in Lao People's Democratic Republic: a cross-sectional pilot study.

PubMed

Kitamura, Tomomi; Bouakhasith, Viraneth; Phounphenghack, Kongxay; Pathammavong, Chansay; Xeuatvongsa, Anonh; Norizuki, Masataro; Okabayashi, Hironori; Mori, Yoshio; Machida, Munehito; Hachiya, Masahiko

2018-04-27

All childhood vaccines, except the oral polio vaccine, should be kept at 2-8 °C, since the vaccine potency can be damaged by heat or freezing temperature. A temperature monitoring study conducted in 2008-2009 reported challenges in cold chain management from the provincial level downwards. The present cross-sectional pilot study aimed to assess the current status of the cold chain in two provinces (Saravan and Xayabouly) of Lao People's Democratic Republic between March-April 2016. Two types of temperature data loggers recorded the temperatures and the proportions of time exposed to < 0 or > 8 °C were calculated. The temperature remained within the appropriate range in the central and provincial storages. However, the vaccines were frequently exposed to > 8 °C in Saravan and < 0 °C in Xayabouly in the district storage. Vaccines were exposed to > 8 °C during the transportation in Saravan and to both > 8 and < 0 °C in Xayabouly. Thus, challenges in managing the cold chain in the district storage and during transportation remain, despite improvements at the provincial storage. A detailed up-to-date nationwide analysis of the current situation of the cold chain is warranted to identify the most appropriate intervention to tackle the remaining challenges.

[Implementation of the International Health Regulations in Cuba: evaluation of basic capacities of the health sector in selected provinces].

PubMed

Gala, Ángela; Toledo, María Eugenia; Arias, Yanisnubia; Díaz González, Manuel; Alvarez Valdez, Angel Manuel; Estévez, Gonzalo; Abreu, Rolando Miyar; Flores, Gustavo Kourí

2012-09-01

Obtain baseline information on the status of the basic capacities of the health sector at the local, municipal, and provincial levels in order to facilitate identification of priorities and guide public policies that aim to comply with the requirements and capacities established in Annex 1A of the International Health Regulations 2005 (IHR-2005). A descriptive cross-sectional study was conducted by application of an instrument of evaluation of basic capacities referring to legal and institutional autonomy, the surveillance and research process, and the response to health emergencies in 36 entities involved in international sanitary control at the local, municipal, and provincial levels in the provinces of Havana, Cienfuegos, and Santiago de Cuba. The polyclinics and provincial centers of health and epidemiology in the three provinces had more than 75% of the basic capacities required. Twelve out of 36 units had implemented 50% of the legal and institutional framework. There was variable availability of routine surveillance and research, whereas the entities in Havana had more than 40% of the basic capacities in the area of events response. The provinces evaluated have integrated the basic capacities that will allow implementation of IHR-2005 within the period established by the World Health Organization. It is necessary to develop and establish effective action plans to consolidate surveillance as an essential activity of national and international security in terms of public health.

Lifting the Hood: Lifelong Learning and Young, White, Provincial Working-Class Masculinities

ERIC Educational Resources Information Center

Quinn, Jocey; Thomas, Liz; Slack, Kim; Casey, Lorraine; Thexton, Wayne; Noble, John

2006-01-01

Young, white, provincial working-class men are portrayed as a threat to lifelong learning goals. They are least likely to enter university and most likely to drop out. However, white provincial masculinities are neglected in debates on gender and lifelong learning. This article uses a UK-wide study of working-class "drop-out" to explore…

Integrating family planning with other social services.

PubMed

Bernales, E H

1982-01-01

Family planning outreach workers in the 43 municipalities of Iloilo Province, Western Visayas, the Philippines, have provided their communities with health, nutrition, educational, and agricultural services since 1973, when the Provincial Development Staff (PDS) began attempting to integrate services. The early work of the PDS was aided by the launching of the National Population and Family Planning Outreach Project in rural areas in 1976 and the creation of the Provincial Population Office (PPO) in 1977. 43% of the Outreach Project cost is borne by the local government, with the Commission on Population covering the rest. It is anticipated that the local goverment will eventually absorb the full cost. The Outreach officers have become an integral part of the planning body of the provincial government, largely due to the creation of the Provincial Consultative Committee on Population (PCCP) in 1979. The PCCP, composed of 22 governmental and private agencies involved in population-related activities, is charged with implementing the national population program in order to utilize all possible resources for provincial development. Its Integrated Provincial Population Plan has become part of the total provincial development plan. The Municipal Population Planning Actions Teams, whose functions are patterned on those of the PCCPs, further strengthen local planning at the municipal level. Full-Time Outreach Workers participate as well in planning at the barangay level. The various community-based projects initiated by the Outreach staff in Iloilo demonstrate a concern with making the population program responsive to the immediate needs of the provincial population. Organizations which teach better farming methods and undertake community projects emphasize local initiative and solutions to problems, and demonstrate the committment of population workers to broader development efforts. Outreach workers are involved in primary health care, social service delivery, income generating projects, and other activities even in backward and inaccessible areas.

Does public reporting measure up? Federalism, accountability and child-care policy in Canada.

PubMed

Anderson, Lynell; Findlay, Tammy

2010-01-01

Governments in Canada have recently been exploring new accountability measures within intergovernmental relations. Public reporting has become the preferred mechanism in a range of policy areas, including early learning and child-care, and the authors assess its effectiveness as an accountability measure. The article is based on their experience with a community capacity-building project that considers the relationship between the public policy, funding and accountability mechanisms under the federal/provincial/territorial agreements related to child-care. The authors argue that in its current form, public reporting has not lived up to its promise of accountability to citizens. This evaluation is based on the standards that governments have set for themselves under the federal/provincial/territorial agreements, as well as guidelines set by the Public Sector Accounting Board, an independent body that develops accounting standards over time through consultation with governments.

Inter-Provincial Migration Intentions of Family Physicians in Canada: The Roles of Income and Community Characteristics

PubMed Central

Olfert, M. Rose

2015-01-01

The inter-provincial migration patterns of family physicians in Canada show that some provinces like Newfoundland and Saskatchewan experience persistent net out-migration, while others, including Ontario and British Columbia, are destinations more often than origins of migrants. Governments in provinces exhibiting net out-migration have responded with a number of incentive and recruitment programs. In this study, we investigate the determinants of the stated interprovincial migration intentions of 3,995 rural and urban family physicians in the 2010 wave of the National Physician Survey. We consider a range of physician characteristics, community attributes and working conditions. We find that in the intention to move, higher compensation has a modest effect, while the community characteristics have a consistently important influence. Our results suggest that policy and program designers should acknowledge the critical role of community-level living and working conditions in their family physician recruitment and retention efforts. PMID:26742116

Rules that Need to Be Broken? Canada's McGill University Announces MBA Tuition Fee Increase in Breach of Provincial Ministry of Education Regulation

ERIC Educational Resources Information Center

Observatory on Borderless Higher Education, 2010

2010-01-01

The Ministry of Education in Canada's province of Quebec is threatening to significantly reduce McGill University (McGill)'s operating grant in response to a proposed Master's of Business Administration (MBA) tuition fee increase. From September 2010, the university's Desautels Faculty of Management is aiming to substantially raise the current…

Cultural Differences and Students' Spontaneous Models of the Water Cycle: A Case Study of Jewish and Bedouin Children in Israel

ERIC Educational Resources Information Center

Ben-Zvi Assaraf, Orit; Eshach, Haim; Orion, Nir; Alamour, Yousif

2012-01-01

The present research aims at pinpointing differences in spontaneous and non-spontaneous mental models of water cycle conceptions of two 4th grade student groups: the Jewish residents of a small provincial town and a group of students from an indigenous Bedouin community. Students' conceptions were elicited using the Repertory Grid technique as…

Educational Technology Program for Nova Scotia: Initial Phase. A Report on the Federal-Provincial Study of Educational Technology in Nova Scotia.

ERIC Educational Resources Information Center

deVille, Barry, Ed.

This is a preliminary examination of the present status and future prospects of educational technology in Nova Scotian schools. It is aimed at developing a plan to enhance the quality of educational technology by concentrating on systems which will be conducive to realizing educational goals at a reasonable cost. An overview of the institutional…

A review of health leadership and management capacity in the Solomon Islands.

PubMed

Asante, Augustine; Roberts, Graham; Hall, John

2012-04-01

ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially in rural and remote areas. There is one doctor for 3,300 people and approximately 13 nurses and midwives for 10,000 people. Despite limitations 87% of people seek health care when sick. FINANCING THE HEALTH SYSTEM: The SIG placed a series of reservations on ministerial goods and services budgets that effectively the budget by 33%, severely impacting provincial budgets and resulting in acquired debts. Shortfalls have been addressed by allocating Health Sector Support Program funds to the provinces to allow services to continue, a strategy that will likely recur, but by which donor support replaces government provision Provincial health accountants have received training in MYOB in 2009 but acquittal systems require higher level accounting skills for reports to be submitted on time to permit the release of subsequent funding tranches. HUMAN RESOURCES FOR HEALTH: The shortage of doctors and specialists is a key challenge. As at December 2010, there were a total of 2,728 health workers in the public sector in Solomon Islands. Staff costs consume on average 55% of provincial health grants Filled Public Service Division staff establishments and budgetary reservations have reduced the ability to meet the salary and wage costs of new graduates. Solomon Islands is currently negotiating to assist Vanuatu in filling its nursing staff vacancies with its surplus The return of 75 Cuban trained medical officers from 2013 presents the management challenge of accessing budget provisions for so many new positions and in funding the infrastructure needed to house, equip and maintain them in service. HEALTH MANAGEMENT STRUCTURE: Provincial health managers are operationally responsive to local needs, managerially responsible to provincial governments, while being concerned with adherence to central MHMS policy and to Ministry of Finance and Public Service Division regulations. The delineation of central and provincial health authorities' responsibilities requires guidelines in a changing system, where both population-based and targeted vertical programs are implemented at local levels. NUMBER AND DISTRIBUTION OF MANAGERS: Nine of the 10 positions of Provincial Health Director have experienced high turnover, which reportedly occurs without adequate handover to incoming appointees, most of whom are recent clinical graduates. Health services in the Honiara urban area are provided through the Honiara City Council. Church health services are staffed by government employees. COMPETENCE OF DISTRICT HEALTH MANAGERS: Management skills are reportedly weak at the provincial level. The Regional Assistance Mission to Solomon Islands provides governance training inputs to provincial government staff. Provincial health departments have limited financial and human resource management capacity. They also have clinical backgrounds and no training in public health planning or health services management, other than that provided by donors, the Regional Assistance Mission itself and the MHMS. MANAGEMENT WORKING ENVIRONMENT: Provincial health directors have limited control over health staff. Little supportive supervision in management is provided to new provincial health directors. No performance management systems are in place to ensure that staff are properly assessed and supported to do their best Large numbers of non-government organisations working at the provincial level in youth and women's programs require coordination by Provincial health directors to avoid duplication or implementation of programs that will require ongoing funding, but this is not done. FUNCTIONING OF MANAGEMENT SUPPORT SYSTEMS: Management support systems for budgeting and finance, management information and procurement and supply do not function adequately to support provincial health directors to manage effectively. THE SOCIO-CULTURAL CONTEXT: Socio-cultural issues such as favouritism based on kinship, discrimination against women and the big-man culture have implications for effective management and strong health leadership These cultural features create situations where a manager may be reluctant to discipline a member of their clan, or where a person with cultural influence may be able to distort systems.

Examining fiscal federalism, regionalization and community-based initiatives in Canada's health care delivery system.

PubMed

Forest, Pierre-Gerlier; Palley, Howard A

2008-01-01

This study focuses on the ability of Canadian provinces to shape in different ways the development of various provincial health delivery systems within the constraints of the mandates of the federal Canada Health Act of 1984 and the fiscal revenues that the provinces receive if they comply with these mandates. In so doing, it will examine the operation of Canadian federalism with respect to various provincial health systems. This study applies a comparative analysis framework developed by Heisler and Peters to facilitate an understanding of the dimensionality of provincial health delivery systems as applied to the case of provincial regionalization and community-based initiatives. The three sets of relationships touched upon are: first, the levels of government and the nature of their involvement in public policy concerning the provincial health care delivery systems; and secondly, understanding of the factors influencing provincial governments' political dispositions to act in various directions. A third dimension that is taken are the factors influencing the "timing" of particular decisions. A fourth area noted by Heisler and Peters and other comparative analysts is the nature and characteristics of public and private sector activities in health care and other social policy areas. While the evolving nature of public and private sector health care delivery activities within Canada's provincial and territorial systems is a significant policy matter in the Canadian context, due to the space limitations of this article, they are not discussed herein.

Journeys of Mike and Wayland: Reflections on a Friend and Mentor

ERIC Educational Resources Information Center

Gifford, Paul

2010-01-01

According to the author, Mike was his close friend and also his mentor. Mike helped him find his way into teaching and he drew him into traditional winter camping. His first winter camping experience was with Mike 16 years ago in Killbear Provincial Park, near Parry Sound. Mike was thinking up Community Environmental Leadership Program (CELP) way…

Regionalization: making sense of the Canadian experience.

PubMed

Lewis, Steven; Kouri, Denise

2004-01-01

This paper revisits the purposes and achievements of regionalization, a decade after its widespread implementation across Canada, and considers to what extent changes in healthcare concepts, emphasis and delivery can reasonably be attributed to it. The authors address four main questions. What, conceptually, is regionalization in healthcare, and what distinguishes it as a structure? How was regionalization intended to contribute to the achievement of the goals for the health system articulated in the 1980s and 1990s? How has regionalization been implemented in Canada, and how have these factors affected its potential to achieve its intended impact? And finally, with the experience gained over the last decade, how might we now (re)design regionalization to better contribute to health system goals? In Canada, regionalization of healthcare has entailed more than devolution and decentralization of services from provincial governments to regional authorities. It included consolidation of authority from local boards and agencies, and some centralization of services. Regionalization was the remedy proposed for the diagnosis of fragmentation and incoherence made by commissions across the country in the 1980s. Regionalization addressed the organizational dimensions of the perceived problems, but provincial governments added goals unrelated to structural change to its mandate. The authors assess the potential impact of regionalization on health system goals and take stock of current Canadian circumstances. Even where regionalization's impact is theoretically high, there are many practical limits to its effect. Although it can facilitate or impede change, in the end the will and actions of provincial governments, providers and other actors in the health system are fundamental to attaining more substantive goals. Many health reform goals require nothing less than a transformation of how society views health, and in the culture of healthcare delivery. Further, the authors argue that the implementation of regionalization in Canada has been limited. Devolution has typically been halting and provisional; there has been little stability; and there have been constraints on the ability to act. These limitations have reduced its potential effect. The authors conclude with proposals for increasing regionalization's contribution to health reform goals. These include a more stable and transparent provincial-RHA relationship, information and measures to better align resources to needs, increased regional-level system integration and changes to organizational culture and practice in the health system.

pH1N1 - a comparative analysis of public health responses in Ontario to the influenza outbreak, public health and primary care: lessons learned and policy suggestions

PubMed Central

2013-01-01

Background Ontario’s 36 Public Health Units (PHUs) were responsible for implementing the H1N1 Pandemic Influenza Plans (PIPs) to address the first pandemic influenza virus in over 40 years. It was the first under conditions which permitted mass immunization. This is therefore the first opportunity to learn and document what worked well, and did not work well, in Ontario’s response to pH1N1, and to make recommendations based on experience. Methods Our objectives were to: describe the PIP models, obtain perceptions on outcomes, lessons learned and to solicit policy suggestions for improvement. We conducted a 3-phase comparative analysis study comprised of semi-structured key informant interviews with local Medical Officers of Health (n = 29 of 36), and Primary Care Physicians (n = 20) and in Phase 3 with provincial Chief-Medical Officers of Health (n = 6) and a provincial Medical Organization. Phase 2 data came from a Pan-Ontario symposium (n = 44) comprised leaders representing: Public Health, Primary Care, Provincial and Federal Government. Results PIPs varied resulting in diverse experiences and lessons learned. This was in part due to different PHU characteristics that included: degree of planning, PHU and Primary Care capacity, population, geographic and relationships with Primary Care. Main lessons learned were: 1) Planning should be more comprehensive and operationalized at all levels. 2) Improve national and provincial communication strategies and eliminate contradictory messages from different sources. 3) An integrated community-wide response may be the best approach to decrease the impact of a pandemic. 4) The best Mass Immunization models can be quickly implemented and have high immunization rates. They should be flexible and allow for incremental responses that are based upon: i) pandemic severity, ii) local health system, population and geographic characteristics, iii) immunization objectives, and iv) vaccine supply. Conclusion “We were very lucky that pH1N1 was not more severe.” Consensus existed for more detailed planning and the inclusion of multiple health system and community stakeholders. PIPs should be flexible, allow for incremental responses and have important decisions (E.g., under which conditions Public Health, Primary Care, Pharmacists or others act as vaccine delivery agents.) made prior to a crisis. PMID:23890226

Health technology assessment in an argentinean province: adapting existing tools.

PubMed

Brisson, Maria Eugenia; Schapochnik, Norberto

2014-01-01

This study reports on the development of a critical process for health technologies incorporation concerning an Argentinean Provincial Ministry of Health (MOH) in collaboration with the University of Lanús from 2008 to 2010. We describe the approach developed to adapt selected international experiences to provincial scenario. Bibliographic review, regulations examination, key informants interviews and iterative adjustments after various stages of consultation and consensus building with main local players, contribution from foreign experts, and piloting of process and instruments for ultimate fine-tuning are described. We examine final proposal in the light of new updated studies. Analysis of regulations revealed that rules governing the provincial system were historically linked to administrative resolutions in relation to procurement with poor consideration to clinical, epidemiological, organizational, and health policy aspects. Key informants from hospitals, MOH, and other governmental agencies agreed on the lack of a process capable of guaranteeing a decision about health technology incorporation based on a transparent use of the best available information, ready to deal with competitive pressures. This adaptation provided a structured and explicit process (introduction, implementation, and development) as well as essential and supporting tools. MOH adopted the proposal for its progressive implementation while institutional evaluation capacity develops. Further studies are needed on the value placed on health technology assessment-based processes and recommendations by clinicians, managers, policy makers, and patients.

Interaction between Breathers and Rogue Waves in a Nonlinear Optical Fiber

NASA Astrophysics Data System (ADS)

Liu, Xiang-Shu; Zhao, Li-Chen; Duan, Liang; Gao, Peng; Yang, Zhan-Ying; Yang, Wen-Li

2018-02-01

Not Available Supported by the National Natural Science Foundation of China under Grant No 11475135, the Guangxi Provincial Education Department Research Project of China under Grant No 2017KY0776, the Shaanxi Provincial Science Association of Colleges and Universities of China under Grant No 20160216, and the Special Research Project of Education Department of Shaanxi Provincial Government under Grant No 16JK1763.

Examination of the Relationship between Organizational Stress and Employee Performance: A Research on Staff Working on Provincial Directorate of Youth and Sports

ERIC Educational Resources Information Center

Goksel, Ali Gurel; Caz, Cagdas; Yazici, Omer Faruk; Ikizler, Huseyin Can

2017-01-01

The purpose of this research is to study the relation between the level of organizational stress at the staff of the Youth Services and Sports Provincial Directorate and their performance. The study group of research, Istanbul province in the Uskudar district officials operating in the Youth Services and Sports Provincial Directorate constitute a…

China Report Economic Affairs

DTIC Science & Technology

1985-02-22

RIBAO, 24 Jan 85) 57 Qinghai Forms Survey Team to Check Economic Reform Progress (Qinghai Provincial Service, 4 Feb 85) 59 Yunnan Raises...Industrial Survey Work (Henan Provincial Service, 4 Feb 85) 109 PRC To Increase Steel Production in 1985 (XINHUA, 2 Feb 85) 110 Briefs Beijing...QINGHAI FORMS SURVEY TEAM TO CHECK ECONOMIC REFORM PROGRESS HK050416 Xining Qinghai Provincial Service in Mandarin 1100 GMT 4 Feb 85 [Text

[Provincial representativeness assessment of China Non-communicable and Chronic Disease Risk Factor Surveillance System in 2013].

PubMed

Zhao, Z P; Wang, L M; Li, Y C; Jiang, Y; Zhang, M; Huang, Z J; Zhang, X; Li, C; Zhou, M G

2018-02-06

Objective: To evaluate the provincial representativeness of China Non-communicable and Chronic Disease Risk Factor Surveillance System, 2013. Methods: The Sixth National Population Census data which was collected by National Bureau of Statistics of People's Republic of China was used to calculate proportion of population who aged 65 and above, mortality rate, the proportion of non-agriculture population, the illiteracy rate and urbanization rate in order to evaluate the surveillance system in each province. The Mann-Whitney U test was used to determine the statistically differences between the surveillance system and corresponding general population. Results: Among the 298 disease surveillance points (DSPs) in China Non-communicable and Chronic Disease Risk Factor Surveillance System, there were 111, 85, and 102 DSPs located in the east, middle, and west area of China, which covering 13.90%, 11.48%, and 12.28% of the total population, respectively. The surveillance system covered 169 million of the population of China, accounting for 12.70% of Chinese population. The number of DSPs by provinces ranges from 6 (Hainan, Qinghai, and Ningxia) to 14 (Shandong, Guangdong and Henan). It indicated that mortality rate (DSP: 0.238%; Province: 0.482%) and the illiteracy rate (DSP: 15.54%; Province: 26.22%) among DSPs in Tibet were significantly lower than the provincial level, on the other hand, the proportion of non-agriculture population among DSPs (40.6%) was significantly higher than the provincial level (18.8%). The urbanization rate among Jiangxi DSPs (43.4%) was significantly lower than the provincial level (59.9%). The proportion of non-agriculture population among Shandong DSPs (32.8%) was significantly higher than the provincial level (24.2%), however, the illiteracy rate among Shandong DSPs (3.86%) was significantly lower than the provincial level (5.25%). Other than the provinces mentioned above, there was no statistical differences ( P> 0.05) among proportions of population who aged 65 and above, mortality rates, the proportions of non-agriculture population, the illiteracy rates and urbanization rate between provincial surveillance system and corresponding area. Conclusion: Other than 3 provinces, in general, China Non-communicable and Chronic Disease Risk Factor Surveillance System had provincial representativeness.

Experiences of women who reported sexual assault at a provincial hospital, South Africa.

PubMed

Sebaeng, Jeanette M; Davhana-Maselesele, Mashudu; Manyedi, Eva

2016-11-16

Sexual assault poses a serious health problem to both the survivor and the health system. Experiencing sexual assault requires women to seek medical and psychological assistance as part of their journey towards recovery. This study examined the experiences of women who received post-sexual assault services from a specialised care centre within a provincial hospital. A qualitative, exploratory and contextual design was used to explore and describe experiences of women. Data were obtained through individual in-depth interviews from a total of 18 women aged between 18 and 55 years. Interviews were supplemented by the researcher's field notes and audiotape recordings. Findings yielded two main themes: Women expressed their lived experiences of sexual assault characterised by different forms of trauma. The second theme was an expression of a need for safety and support. Women who experience sexual assault are left with devastating effects such as physical and psychological harm and social victimisation. There is also a need for safety and support towards the recovery of these women. This study recommends that professional practitioners involved in the management of sexual assault be sensitised regarding the ordeal experienced by women and stop perceiving survivors as crime scene 'clients' from whom only medico-legal evidence has to be collected. Professional practitioners and family members must be supportive, non-judgemental and considerate of the dignity of survivors. The establishment of sexual assault response teams (SART) is also recommended. There should also be inter-professional education for better coordination of services rendered to sexually assaulted women.

Spatio-Temporal Epidemiology of Viral Hepatitis in China (2003-2015): Implications for Prevention and Control Policies.

PubMed

Zhu, Bin; Liu, Jinlin; Fu, Yang; Zhang, Bo; Mao, Ying

2018-04-02

Viral hepatitis, as one of the most serious notifiable infectious diseases in China, takes heavy tolls from the infected and causes a severe economic burden to society, yet few studies have systematically explored the spatio-temporal epidemiology of viral hepatitis in China. This study aims to explore, visualize and compare the epidemiologic trends and spatial changing patterns of different types of viral hepatitis (A, B, C, E and unspecified, based on the classification of CDC) at the provincial level in China. The growth rates of incidence are used and converted to box plots to visualize the epidemiologic trends, with the linear trend being tested by chi-square linear by linear association test. Two complementary spatial cluster methods are used to explore the overall agglomeration level and identify spatial clusters: spatial autocorrelation analysis (measured by global and local Moran's I) and space-time scan analysis. Based on the spatial autocorrelation analysis, the hotspots of hepatitis A remain relatively stable and gradually shrunk, with Yunnan and Sichuan successively moving out the high-high (HH) cluster area. The HH clustering feature of hepatitis B in China gradually disappeared with time. However, the HH cluster area of hepatitis C has gradually moved towards the west, while for hepatitis E, the provincial units around the Yangtze River Delta region have been revealing HH cluster features since 2005. The space-time scan analysis also indicates the distinct spatial changing patterns of different types of viral hepatitis in China. It is easy to conclude that there is no one-size-fits-all plan for the prevention and control of viral hepatitis in all the provincial units. An effective response requires a package of coordinated actions, which should vary across localities regarding the spatial-temporal epidemic dynamics of each type of virus and the specific conditions of each provincial unit.

Disparity and convergence: Chinese provincial government health expenditures.

PubMed

Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang

2013-01-01

The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

Disparity and Convergence: Chinese Provincial Government Health Expenditures

PubMed Central

Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang

2013-01-01

The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed. PMID:23977049

CHINA Report, Political, Sociological and Military Affairs

DTIC Science & Technology

1985-03-18

Women Meet for Spring Festival (XINHUA, 17 Feb 85) 25 PRC-Aided Farm in Somalia Reaps Good Harvest (XINHUA, 18 Feb 85) 26 WESTERN HEMISPHERE...Service, 16 Feb 85) 68 Anhui Extends Spring Festival Greetings to PLA, Others (Anhui Provincial Service, 14 Feb 85) 69 Huang Addresses Anhui...Spring Festival Party (Anhui Provincial Service, 16 Feb 85) 70 Jiangxi’s Bai Dongcai Greets Retired Cadres (Jiangxi Provincial Service, 14 Feb 85

A Study to Develop a Scale for Determining the Social Acceptance Levels of Special-Needs Students, Participating in Inclusion Practices

ERIC Educational Resources Information Center

Arslan, Erdinc; Sahbaz, Umit

2012-01-01

The aim of this study is to develop a scale of social acceptance for determining the social acceptance levels of special-needs students, participating in inclusion practices. The target population of the research is 8th grade students of all primary schools in the provincial center of Burdur in the 2008 to 2009 academic year and the target study…

Network analysis of Chinese provincial economies

NASA Astrophysics Data System (ADS)

Sun, Xiaoqi; An, Haizhong; Liu, Xiaojia

2018-02-01

Global economic system is a huge network formed by national subnetworks that contains the provincial networks. As the second largest world economy, China has "too big to fail" impact on the interconnected global economy. Detecting the critical sectors and vital linkages inside Chinese economic network is meaningful for understanding the origin of this Chinese impact. Different from tradition network research at national level, this paper focuses on the provincial networks and inter-provincial network. Using Chinese inter-regional input-output table to construct 30 provincial input-output networks and one inter-provincial input-output network, we identify central sectors and vital linkages, as well as analyze economic structure similarity. Results show that (1) Communication Devices sector in Guangdong and that in Jiangsu, Transportation and Storage sector in Shanghai play critical roles in Chinese economy. (2) Advanced manufactures and services industry occupy the central positions in eastern provincial economies, while Construction sector, Heavy industry, and Wholesale and Retail Trades sector are influential in middle and western provinces. (3) The critical monetary flow paths in Chinese economy are Communication Devices sector to Communication Devices sector in Guangdong, Metals Mining sector to Iron and Steel Smelting sector in Henan, Communication Devices sector to Communication Devices sector in Jiangsu, as well as Petroleum Mining sector in Heilongjiang to Petroleum Processing sector in Liaoning. (4) Collective influence results suggest that Finance sector, Transportation and Storage sector, Production of Electricity and Heat sector, and Rubber and Plastics sector in Hainan are strategic influencers, despite being weakly connected. These sectors and input-output relations are worthy of close attention for monitoring Chinese economy.

A four year prospective study of injuries in elite Ontario youth provincial and national soccer players during training and matchplay

PubMed Central

Mohib, Milad; Moser, Nicholas; Kim, Richard; Thillai, Maathavan; Gringmuth, Robert

2014-01-01

Introduction: With over 200 million amateur players worldwide, soccer is one of the most popular and internationally recognized sports today. By understanding how and why soccer injuries occur we hope to reduce prevalent injuries amongst elite soccer athletes. Methods: Via a prospective cohort, we examined both male and female soccer players eligible to train with the Ontario Soccer Association provincial program between the ages of 13 to 17 during the period of October 10, 2008 and April 20, 2012. Data collection occurred during all player exposures to potential injury. Exposures occurred at the Soccer Centre, Ontario Training grounds and various other venues on multiple playing surfaces. Results: A total number of 733 injuries were recorded. Muscle strain, pull or tightness was responsible for 45.6% of all injuries and ranked as the most prevalent injury. Discussion: As anticipated, the highest injury reported was muscular strain, which warrants more suitable preventive programs aimed at strengthening and properly warming up the players’ muscles. PMID:25550661

Community rheumatology practice in Thunder Bay: a Canadian experience from northwestern Ontario.

PubMed

Koehler, M G; Koehler, B E

1981-01-01

The practice experience of a rheumatologist in Thunder Bay, within the well-defined, relatively isolated area of Northwestern Ontario, is described. The population base of approximately 200,000 results in a waiting period for elective consultations of 3 months. (The number of other consultants for musculoskeletal problems in the community compares favorably with national and provincial ratios.) The majority of patients had well-defined rheumatic diseases. Nonarticular rheumatism comprised a relatively small proportion of visits. A ratio of 1 rheumatologist: 100,000 population would seem to be a realistic one.

Games of Subversion and Sabotage: Issues of Power, Masculinity, Class, Rurality and Schooling

ERIC Educational Resources Information Center

Keddie, Amanda

2007-01-01

This paper presents a longitudinal insight into the experiences of "Adam," a young boy who lives with his single-parent father (a farmer and builder) in a rural working-class community on the outskirts of a provincial town in Tasmania, Australia. Adam's story juxtaposes my representations of him as an eight year old in 1999 and as a 12…

CAUSE Resiliency (West Coast) Experiment Final Report

DTIC Science & Technology

2012-10-01

implemented in BCeMap and can therefore consume alerting messages direct from MASAS. This would solve the issue with the update frequency and speed of the...in production for use by the Provincial Emergency Operations Centres and brings together multiple static layers together with several dynamic data...executive order established the requirement for an “effective, reliable, integrated, flexible, and comprehensive system to alert and warn the

Khuzestan dust phenomenon: a content analysis of most widely circulated newspapers.

PubMed

Mojadam, Mehdi; Matlabi, Mohammad; Haji, Alireza; Cheraghi, Maria; Bitaraf, Saeid; Khafaie, Morteza Abdullatif

2018-06-01

Dust is an atmospheric phenomenon that causes adverse environmental effects. It is deemed to have harmful effects on health, economics, and climate. This study aimed to analyze the content published on the phenomenon of dust in the widely circulated newspapers in Iran. We investigated the content of all national and provincial newspapers that were published between July and August 2014. Data on the materials related to the dust phenomenon in the newspapers were categorized and coded. From a total of 510 newspaper issues, 143 articles were devoted to the dust phenomenon which 74.1% of them were published in provincial newspapers. Among the national newspapers, Hamshahri newspaper with 16 headlines and from the provincial newspapers; Karoon with 23 headlines published the highest number of articles on dust phenomenon. 45.5% of content on dust were printed on the first page of the newspapers. The most common approach to the type of content published in these newspapers was an interview. Moreover, we noticed that 28.7% of the content published in the newspapers was related to the health issue. The media plays an important role in the transmission of health information. Weaknesses in addressing the causes of dust occurrence and also in providing solutions for the dust control and prevention were noticeable in the content published in the newspaper. It seems necessary to take practical measures to disseminate relevant information to dust and also address the needs of the target audience community influenced by the dust phenomenon properly.

Climate, air quality and human health benefits of various solar photovoltaic deployment scenarios in China in 2030

NASA Astrophysics Data System (ADS)

Yang, Junnan; Li, Xiaoyuan; Peng, Wei; Wagner, Fabian; Mauzerall, Denise L.

2018-06-01

Solar photovoltaic (PV) electricity generation can greatly reduce both air pollutant and greenhouse gas emissions compared to fossil fuel electricity generation. The Chinese government plans to greatly scale up solar PV installation between now and 2030. However, different PV development pathways will influence the range of air quality and climate benefits. Benefits depend on how much electricity generated from PV is integrated into power grids and the type of power plant displaced. Using a coal-intensive power sector projection as the base case, we estimate the climate, air quality, and related human health benefits of various 2030 PV deployment scenarios. We use the 2030 government goal of 400 GW installed capacity but vary the location of PV installation and the extent of inter-provincial PV electricity transmission. We find that deploying distributed PV in the east with inter-provincial transmission maximizes potential CO2 reductions and air quality-related health benefits (4.2% and 1.2% decrease in national total CO2 emissions and air pollution-related premature deaths compared to the base case, respectively). Deployment in the east with inter-provincial transmission results in the largest benefits because it maximizes displacement of the dirtiest coal-fired power plants and minimizes PV curtailment, which is more likely to occur without inter-provincial transmission. We further find that the maximum co-benefits achieved with deploying PV in the east and enabling inter-provincial transmission are robust under various maximum PV penetration levels in both provincial and regional grids. We find large potential benefits of policies that encourage distributed PV deployment and facilitate inter-provincial PV electricity transmission in China.

A hybrid method for provincial scale energy-related carbon emission allocation in China.

PubMed

Bai, Hongtao; Zhang, Yingxuan; Wang, Huizhi; Huang, Yanying; Xu, He

2014-01-01

Achievement of carbon emission reduction targets proposed by national governments relies on provincial/state allocations. In this study, a hybrid method for provincial energy-related carbon emissions allocation in China was developed to provide a good balance between production- and consumption-based approaches. In this method, provincial energy-related carbon emissions are decomposed into direct emissions of local activities other than thermal power generation and indirect emissions as a result of electricity consumption. Based on the carbon reduction efficiency principle, the responsibility for embodied emissions of provincial product transactions is assigned entirely to the production area. The responsibility for carbon generation during the production of thermal power is borne by the electricity consumption area, which ensures that different regions with resource endowments have rational development space. Empirical studies were conducted to examine the hybrid method and three indices, per capita GDP, resource endowment index and the proportion of energy-intensive industries, were screened to preliminarily interpret the differences among China's regional carbon emissions. Uncertainty analysis and a discussion of this method are also provided herein.

Male marriage squeeze and inter-provincial marriage in central China: evidence from Anhui.

PubMed

Liu, Lige; Jin, Xiaoyi; Brown, Melissa J; Feldman, Marcus W

Since the 1990s, inter-provincial female migration for marriage has become important in central and eastern rural China. Using survey data from X County in rural Anhui Province, we explore the arrangement of inter-provincial marriages, as well as the characteristics of husbands and wives, marital satisfaction, and marital stability for these marriages. We find that inter-provincial marriage is an important option for local men to respond to the marriage squeeze and the increasing expense of marriage. It helps to relieve the shortage of marriageable women in the local marriage market. Because this kind of marriage is based on economic exchange, but not affection, it is often subject to a higher risk of marriage instability, and can lead to such illegal behaviors as marriage fraud and mercenary marriage.

Inter-Provincial Migration Intentions of Family Physicians in Canada: The Roles of Income and Community Characteristics.

PubMed

Mou, Haizhen; Olfert, M Rose

2015-11-01

The inter-provincial migration patterns of family physicians in canada show that some provinces like newfoundland and saskatchewan experience persistent net out-migration, while others, including ontario and british columbia, are destinations more often than origins of migrants. Governments in provinces exhibiting net out-migration have responded with a number of incentive and recruitment programs. In this study, we investigate the determinants of the stated interprovincial migration intentions of 3,995 rural and urban family physicians in the 2010 wave of the national physician survey. We consider a range of physician characteristics, community attributes and working conditions. We find that in the intention to move, higher compensation has a modest effect, while the community characteristics have a consistently important influence. Our results suggest that policy and program designers should acknowledge the critical role of community-level living and working conditions in their family physician recruitment and retention efforts. Copyright © 2015 Longwoods Publishing.

THE UPTAKE OF MODERN CONTRACEPTIVES AMONG WOMEN OF REPRODUCTIVE AGE ATTENDING MATERNAL CHILD HEALTH AND FAMILY PLANNING (MCH/FP) CLINICS.

PubMed

Mukthar, V K; Maranga, A K; Kulei, S J; Chemoiwa, R K

2014-12-01

To determine the uptake ana factors associated with the uptake of modern contraceptives among women of reproductive age (15-49 years) attending Maternal Child Health and Family Planning Clinics/Units in Rift Valley Provincial Hospital in Kenya. A descriptive cross-sectional study. Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. Women of reproductive age (15-49 years) who were attending Maternal Child Health and Family Planning Clinics at the Rift Valley Provincial Hospital. The respondents were identified by systematic random sampling Modern contraceptive uptake is over ninety percent (90.4, n = 218). The factors that are significantly associated with uptake of modern contraceptives are perceived convenience to use modern contraceptives (OR 0.39, CI: 0.16 - 0.93, p value- 0.04), experience of unmet needs of contraception (OR 0.08, CI: 0.03 - 0.2, p value- 0.001), history of a modern contraception discontinuation (OR 5.5, CI: 1.7 - 9.2, p value- 0.036) and knowledge of modern contraceptives (OR 19.1, CI: 12.3 - 27.5, p value-0.001). Conclusion: This study concluded that uptake of modern contraceptive is relatively high in Nakuru, Kenya and there is need for programmes to focus more on the client of modern contraceptive and the attributes of the modern contraceptives in up-scaling the uptake of modern contraceptives.

Challenges in Assessing Progress in Multifunctional Operations: Experiences from a Provincial Reconstruction Team in Afghanistan

DTIC Science & Technology

2011-06-01

these measures. Assessment of progress can thus be seen as a process consisting of monitoring and evaluation activities ( Sida , 2007). Input...limited integration and understanding between the Swedish Armed Forces and SIDA at the domestic interagency level. Four participants said that the...military and SIDA personnel had been sent to the PRT with different mandates, objectives and cultures, without practical instructions on how to

The Pashtun of Southern Afghanistan: Contextualizing a Hearts and Minds Message

DTIC Science & Technology

2010-03-31

Provincial Reconstruction Team (PRT) negotiations. With proper cultural training, PRTs will be able to effectively contextualize the coalition’s...followed by a Communist counter-coup in 1978, which effectively ended the democratic experiment. The Soviets invaded in 1979 to prop up the failing...part of Pashtun life. Their geographic region has been the birthplace of two major religions: Hinduism , and Zoroastrianism. Prior to the forced

The Gateway Paper--proposed health reforms in Pakistan--interface considerations.

PubMed

Nishtar, Sania

2006-12-01

The Gateway Paper recognizes three system interfaces as being critical to the delivery of healthcare within Pakistan. These include the federal/provincial interface, the provincial-district interface and the public-private interface. A number of gaps in each area have been highlighted. At the federal-provincial interface lack of provincial ownership of federal initiatives, gaps in provincial counterpart arrangements, ambiguities about federal and provincial roles and responsibilities, conflicts over sharing of resources and gaps in understanding provincial requirements and poor coordination have been articulated as core issues. It is envisaged that the development of a broad based mechanism to develop a consensus on national policy positions, incorporation of appropriate guidance from the provinces, giving provinces an active participatory role in decision-making, garnering their support and clearly demarcating roles and responsibilities will obviate some of these issues as would the institutionalization of a federal-provincial coordinating mechanism to review actions at both levels with regards to progress on meeting stipulating goals. At a district level poor governance, limited capacity within the system, lag in granting full district level financial and administrative autonomy, and lack of operational clarity in the rules of business have contributed to the challenge. This is compounded by inadvertent centralization of some functions within the district, which political and administrative decentralization has paradoxically created and impediments to harnessing the role of communities. The clear delineation of these issues provides a substrate, which need to be at the heart of strategic reform within the context of the recent devolution initiative. At the public-private interface the absence of locally established principles, legislative frameworks, policies and operational strategies have been contributing to the adhoc nature of public-private engagement within the country, which leads to skewed powered relationships and lack of clarity in combined models of governance. Within this context the Gateway Paper makes a strong case for developing a set of norms and ethical principles, developing legislative and policy frameworks, and specific guidelines to steer such relationships with careful attention to accountability and sustainability related parameters.

Male marriage squeeze and inter-provincial marriage in central China: evidence from Anhui

PubMed Central

Liu, Lige; Brown, Melissa J.; Feldman, Marcus W.

2015-01-01

Since the 1990s, inter-provincial female migration for marriage has become important in central and eastern rural China. Using survey data from X County in rural Anhui Province, we explore the arrangement of inter-provincial marriages, as well as the characteristics of husbands and wives, marital satisfaction, and marital stability for these marriages. We find that inter-provincial marriage is an important option for local men to respond to the marriage squeeze and the increasing expense of marriage. It helps to relieve the shortage of marriageable women in the local marriage market. Because this kind of marriage is based on economic exchange, but not affection, it is often subject to a higher risk of marriage instability, and can lead to such illegal behaviors as marriage fraud and mercenary marriage. PMID:26594102

Priority setting in the provincial health services authority: survey of key decision makers

PubMed Central

Teng, Flora; Mitton, Craig; MacKenzie, Jennifer

2007-01-01

Background In recent years, decision makers in Canada and elsewhere have expressed a desire for more explicit, evidence-based approaches to priority setting. To achieve this aim within health care organizations, knowledge of both the organizational context and stakeholder attitudes towards priority setting are required. The current work adds to a limited yet growing body of international literature describing priority setting practices in health organizations. Methods A qualitative study was conducted using in-depth, face-to-face interviews with 25 key decision makers of the Provincial Health Services Authority (PHSA) of British Columbia. Major themes and sub-themes were identified through content analysis. Results Priorities were described by decision makers as being set in an ad hoc manner, with resources generally allocated along historical lines. Participants identified the Strategic Plan and a strong research base as strengths of the organization. The main areas for improvement were a desire to have a more transparent process for priority setting, a need to develop a culture which supports explicit priority setting, and a focus on fairness in decision making. Barriers to an explicit allocation process included the challenge of providing specialized services for disparate patient groups, and a lack of formal training in priority setting amongst decision makers. Conclusion This study identified factors important to understanding organizational context and informed next steps for explicit priority setting for a provincial health authority. While the PHSA is unique in its organizational structure in Canada, lessons about priority setting should be transferable to other contexts. PMID:17565691

76 FR 34962 - Eastern Washington Cascades Provincial Advisory Committee and the Yakima Provincial Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... forest activities that have occurred during the past year. All Eastern Washington Cascades and Yakima... questions regarding this meeting to Clint Kyhl, Designated Federal Official, USDA, Okanogan- Wenatchee...

76 FR 76359 - Deschutes Provincial Advisory Committee (DPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-07

... identify key areas of interest for 2012 meetings and field trips. The meeting will also provide updates on... 9 AM until 2 PM. All Deschutes Provincial Advisory Committee meetings are open to the public. FOR...

Optimizing the detection of venous invasion in colorectal cancer: the ontario, Canada, experience and beyond.

PubMed

Dawson, Heather; Kirsch, Richard; Driman, David K; Messenger, David E; Assarzadegan, Naziheh; Riddell, Robert H

2014-01-01

Venous invasion (VI) is a well-established independent prognostic indicator in colorectal cancer (CRC). Its accurate detection is particularly important in stage II CRC as it may influence the decision to administer adjuvant therapy. The Royal College of Pathologists (RCPath) of the United Kingdom state that VI should be detected in at least 30% of CRC resection specimens. However, our experience in Ontario, Canada suggests that this (conservative) benchmark is rarely met. This article highlights the "Ontario experience" with respect to VI reporting and the key role that careful morphologic assessment, elastin staining and knowledge transfer has played in improving VI detection provincially and beyond.

Using survival analysis of artificial and Real Brewer's sparrow (Spizella breweri breweri) nests to model site level and nest site factors associated with nest success in the South Okanagan region of Canada

Treesearch

Pam Krannitz Kym Welstead

2005-01-01

Predation is the predominant cause of nest failure for the Brewer's Sparrow (Spizella breweri breweri), a provincially red-listed shrub-steppe species that has experienced significant declines throughout most of its range. We monitored Brewer’s Sparrow nests and conducted an artificial nest experiment, in the South Okanagan Valley,...

PubMed Central

Martin, Michel

1995-01-01

Three physicians elected to Quebec's national assembly during the 1994 provincial election are trying to sell the benefits of sovereignty. Psychiatrist Denis Lazure says it is time for Quebec to go its own way because “there are two distinct peoples in Canada and one of them doesn't have a country.” He says his experiences within organized medicine helped him reach this conclusion. Dr. Ed Coffey, president of the Quebec Medical Association, disputes Lazure's conclusions. Imagesp1125-ap1127-a

Does variation among provincial drug formulary antimicrobial listings in Canada influence prescribing rates?

PubMed

Glass-Kaastra, Shiona K; Finley, Rita; Hutchinson, Jim; Patrick, David M; Weiss, Karl; Conly, John

2014-01-01

The financial accessibility of antimicrobial drugs to the outpatient community in Canada is governed at the provincial level through formularies. Each province may choose to list particular drugs or impose restriction criteria on products in order to guide prescribing and/or curtail costs. Although changes to formularies have been shown to change patterns in the use of individual products and alter costs, no comparison has been made among the provincial antimicrobial formularies with regards to flexibility/stringency, or an assessment of how these formularies impact overall antimicrobial use in the provinces. To summarize provincial antimicrobial formularies and assess whether their relative flexibility/stringency had a statistical impact upon provincial prescription volume during a one year period. Provincial drug plan formularies were accessed and summarized for all prescribed antimicrobials in Canada during 2010. The number of general and restricted benefits for each plan was compiled by antimicrobial classification. Population-adjusted prescription rates for all individual antimicrobials and by antimicrobial class were obtained from the Canadian Integrated Program for Antimicrobial Resistance Surveillance. Correlations between the number of general benefits, restricted benefits, and total benefits with the prescription rate in the provinces were assessed by Spearman rank correlation coefficients. Formularies varied considerably among the Canadian provinces. Quebec had the most flexible formulary, offering the greatest number of general benefits and fewest restrictions. In contrast, Saskatchewan's formulary displayed the lowest number of general benefits and most restrictions. Correlation analyses detected a single significant result; macrolide prescription rates decreased as the number of general macrolide benefits increased. All other rates of provincial antimicrobial prescribing and measures of flexibility/stringency revealed no significant correlations. Although antimicrobial formulary listings are used to guide prescribing rates within a province, our analysis of one year's data of the impact of the antimicrobial formulary structure did not correlate with antimicrobial prescribing rates, and other factors are likely to be at play.

A combination of process of care and clinical target among type 2 diabetes mellitus patients in general medical clinics and specialist diabetes clinics at hospital levels.

PubMed

Sieng, Sokha; Hurst, Cameron

2017-08-07

This study compares a combination of processes of care and clinical targets among patients with type 2 diabetes mellitus (T2DM) between specialist diabetes clinics (SDCs) and general medical clinics (GMCs), and how differences between these two types of clinics differ with hospital type (community, provincial and regional). Type 2 diabetes mellitus patient medical records were collected from 595 hospitals (499 community, 70 provincial, 26 regional) in Thailand between April 1 to June 30, 2012 resulting in a cross-sectional sample of 26,860 patients. Generalized linear mixed modeling was conducted to examine associations between clinic type and quality of care. The outcome variables of interest were split into clinical targets and process of care. A subsequent subgroup analysis was conducted to examine if the nature of clinical target and process of care differences between GMCs and SDCs varied with hospital type (regional, provincial, community). Regardless of the types of hospitals (regional, provincial, or community) patients attending SDCs were considerably more likely to have eye and foot exam. In terms of larger hospitals (regional and provincial) patients attending SDCs were more likely to achieve HbA1c exam, All FACE exam, BP target, and the Num7Q. Interestingly, SDCs performed better than GMCs at only provincial hospitals for LDL-C target and the All7Q. Finally, patients with T2DM who attended community hospital-GMCs had a better chance of achieving the blood pressure target than patients who attended community hospital-SDCs. Specialized diabetes clinics outperform general medical clinics for both regional and provincial hospitals for all quality of care indicators and the number of quality of care indicators achieved was never lower. However, this better performance of SDC was not observed in community hospital. Indeed, GMCs outperformed SDCs for some quality of care indicators in the community level setting.

The food industry and provincial economies.

PubMed

Walsh, Greg; Li, Duo

2004-01-01

This paper discusses the significance of the food industry for the Zhejiang provincial economy and for provincial economies generally. It is suggested that the strong ties between the food industry and provincial economies in China means that the food industry can be a key influence in the economic development of regional China. Moreover, the geographically diffuse nature of the food industry in China gives the industry a strategic significance in countering regional inequality within and between provinces, a by-product of China's rapid growth over the past 25 years. For these reasons, change in the food industry, whether it has its origins in the introduction of western fast foods, or in environmental, technological or economic trends, not only assumes significance for the health of the Chinese people (as other papers presented to the International Cuisine and Health Workshop at Hangzhou have pointed out), but also for the wealth of the nation and the way that wealth is distributed.

An impact assessment of sustainable technologies for the Chinese urban residential sector at provincial level

NASA Astrophysics Data System (ADS)

Xing, Rui; Hanaoka, Tatsuya; Kanamori, Yuko; Dai, Hancheng; Masui, Toshihiko

2015-06-01

Recently, energy use in the urban residential sector of China has drastically increased due to higher incomes and urbanization. The fossil fuels dominant energy supply has since worsened the air quality, especially in urban areas. In this study we estimate the future energy service demands in Chinese urban residential areas, and then use an AIM/Enduse model to evaluate the emission reduction potential of CO2, SO2, NOx and PM. Considering the climate diversity and its impact on household energy service demands, our analysis is down-scaled to the provincial-level. The results show that in most of the regions, penetration of efficient technologies will bring CO2 emission reductions of over 20% compared to the baseline by the year 2030. Deployment of energy efficient technologies also co-benefits GHG emission reduction. However, efficient technology selection appears to differ across provinces due to climatic variation and economic disparity. For instance, geothermal heating technology is effective for the cold Northern areas while biomass technology contributes to emission reduction the most in the warm Southern areas.

Economic level and human longevity: Spatial and temporal variations and correlation analysis of per capita GDP and longevity indicators in China.

PubMed

Wang, Shaobin; Luo, Kunli; Liu, Yonglin; Zhang, Shixi; Lin, Xiaoxu; Ni, Runxiang; Tian, Xinglei; Gao, Xing

2015-01-01

We show the variation of longevity indicators in China during the past 60 years and its correlation patterns with per capita GDP (GDPpc) both at provincial and inner-provincial level. Population data from six national population censuses in China (1953-2010) at provincial level and in several typical provinces in 2010 at county-level were selected. Four main longevity indicators were calculated. Pearson's r and distributed lags time series analysis between longevity indicators and GDPpc were conducted. The results show that Guangxi and Hainan Provinces maintain relatively high long-lived population (population over the age of 90) across various population censuses. The distributions of the population over the age of 80 and life expectancy are significantly affected by both contemporaneous and historical GDPpc at provincial level. However, areas of high long-lived population (over the age of 90) exhibit continuously stable features that lack any significant correlation with GDPpc both at provincial and inner-provincial level. Our results indicate a mixed distribution pattern of several longevity indexes and different relation to GDPpc. It shows consistent trend with Preston curve, that is, economic conditions may have limited influence on human longevity, especially for those who live longer than 90 years old. This study suggests that the economic development may favor the local residents to have access to live as old as 80 years old, but it is still difficult for most residents to reach the level of centenarians. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Physical activity opportunities in Canadian childcare facilities: a provincial/territorial review of legislation.

PubMed

Vanderloo, Leigh M; Tucker, Patricia; Ismail, Ali; van Zandvroort, Melissa M

2012-05-01

Preschoolers spend a substantial portion of their day in childcare; therefore, these centers are an ideal venue to encourage healthy active behaviors. It is important that provinces'/territories' childcare legislation encourage physical activity (PA) opportunities. The purpose of this study was to review Canadian provincial/territorial childcare legislation regarding PA participation. Specifically, this review sought to 1) appraise each provincial/territorial childcare regulation for PA requirements, 2) compare such regulations with the NASPE PA guidelines, and 3) appraise these regulations regarding PA infrastructure. A review of all provincial/territorial childcare legislation was performed. Each document was reviewed separately by 2 researchers, and the PA regulations were coded and summarized. The specific provincial/territorial PA requirements (eg, type/frequency of activity) were compared with the NASPE guidelines. PA legislation for Canadian childcare facilities varies greatly. Eight of the thirteen provinces/territories provide PA recommendations; however, none provided specific time requirements for daily PA. All provinces/territories did require access to an outdoor play space. All Canadian provinces/territories lack specific PA guidelines for childcare facilities. The development, implementation, and enforcement of national PA legislation for childcare facilities may aid in tackling the childhood obesity epidemic and assist childcare staff in supporting and encouraging PA participation.

75 FR 13252 - Oregon Coast Provincial Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... DEPARTMENT OF AGRICULTURE Forest Service Oregon Coast Provincial Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Oregon Coast Province Advisory Committee will meet... Schools, BLM Update, Budget, Timber Sale Plan, Oregon Dunes Designated Routes, Rural Job Creation, 30-mile...

Trends in Canadian School Finance.

ERIC Educational Resources Information Center

Atherton, Peter J.

The great similarity between the Canadian and American structures of school finance conceals some fundamental, constitutional, and structural differences that shape the trends in Canadian school finance. First, provincial governments exercise a high degree of centralized control over education and its finance. Second, provincial governments have…

Tradition of the pharmacies of Celje.

PubMed

Pocivavsek, Marija

2009-01-01

In Celje, the first pharmacist is mentioned as early as 1578, among the first cities in Styria. In the 16th century, provincial classes hired and paid for the so-called provincial pharmacists and also monitored their work. Until the 19th century, pharmacists were considered tradesmen, then the public character of the profession changed: a court decree from 1820 required university education in pharmacy or chemistry. Since pharmacy trade was licensed and the number of pharmacies regulated, there was only one pharmacy in Celje for many years (pharmacy Pri orlu). The next two pharmacies were opened only after lengthy efforts: in the first half of the 17th century the second one (pharmacy Pri Mariji Pomagaj) and only in 1922 the third one (pharmacy Pri kriZu). After World War II, all private pharmacies were nationalized; in 1968 a public institute The pharmacies of Celje was established. In February 2009, the Museum of Recent Histoy Celje opened a museum pharmacy, which gives visitors an opportunity to experience the middle-class lifestyle from the time before World War II.

The timing of drug funding announcements relative to elections: a case study involving dementia medications.

PubMed

Gill, Sudeep S; Gupta, Neeraj; Bell, Chaim M; Rochon, Paula A; Austin, Peter C; Laupacis, Andreas

2013-01-01

Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions. Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections. Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032); funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements. Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.

Trends and Regional Variation in Hospital Mortality, Length of Stay and Cost in Hospital of Ischemic Stroke Patients in Alberta Accompanying the Provincial Reorganization of Stroke Care.

PubMed

Ohinmaa, Arto; Zheng, Yufei; Jeerakathil, Thomas; Klarenbach, Scott; Häkkinen, Unto; Nguyen, Thanh; Friesen, Dan; Ruseski, Jane; Kaul, Padma; Ariste, Ruolz; Jacobs, Philip

2016-12-01

This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy. New ischemic stroke patients (N = 7632) admitted to Alberta acute care hospitals between 2006 and 2011 were followed for 1 year. We analyzed in-hospital mortality with logistic regression, LOS with negative binomial regression, and the hospital costs with generalized gamma model (log link). The risk-adjusted results were compared over years and between zones using observed/expected results. The risk-adjusted mortality rates decreased from 12.6% in 2006/2007 to 9.9% in 2010/2011. The regional variations in mortality decreased from 8.3% units in 2008/2009 to 5.6 in 2010/2011. The LOS of the first episode dropped significantly in 2010/2011 after a 4-year slight increase. The regional variation in LOS was 15.5 days in 2006/2007 and decreased to 10.9 days in 2010/2011. The 1-year hospitalization cost increased initially, and then kept on declining during the last 3 years. The South and Calgary zones had the lowest costs over the study period. However, this gap was diminishing. After implementation of the Alberta Provincial Stroke Strategy, both mortality and hospital costs demonstrated a decreasing trend during the later years of study. The LOS increased slightly during the first 4 years but had a significant drop at the last year. In general, the regional variations in all 3 indicators had a diminishing trend. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Health technology funding decision-making processes around the world: the same, yet different.

PubMed

Stafinski, Tania; Menon, Devidas; Philippon, Donald J; McCabe, Christopher

2011-06-01

All healthcare systems routinely make resource allocation decisions that trade off potential health gains to different patient populations. However, when such trade-offs relate to the introduction of new, promising health technologies, perceived 'winners' and 'losers' are more apparent. In recent years, public scrutiny over such decisions has intensified, raising the need to better understand how they are currently made and how they might be improved. The objective of this paper is to critically review and compare current processes for making health technology funding decisions at the regional, state/provincial and national level in 20 countries. A comprehensive search for published, peer-reviewed and grey literature describing actual national, state/provincial and regional/institutional technology decision-making processes was conducted. Information was extracted by two independent reviewers and tabulated to facilitate qualitative comparative analyses. To identify strengths and weaknesses of processes identified, websites of corresponding organizations were searched for commissioned reviews/evaluations, which were subsequently analysed using standard qualitative methods. A total of 21 national, four provincial/state and six regional/institutional-level processes were found. Although information on each one varied, they could be grouped into four sequential categories: (i) identification of the decision problem; (ii) information inputs; (iii) elements of the decision-making process; and (iv) public accountability and decision implementation. While information requirements of all processes appeared substantial and decision-making factors comprehensive, the way in which they were utilized was often unclear, as were approaches used to incorporate social values or equity arguments into decisions. A comprehensive inventory of approaches to implementing the four main components of all technology funding decision-making processes was compiled, from which areas for future work or research aimed at improving the acceptability of decisions were identified. They include the explication of decision criteria and social values underpinning processes.

Variation of antibiotic consumption and its correlated factors in Turkey.

PubMed

Sahin, Ayfer; Akici, Ahmet; Aydin, Volkan; Melik, Bahar; Aksoy, Mesil; Alkan, Ali

2017-07-01

Presentation of antibiotic utilization data by reliable and comparable analyses constitutes an important way of ensuring rational use of antibiotics. This study aimed to evaluate antibiotic consumption (AC) of Turkey by each city/region and to investigate any association of such consumption with socio-economic factors. For 81 provinces and 12 regions in Turkey, AC data from IMS (Intercontinental Medical Statistics) in 2011 was analyzed in accordance with "ATC/DDD, DID" (Anatomical Therapeutic Chemical/Defined Daily Doses, DID = DDD/1000 inhabitants/day) methodology supported by World Health Organization. Association between provincial AC rates and socio-economic development index (SEDI)-2011 and between regional AC rates and some health indicators were analyzed. While provincial AC data of Turkey was detected to vary between 17.2 and 55.2 DID (Hakkari and Usak, respectively), regional AC ranged from 28.4 to 48.9 DID (Middle Eastern Anatolia and Western Anatolia, respectively). Mostly consumed antibiotic group among all regions were beta-lactamase inhibitor/penicillin combinations (range: 9.9-17.6 DID). SEDI and AC of each city showed positive correlation (rho = 0.683, p < 0.001). While regional AC was positively associated with percentage of 14-year-old population (p = 0.002) and pharmacist density (p < 0.001), it was negatively associated with physician density (p = 0.038). It is remarkable that Turkey, at both provincial and regional levels, exhibits important variations in AC, which is proportional to socio-economic status. Besides, the consumption is found to be closely associated with recognized critical factors of access to healthcare. These findings are expected to provide important insights to the activities promoting rational use of antibiotics.

The Rural Type of Settlement through the Eyes of Provincial College Students in Penza Oblast

ERIC Educational Resources Information Center

Davydova, N. E.

2013-01-01

Research on provincial students in Russia indicates that the barriers to living and working in rural areas are seen as real, but that they may also be outweighed by the perceived benefits for family life. (Contains 2 tables.)

Computers in the Schools: State/Provincial Implications.

ERIC Educational Resources Information Center

Thiessen, S. J.

The Alberta goverment has attempted to systematically address educational computing issues through programs of the provincial (K-12) education department (Alberta Education), which have included the development of computer literacy curricula for elementary, junior, and senior high schools; the Computer Technology Project (CTP); evaluation studies;…

Intergovernmental Relations in Education.

ERIC Educational Resources Information Center

Bartunek, Frank

1994-01-01

The relationships between provincial and local goverments in Canada have important effects on the course of public education. School districts in British Columbia use a wide variety of political strategies to influence provincial government behavior. Greater knowledge of the nature of such political strategies by school districts would make…

Command and Control Analysis of the South West Provincial Regional Emergency Operations Centre during Vancouver 2010

DTIC Science & Technology

2011-06-01

Venue Site WACC - Whistler Area Command Centre OTHER GPPAG - Government Partners Public Affairs Group 18 ANNEX B. Interview questions...Vancouver Vancouver Richmond WACC Decision Authority Link Information Sharing Link DOC’s 2010 Provincial Games Secretariat GPPAG CCG

Toward a harmonized approach to animal welfare law in Canada.

PubMed

Fraser, David; Koralesky, Katherine E; Urton, Geoff

2018-03-01

Animal protection law in Canada varies across the country. Federal animal protection law exists in the Criminal Code, in regulations for the transport of animals, and in regulations for humane handling and slaughter at abattoirs that are inspected by the Canadian Food Inspection Agency. Provincial animal protection laws often include provisions that i) describe a duty of care toward animals; ii) prohibit causing or permitting animal "distress;" iii) specify exemptions from prosecution; and iv) reference various national and other standards. Inconsistencies lead to duplication of effort, create difficulty in working across jurisdictions, and may erode public trust. A more consistent approach might be achieved by i) referencing a common suite of standards in provincial statutes; ii) citing the federal transport and humane slaughter regulations in provincial regulations; iii) establishing agreements so provincial authorities may enforce federal regulations; iv) wider and more uniform adoption of enforcement tools that require people to take immediate action to protect animal welfare; v) developing new standards; and vi) national consultation to define frequently used terms.

Evaluation of environmental health benefits of China's building energy conservation policies: an integrated assessment on national and provincial levels.

PubMed

Yang, Xi; Xi, Xiaoqian; Lin, Wanqi; Guo, Shan; Feng, Xiangzhao; Gilmore, Elisabeth

2018-05-04

This article evaluates the effect of energy conservation policies and carbon mitigation efforts on reducing health damage in China's building sector, which has been long ignored. The study bases on both national and provincial levels. To evaluate the health damage effect, we use domestic data by region to ensure the reliability of the evaluation. Results show that in the co-control scenario, the GDP loss saved from health benefit in 2020, 2030, and 2050 is 0.13 %, 0.16 %, and 0.23 %, respectively, compared to reference scenario. At a provincial level, extra health benefit of 16, 16, 33, 25, and 23 RMB/person can be observed for Beijing, Heilongjiang, Guangdong, Henan, and Qinghai owing to energy conservation, even with the strictest end-of-pipe control measures. The results confirm the significant effect of energy conservation efforts on reducing the health damage in China's building sector at both national and provincial levels.

Harm reduction in name, but not substance: a comparative analysis of current Canadian provincial and territorial policy frameworks.

PubMed

Hyshka, Elaine; Anderson-Baron, Jalene; Karekezi, Kamagaju; Belle-Isle, Lynne; Elliott, Richard; Pauly, Bernie; Strike, Carol; Asbridge, Mark; Dell, Colleen; McBride, Keely; Hathaway, Andrew; Wild, T Cameron

2017-07-26

In Canada, funding, administration, and delivery of health services-including those targeting people who use drugs-are primarily the responsibility of the provinces and territories. Access to harm reduction services varies across jurisdictions, possibly reflecting differences in provincial and territorial policy commitments. We examined the quality of current provincial and territorial harm reduction policies in Canada, relative to how well official documents reflect internationally recognized principles and attributes of a harm reduction approach. We employed an iterative search and screening process to generate a corpus of 54 provincial and territorial harm reduction policy documents that were current to the end of 2015. Documents were content-analyzed using a deductive coding framework comprised of 17 indicators that assessed the quality of policies relative to how well they described key population and program aspects of a harm reduction approach. Only two jurisdictions had current provincial-level, stand-alone harm reduction policies; all other documents were focused on either substance use, addiction and/or mental health, or sexually transmitted and/or blood-borne infections. Policies rarely named specific harm reduction interventions and more frequently referred to generic harm reduction programs or services. Only one document met all 17 indicators. Very few documents acknowledged that stigma and discrimination are issues faced by people who use drugs, that not all substance use is problematic, or that people who use drugs are legitimate participants in policymaking. A minority of documents recognized that abstaining from substance use is not required to receive services. Just over a quarter addressed the risk of drug overdose, and even fewer acknowledged the need to apply harm reduction approaches to an array of drugs and modes of use. Current provincial and territorial policies offer few robust characterizations of harm reduction or go beyond rhetorical or generic support for the approach. By endorsing harm reduction in name, but not in substance, provincial and territorial policies may communicate to diverse stakeholders a general lack of support for key aspects of the approach, potentially challenging efforts to expand harm reduction services.

A towel less: social norms enhance pro-environmental behavior in hotels.

PubMed

Reese, Gerhard; Loew, Kristina; Steffgen, Georges

2014-01-01

Previous research has shown that normative appeals to engage in environmentally friendly behavior were most effective when they were accompanied by a provincial norm (e.g., when norms matched individuals' immediate situational circumstances). Analyzing hotel guests' towel-use during their stay, the current study tests whether messages employing provincial norms were more effective in reducing towel-use than standard environmental messages. In line with previous findings, guests of two hotels used significantly fewer towels when provincial normative appeals--rather than standard environmental messages--were communicated. These findings corroborate to the body of research demonstrating the power of social norms on environmental behavior.

[Audits across state borders for medical consulting agencies within the German healthcare insurance system].

PubMed

Schneider, T; Sommerfeld, W; Möller, J

2003-06-01

The Medizinischer Dienst der Krankenversicherung (MDK) is a non-profit medical consulting organisation serving the German Healthcare Insurance System. Despite its uniform commission throughout Germany, organisation and structure differ considerably between Provincial States which is reflected by differing results. A common nationwide system of key figures and indicators aims at analysing results and learning from one another. Development of an audit concept for analysing key figures and indicators within the MDK aiming at quality improvement. Development of a system of key figures and indicators covering five spheres (products, staff, costs, data analysis, structure). Analysis by means of audits carried out across provincial state borders in five steps (audit manual, training of auditors, visitation, audit report, repetition audit). The system of key figures and indicators assures relevant and comparable data. Audit manual, training of auditors, visitation, and audit report meet the needs of all people and institutions involved. Preparation of auditors as well as openness, and flow of information within audited organisations offer areas for improvement. There is as yet no assessment of the cost-benefit ratio of audits. The concept presented in this article consists of two parts: A system of key figures and indicators as well as a concept for audits. The concept is suitable for a) generating and analysing relevant key figures and indicators for each MDK, and b) providing information for benchmarking between different MDK. Further development of the concept to a comprehensive management concept is necessary.

JPRS Report, Near East & South Asia.

DTIC Science & Technology

1988-02-12

and Maulana Imran Bok- hari. Meanwhile, the Friday prayer leaders in different mosques of the twin cities condemned, in their Friday sermons, the...Akhtar Ali G. Kazi, Provincial Minister for Law and Parliamen- tary Affairs and Finance; Mr Saleem Jan Mazari, now a Minister in the Provincial Cabinet

Medical science and the Cruelty to Animals Act 1876: A re-examination of anti-vivisectionism in provincial Britain.

PubMed

Finn, Michael A; Stark, James F

2015-02-01

The Cruelty to Animals Act 1876 was an important but ambiguous piece of legislation. For researchers it stymied British science, yet ensured that vivisection could continue under certain restrictions. For anti-vivisection protestors it was positive proof of the influence of their campaigns, yet overly deferent to Britain's scientific elite. In previous accounts of the Act and the rise of anti-vivisectionism, scientific medicine central to these debates has been treated as monolithic rather than a heterogeneous mix of approaches; and this has gone hand-in-hand with the marginalizing of provincial practices, as scholarship has focused largely on the 'Golden Triangle' of London, Oxford and Cambridge. We look instead at provincial research: brain studies from Wakefield and anthrax investigations in Bradford. The former case elucidates a key role for specific medical science in informing the anti-vivisection movement, whilst the latter demonstrates how the Act affected the particular practices of provincial medical scientists. It will be seen, therefore, how provincial medical practices were both influential upon, and profoundly affected by, the growth of anti-vivisectionism and the passing of the Act. This paper emphasises how regional and varied medico-scientific practices were central to the story of the creation and impact of the Cruelty to Animals Act. Copyright © 2014 Elsevier Ltd. All rights reserved.

Geographic variation in work injuries: a multilevel analysis of individual-level data and area-level factors within Canada.

PubMed

Morassaei, Sara; Breslin, F Curtis; Ibrahim, Selahadin A; Smith, Peter M; Mustard, Cameron A; Amick, Benjamin C; Shankardass, Ketan; Petch, Jeremy

2013-05-01

This study sought to examine provincial variation in work injuries and to assess whether contextual factors are associated with geographic variation in work injuries. Individual-level data from the 2003 and 2005 Canadian Community Health Survey was obtained for a representative sample of 89,541 Canadians aged 15 to 75 years old who reported working in the past 12 months. A multilevel regression model was conducted to identify geographic variation and contextual factors associated with the likelihood of reporting an activity limiting work injury [corrected], while adjusting for demographic and work variables. Provincial differences in work injuries were observed, even after controlling for other risk factors. Workers in western provinces such as Saskatchewan (adjusted odds ratio [AOR], 1.30; 95% confidence interval [CI], 1.09-1.55), Alberta (AOR, 1.31; 95% CI, 1.13-1.51), and British Columbia (AOR, 1.46; 95% CI, 1.26-1.71) had a higher risk of work injuries compared with Ontario workers. Indicators of area-level material and social deprivation were not associated with work injury risk. Provincial differences in work injuries suggest that broader factors acting as determinants of work injuries are operating across workplaces at a provincial level. Future research needs to identify the provincial determinants and whether similar large area-level factors are driving work injuries in other countries. Copyright © 2013 Elsevier Inc. All rights reserved.

Financing Elementary and Secondary Education in Ontario: Toward the Future.

ERIC Educational Resources Information Center

Thom, Douglas J.

The British North America Act of 1867 mandates the education of Canadians as a provincial responsibility, although some funding comes from federal sources and municipalities share expenditures with provincial authorities. This paper summarizes a study that investigated effective methods of financing elementary and secondary education in Ontario.…

Accountability: Its Implications for Provincial and State Governments.

ERIC Educational Resources Information Center

Kolesar, H.

This paper examines the implications of the accountability concept for provincial or State authorities. Accountability is defined as a concomitant of an agreement between two parties. The author suggests that, in education, agreements between parties have lacked preciseness and clarity, making it extremely difficult to assess performance and to…

Quantum speed limit time of a two-level atom under different quantum feedback control

NASA Astrophysics Data System (ADS)

Yu, Min; Fang, Mao-Fa; Zou, Hong-Mei

2018-01-01

Not Available Project supported by the National Natural Science Foundation of China (Grant No. 11374096), Hunan Provincial Innovation Foundation for Postgraduate, China (Grant No. CX2017B177), and the Scientific Research Project of Hunan Provincial Education Department, China (Grant No. 16C0949).

Handbook of Procedures for the Graduation Program: 2014\\2015

ERIC Educational Resources Information Center

British Columbia Ministry of Education, 2014

2014-01-01

This handbook outlines procedures for sharing student data between schools and the Ministry of Education, and answers questions pertaining to provincial examinations. It supports the work of both educators and the Ministry, which works with schools to produce transcripts and administer provincial exams. The following are appended: (1) Forms; and…

Effective U.S. Aid and Assistance to Pakistan’s Federally Administered Tribal Area and Northwest Frontier Province

DTIC Science & Technology

2010-03-16

federal, provincial and district level. They created the National Disaster Management Authority ( NDMA ) to serve as that agency. In 2009, the Pakistan...Government created two subordinate levels to the NDMA : the Provincial Disaster Management Authority (PDMA) and the District Disaster Management

School Life and Community Economic Challenge: A Newfoundland Case Study

ERIC Educational Resources Information Center

Fowler, Ken

2007-01-01

This study explored changes in student attitudes toward school life following the 1992 Newfoundland groundfishery closure. Using data extracted from a provincial quality of school life (QSL) survey, means associated with students from a sample of fishing communities were compared with provincial means. Although community students had poorer…

75 FR 1749 - Eastern Washington Cascades Provincial Advisory Committee and the Yakima Provincial Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

... Committee will meet on February 3, 2010 at the Okanogan-Wenatchee National Forest Headquarters office, 215 Melody Lane, Wenatchee, WA. During this meeting information will be shared about Holden Mine clean-up operations, Stehekin River Corridor Implementation Plan/Environmental Impact Statement, and Bureau of Land...

77 FR 21526 - Eastern Washington Cascades Provincial Advisory Committee and the Yakima Provincial Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... Parks office, 270 9th Street NE., East Wenatchee, WA has been replaced with an open public meeting... Stewardship Challenge, Yakima River Basin Integrated Water Resource Management Plan, Holden Mine Remediation..., Okanogan- Wenatchee National Forest, 215 Melody Lane, Wenatchee, Washington 98801, phone 509-664-9200...

Transforming Regions into High-Performing Health Systems Toward the Triple Aim of Better Health, Better Care and Better Value for Canadians.

PubMed

Bergevin, Yves; Habib, Bettina; Elicksen-Jensen, Keesa; Samis, Stephen; Rochon, Jean; Denis, Jean-Louis; Roy, Denis

2016-01-01

A study on the impact of regionalization on the Triple Aim of Better Health, Better Care and Better Value across Canada in 2015 identified major findings including: (a) with regard to the Triple Aim, the Canadian situation is better than before but variable and partial, and Canada continues to underperform compared with other industrialized countries, especially in primary healthcare where it matters most; (b) provinces are converging toward a two-level health system (provincial/regional); (c) optimal size of regions is probably around 350,000-500,000 population; d) citizen and physician engagement remains weak. A realistic and attainable vision for high-performing regional health systems is presented together with a way forward, including seven areas for improvement: 1. Manage the integrated regionalized health systems as results-driven health programs; 2. Strengthen wellness promotion, public health and intersectoral action for health; 3. Ensure timely access to personalized primary healthcare/family health and to proximity services; 4. Involve physicians in clinical governance and leadership, and partner with them in accountability for results including the required changes in physician remuneration; 5. Engage citizens in shaping their own health destiny and their health system; 6. Strengthen health information systems, accelerate the deployment of electronic health records and ensure their interoperability with health information systems; 7. Foster a culture of excellence and continuous quality improvement. We propose a turning point for Canada, from Paradigm Freeze to Paradigm Shift: from hospital-centric episodic care toward evidence-informed population-based primary and community care with modern family health teams, ensuring integrated and coordinated care along the continuum, especially for high users. We suggest goals and targets for 2020 and time-bound federal/provincial/regional working groups toward reaching the identified goals and targets and placing Canada on a rapid path toward the Triple Aim.

Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010

PubMed Central

Mbaisi, Everline Muhonja; Ng'ang'a, Zipporah; Wanzala, Peter; Omolo, Jared

2013-01-01

Introduction Accidental occupational exposure of healthcare workers to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. Such pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We conducted a study to determine the prevalence and associated factors for percutaneous injuries and splash exposures among health-care workers in Rift Valley provincial hospital. Methods A cross-sectional study was carried out from October to November 2010. Self reported incidents, circumstances surrounding occupational exposure and post-exposure management were sought by use of interviewer administered questionnaire. Descriptive, bivariate and multiple logistic regression (forward stepwise procedure) analyses were performed. The level of significance was set at 0.05. Results Twenty five percent of health-care workers interviewed (N = 305) reported having been exposed to blood and body fluids in the preceding 12 months. Percutaneous injuries were reported by 19% (n = 305) and splash to mucous membrane by 7.2%. Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR= 3.7; 95% CI = 1.08-9.13) while previous training in infection prevention was protective (OR= 0.52; 95% CI = 0.03-0.90). Forty eight percent (n = 83) reported the incidents with 20% (n = 83) taking PEP against HIV. Conclusion Percutaneous injuries and splashes are common in Rift Valley Provincial hospital. Preventive measures remain inadequate. Health institutions should have policies, institute surveillance for occupational risks and enhance training of health care workers. PMID:23504245

Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010.

PubMed

Mbaisi, Everline Muhonja; Ng'ang'a, Zipporah; Wanzala, Peter; Omolo, Jared

2013-01-01

Accidental occupational exposure of healthcare workers to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. Such pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We conducted a study to determine the prevalence and associated factors for percutaneous injuries and splash exposures among health-care workers in Rift Valley provincial hospital. A cross-sectional study was carried out from October to November 2010. Self reported incidents, circumstances surrounding occupational exposure and post-exposure management were sought by use of interviewer administered questionnaire. Descriptive, bivariate and multiple logistic regression (forward stepwise procedure) analyses were performed. The level of significance was set at 0.05. Twenty five percent of health-care workers interviewed (N=305) reported having been exposed to blood and body fluids in the preceding 12 months. Percutaneous injuries were reported by 19% (n=305) and splash to mucous membrane by 7.2%. Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR=3.7; 95% CI=1.08-9.13) while previous training in infection prevention was protective (OR=0.52; 95% CI=0.03-0.90). Forty eight percent (n=83) reported the incidents with 20% (n=83) taking PEP against HIV. Percutaneous injuries and splashes are common in Rift Valley Provincial hospital. Preventive measures remain inadequate. Health institutions should have policies, institute surveillance for occupational risks and enhance training of health care workers.

Differences and changes in the physical characteristics of professional and amateur rugby union players.

PubMed

Smart, Daniel J; Hopkins, Will G; Gill, Nicholas D

2013-11-01

Numerous studies have highlighted differences between playing levels and positions in rugby union; however, few studies have investigated longitudinal progressions of body composition and physical performance. Between-player differences and within-player changes in body composition, strength, power, speed, and repeated sprint ability, from 1,161 New Zealand rugby union players from 2004 to 2007, were estimated using a mixed modeling procedure. Props had the highest mass, percent body fat, strength, and slowest speed times compared with the other positions, whereas outside backs had the fastest speed time and lowest percent body fat. For most measures, there were small-to-moderate differences (range, 1.1-14%) between players selected and not selected for provincial teams and small-to-large differences (range, 1.8-15%) between provincial and Super Rugby (professional) players. The faster 20-m sprint times in international compared with Super Rugby players was small in magnitude for both the forwards (1.9%) and backs (2.2%). The average annual improvements were small to moderate for strength (range, 2.1-15%) and small for repeated sprint ability within the lower playing levels (~1.5%). Small increases occurred in lower body strength (~7.0%) as players moved from Super Rugby to provincial competition. Small decreases in sprint time (~1.6%) and small increases in strength (~6.3%) occurred as players moved from Super Rugby to midyear international competition. The differences between levels in performance provide level-specific characteristics from Super Rugby and below, but international players may be selected because of greater skill and experience. Changes in physical performance between competitions may be a result of reduced training loads because of regular high-intensity matches and greater travel involved in the Super Rugby competition.

Why seek a second consultation at an emergency centre? A qualitative study

PubMed Central

2017-01-01

Background The inappropriate use of emergency centres (ECs) is an expanding problem globally. The high attendance of non-urgent return presentations to ECs is recognised as part of the problem, placing an unnecessary demand on limited staff and resources. Of unscheduled returns 34% of cases had no change to diagnosis or treatment with the conclusion that 80% of re-attendance could be attributed to deficiencies in the initial consultation. This study aimed to evaluate the reasons why patients sought an early second consultation for the same complaint at a hospital EC in South Africa, by exploring the patient’s experience and shortcomings in the first consultation. Method A qualitative study was conducted using in-depth, semi-structured interviews with 20 purposively selected participants who presented to a rural regional provincial hospital’s EC within 7 days of a prior consultation for the same complaint. Verbatim transcripts were analysed using the framework method. Results The main reasons for a second consultation were symptom related factors and the need for diagnostic certainty. The major themes around patient experience of the initial consultation were shortcomings in effective evaluation and management of pain, diagnostic uncertainty including poor examination, poor explanation, uncertain access and follow-up and societal encouragement to utilise a hospital EC. Conclusion Further interventions should explore pain as a presenting symptom of the illness experience, and promote competence in addressing physical and psychological causative factors within a patient-centred approach for all health staff, especially in primary care services. PMID:28828871

Why seek a second consultation at an emergency centre? A qualitative study.

PubMed

Crafford, Lize; Jenkins, Louis S

2017-07-27

The inappropriate use of emergency centres (ECs) is an expanding problem globally. The high attendance of non-urgent return presentations to ECs is recognised as part of the problem, placing an unnecessary demand on limited staff and resources. Of unscheduled returns 34% of cases had no change to diagnosis or treatment with the conclusion that 80% of re-attendance could be attributed to deficiencies in the initial consultation. This study aimed to evaluate the reasons why patients sought an early second consultation for the same complaint at a hospital EC in South Africa, by exploring the patient's experience and shortcomings in the first consultation. A qualitative study was conducted using in-depth, semi-structured interviews with 20 purposively selected participants who presented to a rural regional provincial hospital's EC within 7 days of a prior consultation for the same complaint. Verbatim transcripts were analysed using the framework method. The main reasons for a second consultation were symptom related factors and the need for diagnostic certainty. The major themes around patient experience of the initial consultation were shortcomings in effective evaluation and management of pain, diagnostic uncertainty including poor examination, poor explanation, uncertain access and follow-up and societal encouragement to utilise a hospital EC. Further interventions should explore pain as a presenting symptom of the illness experience, and promote competence in addressing physical and psychological causative factors within a patient-centred approach for all health staff, especially in primary care services.

The demographic and contextual correlates of work-related repetitive strain injuries among Canadian men and women.

PubMed

Breslin, F Curtis; Ibrahim, S; Smith, P; Mustard, C; Amick, B; Shankardass, K

2013-10-01

The study sought to identify gender differences in work-related repetitive strain injuries (RSI), as well as examine the degree to which non-work factors such as family roles interact with gender to modify RSI risk. Another aim is to examine whether there are potential provincial differences in work-related RSI risk. The 2003/2005 Canadian Community Health Survey included over 89,000 respondents who reported working in the past 12 months. Separate multi-level models for men and women were used to identify the correlates of work-related RSIs. Women reported sustaining more work-related RSIs than men. Also, having one or more children in the household was associated with lower work-related RSI risk for females. Both men and women in British Columbia reported higher work-related RSI rates than in Ontario. Gender contributes to RSI risk in multiple and diverse ways based on labor market segregation, non-work exposures, and possibly biological vulnerability, which suggests more tailored interventions. Also, the provincial differences indicate that monitoring and surveillance of work injury across jurisdictions can assist in province-wide prevention and occupational health and safety evaluation. Copyright © 2013 Wiley Periodicals, Inc.

A Spatial Panel Data Analysis of Economic Growth, Urbanization, and NOx Emissions in China

PubMed Central

Ge, Xiangyu; Zhou, Yanli; Liu, Songlin

2018-01-01

Is nitrogen oxides emissions spatially correlated in a Chinese context? What is the relationship between nitrogen oxides emission levels and fast-growing economy/urbanization? More importantly, what environmental preservation and economic developing policies should China’s central and local governments take to mitigate the overall nitrogen oxides emissions and prevent severe air pollution at the provincial level in specific locations and their neighboring areas? The present study aims to tackle these issues. This is the first research that simultaneously studies the nexus between nitrogen oxides emissions and economic development/urbanization, with the application of a spatial panel data technique. Our empirical findings suggest that spatial dependence of nitrogen oxides emissions distribution exists at the provincial level. Through the investigation of the existence of an environmental Kuznets curve (EKC) embedded within the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) framework, we conclude something interesting: an inverse N-shaped EKC describes both the income-nitrogen oxides nexus and the urbanization-nitrogen oxides nexus. Some well-directed policy advice is provided to reduce nitrogen oxides in the future. Moreover, these results contribute to the literature on development and pollution. PMID:29641500

Anticipating and preventing pollution -- How governments in Canada are meeting the challenge of pollution prevention

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

Wilkes, B.D.

1997-12-31

Provincial, territorial governments in Canada, along with the federal government, are putting in place innovative, interesting programs that are aimed at implementing pollution prevention. All governments, through the Canadian Council of Ministers of the Environment, have reached a consensus on the meaning of pollution prevention, and have adopted a national strategy to guide program development within each jurisdiction. Pollution prevention holds the promise of improving environmental protection and at the same time relieving regulatory burdens. This paper will trace the development of the consensus in Canada over the direction being taken by governments on pollution prevention, outline the principal programsmore » now underway within selected jurisdictions, and look at some of the institutional and policy responses that have been developed to address key challenges. Among these are shifting the culture in government and industry from control to prevention, and finding effective ways of building prevention into government permitting and licensing. The Canadian Council of Ministers of the Environment (CCME) is the major intergovernmental forum in Canada for discussion and joint action on environmental issues of national and international concern. It is comprised of environment ministers from the federal, provincial and territorial governments.« less

Healthcare costs of burn patients from homes without fire sprinklers

PubMed Central

Banfield, Joanne; Rehou, Sarah; Gomez, Manuel; Redelmeier, Donald A.; Jeschke, Marc G.

2014-01-01

The treatment of burn injuries requires high-cost services for healthcare and society. Automatic fire sprinklers are a preventive measure that can decrease fire injuries, deaths, property damage and environmental toxins. This study’s aim was to conduct a cost-analysis of patients with burn or inhalation injuries due to residential fires, and to compare this to the cost of implementing residential automatic fire sprinklers. We conducted a cohort analysis of adult burn patients admitted to our provincial burn center (1995–2012). Patient demographics and injury characteristics were collected from medical records, and clinical and coroner databases. Resource costs included average cost per day at our intensive care and rehabilitation program, transportation, and property loss. During the study period there were 1,557 residential fire-related deaths province-wide and 1,139 patients were admitted to our provincial burn center due to a flame injury occurring at home. At our burn center, the average cost was CAN$84,678 per patient with a total cost of CAN$96,448,194. All resources totaled CAN$3,605,775,200. This study shows the considerable healthcare costs of burn patients from homes without fire sprinklers. PMID:25412056

A Spatial Panel Data Analysis of Economic Growth, Urbanization, and NOx Emissions in China.

PubMed

Ge, Xiangyu; Zhou, Zhimin; Zhou, Yanli; Ye, Xinyue; Liu, Songlin

2018-04-11

Abstract : Is nitrogen oxides emissions spatially correlated in a Chinese context? What is the relationship between nitrogen oxides emission levels and fast-growing economy/urbanization? More importantly, what environmental preservation and economic developing policies should China's central and local governments take to mitigate the overall nitrogen oxides emissions and prevent severe air pollution at the provincial level in specific locations and their neighboring areas? The present study aims to tackle these issues. This is the first research that simultaneously studies the nexus between nitrogen oxides emissions and economic development/urbanization, with the application of a spatial panel data technique. Our empirical findings suggest that spatial dependence of nitrogen oxides emissions distribution exists at the provincial level. Through the investigation of the existence of an environmental Kuznets curve (EKC) embedded within the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) framework, we conclude something interesting: an inverse N-shaped EKC describes both the income-nitrogen oxides nexus and the urbanization-nitrogen oxides nexus. Some well-directed policy advice is provided to reduce nitrogen oxides in the future. Moreover, these results contribute to the literature on development and pollution.

Rural women's aspirations through art work. Responses to ICPD.

PubMed

1995-04-01

Members of Women, Population and Development groups, which aim to improve women's status in rural areas of China, will use their embroidery and tapestries to tell their stories at the Fourth World Conference on Women in Beijing in September 1995. Contests were held at the county and provincial levels to decide whose artwork, from over a 1000 groups, would go to the conference. 35 pieces (one group tapestry or embroidery from each county) were judged at the provincial level based on how the artwork and the stories of the women who made it demonstrated the achievements of the women as a result of their group involvement. The criteria included: 1) higher self image, confidence, and desire for personal growth; 2) increased social mobility and creativity; 3) more independence and self-reliance in income generation and other activities; 4) increased ability to make decisions for self; 5) increased respect within family and community; 6) more consciousness of maternal and child health and family planning needs; and 7) more awareness of the need for literacy. The Women, Population and Development Project is funded by the United Nations Population Fund (UNFPA), executed by FAO, and implemented by MOFTEC¿DIR.

In itinere strategic environmental assessment of an integrated provincial waste system.

PubMed

Federico, Giovanna; Rizzo, Gianfranco; Traverso, Marzia

2009-06-01

In the paper, the practical problem of analysing in an integrated way the performance of provincial waste systems is approached, in the framework of the Strategic Environmental Assessment (SEA). In particular, the in itinere phase of SEA is analysed herein. After separating out a proper group of ambits, to which the waste system is supposed to determine relevant impacts, pertinent sets of single indicators are proposed. Through the adoption of such indicators the time trend of the system is investigated, and the suitability of each indicator is critically revised. The structure of the evaluation scheme, which is essentially based on the use of ambit issues and analytical indicators, calls for the application of the method of the Dashboard of Sustainability for the integrated evaluation of the whole system. The suitability of this method is shown through the paper, together with the possibility of a comparative analysis of different scenarios of interventions. Of course, the reliability of the proposed method strongly relies on the availability of a detailed set of territorial data. The method appears to represent a useful tool for public administration in the process of optimizing the policy actions aimed at minimizing the increasing problem represented by waste production in urban areas.

Improving performance management for delivering appropriate care for patients no longer needing acute hospital care.

PubMed

Penney, Christine; Henry, Effie

2008-01-01

The public, providers and policy-makers are interested in a service continuum where care is provided in the appropriate place. Alternate level of care is used to define patients who no longer need acute care but remain in an acute care bed. Our aims were to determine how subacute care and convalescent care should be defined in British Columbia (BC); how these care levels should be aligned with existing legislation to provide more consistent service standards to patients and what reporting requirements were needed for system planning and performance management. A literature review was conducted to understand the international trends in performance management, care delivery models and change management. A Canada-wide survey was carried out to determine the directions of other provinces on the defined issues and a BC survey provided a current state analysis of programming within the five regional health authorities (HAs). A provincial policy framework for subacute and convalescent care has been developed to begin to address the concerns raised and provide a base for performance measurement. The policy has been approved and disseminated to BC HAs for implementation. An implementation plan has been developed and implementation activities have been integrated into the work of existing provincial committees. Evaluation will occur through performance measurement. The benefits anticipated include: clear policy guidance for programme development; improved comparability of performance information for system monitoring, planning and integrity of the national acute care Discharge Abstracting Database; improved efficiency in acute care bed use; and improved equity of access, insurability and quality for patients requiring subacute and convalescent care. While a national reporting system exists for acute care in Canada, this project raises questions about the implications for this system, given the shifting definition of acute care as other care levels emerge. Questions are also raised by the finding in Australia that the current case-mix system is inadequate to describe these patients. Further, given the inadequacy of our understanding of health system capacity and output, consideration of a more comprehensive national reporting system along the care continuum may be warranted. This project is an example of effective collaboration between the provincial government, a national organization and HAs, and suggests that provincial governments can participate in a meaningful way to accomplish research-informed health services policy.

The impact of China's retail drug price control policy on hospital expenditures: a case study in two Shandong hospitals.

PubMed

Meng, Qingyue; Cheng, Gang; Silver, Lynn; Sun, Xiaojie; Rehnberg, Clas; Tomson, Göran

2005-05-01

In China, 44.4% of total health expenditures in 2001 were for pharmaceuticals. Containment of pharmaceutical expenditures is a top priority for policy intervention. Control of drug retail prices was adopted by the Chinese government for this purpose. This study aims to examine the impact of this policy on the containment of hospital drug expenditures, and to analyze contributing factors. This is a retrospective pre/post-reform case study in two public hospitals. Financial records were reviewed to analyze changes in drug expenditures for all patients. A tracer condition, cerebral infarction, was selected for in-depth examination of changes in prices, utilization, expenditures and rationality of drugs. In the two hospitals, a total of 104 and 109 cerebral infarction cases, hospitalized respectively before and after the reform, were selected. Prescribed daily dose (PDD) was used for measuring drug utilization, and the contribution of price and utilization to changes in drug expenditures were decomposed. Rationality of drug use post-reform was reviewed based on published literature. Drug expenditures for all patients still increased rapidly in the two hospitals after implementation of the pricing policy. In the provincial hospital, drug expenditures per patient for cerebral infarction cases declined, but not significantly. This was mainly attributable to reduced utilization. In the municipal hospital, drug expenditure per patient increased by 50.1% after the reform, mainly due to greater drug utilization. Three to five fold higher drug expenditure per inpatient day in the provincial hospital was due to use of more expensive drugs. Of the top 15 drugs for treating cerebral infarction cases after the reform, 19.5% and 46.5% of the expenditures, in the provincial and municipal hospitals, respectively, were spent on drugs with prices set by the government. A large proportion of expenditures for the top 15 drugs, at least 65% and 41% in the provincial and municipal hospitals, respectively, was spent on allopathic drugs without an adequate evidence base of safety and efficacy supporting use for cerebral infarction. Control of retail prices, implemented in isolation, was not effective in containing hospital drug expenditures in these two Chinese hospitals. Utilization, more than price, determined drug expenditures. Improvement of rational use of drugs and correcting the present incentive structure for hospitals and drug prescribers may be important additional strategies for achieving containment of drug expenditures.

Balanced Development for Provincial-Level Coordination and Higher Vocational Education

ERIC Educational Resources Information Center

Po, Yang; Yunbo, Liu

2017-01-01

In the rapid development of Chinese higher vocational education, large gaps have appeared in the scale of development and resource generation among the provinces, among regions in the provinces, and among higher education institutions in the provinces. Balanced regional development and provincial-level coordination have become policy focal points,…

The Grade 3 Provincial Achievement Tests: In Need of Revamping?

ERIC Educational Resources Information Center

Roessingh, Hetty

2012-01-01

This article advances an argument for retaining but revamping the grade 3 Provincial Achievement Tests (PATs). Alberta's demographic landscape is rapidly changing to include significant numbers of English language learners who are still in the early stages of developing English language proficiency at grade 3. Online tools are used to generate…

Fostering a Provincial Identity: Two Eras in Alberta Schooling

ERIC Educational Resources Information Center

von Heyking, Amy

2006-01-01

In this article, I analyse how schools in Alberta have defined the province's identity and its role in Confederation. During two eras, the 1930s and the 1980s, social studies curriculum and teaching resources contained assertions of provincial uniqueness. In the late 1930s, the progressive curriculum implemented in Alberta's schools represented…

Mapping the Typology of Transition Systems in a Liberal Market Economy: The Case of Canada

ERIC Educational Resources Information Center

Arnold, Christine Helen; Wheelahan, Leesa; Moodie, Gavin; Beaulieu, Jacqueline; Taylor-Cline, Jean-Claude

2018-01-01

This research explores links between tertiary education institutions and between tertiary education and the labour market as determinants of provincial and national transition patterns in Canada. The study consists of a provincial analysis that maps the typology of transition systems across Canada's devolved federated tertiary education structure.…

Fundamental and dressed annular solitons in saturable nonlinearity with parity–time symmetric Bessel potential

NASA Astrophysics Data System (ADS)

Wang, Hong-Cheng; Wei, Ya-Dong; Huang, Xiao-Yuan; Chen, Gui-Hua; Ye, Hai

2018-04-01

Not Available Project supported by the National Natural Science Foundation of China (Grant No. 61308019), the Guangdong Provincial Natural Science Foundation, China (Grant Nos. 2015A030313650 and 2014A030310262), and the Guangdong Provincial Science and Technology Planning Program, China (Grant No. 2017A010102019).

Phase transition of a diblock copolymer and homopolymer hybrid system induced by different properties of nanorods

NASA Astrophysics Data System (ADS)

Geng, Xiao-bo; Pan, Jun-xing; Zhang, Jin-jun; Sun, Min-na; Cen, Jian-yong

2018-05-01

Not Available Project supported by the National Natural Science Foundation of China (Grant No. 21373131), the Provincial Natural Science Foundation of Shanxi, China (Grant No. 2015011004), and the Research Foundation for Excellent Talents of Shanxi Provincial Department of Human Resources and Social Security, China.

Multi-dimension and Comprehensive Assessment on the Utilizing and Sharing of Regional Large-Scale Scientific Equipment

PubMed Central

Li, Chen; Yongbo, Lv; Chi, Chen

2015-01-01

Based on the data from 30 provincial regions in China, an assessment and empirical analysis was carried out on the utilizing and sharing of the large-scale scientific equipment with a comprehensive assessment model established on the three dimensions, namely, equipment, utilization and sharing. The assessment results were interpreted in light of relevant policies. The results showed that on the whole, the overall development level in the provincial regions in eastern and central China is higher than that in western China. This is mostly because of the large gap among the different provincial regions with respect to the equipped level. But in terms of utilizing and sharing, some of the Western provincial regions, such as Ningxia, perform well, which is worthy of our attention. Policy adjustment targeting at the differentiation, elevation of the capacity of the equipment management personnel, perfection of the sharing and cooperation platform, and the promotion of the establishment of open sharing funds, are all important measures to promote the utilization and sharing of the large-scale scientific equipment and to narrow the gap among different regions. PMID:25937850

Provincial variation of carbon emissions from bituminous coal: Influence of inertinite and other factors

USGS Publications Warehouse

Quick, J.C.; Brill, T.

2002-01-01

We observe a 1.3 kg C/net GJ variation of carbon emissions due to inertinite abundance in some commercially available bituminous coal. An additional 0.9 kg C/net GJ variation of carbon emissions is expected due to the extent of coalification through the bituminous rank stages. Each percentage of sulfur in bituminous coal reduces carbon emissions by about 0.08 kg C/net GJ. Other factors, such as mineral content, liptinite abundance and individual macerals, also influence carbon emissions, but their quantitative effect is less certain. The large range of carbon emissions within the bituminous rank class suggests that rank- specific carbon emission factors are provincial rather than global. Although carbon emission factors that better account for this provincial variation might be calculated, we show that the data used for this calculation may vary according to the methods used to sample and analyze coal. Provincial variation of carbon emissions and the use of different coal sampling and analytical methods complicate the verification of national greenhouse gas inventories. Published by Elsevier Science B.V.

Keynote Address: Use of telecommunications to meet health needs of rural, remote and isolated communities

NASA Astrophysics Data System (ADS)

House, Max

1990-06-01

Difficulties in delivering health and education services to isolated remote and underserviced areas have stimulated the application of telecommunications including satellite and ground-based systems to meet health care and education needs. Over a 12-year period Memorial University Telemedicine Centre has developed a number of telemedicine and distance education projects in the Province of Newfoundland in other Canadian provinces and internationally. Early experiences included a one-way television two-way voice system linking remote provincial sites to St. John''s by satellite. Following this emphasis was placed on the development of a major Province-wide terrestrially based dedicated 4-wire audio teleconference system which now has five separate divisions and an associated 30-port 2-wire teleconference bridge. The Teleconference System (TCS) is used by about 50 user groups in the fields of health education and community programming in 1989. Medical and educational data are transmitted using telewriters slow scan television and electroencephalograph and electrocardiograph transmission equipment. Research and development activities have included an offshore satellite telemedicine project several teleradiology experiments using slow scan and intercontinental X-ray transmission trials. International projects have included (1) satellite links to East Africa (Kenya and Canada/- European satellite trial using the European Space Agency (ESA) satellite Olympus (hybrid 14/12 and 20/30 Geighz) which was launched in July 1989 (2) the use of a low orbit packet radio satellite in cooperation with SatelLife (an international telemedicine organization) to link Memorial University in Newfoundland with and Uganda in order to support remote health care endeavours (3) a provincial teleradiology experiment using digital slow scan equipment. This presentation will also discuss guidelines followed in the development of a successful telemedicine project. 1.

Offering integrated care for HIV/AIDS, diabetes and hypertension within chronic disease clinics in Cambodia.

PubMed

Janssens, B; Van Damme, W; Raleigh, B; Gupta, J; Khem, S; Soy Ty, K; Vun, Mc; Ford, N; Zachariah, R

2007-11-01

In Cambodia, care for people with HIV/AIDS (prevalence 1.9%) is expanding, but care for people with type II diabetes (prevalence 5-10%), arterial hypertension and other treatable chronic diseases remains very limited. We describe the experience and outcomes of offering integrated care for HIV/AIDS, diabetes and hypertension within the setting of chronic disease clinics. Chronic disease clinics were set up in the provincial referral hospitals of Siem Reap and Takeo, 2 provincial capitals in Cambodia. At 24 months of care, 87.7% of all HIV/AIDS patients were alive and in active follow-up. For diabetes patients, this proportion was 71%. Of the HIV/AIDS patients, 9.3% had died and 3% were lost to follow-up, while for diabetes this included 3 (0.1%) deaths and 28.9% lost to follow-up. Of all diabetes patients who stayed more than 3 months in the cohort, 90% were still in follow-up at 24 months. Over the first three years, the chronic disease clinics have demonstrated the feasibility of integrating care for HIV/AIDS with non-communicable chronic diseases in Cambodia. Adherence support strategies proved to be complementary, resulting in good outcomes. Services were well accepted by patients, and this has had a positive effect on HIV/AIDS-related stigma. This experience shows how care for HIV/AIDS patients can act as an impetus to tackle other common chronic diseases.

Pregnancy after heart transplantation: a well-thought-out decision? The Quebec provincial experience - a multi-centre cohort study.

PubMed

Dagher, Olina; Alami Laroussi, Nassiba; Carrier, Michel; Cecere, Renzo; Charbonneau, Eric; de Denus, Simon; Giannetti, Nadia; Leduc, Line; Cantin, Bernard; Mansour, Asmaa; Poirier, Nancy; Raboisson, Marie-Josée; White, Michel; Ducharme, Anique

2018-02-26

Despite reports of successful pregnancies in heart transplant (HTx) recipients, many centers recommend their patients against maternity. We reviewed our provincial experience of pregnancy in HTx recipients by performing charts review of all known gestations following HTx in the province of Quebec (Canada), stratified between planned and unplanned pregnancies. Long-term survival was compared to HTx recipient women of childbearing age who did not become pregnant. Eighteen pregnancies, 56% unplanned, occurred in eight patients, 10.1 (2.6-27.0) years after HTx. Immunosuppression was CNI-based, with a mean dose increase of 48.3% (tacrolimus) and 26.5% (cyclosporine), without rejection. Cardiometabolic complications were high compared to the general Canadian population, including preeclampsia (15.4% vs. 5.5%), hypertension (38.5% vs. 4.6%), and diabetes (15.4% vs. 5.6%). Mean gestational age was 35.1 (23.4-39.6) weeks (72.2% live births; 53.8% prematurity). Mean birthweight was 2418 (660-3612) g. Serum creatinine increased during pregnancy, becoming significant after delivery (P = 0.0239), and returning to preconception level in all but three patients within a year. After 4.6 (1.2-17.2) years of follow-up, two rejection episodes occurred in one patient. Long-term mortality was similar to overall HTx women (Kaplan-Meier; P = 0.8071). Pregnancy in HTx carries high cardiometabolic complications and decreased kidney function, but is feasible with acceptable outcomes and no impact on mother's survival. © 2018 Steunstichting ESOT.

Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities.

PubMed

Giesbrecht, Norman; Wettlaufer, Ashley; Thomas, Gerald; Stockwell, Tim; Thompson, Kara; April, Nicole; Asbridge, Mark; Cukier, Samantha; Mann, Robert; McAllister, Janet; Murie, Andrew; Pauley, Chris; Plamondon, Laurie; Vallance, Kate

2016-05-01

Alcohol pricing is an effective prevention policy. This paper compares the 10 Canadian provinces on three research-based alcohol pricing policies-minimum pricing, pricing by alcohol content and maintaining prices relative to inflation. The selection of these three policies was based on systematic reviews and seminal research papers. Provincial data for 2012 were obtained from Statistics Canada and relevant provincial ministries, subsequently sent to provincial authorities for verification, and then scored by team members. All provinces, except for Alberta, have minimum prices for at least one beverage type sold in off-premise outlets. All provinces, except for British Columbia and Quebec, have separate (and higher) minimum pricing for on-premise establishments. Regarding pricing on alcohol content, western and central provinces typically scored higher than provinces in Eastern Canada. Generally, minimum prices were lower than the recommended $1.50 per standard drink for off-premise outlets and $3.00 per standard drink in on-premise venues. Seven of 10 provinces scored 60% or higher compared to the ideal on indexing prices to inflation. Prices for a representative basket of alcohol products in Ontario and Quebec have lagged significantly behind inflation since 2006. While examples of evidence-based alcohol pricing policies can be found in every jurisdiction in Canada, significant inter-provincial variation leaves substantial unrealised potential for further reducing alcohol-related harm and costs. This comparative assessment of alcohol price policies provides clear indications of how individual provinces could adjust their pricing policies and practices to improve public health and safety. [Giesbrecht N, Wettlaufer A, Thomas G, Stockwell T, Thompson K, April N, Asbridge M, Cukier S, Mann R, McAllister J, Murie A, Pauley C, Plamondon L, Vallance K. Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities. Drug Alcohol Rev 2016;35:289-297]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Decentralization of Sports Services Opinions of Youth Services and Provincial Directors of Sports

ERIC Educational Resources Information Center

Aydogan, Hayri

2016-01-01

The purpose of this paper is to make a study on opinions of Youth Services and Provincial Directors of Sports related to decentralization of sports services according to demographical variables like educational background, age, total professional working period, and working period as a director. While the population of the study consists of 81…

Provincially and Locally Initiated Curriculum Program Assessment, Final Report.

ERIC Educational Resources Information Center

1999

This report is an independent assessment of the Provincially Initiated Curriculum (PIC) and Locally Initiated Curriculum (LIC) for British Columbia's Centre for Curriculum, Transfer and Technology (C2T2), which manages both PIC and LIC projects. The report makes four recommendations for C2T2's consideration: (1) a renewed emphasis on communication…

Interpretation of age-structure gaps in hemlock (Tsuga canadensis) populations of Algonquin Provincial Park, Ontario, Canada

Treesearch

S. A. Vasiliauskas; L. W. Aarssen

2000-01-01

Casual observations have suggested that intermediate size and age gaps may exist in the eastern hemlock (Tsuga canadensis (L.)Carr.) populations of Algonquin Provincial Park, Ontario. This was confirmed in vegetation surveys reported here. Several hypotheses, involving mortality risks at different points in the life cycle of hemlock, are proposed to...

The Inclusive Classroom - Can the Teachers Keep Up? A Comparison of Nova Scotia and Newfoundland & Labrador Teachers' Perspectives.

ERIC Educational Resources Information Center

Edmunds, Alan

2003-01-01

A study compared the results of a previous study on 725 Nova Scotia teachers' general attitudes toward inclusion and confidence in their abilities with those of 287 teachers from Newfoundland & Labrador. No provincial differences in teachers' perceptions of inclusion were found despite differences in provincial policy/practice. (Contains…

Ontario's Primary Class Size Reduction Initiative: Report on Early Implementation

ERIC Educational Resources Information Center

Bascia, Nina

2010-01-01

Reduction in the size of classes from Kindergarten to Grade 3 was a major Liberal Party campaign promise in Ontario's 2003 provincial election. It was intended to demonstrate a new government's commitment to improving public education. By the 2008-09 school year, the provincial government's goals had been achieved: over 90% of all primary classes…

Defense.gov - Special Report - On Location in Afghanistan

Science.gov Websites

team in Afghanistan’s Paktia province safe as it travels around the region meeting with local leaders FORWARD OPERATING BASE GARDEZ, Afghanistan, Feb. 19, 2009 – A provincial reconstruction team is working are working with the Paktia Provincial Reconstruction Team to help convince villagers to reject the

Rhythm Masters: Developing a Master Program in Popular Music and Folk Music in Provincial Areas in Finland

ERIC Educational Resources Information Center

Vakeva, Lauri; Kurkela, Vesa

2012-01-01

This paper reports a project organized by Sibelius-Academy Department of Folk Music and Tampere University, Department of Music Anthropology in 2008-2010. The goal of the project was to develop and implement a master program for "rytmimusiikki" (lit. "rhythm music" in Seinajoki, Finland--a musically active provincial area…

Labour Market Transfers and the Implications for Literacy and Essential Skills: Briefing Package

ERIC Educational Resources Information Center

Hayes, Brigid

2012-01-01

This revised report was prepared for the Canadian Literacy and Learning Network (CLLN) and the thirteen-member provincial and territorial literacy coalitions. The purpose of the report is: (1) To provide background information on the labour market transfers from the Federal Government to the provincial and territorial governments; (2) To outline…

Physician recruitment in Ontario Provincial Psychiatric Hospitals.

PubMed

Draper, R; Galbraith, D; Frost, B

1989-11-01

Recruitment of Physicians/Psychiatrists to staff the Ontario Provincial Psychiatric Hospitals remains an ongoing problem despite the introduction of measures such as University Affiliation and Incentive Grants. Historically there has been heavy reliance upon Foreign Medical Graduates (GOFM's) who have been denied the possibility of professional mobility and advancement because of restrictive licences. Recent changes in regulations have severely restricted the recruitment of GOFM's. During 1987, details of all physicians employed in the provincial hospitals during the preceeding five years were entered into a computerized data base. This paper presents some initial analyses which indicate that Canadian graduates have provided low levels of service, especially outside major urban centres, quite insufficient to replace the GOFM's. These findings raise urgent social and professional concerns.

A General Provincial Situation Visualization System Based on iPhone Operating System of Shandong Province

NASA Astrophysics Data System (ADS)

Ye, Z.; Xiang, H.

2014-04-01

The paper discusses the basic principles and the problem solutions during the design and implementation of the mobile GIS system, and base on the research result, we developed the General Provincial Situation Visualization System Based on iOS of Shandong Province. The system is developed in the Objective-C programming language, and use the ArcGIS Runtime SDK for IOS as the development tool to call the "World-map Shandong" services to implement the development of the General Provincial Situation Visualization System Based on iOS devices. The system is currently available for download in the Appstore and is chosen as the typical application case of ESRI China ArcGIS API for iOS.

Recovery in Canada: Toward social equality

PubMed Central

PIAT, MYRA; SABETTI, JUDITH

2016-01-01

This article reviews evolution of the recovery paradigm in Canadian mental health. We first trace the origins and development of the recovery concept through the literature, followed by an examination of how the recovery concept has been implemented in national and provincial mental health policy since publication of the 2006 Kirby Commission Report. Based on consultations with Canadian policymakers, and an examination of available policy documents, we explore how the dual theme of ‘recovery’ and ‘well-being’, adopted by the Mental Health Commission of Canada in its 2009 strategy: Toward Recovery and Well-being - A Framework For a Mental Health Strategy has subsequently played out in mental health policymaking at the provincial level. Findings reveal mixed support for recovery as a guiding principle for mental health reform in Canada. While policies in some provinces reflect widespread support for recovery, and strong identification with the aspirations of the consumer movement; other provinces have shifted to population-based, wellness paradigms that privilege evidence-based services and professional expertise. The recognition of social equality for people who experience mental illness emerges as an important value in Canadian mental health policy, cutting across the conceptual divide between recovery and well-being. PMID:22385423

Analysis of current laboratory animal science policies and administration in China.

PubMed

Kong, Qi; Qin, Chuan

2009-01-01

Laboratory animal science (LAS) advances scientific understanding of the care and use of animals that play a key role in research supporting the development of biomedicine. LAS has developed quickly in China in recent decades, and this report provides an analysis of the current status of the countrys LAS policies and administration. National and provincial laws, regulations, guidelines, and standards apply to quality control and licensing, quarantine and infectious disease control, breeding and husbandry, transgenic animals, staff qualifications, animal welfare, and imports, exports, and transportation. Regulation and oversight of lab animal use are the responsibility of the national Ministry of Science and Technology, provincial departments of science and technology, and institutional animal care and use committees. We begin with an explanation of the rationale behind this paper and then offer a brief history of policy-related activities and achievements. We then present various policies, discuss their implementation, and hypothesize about future policy developments. With the improvement of policies under an integrated, multitiered administration, the use of high-quality lab animals in Chinese scientific research is increasing and many more papers describing animal experiments performed in China are being published in international journals.

Controlling the Cost of Drugs: the Canadian Experience

PubMed Central

Fulda, Thomas K.; Dickens, Paul F.

1979-01-01

In 1969 Canada began programs at both the national and provincial levels to lower prescription drug prices. These programs may have contributed to a significant decline between 1970 and 1974 of 39 percent in the average price of 16 drugs selected for study. During this time, the average price for the same drugs in the United States declined only 1.4 percent. One major program, a change in the compulsory patent licensing, is described and analyzed. Other Canadian programs, designed to promote competition in the drug industry, and their effects are discussed. PMID:10309114

Alberta's provincial take-home naloxone program: A multi-sectoral and multi-jurisdictional response to overdose.

PubMed

Freeman, Lisa K; Bourque, Stacey; Etches, Nick; Goodison, Karin; O'Gorman, Claire; Rittenbach, Kay; Sikora, Christopher A; Yarema, Mark

2017-11-09

Alberta is a prairie province located in western Canada, with a population of approximately 4.3 million. In 2016, 363 Albertans died from apparent drug overdoses related to fentanyl, an opioid 50-100 times more toxic than morphine. This surpassed the number of deaths from motor vehicle collisions and homicides combined. Naloxone is a safe, effective, opioid antagonist that may quickly reverse an opioid overdose. In July 2015, a committee of community-based harm reduction programs in Alberta implemented a geographically restricted take-home naloxone (THN) program. The successes and limitations of this program demonstrated the need for an expanded, multi-sectoral, multi-jurisdictional response. The provincial health authority, Alberta Health Services (AHS), used previously established incident command system processes to coordinate implementation of a provincial THN program. Alberta's provincial THN program was implemented on December 23, 2015. This collaborative program resulted in a coordinated response across jurisdictional levels with wide geographical reach. Between December 2015 and December 2016, 953 locations, including many community pharmacies, registered to dispense THN kits, 9572 kits were distributed, and 472 reversals were reported. The provincial supply of THN kits more than tripled from 3000 to 10 000. Alberta was uniquely poised to deliver a large, province-wide, multi-sectoral and multi-jurisdictional THN program as part of a comprehensive response to increasing opioid-related morbidity and mortality. The speed at which AHS was able to roll out the program was made possible by work done previously and the willingness of multiple jurisdictions to work together to build on and expand the program.

Urban Boundary Extraction and Urban Sprawl Measurement Using High-Resolution Remote Sensing Images: a Case Study of China's Provincial

NASA Astrophysics Data System (ADS)

Wang, H.; Ning, X.; Zhang, H.; Liu, Y.; Yu, F.

2018-04-01

Urban boundary is an important indicator for urban sprawl analysis. However, methods of urban boundary extraction were inconsistent, and construction land or urban impervious surfaces was usually used to represent urban areas with coarse-resolution images, resulting in lower precision and incomparable urban boundary products. To solve above problems, a semi-automatic method of urban boundary extraction was proposed by using high-resolution image and geographic information data. Urban landscape and form characteristics, geographical knowledge were combined to generate a series of standardized rules for urban boundary extraction. Urban boundaries of China's 31 provincial capitals in year 2000, 2005, 2010 and 2015 were extracted with above-mentioned method. Compared with other two open urban boundary products, accuracy of urban boundary in this study was the highest. Urban boundary, together with other thematic data, were integrated to measure and analyse urban sprawl. Results showed that China's provincial capitals had undergone a rapid urbanization from year 2000 to 2015, with the area change from 6520 square kilometres to 12398 square kilometres. Urban area of provincial capital had a remarkable region difference and a high degree of concentration. Urban land became more intensive in general. Urban sprawl rate showed inharmonious with population growth rate. About sixty percent of the new urban areas came from cultivated land. The paper provided a consistent method of urban boundary extraction and urban sprawl measurement using high-resolution remote sensing images. The result of urban sprawl of China's provincial capital provided valuable urbanization information for government and public.

Quantum coherence and non-Markovianity of an atom in a dissipative cavity under weak measurement

NASA Astrophysics Data System (ADS)

Liu, Yu; Zou, Hong-Mei; Fang, Mao-Fa

2018-01-01

Not Available Project supported by the Scientific Research Project of Hunan Provincial Education Department, China (Grant No. 16C0949), the Hunan Provincial Innovation Foundation for Postgraduate, China (Grant No. CX2017B177), the National Natural Science Foundation of China (Grant No. 11374096), and the Doctoral Science Foundation of Hunan Normal University, China.

BIOLOGY OF THE LEECH ACTINOBDELLA INEQUIANNULATA MOORE, 1901 (ANNELIDA: HIRUDINEA: RHYNCHOBDELLIDA: GLOSSIPHONIIDAE), PARASITIC ON THE WHITE SUCKER, CATOSTOMUS COMMERSONI LACEPEDE, 1803 AND THE LONGNOSE SUCKER, CATOSTOMUS CATOSTOMUS FORSTER, 1773, IN ALGONQUIN PROVINCIAL PARK, ONTARIO, CANADA

EPA Science Inventory

Actinobdella inequiannulata was found on the white sucker, Catostomus commersoni, and less frequently on the longnose sucker, Catostomus catostomus, in Algonquin Provincial Park, Ontario, Canada. Catostomus commersoni parasitized with Act. inequiannulata was collected from July ...

Special Report of the Ombudsman for Alberta Re: Complaints of the Lubicon Lake Indian Band.

ERIC Educational Resources Information Center

Alberta Office of the Ombudsman, Edmonton.

The Ombudsman for Alberta investigated five allegations raised by the Lubicon Lake Indian Band: (1) that provincial officials had deliberately allowed fires in the Band's traditional area to rage unchecked; (2) that provincial and oil company workers had been instructed to bulldoze deliberately Indian traplines and to scare game out of the area by…

The Regulation of Multi-Age Groupings in Canadian Centre-based Child Care Settings: An Analysis of Provincial and Territorial Policies, Legislation and Regulations.

ERIC Educational Resources Information Center

Bernhard, Judith; Pollard, June; Chud, Gyda; Vukelich, Goranka; Pacini-Ketchabaw, Veronica

2000-01-01

Examined the ways Canadian provincial and territorial policies address the inclusion of infants in multi-age early childhood education settings and the ways practitioners and licensing personnel interpret these policies. Noted policy patterns that affect the inclusion of infants and older children. Derived recommendations for policymakers and…

Off-stoichiometry indexation of BiFeO3 thin film on silicon by Rutherford backscattering spectrometry

NASA Astrophysics Data System (ADS)

Wang, Ze-Song; Xiao, Ren-Zheng; Zou, Chang-Wei; Xie, Wei; Tian, Can-Xin; Xue, Shu-Wen; Liu, Gui-Ang; Devi, Neena; Fu, De-Jun

2018-04-01

Not Available Project supported by the National Natural Science Foundation of China (Grant Nos. 11605103, 11405117, and 11747074), the Guangdong Provincial Natural Science Foundation, China (Grant Nos. 2014A030307008 and 2016A030313670), and the Guangdong Provincial Science and Technology Planning Project, China (Grant Nos. 2016A010103041 and 2017A010103025).

Genus age, provincial area and the taxonomic structure of marine faunas.

PubMed

Harnik, Paul G; Jablonski, David; Krug, Andrew Z; Valentine, James W

2010-11-22

Species are unevenly distributed among genera within clades and regions, with most genera species-poor and few species-rich. At regional scales, this structure to taxonomic diversity is generated via speciation, extinction and geographical range dynamics. Here, we use a global database of extant marine bivalves to characterize the taxonomic structure of climate zones and provinces. Our analyses reveal a general, Zipf-Mandelbrot form to the distribution of species among genera, with faunas from similar climate zones exhibiting similar taxonomic structure. Provinces that contain older taxa and/or encompass larger areas are expected to be more species-rich. Although both median genus age and provincial area correlate with measures of taxonomic structure, these relationships are interdependent, nonlinear and driven primarily by contrasts between tropical and extra-tropical faunas. Provincial area and taxonomic structure are largely decoupled within climate zones. Counter to the expectation that genus age and species richness should positively covary, diverse and highly structured provincial faunas are dominated by young genera. The marked differences between tropical and temperate faunas suggest strong spatial variation in evolutionary rates and invasion frequencies. Such variation contradicts biogeographic models that scale taxonomic diversity to geographical area.

Genus age, provincial area and the taxonomic structure of marine faunas

PubMed Central

Harnik, Paul G.; Jablonski, David; Krug, Andrew Z.; Valentine, James W.

2010-01-01

Species are unevenly distributed among genera within clades and regions, with most genera species-poor and few species-rich. At regional scales, this structure to taxonomic diversity is generated via speciation, extinction and geographical range dynamics. Here, we use a global database of extant marine bivalves to characterize the taxonomic structure of climate zones and provinces. Our analyses reveal a general, Zipf–Mandelbrot form to the distribution of species among genera, with faunas from similar climate zones exhibiting similar taxonomic structure. Provinces that contain older taxa and/or encompass larger areas are expected to be more species-rich. Although both median genus age and provincial area correlate with measures of taxonomic structure, these relationships are interdependent, nonlinear and driven primarily by contrasts between tropical and extra-tropical faunas. Provincial area and taxonomic structure are largely decoupled within climate zones. Counter to the expectation that genus age and species richness should positively covary, diverse and highly structured provincial faunas are dominated by young genera. The marked differences between tropical and temperate faunas suggest strong spatial variation in evolutionary rates and invasion frequencies. Such variation contradicts biogeographic models that scale taxonomic diversity to geographical area. PMID:20534619

Legislation for Youth Sport Concussion in Canada: Review, Conceptual Framework, and Recommendations.

PubMed

Russell, Kelly; Ellis, Michael J; Bauman, Shannon; Tator, Charles H

2017-05-01

In this article, we conduct a review of introduced and enacted youth concussion legislation in Canada and present a conceptual framework and recommendations for future youth sport concussion laws. We conducted online searches of federal, provincial, and territorial legislatures to identify youth concussion bills that were introduced or successfully enacted into law. Internet searches were carried out from July 26 and 27, 2016. Online searches identified six youth concussion bills that were introduced in provincial legislatures, including two in Ontario and Nova Scotia and one each in British Columbia and Quebec. One of these bills (Ontario Bill 149, Rowan's Law Advisory Committee Act, 2016) was enacted into provincial law; it is not actual concussion legislation, but rather a framework for possible enactment of legislation. Two bills have been introduced in federal parliament but neither bill has been enacted into law. At present, there is no provincial or federal concussion legislation that directly legislates concussion education, prevention, management, or policy in youth sports in Canada. The conceptual framework and recommendations presented here should be used to guide the design and implementation of future youth sport concussion laws in Canada.

Does gynecologic malignancy predict likelihood of a tertiary palliative care unit hospital admission? A comparison of local, provincial and national death rates.

PubMed

Pilkey, Jana; Demers, Chantale; Chochinov, Harvey; Venkatesan, Nithya

2012-12-01

The purpose of this study was to determine whether the presence of gynecologic malignancies predicts the likelihood of a tertiary palliative care unit hospital admission. In this study, patients admitted to a specialized tertiary palliative care unit (TPCU) with gynecologic malignancies were compared to national and provincial death rates to determine if gynecologic malignancy predicts admission, and subsequent death, in a TPCU. Eighty-two gynecologic cancer patients were admitted to our TPCU over the 5- year study period. Out of all cancer deaths in the TPCU, death from ovarian cancer was 3.7% compared with 2.4% (p = 0.0068) of all cancer deaths in Manitoba and 2.3% (p = 0.0043) of all cancer deaths in Canada. Cervical cancer accounted for 1.7% of all our patients deaths compared with 0.7% (p = 0.0001) provincially and 0.6% (p = 0.0001) nationally. Uterine cancer deaths were not significantly different from the provincial and national death rates, whereas vulvar and fallopian cancers were too rare to allow for statistical analysis. Gynecologic cancers may be predictive of admission to a palliative care unit.

Relationship between air pollutants and economic development of the provincial capital cities in China during the past decade.

PubMed

Luo, Yunpeng; Chen, Huai; Zhu, Qiu'an; Peng, Changhui; Yang, Gang; Yang, Yanzheng; Zhang, Yao

2014-01-01

With the economic development of China, air pollutants are also growing rapidly in recent decades, especially in big cities of the country. To understand the relationship between economic condition and air pollutants in big cities, we analysed the socioeconomic indictors such as Gross Regional Product per capita (GRP per capita), the concentration of air pollutants (PM10, SO2, NO2) and the air pollution index (API) from 2003 to 2012 in 31 provincial capitals of mainland China. The three main industries had a quadratic correlation with NO2, but a negative relationship with PM10 and SO2. The concentration of air pollutants per ten thousand yuan decreased with the multiplying of GRP in the provincial cities. The concentration of air pollutants and API in the provincial capital cities showed a declining trend or inverted-U trend with the rise of GRP per capita, which provided a strong evidence for the Environmental Kuznets Curve (EKC), that the environmental quality first declines, then improves, with the income growth. The results of this research improved our understanding of the alteration of atmospheric quality with the increase of social economy and demonstrated the feasibility of sustainable development for China.

Evaluating Childhood Vaccination Coverage of NIP Vaccines: Coverage Survey versus Zhejiang Provincial Immunization Information System.

PubMed

Hu, Yu; Chen, Yaping

2017-07-11

Vaccination coverage in Zhejiang province, east China, is evaluated through repeated coverage surveys. The Zhejiang provincial immunization information system (ZJIIS) was established in 2004 with links to all immunization clinics. ZJIIS has become an alternative to quickly assess the vaccination coverage. To assess the current completeness and accuracy on the vaccination coverage derived from ZJIIS, we compared the estimates from ZJIIS with the estimates from the most recent provincial coverage survey in 2014, which combined interview data with verified data from ZJIIS. Of the enrolled 2772 children in the 2014 provincial survey, the proportions of children with vaccination cards and registered in ZJIIS were 94.0% and 87.4%, respectively. Coverage estimates from ZJIIS were systematically higher than the corresponding estimates obtained through the survey, with a mean difference of 4.5%. Of the vaccination doses registered in ZJIIS, 16.7% differed from the date recorded in the corresponding vaccination cards. Under-registration in ZJIIS significantly influenced the coverage estimates derived from ZJIIS. Therefore, periodic coverage surveys currently provide more complete and reliable results than the estimates based on ZJIIS alone. However, further improvement of completeness and accuracy of ZJIIS will likely allow more reliable and timely estimates in future.

[Purveyors of technology: provincial engineers and the construction of road infrastructure in Minas Gerais].

PubMed

Barbosa, Lidiany Silva

2011-01-01

The article analyzes the role played by engineers in the construction of road infrastructure in Minas Gerais between the 1840s and 1880s. Building and providing regular maintenance for roads and bridges was a task carried out by the Minas Gerais provincial government, which since the 1830s had a specific agency assigned to designing, building, and maintaining public communication routes. Engineers were part of the agency from its inception, playing a significant role in designing projects and in the actual execution of certain works. The current study is grounded in administrative documentation in which the details of work progress are reported to the provincial government. The gathered records provide technical, administrative, and financial information, along with data on labor power and the agents engaged in construction works.

Guidelines for Management Information Systems in Canadian Health Care Facilities

PubMed Central

Thompson, Larry E.

1987-01-01

The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

[Assessment on the capacity for programs regarding chronic non-communicable diseases prevention and control, in China].

PubMed

Si, Xiang; Zhai, Yi; Shi, Xiaoming

2014-06-01

To assess the policies and programs on the capacity of prevention and control regarding non-communicable diseases (NCDs) at the Centers for Disease Control and Prevention (CDCs) at all levels and grass roots health care institutions, in China. On-line questionnaire survey was adopted by 3 352 CDCs at provincial, city and county levels and 1 200 grass roots health care institutions. 1) On policies: 75.0% of the provincial governments provided special funding for chronic disease prevention and control, whereas 19.7% city government and 11.3% county government did so. 2) Infrastructure:only 7.1% county level CDCs reported having a department taking care of NCD prevention and control. 8 263 staff members worked on NCDs prevention and control, accounting for 4.2% of all the CDCs' personnel. 40.2% CDCs had special funding used for NCDs prevention and control. 3)Capacity on training and guidance:among all the CDCs, 96.9% at provincial level, 50.3% at city level and 42.1% at county level had organized training on NCDs prevention and control. Only 48.3% of the CDCs at county level provided technical guidance for grass-roots health care institutions. 4) Capacities regarding cooperation and participation: 20.2% of the CDCs had experience in collaborating with mass media. 5) Surveillance capacity: 64.6% of the CDCs at county level implemented death registration, compare to less than 30.0% of CDCs at county level implemented surveillance programs on major NCDs and related risk factors. In the grass roots health care institutions, 18.6% implemented new stroke case reporting system but only 3.0% implemented program on myocardial infarction case reporting. 6) Intervention and management capacity: 36.1% and 32.2% of the CDCs conducted individualized intervention on hypertension and diabetes, while less than another 20% intervened into other NCDs and risk factors. More than 50% of the grass roots health care institutions carried follow-up survey on hypertension and diabetes. Rates on hypertension and diabetes patient management were 12.0% and 7.9% , with rates on standard management as 73.8% and 80.1% and on control as 48.7% and 50.0%, respectively. 7) Capacity on Assessment: 13.3% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs in their respective jurisdiction. 8) On scientific research: the capacity on scientific research among provincial CDCs was apparently higher than that at the city or county level CDCs. Policies for NCDs prevention and control need to be improved. We noticed that there had been a huge gap between county level and provincial/city level CDCs on capacities related to NCDs prevention and control. At the grass-roots health care institutions, both prevention and control programs on chronic diseases did not seem to be effective.

Assessing Provincial PM2.5 Trends in China from 2001 to 2015 Using High-Resolution Satellite Remote Sensing

NASA Astrophysics Data System (ADS)

Lin, C.; Lau, A. K. H.; LI, Y.; Li, C.

2017-12-01

Given the vast territory of China, control efforts for air pollution and the long-term PM2.5 trends may substantially differ among the provinces. In this study, we aim to assess the provincial PM2.5 trends in China during the past few Five-Year Plan (FYP) periods. The lack of long-term PM2.5 measurements, however, makes such assessment difficult. Satellite remote sensing of PM2.5 concentration is an important step toward filling this data gap. In this study, a PM2.5 data set was built over China at a resolution of 1 km from 2001 to 2015 using satellite remote sensing. Analyses show that the national average of PM2.5 concentration increased by 0.11 µg·m-3·yr-1 during the 10th FYP period (2001 to 2005) and started to decline by -0.75 µg·m-3·yr-1 and -2.20 µg·m-3·yr-1 during the 11th (2006 to 2010) and the 12th (2011 to 2015) FYP period, respectively. In addition, substantial differences in the PM2.5 trends were observed among the provinces. Although PM2.5 concentrations remained steady or worsened in most provinces during the 10th FYP period, PM2.5 concentrations substantially declined for provinces in the Beijing-Tianjin-Hebei (BTH) region, suggesting that these provinces were the most successful in their control efforts during this period. The most substantial decline in provincial PM2.5 concentration during the 12th FYP period was also observed in the BTH region. In contrast, PM2.5 concentrations remained steady for provinces in eastern and southeastern China (e.g., Shanghai) during the 12th FYP period, suggesting that these provinces have been less successful in controlling PM2.5 concentrations since 2011 and therefore require more efforts to effectively reduce the PM2.5 concentrations in future.

Socioeconomic inequality in childhood obesity and its determinants: a Blinder-Oaxaca decomposition.

PubMed

Kelishadi, Roya; Qorbani, Mostafa; Heshmat, Ramin; Djalalinia, Shirin; Sheidaei, Ali; Safiri, Saeid; Hajizadeh, Nastaran; Motlagh, Mohammad Esmaeil; Ardalan, Gelayol; Asayesh, Hamid; Mansourian, Morteza

Childhood obesity has become a priority health concern worldwide. Socioeconomic status is one of its main determinants. This study aimed to assess the socioeconomic inequality of obesity in children and adolescents at national and provincial levels in Iran. This multicenter cross-sectional study was conducted in 2011-2012, as part of a national school-based surveillance program performed in 40,000 students, aged 6-18-years, from urban and rural areas of 30 provinces of Iran. Using principle component analysis, the socioeconomic status of participants was categorized to quintiles. Socioeconomic status inequality in excess weight was estimated by calculating the prevalence of excess weight (i.e., overweight, generalized obesity, and abdominal obesity) across the socioeconomic status quintiles, the concentration index, and slope index of inequality. The determinants of this inequality were determined by the Oaxaca Blinder decomposition. Overall, 36,529 students completed the study (response rate: 91.32%); 50.79% of whom were boys and 74.23% were urban inhabitants. The mean (standard deviation) age was 12.14 (3.36) years. The prevalence of overweight, generalized obesity, and abdominal obesity was 11.51%, 8.35%, and 17.87%, respectively. The SII for overweight, obesity and abdominal obesity was -0.1, -0.1 and -0.15, respectively. Concentration index for overweight, generalized obesity, and abdominal obesity was positive, which indicate inequality in favor of low socioeconomic status groups. Area of residence, family history of obesity, and age were the most contributing factors to the inequality of obesity prevalence observed between the highest and lowest socioeconomic status groups. This study provides considerable information on the high prevalence of excess weight in families with higher socioeconomic status at national and provincial levels. These findings can be used for international comparisons and for healthcare policies, improving their programming by considering differences at provincial levels. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Towards malaria risk prediction in Afghanistan using remote sensing.

PubMed

Adimi, Farida; Soebiyanto, Radina P; Safi, Najibullah; Kiang, Richard

2010-05-13

Malaria is a significant public health concern in Afghanistan. Currently, approximately 60% of the population, or nearly 14 million people, live in a malaria-endemic area. Afghanistan's diverse landscape and terrain contributes to the heterogeneous malaria prevalence across the country. Understanding the role of environmental variables on malaria transmission can further the effort for malaria control programme. Provincial malaria epidemiological data (2004-2007) collected by the health posts in 23 provinces were used in conjunction with space-borne observations from NASA satellites. Specifically, the environmental variables, including precipitation, temperature and vegetation index measured by the Tropical Rainfall Measuring Mission and the Moderate Resolution Imaging Spectoradiometer, were used. Regression techniques were employed to model malaria cases as a function of environmental predictors. The resulting model was used for predicting malaria risks in Afghanistan. The entire time series except the last 6 months is used for training, and the last 6-month data is used for prediction and validation. Vegetation index, in general, is the strongest predictor, reflecting the fact that irrigation is the main factor that promotes malaria transmission in Afghanistan. Surface temperature is the second strongest predictor. Precipitation is not shown as a significant predictor, as it may not directly lead to higher larval population. Autoregressiveness of the malaria epidemiological data is apparent from the analysis. The malaria time series are modelled well, with provincial average R2 of 0.845. Although the R2 for prediction has larger variation, the total 6-month cases prediction is only 8.9% higher than the actual cases. The provincial monthly malaria cases can be modelled and predicted using satellite-measured environmental parameters with reasonable accuracy. The Third Strategic Approach of the WHO EMRO Malaria Control and Elimination Plan is aimed to develop a cost-effective surveillance system that includes forecasting, early warning and detection. The predictive and early warning capabilities shown in this paper support this strategy.

Legislation Amendment Impact on Coastal Management Pattern: An Edge of Chaos towards Punctuated Equilibrium

NASA Astrophysics Data System (ADS)

Rahmawati, Dian

2017-07-01

Management of coastal areas and small islands in Indonesia refers to a set of coordination consists of planning, utilizing, monitoring, and controlling coastal resources that are carried out by every level of the government and many related sectors. An alteration has occurred in National Act about Local Government, Act No. 23/2014, which has the implications in the coastal management territorial zone. The issues started by the shifting of the seaward delineation authorities, it is stated that from 0 - 12 Nautical Miles (nmi) are under provincial government which previously 0 - 4 nmi were under city government, and 4 - 12 nmi were under provincial government. That said, there are no territorial management that is handled by the city/local government, including permit regulation. In hierarchy, provincial government are in upper level than city government. Chaos are happening especially in the context of authorities’ management level, but to reach the main purpose of the National Act there should be an equilibrium point to normalize the situation and get the stakeholders understand the principles and keep engaged in the new form of management. This article aims to assess the impact of the National Act alteration to the sustainability of coastal management. A case study to simplify the model is in the East Java province. Theoretical framework to assess the alteration impact were related to Integrated Coastal Zone Management principles and regulatory review of the coastal zones. The analytical methods used in this article is descriptive comparative to observe the alteration in the pattern of coastal zone management variables. The comparative study was then mapped in a flow diagram to be compared on different management situation. As a result, significant changes were revealed in the pattern of the coastal management factors: (i) Authorities delineation; (ii) Planning documents; (iii) Permit system; (iv) Control; and (iii) Program Accreditation.

Provincial health accounts in Kerman, Iran: an evidence of a "mixed" healthcare financing system.

PubMed

Mehrolhassani, Mohammad Hossein; Jafari, Mohammad; Zeinali, Javad; Ansari, Mina

2014-02-01

Provincial Health Accounts (PHA) as a subset of National Health Accounts (NHA) present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC). This study aimed to examine Health Accounts in Kerman Province. The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General's office. In order to classify the data, the International Classification for Health Accounts (ICHA) method was used, in which data set was adjusted for the province. During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41) was related to private household funds, of which the Out-of-Pocket (OOP) payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs) (65.19%) was related to curative services. The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By emphasizing on Social Determinant of Health (SDH) approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor initiatives and reforms in healthcare sector.

An environmental scan of policies in support of chronic disease self-management in Canada.

PubMed

Liddy, C; Mill, K

2014-02-01

The evidence supporting chronic disease self-management warrants further attention. Our aim was to identify existing policies, strategies and frameworks that support self-management initiatives. This descriptive study was conducted as an environmental scan, consisting of an Internet search of government and other publicly available websites, and interviews with jurisdictional representatives identified through the Health Council of Canada and academic networking. We interviewed 16 representatives from all provinces and territories in Canada and found 30 publicly available and relevant provincial and national documents. Most provinces and territories have policies that incorporate aspects of chronic disease self-management. Alberta and British Columbia have the most detailed policies. Both feature primary care prominently and are not disease specific. Both also have provincial level implementation of chronic disease self-management programming. Canada's northern territories all lacked specific policies supporting chronic disease self-management despite a significant burden of disease. Engaging patients in self-management of their chronic diseases is important and effective. Although most provinces and territories have policies that incorporate aspects of chronic disease self-management, they were often embedded within other initiatives and/or policy documents framed around specific diseases or populations. This approach could limit the potential reach and effect of self-management.

The future of climate change policy by provincial government in Indonesia: A study on the vision and mission of elected governors in 2017 election

NASA Astrophysics Data System (ADS)

Kurniawan, T.

2018-03-01

The IPCC in 2015 has recognized the critical role of local governments in scaling up the adaptation of communities to climate change. The role will be executed properly if the leaders have an awareness of climate change as a strategic agenda in his administration. In the context of Indonesia, the vision and mission of a regional head can be a clue as to how he supports efforts in tackling climate change. The five-year regional development plan is an elaboration of the development agendas offered by a regional head in his vision and mission. Therefore, this paper aims to analyze the future of climate change policy in some provincial governments based on the vision and mission of the elected governors. To achieve the goal, the author employs a qualitative approach to analyze the contents of the vision and mission and their preference to climate change. The results of the study indicate that the elected governors are still not very aware of climate change and did not specify it in their vision and mission. Therefore, in the preparation of five-year regional development plan, it is necessary for some stakeholders to address and specifically mention the issues of climate change.

Environmental quality and sustainability in the province of Reggio Emilia (Italy): using multi-criteria analysis to assess and compare municipal performance.

PubMed

Ferrarini, A; Bodini, A; Becchi, M

2001-10-01

Sustainability has become an increasingly significant issue, although practical implementation remains difficult. In Italy, promoting sustainability is particularly problematic at the provincial and municipal level, where the lack of resources and expertise, and the effects of uncoordinated policies make it difficult to achieve minimum requirements to make sustainable policies operational. One essential requirement is knowledge of baseline environmental conditions in each municipality. In the province of Reggio Emilia (Northern Italy) Legambiente, an environmental association, launched an initiative called 'Ecopaese' aimed at gathering data on environmental conditions and stimulating local administrations to implement sustainable policies. To this end, the state of the environment in the 45 municipalities within the province has been monitored using 25 indicators. Their values have been used to rank the municipalities by multiple criteria analysis (MCA). The results of this comparative approach provide information about the level of sustainability attained in the province as a whole as well as in the single municipalities. It is hoped that it will provide the basis for direct action plans at the provincial level by identifying areas for remedial action, as recommended by Agenda 21, the declaration adopted by many countries attending the Rio Summit in 1992.

Social audit of provincial health services: building the community voice into planning in South Africa.

PubMed

Andersson, Neil; Matthis, Judith; Paredes, Sergio; Ngxowa, Ncumisa

2004-11-01

Social audits of health services in three South African provinces (Limpopo 2001, Gauteng 2003 and Eastern Cape 2001) demonstrated a fusion of participatory research, qualitative data collection, epidemiological surveys and analysis, and socialising of evidence for action. The social audit in each province involved the community in covering eight principles of service delivery. In the particular case of Gauteng province, householders answered a questionnaire on public perceptions of government health services. In each sentinel community, the results were returned for discussion in focus groups, made up of a sample that had answered the household questionnaire. Institutional reviews of health facilities and interviews with health workers in those facilities gave the government side of the story. Five actions came from the community-based focus groups, all accepted by the provincial government. Firstly, redesigned communication strategies will aim to reach those with lower levels of education. The second set of actions involves rebuilding the culture of care. Thirdly, the public knowledge of ways to complain was closely related to levels of public satisfaction. Leadership in the health services turned out to be a fourth area for development. And finally, related to this, is the longer-term challenge of establishing and reinforcing community consultation mechanisms.

Survey of the sevoflurane sedation status in one provincial dental clinic center for the disabled.

PubMed

Park, Chang-Hyun; Kim, Seungoh

2016-12-01

Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients.

Articulation Guide for English as a Second Language Programs in the British Columbia Post-Secondary Transfer System. Seventh Edition, 2007-2008

ERIC Educational Resources Information Center

Ministry of Advanced Education, 2007

2007-01-01

The purpose of the provincial ESL articulation process is to maintain high standards of quality in ESL programming at the public post-secondary institutions of British Columbia, as well as to facilitate access to programs at other public institutions for students wishing to transfer. Goals of the provincial articulation process are to: (1) provide…

The effects of moose (Alces alces L.) on hemlock (Tsuga canadensis (L.) Carr.) seedling establishment in Algonquin Provincial Park, Ontario, Canada

Treesearch

S. A. Vasiliauskas; L. W. Aarssen

2000-01-01

The effects of moose on eastern hemlock (Tsuga canadensis) natural seedling establishment in Algonquin Provincial Park, Ontario, were examined. Two thousand seedlings were tagged on 56 sites in 1992 and monitored for six years. Initial data collected included seedling height, browsing history and percent crown closure. At the end of the growing...

Toward Co-operation; The Development of a Provincial Voice for Adult Education in British Columbia, 1953 to 1962.

ERIC Educational Resources Information Center

Selman, Gordon R.

This paper traces the origin and development of the British Columbia provincial adult education organization during 1953-62. A series of biannual conferences for those interested in adult education began in late 1954. A more formal structure, the British Columbia Adult Education Council, was created in 1957 and continued until 1962, when it was…

Predictions on the Development Dimensions of Provincial Tourism Discipline Based on the Artificial Neural Network BP Model

ERIC Educational Resources Information Center

Yang, Yang; Hu, Jun; Lv, Yingchun; Zhang, Mu

2013-01-01

As the tourism industry has gradually become the strategic mainstay industry of the national economy, the scope of the tourism discipline has developed rigorously. This paper makes a predictive study on the development of the scope of Guangdong provincial tourism discipline based on the artificial neural network BP model in order to find out how…

The Czech Provincial Reconstruction Team: Civil-Military Teaming in Logar Province

DTIC Science & Technology

2013-03-01

which authorized ISAF forces to assist Afghan authorities in providing security through ISAF operations across Afghanistan. Alexandr Vondra, the...Ministry of Defense Alexandr Vondra, web site Provincional Reconstruction Team Logar news, the Czech Republic, http://www.mzv.cz/prtlogar/cz...Meade Avenue, Building 50 Fort Leavenworth, 1-3. 4 Handbook Afghanistan Provincial Reconstruction Team No.11-16, Feb.11 published by Center for

East Europe Report Political, Sociological and Military Affairs No. 2151

DTIC Science & Technology

1983-06-10

PRON Provincial Council, elected by the congress, whose chairman will be Piotr Boron will concern itself with that. Also elected were 31 101...holidays. The final words during the congress belonged to the newly elected chairman of the PRON Provincial Council, Prof Piotr Boron. He expressed...elected at regional conferences: Walenty Astramowicz, Marcin Blaszczak, Waldemar Brzezinski , Zenon Czarniecki, Ewa Czubaszek, Barbara Glowacka, Jan

Spatial distribution of 12 class B notifiable infectious diseases in China: A retrospective study.

PubMed

Zhu, Bin; Fu, Yang; Liu, Jinlin; Mao, Ying

2018-01-01

China is the largest developing country with a relatively developed public health system. To further prevent and eliminate the spread of infectious diseases, China has listed 39 notifiable infectious diseases characterized by wide prevalence or great harm, and classified them into classes A, B, and C, with severity decreasing across classes. Class A diseases have been almost eradicated in China, thus making class B diseases a priority in infectious disease prevention and control. In this retrospective study, we analyze the spatial distribution patterns of 12 class B notifiable infectious diseases that remain active all over China. Global and local Moran's I and corresponding graphic tools are adopted to explore and visualize the global and local spatial distribution of the incidence of the selected epidemics, respectively. Inter-correlations of clustering patterns of each pair of diseases and a cumulative summary of the high/low cluster frequency of the provincial units are also provided by means of figures and maps. Of the 12 most commonly notifiable class B infectious diseases, viral hepatitis and tuberculosis show high incidence rates and account for more than half of the reported cases. Almost all the diseases, except pertussis, exhibit positive spatial autocorrelation at the provincial level. All diseases feature varying spatial concentrations. Nevertheless, associations exist between spatial distribution patterns, with some provincial units displaying the same type of cluster features for two or more infectious diseases. Overall, high-low (unit with high incidence surrounded by units with high incidence, the same below) and high-high spatial cluster areas tend to be prevalent in the provincial units located in western and southwest China, whereas low-low and low-high spatial cluster areas abound in provincial units in north and east China. Despite the various distribution patterns of 12 class B notifiable infectious diseases, certain similarities between their spatial distributions are present. Substantial evidence is available to support disease-specific, location-specific, and disease-combined interventions. Regarding provinces that show high-high/high-low patterns of multiple diseases, comprehensive interventions targeting different diseases should be established. As to the adjacent provincial units revealing similar patterns, coordinated actions need to be taken across borders.

Quantifying the uncertainties of China's emission inventory for industrial sources: From national to provincial and city scales

NASA Astrophysics Data System (ADS)

Zhao, Yu; Zhou, Yaduan; Qiu, Liping; Zhang, Jie

2017-09-01

A comprehensive uncertainty analysis was conducted on emission inventories for industrial sources at national (China), provincial (Jiangsu), and city (Nanjing) scales for 2012. Based on various methods and data sources, Monte-Carlo simulation was applied at sector level for national inventory, and at plant level (whenever possible) for provincial and city inventories. The uncertainties of national inventory were estimated at -17-37% (expressed as 95% confidence intervals, CIs), -21-35%, -19-34%, -29-40%, -22-47%, -21-54%, -33-84%, and -32-92% for SO2, NOX, CO, TSP (total suspended particles), PM10, PM2.5, black carbon (BC), and organic carbon (OC) emissions respectively for the whole country. At provincial and city levels, the uncertainties of corresponding pollutant emissions were estimated at -15-18%, -18-33%, -16-37%, -20-30%, -23-45%, -26-50%, -33-79%, and -33-71% for Jiangsu, and -17-22%, -10-33%, -23-75%, -19-36%, -23-41%, -28-48%, -45-82%, and -34-96% for Nanjing, respectively. Emission factors (or associated parameters) were identified as the biggest contributors to the uncertainties of emissions for most source categories except iron & steel production in the national inventory. Compared to national one, uncertainties of total emissions in the provincial and city-scale inventories were not significantly reduced for most species with an exception of SO2. For power and other industrial boilers, the uncertainties were reduced, and the plant-specific parameters played more important roles to the uncertainties. Much larger PM10 and PM2.5 emissions for Jiangsu were estimated in this provincial inventory than other studies, implying the big discrepancies on data sources of emission factors and activity data between local and national inventories. Although the uncertainty analysis of bottom-up emission inventories at national and local scales partly supported the ;top-down; estimates using observation and/or chemistry transport models, detailed investigations and field measurements were recommended for further improving the emission estimates and reducing the uncertainty of inventories at local and regional scales, for both industrial and other sectors.

Justice involvement among homeless individuals with mental illnesses: Are self-report and administrative measures comparable?

PubMed

Lemieux, Ashley J; Roy, Laurence; Martin, Michael S; Latimer, Eric A; Crocker, Anne G

2017-04-01

Individuals with mental illnesses who experience homelessness have frequent interactions with the criminal justice system. Correctly measuring this involvement is essential to develop and evaluate the efficacy of intervention programs. Criminal justice involvement is typically assessed through administrative records or self-reported accounts. The aims of this study are to: 1) assess agreement between self-report and administrative data related to court appearances, and 2) identify individual characteristics that affect discrepancies between sources. Participants were 468 homeless persons with mental illness from the Montreal site of the At Home/Chez Soi randomized controlled trial, in Canada. Self-reported data was collected through an interviewer-administered questionnaire. Administrative data was collected through provincial and municipal court databases. Overall, agreement was good. Discrepancies were more common among those with a diagnosis of mood disorder with psychotic features, and those with a criminal history. Increased age and interviewer's perception of sincerity and interest increased likelihood of concordance. Generally, high agreement between self-report and administrative data suggests that either source can provide reliable information. Further work to understand predictors of discrepancies could further enhance the quality of data collected through these different sources. Copyright © 2016 Elsevier Ltd. All rights reserved.

Charting a course for cardiac electrophysiology training in Canada: the vital role of fellows in advanced cardiovascular care.

PubMed

Leather, Richard A; Gardner, Martin; Green, Martin S; Kavanagh, Katherine; Macle, Laurent; Ahmad, Kamran; Gray, Chris; Ayala-Paredes, Felix; Guerra, Peter G; O'Hara, Gilles; Essebag, Vidal; Sturmer, Marcio; Baranchuk, Adrian; Hruczkowski, Tomasz; Lahevsky, Ilan; Novak, Paul; Chakrabarti, Shanta; Harris, Louise; Gula, Lorne J; Morillo, Carlos; Sanatani, Shubhayan; Hamilton, Robert M; Gow, Robert M; Krahn, Andrew D

2013-11-01

Canadian electrophysiology (EP) fellowship programs have evolved in an ad hoc fashion over 30 years. This evolution has occurred in many fields in medicine and is natural when innovators and pioneers attract research fellows who help change the status quo from predominantly research to a predominantly clinical application and focus. Fellows not only push their supervisors and their centres into new areas of inquiry but also function at the most advanced level to encourage and teach junior trainees and to provide examples of excellence to residents, medical students, and other health professionals. Funding for fellows has never been provided in the traditional way through the Ministry of Health or the Ministry of Advanced Education. Each Canadian centre has over the years found novel ways to fund fellowship programs, and many centres have used value-adds from procurement programs. These sources of funding are eroding as provincial government agencies are beginning to assume procurement responsibilities and local flexibility to fund fellowships is lost. In particular, provincial government agencies feel that valuable financial resources should be restricted to Canadian trainees only, despite the international consensus that fellowship is an essential time for advanced trainees to travel abroad to acquire a broad a range of experience, learn new techniques and approaches, make lifelong research connections, and hopefully return home with these skills and expertise. This article summarizes the long history of EP fellowship training in Canada, as well as EP fellowship experiences at home and abroad by Canadian electrophysiologists, in an attempt to contextualize these new realities. Copyright © 2013. Published by Elsevier Inc.

HIV epidemic drivers in South Africa: A model-based evaluation of factors accounting for inter-provincial differences in HIV prevalence and incidence trends.

PubMed

Johnson, Leigh F; Dorrington, Rob E; Moolla, Haroon

2017-01-01

HIV prevalence differs substantially between South Africa's provinces, but the factors accounting for this difference are poorly understood. To estimate HIV prevalence and incidence trends by province, and to identify the epidemiological factors that account for most of the variation between provinces. A mathematical model of the South African HIV epidemic was applied to each of the nine provinces, allowing for provincial differences in demography, sexual behaviour, male circumcision, interventions and epidemic timing. The model was calibrated to HIV prevalence data from antenatal and household surveys using a Bayesian approach. Parameters estimated for each province were substituted into the national model to assess sensitivity to provincial variations. HIV incidence in 15-49-year-olds peaked between 1997 and 2003 and has since declined steadily. By mid-2013, HIV prevalence in 15-49-year-olds varied between 9.4% (95% CI: 8.5%-10.2%) in Western Cape and 26.8% (95% CI: 25.8%-27.6%) in KwaZulu-Natal. When standardising parameters across provinces, this prevalence was sensitive to provincial differences in the prevalence of male circumcision (range 12.3%-21.4%) and the level of non-marital sexual activity (range 9.5%-24.1%), but not to provincial differences in condom use (range 17.7%-21.2%), sexual mixing (range 15.9%-19.2%), marriage (range 18.2%-19.4%) or assumed HIV prevalence in 1985 (range 17.0%-19.1%). The provinces of South Africa differ in the timing and magnitude of their HIV epidemics. Most of the heterogeneity in HIV prevalence between South Africa's provinces is attributable to differences in the prevalence of male circumcision and the frequency of non-marital sexual activity.

Welfare generosity and population health among Canadian provinces: a time-series cross-sectional analysis, 1989-2009.

PubMed

Ng, Edwin; Muntaner, Carles

2015-10-01

Recent work in comparative social epidemiology uses an expenditures approach to examine the link between welfare states and population health. More work is needed that examines the impact of disaggregated expenditures within nations. This study takes advantage of provincial differences within Canada to examine the effects of subnational expenditures and a provincial welfare generosity index on population health. Time-series cross-sectional data are retrieved from the Canadian Socio-Economic Information Management System II Tables for 1989-2009 (10 provinces and 21 years=210 cases). Expenditures are measured using 20 disaggregated indicators, total expenditures and a provincial welfare generosity index, a ombined measure of significant predictors. Health is measured as total, male and female age-standardised mortality rates per 1000 deaths. Estimation techniques include the Prais-Winsten regressions with panel-corrected SEs, a first-order autocorrelation correction model, and fixed-unit effects, adjusted for alternative factors. Analyses reveal that four expenditures effectively reduce mortality rates: medical care, preventive care, other social services and postsecondary education. The provincial welfare generosity index has even larger effects. For an SD increase in the provincial welfare generosity index, total mortality rates are expected to decline by 0.44 SDs. Standardised effects are larger for women (β=-0.57, z(19)=-5.70, p<0.01) than for men (β=-0.38, z(19)=-5.59, p<0.01). Findings show that the expenditures approach can be effectively applied within the context of Canadian provinces, and that targeted spending on health, social services and education has salutary effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Making Canada a destination for medical tourists: why Canadian provinces should not try to become "Mayo Clinics of the North".

PubMed

Turner, Leigh

2012-05-01

When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.

Making Canada a Destination for Medical Tourists: Why Canadian Provinces Should Not Try to Become “Mayo Clinics of the North”

PubMed Central

Turner, Leigh

2012-01-01

When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists. PMID:23634159

[History of the Montpellier Society of Biology].

PubMed

Bali, Jean-Pierre

2017-01-01

The provincial branch of Montpellier was officially created in April, 1956, that is to say if the gestation was long since the birth of the Society of Biology of Paris in 1848. During this long period, famous personalities of Montpellier in the field of biology and physiology came to Paris to present their work, published in the "Comptes Rendus des Séances de la Société de Biologie et de ses Filiales". Following its creation as a 1901 law public association, the provincial branch organized communication sessions, followed by thematic meetings on various topics, always in the spirit of Claude Bernard on the transversality of knowledge. Through the visit of a portrait gallery of famous personalities, the main lines of the life of this provincial branch of Montpellier will be presented. © Société de Biologie, 2017.

Evaluating Childhood Vaccination Coverage of NIP Vaccines: Coverage Survey versus Zhejiang Provincial Immunization Information System

PubMed Central

Hu, Yu; Chen, Yaping

2017-01-01

Vaccination coverage in Zhejiang province, east China, is evaluated through repeated coverage surveys. The Zhejiang provincial immunization information system (ZJIIS) was established in 2004 with links to all immunization clinics. ZJIIS has become an alternative to quickly assess the vaccination coverage. To assess the current completeness and accuracy on the vaccination coverage derived from ZJIIS, we compared the estimates from ZJIIS with the estimates from the most recent provincial coverage survey in 2014, which combined interview data with verified data from ZJIIS. Of the enrolled 2772 children in the 2014 provincial survey, the proportions of children with vaccination cards and registered in ZJIIS were 94.0% and 87.4%, respectively. Coverage estimates from ZJIIS were systematically higher than the corresponding estimates obtained through the survey, with a mean difference of 4.5%. Of the vaccination doses registered in ZJIIS, 16.7% differed from the date recorded in the corresponding vaccination cards. Under-registration in ZJIIS significantly influenced the coverage estimates derived from ZJIIS. Therefore, periodic coverage surveys currently provide more complete and reliable results than the estimates based on ZJIIS alone. However, further improvement of completeness and accuracy of ZJIIS will likely allow more reliable and timely estimates in future. PMID:28696387

Second trimester abortion in Viet Nam: changing to recommended methods and improving service delivery.

PubMed

Tuyet, Hoang T D; Thuy, Phan; Trang, Huynh N K

2008-05-01

In Viet Nam, abortion has been legal up to 22 weeks of pregnancy since the 1960s. There are about one million induced abortions every year. First trimester abortion is provided at central, provincial, district and commune level, while second trimester abortion is provided only at central and provincial level. For second trimester abortion, dilatation and evacuation (D&E) has been introduced at some central and provincial hospitals, and medical abortion protocols have been included in the draft National Standards and Guidelines currently being updated. However, Kovac's, an unsafe method, is still often used at many provincial hospitals. While access to first trimester abortion services is not difficult, there are still many barriers to second trimester abortion, especially for young, unmarried women. In order to prevent unwanted pregnancies, increase access to safe abortion and improve quality of care, the Vietnamese Ministry of Health is working with others to establish national policies and developing effective models for women-friendly comprehensive abortion care, including post-abortion family planning. This paper, based on published information, interviews and observations by the second author of service delivery in 2006-2008, provides an overview of second trimester abortion services in Viet Nam and ongoing plans for improving them.

Hazardous drinking in New Zealand sportspeople: level of sporting participation and drinking motives.

PubMed

O'Brien, Kerry S; Ali, Ajmol; Cotter, James D; O'Shea, Robert P; Stannard, Steve

2007-01-01

To examine the relationship between athlete drinking motives and hazardous drinking across differing levels of sporting participation (club vs elite-provincial vs elite-international). Data from 1214 New Zealand sportspeople was collected. We assessed hazardous drinking with the WHO's AUDIT questionnaire and sportspeople's psychosocial reasons for drinking with the ADS. Level of sporting participation (club/social, provincial/state, or international/olympic level) was also assessed. Hazardous drinking behaviours differed across levels of sporting participation, with elite-provincial sportspeople showing the highest level of hazardous drinking, club/social sportspeople the next highest and elite-international sportspeople the lowest. Sportspeople who placed a greater emphasis on drinking as a reward for participating in their sports tended to display more hazardous drinking behaviours, but other ADS motives differed over level of sporting participation. Elite-provincial sportspeople and elite-international sportspeople placed more emphasis on drinking as a way to cope with the stresses of participating in their sports. A relationship between team/group motives and AUDIT scores was fully mediated by positive reinforcement motives, and partially mediated by stress-related coping motives. These findings have implications for alcohol education programs targeted at sportspeople and sport administration, and may help improve the efficacy and focus of intervention programs.

Poverty assessment using DMSP/OLS night-time light satellite imagery at a provincial scale in China

NASA Astrophysics Data System (ADS)

Wang, Wen; Cheng, Hui; Zhang, Li

2012-04-01

All countries around the world and many international bodies, including the United Nations Development Program (UNDP), United Nations Food and Agricultural Organization (FAO), the International Fund for Agricultural Development (IFAD) and the International Labor Organization (ILO), have to eliminate rural poverty. Estimation of regional poverty level is a key issue for making strategies to eradicate poverty. Most of previous studies on regional poverty evaluations are based on statistics collected typically in administrative units. This paper has discussed the deficiencies of traditional studies, and attempted to research regional poverty evaluation issues using 3-year DMSP/OLS night-time light satellite imagery. In this study, we adopted 17 socio-economic indexes to establish an integrated poverty index (IPI) using principal component analysis (PCA), which was proven to provide a good descriptor of poverty levels in 31 regions at a provincial scale in China. We also explored the relationship between DMSP/OLS night-time average light index and the poverty index using regression analysis in SPSS and a good positive linear correlation was modelled, with R2 equal to 0.854. We then looked at provincial poverty problems in China based on this correlation. The research results indicated that the DMSP/OLS night-time light data can assist analysing provincial poverty evaluation issues.

Local government alcohol policy development: case studies in three New Zealand communities

PubMed Central

Maclennan, Brett; Kypri, Kypros; Room, Robin; Langley, John

2013-01-01

Aims Local alcohol policies can be effective in reducing alcohol-related harm. The aim of this study was to examine local government responses to alcohol-related problems and identify factors influencing their development and adoption of alcohol policy. Designsettings and participants Case studies were used to examine local government responses to alcohol problems in three New Zealand communities: a rural town, a provincial city and a metropolitan city. Newspaper reports, local government documents and key informant interviews were used to collect data which were analysed using two conceptual frameworks: Kingdon's Streams model and the Stakeholder model of policy development. Measurements Key informant narratives were categorized according to the concepts of the Streams and Stakeholder models. Findings Kingdon's theoretical concepts associated with increased likelihood of policy change seemed to apply in the rural and metropolitan communities. The political environment in the provincial city, however, was not favourable to the adoption of alcohol restrictions. The Stakeholder model highlighted differences between the communities in terms of power over agenda-setting and conflict between politicians and bureaucrats over policy solutions to alcohol-related harm. These differences were reflected in the ratio of policies considered versus adopted in each location. Decisions on local alcohol policies lie ultimately with local politicians, although the policies that can be adopted by local government are restricted by central government legislation. Conclusions The adoption of policies and strategies to reduce alcohol-related harm may be better facilitated by an agenda-setting process where no ‘gate-keepers’ determine what is included into the agenda, and community mobilization efforts to create competitive local government elections around alcohol issues. Policy adoption would also be facilitated by more enabling central government legislation. PMID:23130762

The Ilocos Norte Communities against Rabies Exposure Elimination Project in the Philippines: Epidemiological and Economic Aspects.

PubMed

Valenzuela, Loida M; Jayme, Sarah I; Amparo, Anna Charinna B; Taylor, Louise H; Dela Cruz, Maria Pinky Z; Licuan, Dianne A; Gamal-Bitao, Rosebelle; Nel, Louis H

2017-01-01

As canine rabies control in Africa and Asia transitions from research-led proof-of-concept studies to government-led programs for elimination, experience and evidence of their impact and costs must be shared for the benefit of future programs. The Ilocos Norte Communities against Rabies Exposure project was implemented in April 2012 by the provincial veterinary and health offices and supported by many other partners. It delivered a comprehensive dog vaccination program and increased awareness of the need for postexposure prophylaxis (PEP), aiming to eliminate human and animal rabies cases from Ilocos Norte by 2015. Prior to the intervention, confirmed rabies cases in dogs were between 19 and 50 per year (2008-2011). The primary outcome of the project was a reduction in rabies cases in both dogs and humans to 0 in 2014 and 2015, which has subsequently been maintained. Animal bite consultations increased significantly during the project. Economic data for the dog vaccination and PEP components of the project were collated for two sites: Laoag City (an urban setting) and Dingras Municipality (a rural setting) between 2012 and 2014. The average programmatic cost of vaccinating each dog was $4.54 in Laoag City and $8.65 in Dingras, and costs fell as the project reached more dogs. The average costs of providing PEP were $69.72 per patient and $49.02 per patient for the two sites, respectively, again falling as the project reached more people. External donor contributions contributed less than 20% of dog vaccination costs and less than 1% of PEP costs. The project demonstrated that rabies elimination can be achieved in a short period of time, with concerted effort across multiple sectors. A lack of clear dog population estimates hampered interpretation of some aspects of the programme. From 2016, the provincial government has assumed complete responsibility for the programme and must now continue the vaccination and surveillance efforts. Although safeguards are in place, reintroduction from surrounding areas remains a threat, and vigilance must be maintained.

A new species of Anomognathus and new Canadian and provincial records of aleocharine rove beetles from Alberta, Canada (Coleoptera, Staphylinidae, Aleocharinae).

PubMed

Klimaszewski, Jan; Langor, David W; Hammond, H E James; Bourdon, Caroline

2016-01-01

A new species, Anomognathus athabascensis Klimaszewski, Hammond & Langor, sp. n., and nine new provincial records including one new country record of aleocharine beetles are presented for the province of Alberta. Diagnostics, images of habitus and genital structures, distribution, natural history information and new locality data are provided for the newly recorded species. A checklist for all recorded aleocharines from Alberta is updated.

A Comparison of the Democratic Security Policy in Colombia and Provincial Reconstruction Teams in Iraq

DTIC Science & Technology

2009-09-01

disrupting its activities.”18 In 2001, Pastrana broke off negotiations with the FARC. The following year, Alvaro Uribe was elected president of Colombia... Uribe Must Respect Judicial Independence,” report (October 2008), 1. 2 Robert Perito, “Special Report 152: Provincial Reconstruction Teams in Iraq... Uribe inherited two advantages from his predecessor: a popular realization that the FARC was a criminal organization with no real interest in

Taxation and regulation of uranium mining in Canada

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

NONE

1990-11-01

Government taxation and regulation have a profound influence on mineral operations. In Canada, taxation occurs both on the federal and provincial levels. In addition, both federal and provincial regulations also affect mine operations, sometimes with overlapping, or conflicting, legislation and jurisdiction. Three broad areas of regulation affect the mine production of uranium in Canada: (1) mining law or mineral rights; (2) the licensing procedures; and (3) regulation of occupational health and safety.

Need of The Ministry of Health in Federal Democratic Republic of Nepal.

PubMed

Regmi, K; Upadhyay, M; Tarin, E; Chand, P B; Uprety, S R; Lekhak, S C

2017-01-01

The constitution of Nepal provides appointing a council of ministers both at federal and provincial levels without defining portfolios. There is a political agreement that MOH will be retained at the federal level. This article draws evidences around the world to meet health needs of Nepalese, the role of provincial ministry of health and coordinating structure at district/local level. The constitution emphasises on health and pronounced in 46 articles which provides guidance for the creation of federalized governance levels at federal, provincial and local levels. Retaining ministry of health at federal level without creating devolved structure at province and local levels in health sector will create difficulty in translating the spirit of the constitution and may not be effective in addressing health issues nationally and meeting global achievements like SDGs. It is suggested to establish an elaborate health system accordingly in Nepal to ensure constitutional mandate of health as a basic human right.

Technology transfer from havana hospitals to primary care: yamila de armas, MD. Deputy director, provincial health department, havana city province.

PubMed

Giraldo, Gloria

2009-01-01

Dr Yamila de Armas has occupied an array of posts since finishing her residency in family medicine in her home province of Cienfuegos in 1992. She has served as a family doctor; polyclinic, municipal and provincial health director; medical school dean; and twice vice minister of public health. But few would doubt her toughest job is the one she has now: deputy director of the Havana City Provincial Health Department, in charge of medical services for the 2.2 million people living in Cuba's complex, sprawling capital. It was here in 2002-2003 that the program was launched to repair, refurbish and expand the country's nearly 500 community polyclinics. Key to the effort was equipping these facilities with a broader range of new and upgraded medical technology. Dr de Armas offers MEDICC Review her reflections on the results five years later.

The spirit of democracy in the implementation of public information policy at the provincial government of West Java

NASA Astrophysics Data System (ADS)

Sjoraida, D. F.; Asmawi, A.; Anwar, R. K.

2018-03-01

This article analyses the implementation of Law Number 14/2008 on Public Information Disclosure on the Provincial Government of West Java. This descriptive-qualitative study presents a discussion of the spirit of democracy in the implementation of the abovem-entioned policy in West Java Province. With the theory of policy implementation and democratization, data obtains that the element of democratic spirit in the implementation of public information policy in the government of West Java is quite thick. Therefore, there must be a massification of the implementation of the law in West Java, especially its socialization to districts/cities and society in general. It was found that the democratization of the West Java Provincial Government in implementing the Act has been well received in the community. However, the lack of publicity about this Law can reduce the strength of moral messages that exist in the law to the public.

Carbon emission trading system of China: a linked market vs. separated markets

NASA Astrophysics Data System (ADS)

Liu, Yu; Feng, Shenghao; Cai, Songfeng; Zhang, Yaxiong; Zhou, Xiang; Chen, Yanbin; Chen, Zhanming

2013-12-01

The Chinese government intends to upgrade its current provincial carbon emission trading pilots to a nationwide scheme by 2015. This study investigates two of scenarios: separated provincial markets and a linked inter-provincial market. The carbon abatement effects of separated and linked markets are compared using two pilot provinces of Hubei and Guangdong based on a computable general equilibrium model termed Sino-TERMCo2. Simulation results show that the linked market can improve social welfare and reduce carbon emission intensity for the nation as well as for the Hubei-Guangdong bloc compared to the separated market. However, the combined system also distributes welfare more unevenly and thus increases social inequity. On the policy ground, the current results suggest that a well-constructed, nationwide carbon market complemented with adequate welfare transfer policies can be employed to replace the current top-down abatement target disaggregation practice.

Meeting the Challenge of Chronic Conditions in a Sustainable Manner: Building on the AHC Learning.

PubMed

Delgado, Pedro

2016-01-01

The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) set out to achieve three aims: to create a patient- and family-centred approach to manage chronic diseases; to build a network of organizational, regional and provincial teams to share evidence-informed, systems-level solutions and work together to develop, implement and sustain improvement initiatives; and to promote the sustainability of the participating health systems. Important elements of all three aims were achieved and the synthesis provides a meaningful contribution to systems working to improve chronic care. This paper explores those achievements as well as some of the areas for improvement, including replicability, expanded outcome measurement, greater detail around patient and family engagement, increased focus on specific outcomes and processes, and further articulation of lessons learned and recommendations.

Rates of interventions in labor and birth across Canada: findings of the Canadian Maternity Experiences Survey.

PubMed

Chalmers, Beverley; Kaczorowski, Janusz; O'Brien, Beverley; Royle, Cathie

2012-09-01

Rates of interventions in labor and birth should be similar across a country if evidence-based practice guidelines are followed. This assumption is tested by comparison of some practices across the 13 provinces and territories of Canada. The objective of this study was to describe the wide provincial and territorial variations in rates of routine interventions and practices during labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. A sample of 8,244 eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census. The sample was stratified by province and territory. Computer-assisted telephone interviews were conducted with participating birth mothers by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews took an average of 45 minutes and were completed when infants were between 5 and 10 months old (9-14 mo in the territories). Completed responses were obtained from 6,421 women (78%). Provincial and territorial variations in rates of routine intervention used during labor and birth are reported. The percentage range of mothers' experience of induction (range 30.9%), epidural (53.7%), continuous electronic fetal monitoring (37.9%), and medication-free pain management during labor (40.7%) are provided, in addition to the use of episiotomy (14.1%) or "stitches" (48.3%), being in a "flat lying position" (42.2%), and having their legs in stirrups for birth (35.7%). Wide variations in the use of most of the interventions were found, ranging from 14.1 percent to 53.7 percent. Rates of intervention in labor and birth showed considerable variation across Canada, suggesting that usage is not always evidence based but may be influenced by a variety of other factors. © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.

Provincial Disparities of Growth Hormone Coverage for Young Adult Survivors of Paediatric Brain Tumours across Canada

PubMed Central

Hasan, Haroon; Howard, Fuchsia; Morgan, Steven G.; Metzger, Daniel L.; Gill, Sabrina; Johnson, Michelle; Lo, Andrea C.; Goddard, Karen

2014-01-01

Background: Young adult survivors of paediatric brain tumours (PBTs) who have been treated with radiation therapy will likely be severely growth hormone–deficient when retested at the achievement of final height. Growth hormone replacement therapy (GHRT) is administered to treat growth hormone deficiency (GHD). Public drug coverage for GHRT falls under the responsibility of provincial governments across Canada. This study sought to determine the extent of public drug coverage and cost in each Canadian province for GHRT to treat GHD during adulthood for young adult survivors of PBTs. Methods: Data were collected from provincial government resources and drug formularies from 2012–2013 on the extent of coverage for GHRT based on a clinical case scenario representative of a young adult survivor of a PBT with childhood-onset radiation-induced GHD, the ingredient cost for GHRT and the applicable provincial public drug plan cost-sharing policies. A model was then created to simulate out-of-pocket costs incurred by a young adult male and a young adult female survivor of a PBT for one year of GHRT in each province with applicable cost-sharing arrangements and levels of low annual individual total income that best represent the majority of young adult survivors of PBTs. Out-of-pocket costs were expressed as a percentage of annual income. Comparisons were made between provinces descriptively, and variation among provinces was summarized statistically. Results: Alberta, Manitoba, Ontario, Quebec, New Brunswick, and Newfoundland and Labrador provide coverage for GHD during adulthood on a case-by-case basis, while British Columbia, Saskatchewan, Nova Scotia and Prince Edward Island provide no coverage. The percentage of annual income to fund GHRT across the provinces without public coverage ranged from 14.4% to 25.5% for males and 21.5% to 38.3% for females, and with public coverage was 0.0% to 4.1% for males and 0.0% to 5.0% for females. Interpretation: There are considerable out-of-pocket costs and variation in coverage provided by provincial public drug plans to fund GHRT for young adult survivors of PBTs with GHD. The implementation of a national drug formulary could potentially prevent undue financial hardship and remove disparities resulting from variations in provincial drug plans. PMID:24726076

Spatial distribution of 12 class B notifiable infectious diseases in China: A retrospective study

PubMed Central

Zhu, Bin; Fu, Yang; Liu, Jinlin

2018-01-01

Background China is the largest developing country with a relatively developed public health system. To further prevent and eliminate the spread of infectious diseases, China has listed 39 notifiable infectious diseases characterized by wide prevalence or great harm, and classified them into classes A, B, and C, with severity decreasing across classes. Class A diseases have been almost eradicated in China, thus making class B diseases a priority in infectious disease prevention and control. In this retrospective study, we analyze the spatial distribution patterns of 12 class B notifiable infectious diseases that remain active all over China. Methods Global and local Moran’s I and corresponding graphic tools are adopted to explore and visualize the global and local spatial distribution of the incidence of the selected epidemics, respectively. Inter-correlations of clustering patterns of each pair of diseases and a cumulative summary of the high/low cluster frequency of the provincial units are also provided by means of figures and maps. Results Of the 12 most commonly notifiable class B infectious diseases, viral hepatitis and tuberculosis show high incidence rates and account for more than half of the reported cases. Almost all the diseases, except pertussis, exhibit positive spatial autocorrelation at the provincial level. All diseases feature varying spatial concentrations. Nevertheless, associations exist between spatial distribution patterns, with some provincial units displaying the same type of cluster features for two or more infectious diseases. Overall, high–low (unit with high incidence surrounded by units with high incidence, the same below) and high–high spatial cluster areas tend to be prevalent in the provincial units located in western and southwest China, whereas low–low and low–high spatial cluster areas abound in provincial units in north and east China. Conclusion Despite the various distribution patterns of 12 class B notifiable infectious diseases, certain similarities between their spatial distributions are present. Substantial evidence is available to support disease-specific, location-specific, and disease-combined interventions. Regarding provinces that show high–high/high–low patterns of multiple diseases, comprehensive interventions targeting different diseases should be established. As to the adjacent provincial units revealing similar patterns, coordinated actions need to be taken across borders. PMID:29621351

Improving End-To-End Tsunami Warning for Risk Reduction on Canada’s West Coast

DTIC Science & Technology

2015-01-01

Association Jason Wood , B.C. Ministry of Transportation and Infrastructure Steve Waugh, Bela Coola Dave Rainnie, Canadian Broadcasting Corporation...southern tip of Banks Island to the northern tip of Vancouver Island (the western limit of the eastern boundary of Cape Scot Provincial Park.) This... Scot to Port Renfrew Beginning on the eastern boundary of Cape Scot Provincial Park on the northern tip of Vancouver Island and running in a south

Special Inspector General for Iraq Reconstruction Quarterly Report to the United States Congress

DTIC Science & Technology

2012-04-30

Ministry of Provincial Aff airs sponsored a two-day decentralization conference for all non-KRG Provincial Councils and gover - nors to clarify...agriculture, tourism , health, education, housing and light construction, water resources, electricity, oil and gas, and transporta- tion. Th e assessment...2008−2011 Sector Number of Licenses Value of Licenses $ Millions Housing 155 16,250 Industry 136 6,392 Tourism 192 4,416 Trade 146 1,596 Agriculture 62

Years of life lost to incarceration: inequities between Aboriginal and non-Aboriginal Canadians.

PubMed

Owusu-Bempah, Akwasi; Kanters, Steve; Druyts, Eric; Toor, Kabirraaj; Muldoon, Katherine A; Farquhar, John W; Mills, Edward J

2014-06-11

Aboriginal representation in Canadian correctional institutions has increased rapidly over the past decade. We calculated "years of life lost to incarceration" for Aboriginal and non-Aboriginal Canadians. Incarceration data from provincial databases were used conjointly with demographic data to estimate rates of incarceration and years of life lost to provincial incarceration in (BC) and federal incarceration, by Aboriginal status. We used the Sullivan method to estimate the years of life lost to incarceration. Aboriginal males can expect to spend approximately 3.6 months in federal prison and within BC spend an average of 3.2 months in custody in the provincial penal system. Aboriginal Canadians on average spend more time in custody than their non-Aboriginal counterparts. The ratio of the Aboriginal incarceration rate to the non-Aboriginal incarceration rate ranged from a low of 4.28 in Newfoundland and Labrador to a high of 25.93 in Saskatchewan. Rates of incarceration at the provincial level were highest among Aboriginals in Manitoba with an estimated rate of 1377.6 individuals in prison per 100,000 population (95% confidence interval [CI]: 1311.8-1443.4). The results indicate substantial differences in life years lost to incarceration for Aboriginal versus non-Aboriginal Canadians. In light of on-going prison expansion in Canada, future research and policy attention should be paid to the public health consequences of incarceration, particularly among Aboriginal Canadians.

Industrial wind turbine post-construction bird and bat monitoring: A policy framework for Canada.

PubMed

Parisé, Jason; Walker, Tony R

2017-10-01

Electricity generation from wind energy has proliferated throughout North America and will continue to grow. Given Canada's expected increase in wind energy capacity, consideration of the potential adverse impacts to bird and bat populations is prudent given their sensitivity to these projects. The province of Ontario, Canada is currently the leading jurisdiction for wind energy development, and for provincial guidance on pre- and post-construction monitoring. With uniform monitoring guidance in Ontario, wind energy proponents, and third-party consultants, have developed post-construction monitoring protocols that meet provincial guidance, while also providing standardized reporting. In Atlantic Canada, post-construction guidelines vary between provinces, depending mostly on guidance from the Environment Canada Canadian Wildlife Service and relevant provincial agencies. To ensure quality post-construction monitoring results in Atlantic Canada and other provinces, it is imperative that all Canadian provinces adopt similar approaches to those employed in Ontario. This paper reviews major causes of bird and bat mortalities; reviews Canadian federal and Ontario provincial bird and bat monitoring guidelines to elucidate gaps between environmental assessment (EA) theory and application; summarizes post-construction monitoring protocols from eight bird and bat post-construction monitoring programs used in Ontario; and, proposes recommendations to support future wind development opportunities across Canada and specifically in Atlantic Canada. Copyright © 2017 Elsevier Ltd. All rights reserved.

A comparison of catastrophic injury incidence rates by Provincial Rugby Union in South Africa.

PubMed

Badenhorst, Marelise; Verhagen, Evert A L M; van Mechelen, Willem; Lambert, Michael I; Viljoen, Wayne; Readhead, Clint; Baerecke, Gail; Brown, James C

2017-07-01

To compare catastrophic injury rates between the 14 South African Provincial Rugby Unions. A prospective, population-based study conducted among all South African Unions between 2008-2014. Player numbers in each Union were obtained from South African Rugby's 2013 Census. Catastrophic injuries were analysed from BokSmart's serious injury database. Incidence rates with 95% Confidence Intervals were calculated. Catastrophic injuries (Acute Spinal Cord Injuries and catastrophic Traumatic Brain Injuries) within Unions were compared statistically, using a Poisson regression with Incidence Rate Ratios (IRR) and a 95% confidence level (p<0.05). Catastrophic injury incidence rates per Union ranged from 1.8 per 100000 players (95% CI: 0.0-6.5) to 7.9 (95% CI: 0.0-28.5) per 100000 players per year. The highest incidence rate of permanent outcome Acute Spinal Cord Injuries was reported at 7.1 per 100000 players (95% CI: 0.0-17.6). Compared to this Union, five (n=5/14, 36%) of the Unions had significantly lower incidence rates of Acute Spinal Cord Injuries. Proportionately, three Unions had more Acute Spinal Cord Injuries and three other Unions had more catastrophic Traumatic Brain Injuries. There were significant differences in the catastrophic injury incidence rates amongst the Provincial Unions in South Africa. Future studies should investigate the underlying reasons contributing to these provincial differences. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

An integrated national mortality surveillance system for death registration and mortality surveillance, China.

PubMed

Liu, Shiwei; Wu, Xiaoling; Lopez, Alan D; Wang, Lijun; Cai, Yue; Page, Andrew; Yin, Peng; Liu, Yunning; Li, Yichong; Liu, Jiangmei; You, Jinling; Zhou, Maigeng

2016-01-01

In China, sample-based mortality surveillance systems, such as the Chinese Center for Disease Control and Prevention's disease surveillance points system and the Ministry of Health's vital registration system, have been used for decades to provide nationally representative data on health status for health-care decision-making and performance evaluation. However, neither system provided representative mortality and cause-of-death data at the provincial level to inform regional health service needs and policy priorities. Moreover, the systems overlapped to a considerable extent, thereby entailing a duplication of effort. In 2013, the Chinese Government combined these two systems into an integrated national mortality surveillance system to provide a provincially representative picture of total and cause-specific mortality and to accelerate the development of a comprehensive vital registration and mortality surveillance system for the whole country. This new system increased the surveillance population from 6 to 24% of the Chinese population. The number of surveillance points, each of which covered a district or county, increased from 161 to 605. To ensure representativeness at the provincial level, the 605 surveillance points were selected to cover China's 31 provinces using an iterative method involving multistage stratification that took into account the sociodemographic characteristics of the population. This paper describes the development and operation of the new national mortality surveillance system, which is expected to yield representative provincial estimates of mortality in China for the first time.

Increasing the Rate of Living Donor Kidney Transplantation in Ontario: Donor- and Recipient-Identified Barriers and Solutions

PubMed Central

Getchell, Leah E.; McKenzie, Susan Q.; Sontrop, Jessica M.; Hayward, Jade S.; McCallum, Megan K.; Garg, Amit X.

2017-01-01

Purpose of Review: To hear from living kidney donors and recipients about what they perceive are the barriers to living donor kidney transplantation, and how patients can develop and lead innovative solutions to increase the rate and enhance the experiences of living donor kidney transplantation in Ontario. Sources of Information: A one-day patient-led workshop on March 10th, 2016 in Toronto, Ontario. Methods: Participants who were previously engaged in priority-setting exercises were invited to the meeting by patient lead, Sue McKenzie. This included primarily past kidney donors, kidney transplant recipients, as well as researchers, and representatives from renal and transplant health care organizations across Ontario. Key Findings: Four main barriers were identified: lack of education for patients and families, lack of public awareness about living donor kidney transplantation, financial costs incurred by donors, and health care system-level inefficiencies. Several novel solutions were proposed, including the development of a peer network to support and educate patients and families with kidney failure to pursue living donor kidney transplantation; consistent reimbursement policies to cover donors’ out-of-pocket expenses; and partnering with the paramedical and insurance industry to improve the efficiency of the donor and recipient evaluation process. Limitations: While there was a diversity of experience in the room from both donors and recipients, it does not provide a complete picture of the living kidney donation process for all Ontario donors and recipients. The discussion was provincially focused, and as such, some of the solutions suggested may already be in practice or unfeasible in other provinces. Implications: The creation of a patient-led provincial council was suggested as an important next step to advance the development and implementation of solutions to overcome patient-identified barriers to living donor kidney transplantation. PMID:28491334

The road maintenance funding models in Indonesia use earmarked tax

NASA Astrophysics Data System (ADS)

Gultom, Tiopan Henry M.; Tamin, Ofyar Z.; Sjafruddin, Ade; Pradono

2017-11-01

One of the solutions to get a sustainable road maintenance fund is to separate road sector revenue from other accounts, afterward, form a specific account for road maintenance. In 2001, Antameng and the Ministry of Public Works proposed a road fund model in Indonesia. Sources of the road funds proposal was a tariff formed on the nominal total tax. The policy of road funds was proposed to finance the road network maintenance of districts and provincials. This research aims to create a policy model of road maintenance funds in Indonesia using an earmarked tax mechanism. The research method is qualitative research, with data collection techniques are triangulation. Interview methods conducted were semi-structured. Strength, Weakness, Opportunities, and Threat from every part of the models were showen on the survey format. Respondents were representative of executives who involved directly against the financing of road maintenance. Validation model conducted by a discussion panel, it was called the Focus Group Discussion (FGD). The FGD involved all selected respondents. Road maintenance financing model that most appropriately applied in Indonesia was a model of revenue source use an earmarked PBBKB, PKB and PPnBM. Revenue collection mechanism was added tariff of registered vehicle tax (PKB), Vehicle Fuel Tax (PBBKB) and the luxury vehicle sales tax (PPnBM). The funds are managed at the provincial level by a public service agency.

Do physical maturity and birth date predict talent in male youth ice hockey players?

PubMed

Sherar, Lauren B; Baxter-Jones, Adam D G; Faulkner, Robert A; Russell, Keith W

2007-06-01

The aim of this study was to examine the relationships among biological maturity, physical size, relative age (i.e. birth date), and selection into a male Canadian provincial age-banded ice hockey team. In 2003, 619 male ice hockey players aged 14-15 years attended Saskatchewan provincial team selection camps, 281 of whom participated in the present study. Data from 93 age-matched controls were obtained from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-1997). During the initial selection camps, birth dates, heights, sitting heights, and body masses were recorded. Age at peak height velocity, an indicator of biological maturity, was determined in the controls and predicted in the ice hockey players. Data were analysed using one-way analysis of variance, logistic regression, and a Kolmogorov-Smirnov test. The ice hockey players selected for the final team were taller, heavier, and more mature (P < 0.05) than both the unselected players and the age-matched controls. Furthermore, age at peak height velocity predicted (P < 0.05) being selected at the first and second selection camps. The birth dates of those players selected for the team were positively skewed, with the majority of those selected being born in the months January to June. In conclusion, team selectors appear to preferentially select early maturing male ice hockey players who have birth dates early in the selection year.

Electric bicycle-related injuries presenting to a provincial hospital in China: A retrospective study.

PubMed

Zhou, Sheng Ang; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock; Liu, Nan; Pek, Pin Pin; Wang, Yi Qing; Jin, Tao; Yan, Guang Zhao; Han, Nan Nan; Li, Gang; Xu, Li Ming; Cai, Wen Wei

2017-06-01

The use of electric bicycles (EBs) in China is growing. In the present study, we aimed to characterize the pattern and outcomes of EB-related injuries presenting to a major general hospital in China.This was a retrospective review of EB-related injuries presenting to Zhejiang Provincial People's Hospital from 2008 to 2011. Cases were identified from medical records according to diagnosis codes. Data captured included demographics, injury characteristics, and outcomes.A total of 3156 cases were reviewed in the present study. There were 1460 cases of traffic accidents, of which 482 cases were EB-related (32.7%). In addition, most of EB-related cases (44.6%) belonged to the 41- to 60-year-old age group. Median injury severity score was 10. Moreover, 34.9% underwent surgery and 24.7% were admitted to intensive care unit. The median hospitalization cost was 14,269 USD. Fracture (56.5%) was the most frequently diagnosed injury type, and head was the most commonly injured body region (31.1%).EB-related injuries have become a major health concern, making up a sizeable proportion of injuries presenting to the emergency department. Therefore, it is necessary to establish injury prevention and strategies for EB road safety. Implementation of policy such as compulsory helmet use, as well as popularization of EB road safety education should be considered to improve the current situation of EB-related injuries in China.

Application of Telemedicine in Gansu Province of China.

PubMed

Cai, Hui; Wang, Hongjing; Guo, Tiankang; Bao, Guoxian

2016-01-01

Telemedicine has become an increasingly popular option for long-distance health care and continuing education. As information and communication technology is underdeveloped in China, telemedicine develops slowly. At present, telemedicine consultation centers are situated mainly in developed cities, such as Beijing, Shanghai, and Guangzhou. In many less developed regions, such as northwest China, the conditions or related facilities are not available for the application of a better medical service. Accordingly, the aim of this paper was to introduce the construction and application of a telemedicine consultation center in Gansu Province in the northwest of China. In addition, the function of Gansu Provincial Telemedicine Consultation Center on emergency public events was introduced. As a whole, there was a great demand for telemedicine service in the local medical institutions. In the telemedicine consultation center, the telemedicine equipments and regulations were needed to be improved. The function of telemedicine service was not fully used, there was a large space to be applied and the publicity of telemedicine service was important. What is important was that telemedicine played a significance role in promoting the medical policy reform, improving the medical environment and launching the remote rescue in the emergency public events. This paper emphasizes the health care challenges of poor regions, and indicates how to share the high-quality medical service of provincial hospitals effectively and how to help residents in resource-poor environments.

Survey of the sevoflurane sedation status in one provincial dental clinic center for the disabled

PubMed Central

Park, Chang-hyun

2016-01-01

Background Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. Methods We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. Results We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. Conclusions Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients. PMID:28879316

Application of Telemedicine in Gansu Province of China

PubMed Central

Cai, Hui; Wang, Hongjing

2016-01-01

Telemedicine has become an increasingly popular option for long-distance health care and continuing education. As information and communication technology is underdeveloped in China, telemedicine develops slowly. At present, telemedicine consultation centers are situated mainly in developed cities, such as Beijing, Shanghai, and Guangzhou. In many less developed regions, such as northwest China, the conditions or related facilities are not available for the application of a better medical service. Accordingly, the aim of this paper was to introduce the construction and application of a telemedicine consultation center in Gansu Province in the northwest of China. In addition, the function of Gansu Provincial Telemedicine Consultation Center on emergency public events was introduced. As a whole, there was a great demand for telemedicine service in the local medical institutions. In the telemedicine consultation center, the telemedicine equipments and regulations were needed to be improved. The function of telemedicine service was not fully used, there was a large space to be applied and the publicity of telemedicine service was important. What is important was that telemedicine played a significance role in promoting the medical policy reform, improving the medical environment and launching the remote rescue in the emergency public events. This paper emphasizes the health care challenges of poor regions, and indicates how to share the high-quality medical service of provincial hospitals effectively and how to help residents in resource-poor environments. PMID:27332894

Reducing neonatal infections in south and south central Vietnam: the views of healthcare providers

PubMed Central

2013-01-01

Background Infection causes neonatal mortality in both high and low income countries. While simple interventions to prevent neonatal infection are available, they are often poorly understood and implemented by clinicians. A basic understanding of healthcare providers' perceptions of infection control provides a platform for improving current practices. Our aim was to explore the views of healthcare providers in provincial hospitals in south and south central Vietnam to inform the design of programmes to improve neonatal infection prevention and control. Methods All fifty-four participants who attended a workshop on infection prevention and control were asked to complete an anonymous, written questionnaire identifying their priorities for improving neonatal infection prevention and control in provincial hospitals in south and south central Vietnam. Results Hand washing, exclusive breastfeeding and safe disposal of medical waste were nominated by most participants as priorities for preventing neonatal infections. Education through instructional posters and written guidelines, family contact, kangaroo-mother-care, limitation of invasive procedures and screening for maternal GBS infection were advocated by a smaller proportion of participants. Conclusions The opinions of neonatal healthcare providers at the workshop accurately reflect some of the current international recommendations for infection prevention. However, other important recommendations were not commonly identified by participants and need to be reinforced. Our results will be used to design interventions to improve infection prevention in Vietnam, and may be relevant to other low-resource countries. PMID:23570330

Environmental Management Model for Road Maintenance Operation Involving Community Participation

NASA Astrophysics Data System (ADS)

Triyono, A. R. H.; Setyawan, A.; Sobriyah; Setiono, P.

2017-07-01

Public expectations of Central Java, which is very high on demand fulfillment, especially road infrastructure as outlined in the number of complaints and community expectations tweeter, Short Mail Massage (SMS), e-mail and public reports from various media, Highways Department of Central Java province requires development model of environmental management in the implementation of a routine way by involving the community in order to fulfill the conditions of a representative, may serve road users safely and comfortably. This study used survey method with SEM analysis and SWOT with Latent Independent Variable (X), namely; Public Participation in the regulation, development, construction and supervision of road (PSM); Public behavior in the utilization of the road (PMJ) Provincial Road Service (PJP); Safety in the Provincial Road (KJP); Integrated Management System (SMT) and latent dependent variable (Y) routine maintenance of the provincial road that is integrated with the environmental management system and involve the participation of the community (MML). The result showed the implementation of routine maintenance of road conditions in Central Java province has yet to implement an environmental management by involving the community; Therefore developed environmental management model with the results of H1: Community Participation (PSM) has positive influence on the Model of Environmental Management (MML); H2: Behavior Society in Jalan Utilization (PMJ) positive effect on Model Environmental Management (MML); H3: Provincial Road Service (PJP) positive effect on Model Environmental Management (MML); H4: Safety in the Provincial Road (KJP) positive effect on Model Environmental Management (MML); H5: Integrated Management System (SMT) has positive influence on the Model of Environmental Management (MML). From the analysis obtained formulation model describing the relationship / influence of the independent variables PSM, PMJ, PJP, KJP, and SMT on the dependent variable MML as follows: MML = 0.13 + 0.07 PSM PJP PMJ + 0.09 + 0.19 + 0.48 KJP SMT + e

[Assessment of capacity for chronic noncommunicable diseases prevention and control of the Center for Disease Control and Prevention Organizations in China].

PubMed

Yin, Xiang-jun; Shi, Xiao-ming; Si, Xiang; Gao, Xin; Zhai, Yi

2010-10-01

To evaluate the capacity for noncommunicable diseases (NCDs) prevention and control in the Centers for Disease Control and Prevention (CDCs) in China. All CDCs in China, including provincial, city and county CDCs were surveyed by questionnaires designed by China CDC including resource provided, capacity and efforts for NCDs. (1) RESOURCE: 7483 staff members worked on NCDs prevention and control, only accounting for 4.0% of all the CDCs' personnel; 23.6% of the staff members devoted their time to NCDs control less than 6 months in 2008. Fundings for NCDs prevention and control only accounted for 2.29%, 1.70% and 2.69% of the total funds of provincial, city and county CDCs, respectively. (2) Capacity: The proportions of CDCs that had professional institutes of NCD at provincial, city and county level were 100.0%, 62.8% and 43.7% respectively. CDCs mainly cooperated with health agencies regarding NCDs prevention and control programs. 34.7% of the staff members had educational background of college undergraduate or higher, 12.1% had senior professional titles, 61.7% of them worked for NCDs less than 5 years. The average person-times of continuing education in NCDs were 21.90, 4.60 and 1.68 at the provincial, city and county CDCs respectively. 8.7% of the CDCs sent their staff members for advanced studies on NCDs. All provincial CDCs carried out surveillance but only 4.2% of them published reports of NCDs in all the CDCs during the past three years. (3) Efforts: 43.5% and 30.8% of the county CDCs carried out surveillance and intervention of NCDs respectively in 2008. RESOURCEs for NCDs prevention and control were quite limited in CDCs. Fundings and staff members for NCDs were not enough, compared to the heavy disease burden of NCDs. Capacity for NCDs prevention and control need to be improved.

Effect of Misalignment between Hospital and Provincial Formularies on Medication Discrepancies at Discharge: PPITS (Proton Pump Inhibitor Therapeutic Substitution) Study

PubMed Central

Chua, Doson; Chu, Eric; Lo, Angela; Lo, Melissa; Pataky, Fruzina; Tang, Linda; Bains, Ajay

2012-01-01

Background Medication discrepancies may occur on admission, transfer, or discharge from hospital. Therapeutic interchange within a drug class is a common practice in hospitals, and orders for specific proton pump inhibitors (PPIs) are often substituted with the hospital’s formulary PPI through therapeutic interchange protocols. Rabeprazole is the PPI on the formulary of the British Columbia PharmaCare program. However, different PPIs may appear on the formularies of the province’s hospitals. This misalignment and use of therapeutic interchange may lead to increased rates of medication discrepancies at the time of discharge. Objective To evaluate the effect of formulary misalignment for PPIs between St Paul’s Hospital in Vancouver and the British Columbia PharmaCare program and use of therapeutic interchange on the occurrence of medication discrepancies at discharge. Methods A cohort chart review was performed to compare discharge discrepancy rates for PPI orders between 2 periods: June 2006 to June 2008, when the same PPI appeared on the hospital and provincial formularies, and July 2008 to July 2010, when the designated PPIs differed between the hospital and provincial formularies. Data for the first study period were used to establish the baseline discharge discrepancy rate, and data for the later period represented the discharge discrepancy rate in the presence of misalignment between the hospital and PharmaCare formularies. Results The discharge discrepancy rate for PPIs was 27.3% (24/88) when the 2 formularies were aligned and 49.1% (81/165) when the formularies were misaligned. This represents an absolute increase of 21.8 percentage points in the risk of discharge discrepancies (95% confidence interval 9.8–33.9 percentage points; p < 0.001) when the hospital and provincial formularies were misaligned and the hospital’s therapeutic interchange protocol was used. Conclusions Misalignment between the PPIs specified in the hospital and provincial formularies, combined with use of therapeutic interchange, was associated with a significant increase in medication discrepancies at discharge. PMID:22529401

MO-FG-CAMPUS-IeP1-03: Establishment of Provincial Diagnostic Reference Levels in Pediatric Imaging

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

Tonkopi, E; Queen Elizabeth II Health Sciences Ctr; O’Brien, K

Purpose: To establish provincial diagnostic reference levels (DRLs) in pediatric general radiography and computed tomography (CT) as a tool for the optimization of exposure parameters. Methods: Patient dose survey was conducted in the only pediatric hospital in the province of Nova Scotia. The DRLs were established as the 75th percentile of patient dose distributions in different age groups. For routine radiography projections the DRLs were determined in terms of entrance surface dose (ESD) calculated from the radiation output measurements and the tube current-exposure time product (mAs) recorded for each examination. Patient thickness was measured by the technologist during the examination.more » The CR and DR systems, employing respectively a fixed technique and phototiming, were evaluated separately; a two-tailed Student’s t-test was used to determine the significance of differences between the means of dose distributions. The CT studies included routine head, chest, abdomen/pelvis, and chest/abdomen/pelvis. The volume CT dose index (CTDIvol) and dose-length product (DLP) values were extracted retrospectively from PACS. The correction factors based on the effective diameter of the patient were applied to the CT dosimetry metrics based on the standard phantoms. Results: The provincial DRLs were established in the following age groups: newborn, 1, 5, 10, and 15 year olds. In general radiography the DR systems demonstrated slightly lower dose than the CR for all views, however the differences were not statistically significant (p > 0.05) for all examinations. In CT the provincial DRLs were lower than the published data, except for head DLPs in all age categories. This might be due to the small patient sample size in the survey. Future work will include additional CT data collection over an extended period of time. Conclusion: Provincial DRLs were established in the dedicated children’s hospital to provide guidance for the other facilities in examinations of pediatric patients.« less

The Coast Artillery Journal. Volume 75, Number 3, May-June 1932

DTIC Science & Technology

1932-06-01

having a muzzle velocity of 1500 to 1800 f. s. and a maximumvertical range of 18,000feet. .AUfuzes were dependent upon a time powder train. ’rhe...Provincial Constabulary Commander as a guar - antee of good faith. Juan was educated by Captain H. Knauber, Provincial Commander at that time, and is now... gum ; have been decreased. The range probable errors for the 14-inch railway gun using 1460 pound projectile have been increased. These changes were

Two new species and new provincial records of aleocharine rove beetles from Newfoundland and Labrador, Canada (Coleoptera, Staphylinidae, Aleocharinae).

PubMed

Klimaszewski, Jan; Langor, David W; Bourdon, Caroline; Gilbert, Amélie; Labrecque, Myriam

2016-01-01

Two new species, Atheta pseudovestita Klimaszewski & Langor, sp. n., Silusa prettyae Klimaszewski & Langor, sp. n., are described, and 16 new provincial records, including one new country record, of aleocharine beetles are presented for the province of Newfoundland and Labrador. Diagnostics, images of habitus and genital structures, distribution, bionomics information and new locality data are provided for the newly recorded species. A new checklist with 189 species of aleocharines recorded from the province is presented.

Special Inspector General for Iraq Reconstruction. Quarterly Report and Semiannual report to the United States Congress

DTIC Science & Technology

2009-07-30

local gover - nance system” and concluding that the program needed oversight of training courses for GOI offi cials—a key component of the contract.336...of the Provincial Council boycotted a PRT gover - nance training session, and Arab-Kurd tensions spiked when the Arab governor attended a youth...director general of health. Th e federal minister of health “unfi red” him; then the provincial gover - nor issued a warrant for his arrest.583 In June

An epistemic community comes and goes? Local and national expressions of heart health promotion in Canada.

PubMed

Eyles, John; Robinson, Kerry; Elliott, Susan

2009-02-23

The objective of this study is to examine the existence and shape of epistemic communities for (heart) health promotion at the international, national, provincial and regional levels in Canada. Epistemic community may be defined as a network of experts with an authoritative claim to policy relevant knowledge in their area of expertise. An interpretive policy analysis was employed using 60 documents (48 provincial, 8 national and 4 international) and 66 interviews (from 5 Canadian provinces). These data were entered into NUD*IST, a qualitative software analysis package, to assist in the development of codes and themes. These codes form the basis of the results. A scientific and policy epistemic community was identified at the international and Canadian federal levels. Provincially and regionally, the community is present as an idea but its implementation varies between jurisdictions. The importance of economic, political and cultural factors shapes the presence and shape of the epistemic community in different jurisdictions. The community waxes and wanes but appears robust.

Using Grey Relational Analysis to Evaluate Energy Consumption, CO2 Emissions and Growth Patterns in China’s Provincial Transportation Sectors

PubMed Central

Yuan, Changwei; Liu, Hongchao

2017-01-01

The transportation sector is a complex system. Collecting transportation activity and the associated emissions data is extremely expensive and time-consuming. Grey Relational Analysis provides a viable alternative to overcome data insufficiency and gives insights for decision makers into such a complex system. In this paper, we achieved three major goals: (i) we explored the inter-relationships among transportation development, energy consumption and CO2 emissions for 30 provincial units in China; (ii) we identified the transportation development mode for each individual province; and (iii) we revealed policy implications regarding the sustainable transportation development at the provincial level. We can classify the 30 provinces into eight development modes according to the calculated Grey Relational Grades. Results also indicated that energy consumption has the largest influence on CO2 emission changes. Lastly, sustainable transportation policies were discussed at the province level according to the level of economy, urbanization and transportation energy structure. PMID:29292779

Mapping Collaborative Relations among Canada's Chronic Disease Prevention Organizations

PubMed Central

Hanusaik, Nancy; Maximova, Katerina; Paradis, Gilles; O'Loughlin, Jennifer L.

2016-01-01

In the field of chronic disease prevention (CDP), collaborations between organizations provide a vital framework for intersectoral engagement and exchanges of knowledge, expertise and resources. However, little is known about how the structures of preventive health systems actually articulate with CDP capacity and outcomes. Drawing upon data from the Public Health Organizational Capacity Study – a repeat census of all public health organizations in Canada – we used social network analysis to map and examine interorganizational collaborative relationships in the Canadian preventive health system. The network of relationships obtained through our study shows that provincial boundaries remain a major factor influencing collaborative patterns. Not only are collaborations scarce on the interprovincial level but they are also mostly limited to links with federal and multi-provincial organizations. Given this finding, federal or multi-provincial organizations that occupy central bridging positions in the Canadian CDP collaborative structure should serve as key players for shaping CDP practices in the country. PMID:27585030

Mapping Collaborative Relations among Canada's Chronic Disease Prevention Organizations.

PubMed

Contandriopoulos, Damien; Hanusaik, Nancy; Maximova, Katerina; Paradis, Gilles; O'Loughlin, Jennifer L

2016-08-01

In the field of chronic disease prevention (CDP), collaborations between organizations provide a vital framework for intersectoral engagement and exchanges of knowledge, expertise and resources. However, little is known about how the structures of preventive health systems actually articulate with CDP capacity and outcomes. Drawing upon data from the Public Health Organizational Capacity Study - a repeat census of all public health organizations in Canada - we used social network analysis to map and examine interorganizational collaborative relationships in the Canadian preventive health system. The network of relationships obtained through our study shows that provincial boundaries remain a major factor influencing collaborative patterns. Not only are collaborations scarce on the interprovincial level but they are also mostly limited to links with federal and multi-provincial organizations. Given this finding, federal or multi-provincial organizations that occupy central bridging positions in the Canadian CDP collaborative structure should serve as key players for shaping CDP practices in the country. Copyright © 2016 Longwoods Publishing.

A 3D Model Based Imdoor Navigation System for Hubei Provincial Museum

NASA Astrophysics Data System (ADS)

Xu, W.; Kruminaite, M.; Onrust, B.; Liu, H.; Xiong, Q.; Zlatanova, S.

2013-11-01

3D models are more powerful than 2D maps for indoor navigation in a complicate space like Hubei Provincial Museum because they can provide accurate descriptions of locations of indoor objects (e.g., doors, windows, tables) and context information of these objects. In addition, the 3D model is the preferred navigation environment by the user according to the survey. Therefore a 3D model based indoor navigation system is developed for Hubei Provincial Museum to guide the visitors of museum. The system consists of three layers: application, web service and navigation, which is built to support localization, navigation and visualization functions of the system. There are three main strengths of this system: it stores all data needed in one database and processes most calculations on the webserver which make the mobile client very lightweight, the network used for navigation is extracted semi-automatically and renewable, the graphic user interface (GUI), which is based on a game engine, has high performance of visualizing 3D model on a mobile display.

Specialised teams or personal continuity across inpatient and outpatient mental healthcare? Study protocol for a natural experiment.

PubMed

Giacco, Domenico; Bird, Victoria Jane; McCrone, Paul; Lorant, Vincent; Nicaise, Pablo; Pfennig, Andrea; Bauer, Michael; Ruggeri, Mirella; Lasalvia, Antonio; Moskalewicz, Jacek; Welbel, Marta; Priebe, Stefan

2015-11-25

Mental healthcare organisation can either pursue specialisation, that is, distinct clinicians and teams for inpatient and outpatient care or personal continuity of care, that is, the same primary clinician for a patient across the two settings. Little systematic research has compared these approaches. Existing studies subject have serious methodological shortcomings. Yet, costly reorganisations of services have been carried out in different European countries, inconsistently aiming to achieve specialisation or personal continuity of care. More reliable evidence is required on whether specialisation or continuity of care is more effective and cost-effective, and whether this varies for different patient groups and contexts. In a natural experiment, we aim to recruit at least 6000 patients consecutively admitted to inpatient psychiatric care in Belgium, Germany, Italy, Poland, and the UK. In each country, care approaches supporting specialisation and personal continuity coexist. Patients will be followed up at 1 year to compare outcomes, costs and experiences. Inclusion criteria are: 18 years of age or older; clinical diagnosis of psychosis, affective disorder or anxiety/somatisation disorder; sufficient command of the language of the host country; absence of cognitive deterioration and/or organic brain disorders; and capacity to provide informed consent. Ethical approval was obtained in all countries: (1) England: NRES Committee North East-Newcastle & North Tyneside (ref: 14/NE/1017); (2) Belgium: Comité d'Ethique hospitalo-facultaire des Cliniques St-Luc; (3) Germany: Ethical Board, Technische Universität Dresden; (4) Italy: Comitati Etici per la sperimentazione clinica (CESC) delle provincie di Verona, Rovigo, Vicenza, Treviso, Padova; (5) Poland: Komisja Bioetyczna przy Instytucie Psychiatrii i Neurologii w Warszawie. We will disseminate the findings through scientific publications and a study-specific website. At the end of the study, we will develop recommendations for policy decision-making, and organise national and international workshops with stakeholders. ISRCTN registry: ISRCTN40256812. 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/

Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban metropolitan area.

PubMed

King, L A; McInerney, P A

2006-11-01

Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban Metropolitan Area. The purpose of this research was to explore and describe the hospital workplace experiences that had contributed to the resignations of Registered Nurses in the Durban Metropolitan Area. The broad perspective governing this research is qualitative in nature. The researcher employed a phenomenological approach specifically because the researcher was interested in identifying, describing and understanding the subjective experiences of individual nurses at the two Private and two Provincial health care institutions selected to participate in the study - in respect of their decision (s) to resign from their employment, and/or to leave the nursing profession. Two semistructured interviews were conducted with each participant by the researcher. The researcher applied the principle of theoretical saturation and a total of fifteen participants were interviewed and thirty interviews were conducted. Experiential themes and subthemes in the data were identified by a process of meaning condensation, and the data were managed by means of a qualitative software package - NVIVO (QSR - NUD*IST). The resignations of registered nurses in the Durban Metropolitan Area were found to be linked to their respective hospital workplace experiences. These experiences related to their physical working conditions and environment and included the following: unsupportive management structures, autocratic and dehumanizing management styles, negative stereotypy of nurses and the nursing profession, lack of autonomy in the workplace, professional jealousies and fractures within the profession, sub-optimal physical working conditions and shortage of staff, equipment and lack of appropriate surgical supplies, concerns regarding occupational safety e.g. the increasing exposure of health care personnel to HIV and AIDS; lack of opportunities for promotion or continuing one's professional education, the experience of workplace violence--predominantly in the form of verbal and psychological abuse, inaccurate systems of performance assessment (Joint Performance Management, Reports, Personal Profile systems)--compounded by favouritism and racism; and inadequate remuneration. In terms of the findings of this study, the participants' lived experiences in terms of their respective hospital workplace experiences indicated that neither the maintenance factors nor the motivator factors were optimally represented, experienced or enjoyed in their respective workplaces. In terms of Herzberg's Motivator-Maintenance theory, the registered nurses who participated in this study may be described as being 'not satisfied' and 'dissatisfied' with their hospital workplace experiences, physical conditions and environment. A number of recommendations pertaining to strategies for the retention of registered nurses were made for the consideration of both Provincial and Private health care authorities, hospital management structures and the nursing profession respectively. Recommendations for further nursing research were also made.

Organizational factors, planning capacity, and integration challenges constrain provincial planning processes for nutrition in decentralizing Vietnam.

PubMed

Lapping, Karin; Frongillo, Edward A; Nguyen, Phuong H; Coates, Jennifer; Webb, Patrick; Menon, Purnima

2014-09-01

Translating national policies and guidelines into effective action at the subnational level (e.g., province or region) is a prerequisite for ensuring an impact on nutrition. In several countries, including Vietnam, the focus of this paper, this process is affected by the quality of the decentralized process of planning and action. This study examined how provincial planning processes for nutrition occurred in Vietnam during 2009 and 2010. Key goals were to understand variability in processes across provinces, identify factors that influenced the process, and assess the usefulness of the process for individuals involved in planning and action. A qualitative case-study methodology was used. Data were drawn from interviews with 51 government officials in eight provinces. The study found little variability in the planning process among these eight provinces, probably due to a planning process that was predominantly a fiscal exercise within the confines of a largely centralized structure. Respondents were almost unanimous about the main barriers: a top-down approach to planning, limited human capacity for effective planning at subnational levels, and difficulty in integrating actions from multiple sectors. Provincial-level actors were deeply dissatisfied with the nature of their role in the process. Despite the rhetoric to the contrary, too much power is probably still retained at the central level. A strategic multiyear approach is needed to strengthen the provincial planning process and address many of the key barriers identified in this study.

Downsizing of a provincial department of health--causes and implications for fiscal policy.

PubMed

Blecher, Mark

2002-06-01

To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Western Cape (WC) Department of Health (DOH). Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. The WC's share decreased from 11.8% in 1996/97 to 9.8% in 2002/03. This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002/03 and 1995/96, which suggests that financing changes are not the major cause of downsizing. Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. Substantial interprovincial inequities remain. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Disjointed fiscal and wage policy has affected health services. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal.

Cardiac arrest while exercising on mountains in national or provincial parks: A national observational study from 2012 to 2015.

PubMed

Jung, Eujene; Park, Jeong Ho; Kong, So Yeon; Hong, Ki Jeong; Ro, Young Sun; Song, Kyoung Jun; Ryu, Hyun Ho; Shin, Sang Do

2017-12-20

Previous studies on cardiac arrest in mountainous areas were focused on environmental features such as altitude and temperature. However, those are limited to factors affecting the prognosis of patients after cardiac arrest. We analyzed the cardiac arrests in national or provincial parks located in the mountains and determined the factors affecting the prognosis of patients after cardiac arrest. This study included all emergency medical service (EMS) treated patients over the age of 40 experiencing out-of-hospital cardiac arrests (OHCAs) of presumed cardiac etiology during exercise, between January 2012 and December 2015. The main focus of interest was the location of cardiac arrest occurrence (national mountain parks and provincial parks vs. other sites). The main outcome was survival to discharge and multivariable logistic regression was performed to adjust for possible confounding effects. A total 1835 patients who suffered a cardiac arrest while exercising were included. From these, 68 patients experienced cardiac arrest in national or provincial parks, and 1767 occurred in other locations. The unadjusted and adjusted ORs (95% CI) for a good cerebral performance scale (CPC) were 0.09 (0.01-0.63) and 0.08(0.01-0.56), survival discharges were 0.13(0.03-0.53) and 0.11 (0.03-0.48). Cardiac arrests occurring while exercising in the mountainous areas have worse prognosis compared to alternative locations. Copyright © 2017. Published by Elsevier Inc.

Stated Preferences of Doctors for Choosing a Job in Rural Areas of Peru: A Discrete Choice Experiment

PubMed Central

Miranda, J. Jaime; Diez-Canseco, Francisco; Lema, Claudia; Lescano, Andrés G.; Lagarde, Mylene; Blaauw, Duane; Huicho, Luis

2012-01-01

Background Doctors’ scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors’ stated preferences for rural jobs. Methods and Findings A labelled discrete choice experiment (DCE) was performed in Ayacucho, an underserved department of Peru. Preferences were assessed for three locations: rural community, Ayacucho city (Ayacucho’s capital) and other provincial capital city. Policy simulations were run to assess the effect of job attributes on uptake of a rural post. Multiple conditional logistic regressions were used to assess the relative importance of job attributes and of individual characteristics. A total of 102 doctors participated. They were five times more likely to choose a job post in Ayacucho city over a rural community (OR 4.97, 95%CI 1.2; 20.54). Salary increases and bonus points for specialization acted as incentives to choose a rural area, while increase in the number of years needed to get a permanent post acted as a disincentive. Being male and working in a hospital reduced considerably chances of choosing a rural job, while not living with a partner increased them. Policy simulations showed that a package of 75% salary increase, getting a permanent contract after two years in rural settings, and getting bonus points for further specialisation increased rural job uptake from 21% to 77%. A package of 50% salary increase plus bonus points for further specialisation would also increase the rural uptake from 21% to 52%. Conclusions Doctors are five times more likely to favour a job in urban areas over rural settings. This strong preference needs to be overcome by future policies aimed at improving the scarcity of rural doctors. Some incentives, alone or combined, seem feasible and sustainable, whilst others may pose a high fiscal burden. PMID:23272065

Guidelines for economic analysis of pharmaceutical products: a draft document for Ontario and Canada.

PubMed

Detsky, A S

1993-05-01

In Canada, provincial formulary review committees consider the effectiveness, safety, and cost of products when they derive advice for each Minister of Health. This article offers a draft set of guidelines for pharmaceutical manufacturers making submissions which include economic information, moving beyond a simple presentation of the unit price of the pharmaceutical product (e.g. price per day or course of therapy) and comparison to similar prices for alternative products. A full economic analysis compares all relevant costs and clinical outcomes of the new product with alternate therapeutic strategies for treating patients with a particular condition. The perspective of the decision maker must be clearly identified. The quality of the evidence supporting estimates of the variables incorporated in the analysis should be evaluated. Sensitivity analyses are used to assess the robustness of the qualitative conclusions. Reviewers will examine the answers to a set of 19 questions. Manufacturers can use these questions as a worksheet for preparation of an economic analysis to be incorporated in a submission. These guidelines are intended to be a starting point for further refinement, and discussion with health economists in industry and academia. Considerable flexibility will be used in reviewing documentation supporting economic analysis. Those preparing submissions should be encouraged to experiment with various approaches as part of the general development of this field and to engage provincial review committees in ongoing discussions.

Equity and efficiency of medical service systems at the provincial level of China's mainland: a comparative study from 2009 to 2014.

PubMed

Ding, Jingmei; Hu, Xuejun; Zhang, Xianzhi; Shang, Lei; Yu, Min; Chen, Huoliang

2018-02-05

The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems but minor across regions, and the score changed very little over time. More importantly, the central region held the lowest average efficiency score in the past 6 years, while the western region held the largest average efficiency score at the first 5 years, which should receive enough attention of the government and decision-makers. In practice, efficiency was related to many complicated factors, indicating that the improvement of efficiency is a complex and iterative process that requires the strong cooperation of many sectors.

Economic and toxicological aspects of copper industry in Katanga, DR Congo.

PubMed

Kalenga, John Ngoy

2013-02-01

The Katanga province is well known for its copper and cobalt reserves. During the early 2000s a boom of mining projects in Katanga brought again hope for better future to Congolese people. The paper aims to evaluate the impact of recent production recovery on economy and environment. We collected primary and secondary sources on copper industry for economic analysis. We use results of laboratory analysis conducted at the Congolese Office of Control by provincial division of environment for toxicological analysis. The comparison of heavy metal concentration to standards shows that mining industry is the main source of environmental pollution in Katanga. Copper industry generates income for economic growth of the region.

Building China's municipal healthcare performance evaluation system: a Tuscan perspective.

PubMed

Li, Hao; Barsanti, Sara; Bonini, Anna

2012-08-01

Regional healthcare performance evaluation systems can help optimize healthcare resources on regional basis and improve the performance of healthcare services provided. The Tuscany region in Italy is a good example of an institution which meets these requirements. China has yet to build such a system based on international experience. In this paper, based on comparative studies between Tuscany and China, we propose that the managing institutions in China's experimental cities can select and commission a third-party agency to, respectively, evaluate the performance of their affiliated hospitals and community health service centers. Following some features of the Tuscan experience, the Chinese municipal healthcare performance evaluation system can be built by focusing on the selection of an appropriate performance evaluation agency, the design of an adequate performance evaluation mechanism and the formulation of a complete set of laws, rules and regulations. When a performance evaluation system at city level is formed, the provincial government can extend the successful experience to other cities.

Temperature-induced effect on refractive index of graphene based on coated in-fiber Mach-Zehnder interferometer

NASA Astrophysics Data System (ADS)

Li, Li-Jun; Gong, Shun-Shun; Liu, Yi-Lin; Xu, Lin; Li, Wen-Xian; Ma, Qian; Ding, Xiao-Zhe; Guo, Xiao-Li

2017-10-01

Not Available Project supported by the Shandong Provincial Natural Science Foundation of China (Grant Nos. ZR2009AM017 and ZR2013FM019), the National Postdoctoral Project of China (Grant Nos. 200902574 and 20080441150), the Shandong Provincial Education Department Foundation of China (Grant No. J06P14), and the Opening Foundation of State Key Lab of Minning Disaster Prevention and Control Co-founded by Shandong Province and the Ministry of Science and Technology of China (Grant No. MDPC201602).

[Poison cases and types of poisons based on data obtained of patients hospitalized from 1995-2009 with acute poisoning in the second internal ward in a multi-profile provincial hospital in Tarnow].

PubMed

Lata, Stanisław; Janiszewski, Jacek

2010-01-01

The thesis presents a short history and organization of an acute poisoning centre in the1995 functioning within the internal diseases department in a multi-profile provincial hospital. The data show the number of patients treated beetween 1995-2009 an the types of toxic substances that caused poisoning. The conclusions presented refer to the role of the centre to help people suffering from acute poisoning within the city of Tarnow.

Use of a control chart to monitor diarrhoea admissions: a quality improvement exercise in West Kalimantan Provincial Hospital, Pontianak, Indonesia.

PubMed

Purba, M

1999-09-01

Data on the number of admissions for diarrhoea each week to the West Kalimantan Provincial Hospital, Pontianak, Indonesia over a 5 year period, 1992-1996, were collected. After cleaning and exclusion of extreme values, transformation was then performed to ensure that the data were free of special cause variation and normally distributed. A control chart was then constructed to provide an 'early warning' system for hospital authorities in order to facilitate the management of the epidemic and to improve patient care.

Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE): epidemiology, emerging organisms, and economics.

PubMed

Freedman, Stephen B; Lee, Bonita E; Louie, Marie; Pang, Xiao-Li; Ali, Samina; Chuck, Andy; Chui, Linda; Currie, Gillian R; Dickinson, James; Drews, Steven J; Eltorki, Mohamed; Graham, Tim; Jiang, Xi; Johnson, David W; Kellner, James; Lavoie, Martin; MacDonald, Judy; MacDonald, Shannon; Svenson, Lawrence W; Talbot, James; Tarr, Phillip; Tellier, Raymond; Vanderkooi, Otto G

2015-07-31

Each year in Canada there are 5 million episodes of acute gastroenteritis (AGE) with up to 70% attributed to an unidentified pathogen. Moreover, 90% of individuals with AGE do not seek care when ill, thus, burden of disease estimates are limited by under-diagnosing and under-reporting. Further, little is known about the pathogens causing AGE as the majority of episodes are attributed to an "unidentified" etiology. Our team has two main objectives: 1) to improve health through enhanced enteric pathogen identification; 2) to develop economic models incorporating pathogen burden and societal preferences to inform enteric vaccine decision making. This project involves multiple stages: 1) Molecular microbiology experts will participate in a modified Delphi process designed to define criteria to aid in interpreting positive molecular enteric pathogen test results. 2) Clinical data and specimens will be collected from children aged 0-18 years, with vomiting and/or diarrhea who seek medical care in emergency departments, primary care clinics and from those who contact a provincial medical advice line but who do not seek care. Samples to be collected will include stool, rectal swabs (N = 2), and an oral swab. Specimens will be tested employing 1) stool culture; 2) in-house multiplex (N = 5) viral polymerase chain reaction (PCR) panel; and 3) multi-target (N = 15) PCR commercially available array. All participants will have follow-up data collected 14 days later to enable calculation of a Modified Vesikari Scale score and a Burden of Disease Index. Specimens will also be collected from asymptomatic children during their well child vaccination visits to a provincial public health clinic. Following the completion of the initial phases, discrete choice experiments will be conducted to enable a better understanding of societal preferences for diagnostic testing and vaccine policy. All of the results obtained will be integrated into economic models. This study is collecting novel samples (e.g., oral swabs) from previously untested groups of children (e.g., those not seeking medical care) which are then undergoing extensive molecular testing to shed a new perspective on the epidemiology of AGE. The knowledge gained will provide the broadest understanding of the epidemiology of vomiting and diarrhea of children to date.

Enriching the Research Experiences for Undergraduates in Geoscience Through Student Feedback

NASA Astrophysics Data System (ADS)

Sears, R. F.; Bank, C. G.

2014-12-01

Research Experiences for Undergraduates (REU) allow students to work alongside professionals while they conduct scientific research and offer excellent opportunities to expose students to the practical components of their university education. Indeed, anecdotal evidence shows that a well-planned REU builds teamwork skills, provides a deeper understanding of the science learned in the classroom, and allows students to experience the various stages of science and thus consider wider career options. However, such evidence is difficult to measure. In this presentation we will present preliminary results from a survey of 2nd and 3rd year students who have been engaged in separate interdisciplinary projects (a geophysical survey in South Africa to assist archaeologists, and a forensic study in collaboration with the provincial police). Our before and after surveys address criteria such as students' understanding of scientific methodology, familiarity with the topic and tools for the research, expectations of the study and of themselves, and logistics of doing science. It is our hope that the student voices we present will help REU program coordinators to address limitations and establish best practices to provide the richest possible learning experience.

Search is on for most outstanding family planning workers and clinics.

PubMed

1994-01-01

The JSI Research and Training Institute, Inc, sponsored a national wide search in the Philippines commencing March 15, 1994, and ending July 7, 1994, for commendable family planning workers. The winners of the competition were selected from five categories: the best family planning volunteer worker, government family planning service worker, nongovernment family planning service worker, a government family planning clinic or center, and a nongovernment family planning clinic or center. Winners in each category were selected at the provincial or chartered city level, regional level, and national level. Nomination forms were made available in Provincial Health Offices or City Health Offices. Nomination criteria involved a worker who must have worked for at least 18 months for a family planning service agency and a volunteer who must have worked at least a year a family planning service agency in referring cases. Clinics or centers must have been in operation for at least 18 months and preferably accredited by the government. Winner selection criteria was based on the number of clients served, the commitment to family planning, and the quality of their work. Nominations were disqualified if workers were involved with performing abortions, coercing clients to practice family planning, or discriminating against any legally acceptable methods of contraception. Provincial selection of the winner occurred on July 15, 1994, and these winners were entered in the regional competition, which was set for August 1 and September 15, 1994. Regional winners competed in the national competition in November 1994. The award for each provincial winner will be a certificate, an aneroid sphygmomanometer, and a stethoscope. Provincial clinics will receive a certificate and a wall clock. Regional winners will receive a certificate and wrist watches. Regional clinics will receive a certificate and an examining table or karaoke sound system. The five national winners will receive a plaque of appreciation, a three day stay in Manila, and a round trip ticket to award ceremonies. Personnel will receive a complete medical kit, while the center will get a refrigerator. An opportunity to visit a family planning program in an Asian country will be provided to national winners.

Development and evaluation of high-resolution regional emission inventory: A case study for Jiangsu Province, China

NASA Astrophysics Data System (ADS)

Zhao, Y.; Mao, P.; Zhou, Y.

2017-12-01

Improved emission inventories are crucial for better understanding atmospheric chemistry with air quality simulation at regional or local scales. Using the bottom-up approach, a high-resolution emission inventory was developed for Jiangsu China. Key parameters for over 6000 industrial sources were investigated, compiled and revised at plant level based on various data sources and on-site survey. Totally 56 NMVOCs samples were collected in 9 chemical plants and analyzed with a gas chromatography-mass spectrometry system. Source profiles of stack emissions from synthetic rubber, acetate fiber, polyether, vinyl acetate, and ethylene production, and those of fugitive emissions from ethylene, butanol and octanol, propylene epoxide, polyethylene and glycol production were obtained. Improvement of this provincial inventory was evaluated through comparisons with other inventories at larger spatial scales, using satellite observation and air quality modeling. Three inventories (national, regional, and provincial by this work) were applied in the Models-3/Community Multi-scale Air Quality (CMAQ) system to evaluate the model performances with different emission inputs. The best agreement between available ground observation and simulation was found when the provincial inventory was applied, indicated by the smallest normalized mean bias (NMB) and normalized mean errors (NME) for all the concerned species SO2, NO2, O3 and PM2.5. The result thus implied the advantage of improved emission inventory at local scale for high resolution air quality modeling. Under the unfavorable meteorology in which horizontal and vertical movement of atmosphere was limited, the simulated SO2 concentrations at downtown Nanjing (the capital city of Jiangsu) using the regional or national inventories were much higher than observation, implying overestimated urban emissions when economy or population densities were applied to downscale or allocate the emissions. With more accurate spatial distribution of emissions at city level, the simulated concentrations using the provincial inventory were much closer to observation. For daily 1h-max O3, better performance was found for January, April and October 2012 when the provincial inventory was used, indicating the benefits of improved chemical speciation of VOC emissions.

Development and validation of an immunoperoxidase antigen detection test for improved diagnosis of rabies in Indonesia.

PubMed

Rahmadane, Ibnu; Certoma, Andrea F; Peck, Grantley R; Fitria, Yul; Payne, Jean; Colling, Axel; Shiell, Brian J; Beddome, Gary; Wilson, Susanne; Yu, Meng; Morrissy, Chris; Michalski, Wojtek P; Bingham, John; Gardner, Ian A; Allen, John D

2017-11-01

Rabies continues to pose a significant threat to human and animal health in regions of Indonesia. Indonesia has an extensive network of veterinary diagnostic laboratories and the 8 National laboratories are equipped to undertake diagnostic testing for rabies using the commercially-procured direct fluorescent antibody test (FAT), which is considered the reference (gold standard) test. However, many of the Indonesian Provincial diagnostic laboratories do not have a fluorescence microscope required to undertake the FAT. Instead, certain Provincial laboratories continue to screen samples using a chemical stain-based test (Seller's stain test, SST). This test has low diagnostic sensitivity, with negative SST-tested samples being forwarded to the nearest National laboratory resulting in significant delays for completion of testing and considerable additional costs. This study sought to develop a cost-effective and diagnostically-accurate immunoperoxidase antigen detection (RIAD) test for rabies that can be readily and quickly performed by the resource-constrained Provincial laboratories. This would reduce the burden on the National laboratories and allow more rapid diagnoses and implementation of post-exposure prophylaxis. The RIAD test was evaluated using brain smears fixed with acetone or formalin and its performance was validated by comparison with established rabies diagnostic tests used in Indonesia, including the SST and FAT. A proficiency testing panel was distributed between Provincial laboratories to assess the reproducibility of the test. The performance of the RIAD test was improved by using acetone fixation of brain smears rather than formalin fixation such that it was of equivalent accuracy to that of the World Organisation for Animal Health (OIE)-recommended FAT, with both tests returning median diagnostic sensitivity and specificity values of 0.989 and 0.993, respectively. The RIAD test and FAT had higher diagnostic sensitivity than the SST (median = 0.562). Proficiency testing using a panel of 6 coded samples distributed to 16 laboratories showed that the RIAD test had good reproducibility with an overall agreement of 97%. This study describes the successful development, characterisation and use of a novel RIAD test and its fitness for purpose as a screening test for use in provincial Indonesian veterinary laboratories.

How divergent conceptions among health and education stakeholders influence the dissemination of healthy schools in Quebec.

PubMed

Deschesnes, Marthe; Couturier, Yves; Laberge, Suzanne; Campeau, Louise

2010-12-01

This paper focuses on dissemination of the healthy schools (HS) approach in the province of Quebec, Canada. Dissemination aims at raising awareness about HS and promoting its adhesion among actors concerned with youth health in school. As HS is a joint initiative based on agreement and collaboration between health and educational sectors, the positions of stakeholders that foster cooperation between these sectors were considered to be critical to optimize its dissemination. The study's objectives were to: (i) examine and contrast the stakeholders' conceptions of HS and (ii) understand how converging and diverging stakeholders' positions on HS favourably or negatively influence its dissemination in Quebec. Gray's analytical approach to collaboration and its focus on stakeholders' mindframe about a domain served as a conceptual lens to examine stakeholders' positions regarding HS. Collection methods included documentary analysis and semi-structured interviews of 34 key internal and external informants at the provincial, regional and local levels. The results showed consensual adhesion to fundamental principles of the HS approach. However, differences in conceptualization between provincial authorities of the two sectors concerning the way to disseminate HS have been observed. These differences represented a significant barrier to HS optimal dissemination. A dialogue between the two authorities appears to be essential to arrive at a negotiated and shared conceptualization of this issue in the Quebec context, thus allowing agreements for adequate support. The results may serve as the basis for a more fruitful dialogue between actors from the two sectors, at different administrative levels.

Driving forces in energy-related CO2 emissions in south and east coastal China: commonality and variations

NASA Astrophysics Data System (ADS)

Gao, C.; Liu, Y.; Jin, J.; Wei, T.

2015-12-01

East and south coastal China contributes to respectively about 30% and 8% of CO2 emissions in China and the world, and therefore play a critical role in achieving the national goal of emission reduction to mitigate the global warming. It also serves as a benchmark for the less developed regions of China, in terms of achieving the developed world's human development standard under lower per capita emissions. We analyze the driving forces of emissions in this region and their provincial characteristics by applying the Logarithmic Mean Divisia Index method. Our findings show that emissions have been doubled during the period from 2000 to 2012, along with three and two folds increase in economy and energy consumption, respectively. This suggests a persistent lock between economic growth and emissions, even in this socioeconomically advanced region in China. Provincial difference in annual emission growth reveals three distinguished low-carbon developmental stages, owning mainly to the effectiveness of energy efficiency in reducing emission growth. This may explain why previous climate policies have aimed to reduce carbon intensity. These results indicate that targeted measures on enhancing energy efficiency in the short term and de-carbonization of both the economic and energy structure in the long term can lower the emission growth more effectively and efficiently. They also suggest that factor-driven emission reduction strategies and policies are needed in the geographically and socioeconomically similar regions.

Critical care capacity in Canada: results of a national cross-sectional study.

PubMed

Fowler, Robert A; Abdelmalik, Philip; Wood, Gordon; Foster, Denise; Gibney, Noel; Bandrauk, Natalie; Turgeon, Alexis F; Lamontagne, François; Kumar, Anand; Zarychanski, Ryan; Green, Rob; Bagshaw, Sean M; Stelfox, Henry T; Foster, Ryan; Dodek, Peter; Shaw, Susan; Granton, John; Lawless, Bernard; Hill, Andrea; Rose, Louise; Adhikari, Neill K; Scales, Damon C; Cook, Deborah J; Marshall, John C; Martin, Claudio; Jouvet, Philippe

2015-04-01

Intensive Care Units (ICUs) provide life-supporting treatment; however, resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population. We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity. After the 2009-2010 Influenza A (H1N1) pandemic, the Canadian Critical Care Trials Group surveyed all acute care hospitals in Canada to assess ICU capacity. Using a structured survey tool administered to physicians, respiratory therapists and nurses, we determined the number of ICU beds, ventilators, and the ability to provide specialized support for respiratory failure. We identified 286 hospitals with 3170 ICU beds and 4982 mechanical ventilators for critically ill patients. Twenty-two hospitals had an ICU that routinely cared for children; 15 had dedicated pediatric ICUs. Per 100,000 population, there was substantial variability in provincial capacity, with a mean of 0.9 hospitals with ICUs (provincial range 0.4-2.8), 10 ICU beds capable of providing mechanical ventilation (provincial range 6-19), and 15 invasive mechanical ventilators (provincial range 10-24). There was only moderate correlation between ventilation capacity and population size (coefficient of determination (R(2)) = 0.771). ICU resources vary widely across Canadian provinces, and during times of increased demand, may result in geographic differences in the ability to care for critically ill patients. These results highlight the need to evolve inter-jurisdictional resource sharing during periods of substantial increase in demand, and provide background data for the development of appropriate critical care capacity benchmarks.

Provincial Variation of Cochlear Implantation Surgical Volumes and Cost in Canada.

PubMed

Crowson, Matthew G; Chen, Joseph M; Tucci, Debara

2017-01-01

Objectives To investigate provincial cochlear implantation (CI) annual volume and cost trends. Study Design Database analysis. Setting National surgical volume and cost database. Subjects and Methods Aggregate-level provincial CI volumes and cost data for adult and pediatric CI surgery from 2005 to 2014 were obtained from the Canadian Institute for Health Information. Population-level aging forecast estimates were obtained from the Ontario Ministry of Finance and Statistics Canada. Linear fit, analysis of variance, and Tukey's analyses were utilized to compare variances and means. Results The national volume of annual CI procedures is forecasted to increase by <30 per year ( R 2 = 0.88). Ontario has the highest mean annual CI volume (282; 95% confidence interval, 258-308), followed by Alberta (92.0; 95% confidence interval, 66.3-118), which are significantly higher than all other provinces ( P < .05 for each). Ontario's annual CI procedure volume is forecasted to increase by <11 per year ( R 2 = 0.62). Newfoundland and Nova Scotia have the highest CI procedures per 100,000 residents as compared with all other provinces ( P < .05). Alberta, Newfoundland, and Manitoba have the highest estimated implantation cost of all provinces ( P < .05). Conclusions Historical trends of CI forecast modest national volume growth. Potential bottlenecks include provincial funding and access to surgical expertise. The proportion of older adult patients who may benefit from a CI will rise, and there may be insufficient capacity to meet this need. Delayed access to CI for pediatric patients is also a concern, given recent reports of long wait times for CI surgery.

Provincial income inequality and self‐reported health status in China during 1991–7

PubMed Central

Pei, X; Rodriguez, E

2006-01-01

Background The relationship between income inequality and health has been widely explored. Today there is some evidence suggesting that good health is inversely related to income inequality. After the economic reforms initiated in the early 1980s, China experienced one of the fastest‐growing income inequalities in the world. The state of China in the 1990s is focussed on and possible effects of provincial income inequality on individual health status are explored. Methods A multilevel regression model is used to analyse the data collected in 1991, 1993 and 1997 from nine provinces included in the China Health and Nutrition Survey. The effects of provincial Gini coefficients on self‐rated health in each year are evaluated by two logistic regressions estimating the odds ratios of reporting poor or fair health. The patterns of this effect are compared among the survey years and also among different demographic groups. Results The analyses show an independent effect of income inequality on self‐reported health after adjusting for individual and household variables. Furthermore, the effect of income distribution is not attenuated when household income and provincial gross domestic product per capita are included in the model. The results show that there is an increased risk of about 10–15% on average for fair or poor health for people living in provinces with greater income inequalities compared with provinces with modest income inequalities. Conclusions In China, societal income inequality appears to be an important determinant of population health during 1991–7. PMID:17108303

[Sources of finance for provincial occupational health services. Theory and practice].

PubMed

Rydlewska-Liszkowska, I; Jugo, B

1999-01-01

The financing of occupational health services (OHS) at the provincial level is an important issue in view of the transformation process going on not only in OHS but also in the overall health care system in Poland. New principles of financing must be now based on the cost and effects analyses. Thus, the question arises on how to provide financial means adequate to needs of health care institutions resulting from their tasks and responsibilities. The gaps existing in the information system have encouraged us to examine the situation in regard to the structure of financing and internal allocation of financial means. The objectives were formulated as follows: to characterise the sources of financial means received by provincial OHS centres; to analyse the structure of financial means derived from various sources, taking into account forms of financial administration, using the data provided by selected centres; to define the relation between the financial means being at the disposal of OHS centres and the scope of their activities; The information on the financing system was collected using a questionnaire mailed to directors of selected OHS centres. The information collected proved to be a valuable source of knowledge on the above mentioned issues as well as on how far the new system of financing associated with a new form of financial administration--an independent public health institution--has already been implemented. The studies indicated that at the present stage of the OHS system transformation it is very difficult to formulate conclusions on the financing administration in provincial OHS centres.

Public Expenditures for Mental Health Services in Canadian Provinces: Dépenses publiques pour les services de santé mentale dans les provinces canadiennes.

PubMed

Wang, Jian; Jacobs, Philip; Ohinmaa, Arto; Dezetter, Anne; Lesage, Alain

2018-04-01

The purpose of this study is to measure provincial spending for mental health services in fiscal year (FY) 2013 and to compare these cost estimates to those of FY 2003. This study estimated the costs of publicly funded provincial mental health services in FY 2013 and compared them to the estimates for FY 2003 from a previously published report. Our data were obtained from publicly accessible databases. The cross-year cost comparisons for provincial mental health services were restricted to general and psychiatric hospital inpatients, clinical payments to physicians and psychologists, and prescribed psychotropic medications. Total public expenditures were inflation adjusted and expressed per capita and as a percentage of the total provincial health spending. Total public spending for mental health and addiction programs/services was estimated to be $6.75 billion for FY 2013. The largest component of the expenditures was hospital inpatient services ($4.02 billion, 59.6%), followed by clinical payments to physicians or psychologists ($1.69 billion, 25%), and then publicly funded prescribed psychotherapeutic medications ($1.04 billion, 15.4%). Nationally, the portion of total public spending on health that was spent on mental health decreased from FY 2003 to FY 2013 from 5.4% to 4.9%. Our results reveal that mental health spending, as a proportion of public health care expenditures, decreased in the decade from FY 2003 to FY 2013. Due to large differences in how the provinces report community mental health services, we still lack a comprehensive picture of the mental health system.

The Influence of Socioeconomic Status on Selection of Anticoagulation for Atrial Fibrillation.

PubMed

Sholzberg, Michelle; Gomes, Tara; Juurlink, David N; Yao, Zhan; Mamdani, Muhammad M; Laupacis, Andreas

2016-01-01

Without third-party insurance, access to marketed drugs is limited to those who can afford to pay. We examined this phenomenon in the context of anticoagulation for patients with nonvalvular atrial fibrillation (NVAF). To determine whether, among older Ontarians receiving anticoagulation for NVAF, patients of higher socioeconomic status (SES) were more likely to switch from warfarin to dabigatran prior to its addition to the provincial formulary. Population-based retrospective cohort study of Ontarians aged 66 years and older, between 2008 and 2012. Socioeconomic status, as approximated by median neighborhood income. We identified two groups of older adults with nonvalvular atrial fibrillation: those who appeared to switch from warfarin to dabigatran after its market approval but prior to its inclusion on the provincial formulary ("switchers"), and those with ongoing warfarin use during the same interval ("non-switchers"). We studied 34,797 patients, including 3183 "switchers" and 31,614 "non-switchers". We found that higher SES was associated with switching to dabigatran prior to its coverage on the provincial formulary (p<0.0001). In multivariable analysis, subjects in the highest quintile were 50% more likely to switch to dabigatran than those in the lowest income quintile (11.3% vs. 7.3%; adjusted odds ratio 1.50; 95% CI 1.32 to 1.68). Following dabigatran's addition to the formulary, the income gradient disappeared. We documented socioeconomic inequality in access to dabigatran among patients receiving warfarin for NVAF. This disparity was eliminated following the drug's addition to the provincial formulary, highlighting the importance of timely reimbursement decisions.

The Effect of Fiscal Decentralization on Under-five Mortality in Iran: A Panel Data Analysis.

PubMed

Samadi, Ali Hussein; Keshtkaran, Ali; Kavosi, Zahra; Vahedi, Sajad

2013-11-01

Fiscal Decentralization (FD) in many cases is encouraged as a strong means of improving the efficiency and equity in the provision of public goods, such as healthcare services. This issue has urged the researchers to experimentally examine the relationship between fiscal decentralization indicators and health outcomes. In this study we examine the effect of Fiscal Decentralization in Medical Universities (FDMU) and Fiscal Decentralization in Provincial Revenues (FDPR) on Under-Five Mortality Rate (U5M) in provinces of Iran over the period between 2007 and 2010. We employed panel data methods in this article. The results of the Pesaran CD test demonstrated that most of the variables used in the analysis were cross-sectionally dependent. The Hausman test results suggested that fixed-effects were more appropriate to estimate our model. We estimated the fixed-effect model by using Driscoll-Kraay standard errors as a remedy for cross-sectional dependency. According to the findings of this research, fiscal decentralization in the health sector had a negative impact on U5M. On the other hand, fiscal decentralization in provincial revenues had a positive impact on U5M. In addition, U5M had a negative association with the density of physicians, hospital beds, and provincial GDP per capita, but a positive relationship with Gini coefficient and unemployment. The findings of our study indicated that fiscal decentralization should be emphasized in the health sector. The results suggest the need for caution in the implementation of fiscal decentralization in provincial revenues.

Impact of the pan-Canadian Oncology Drug Review on provincial concordance with respect to cancer drug funding decisions and time to funding.

PubMed

Srikanthan, A; Mai, H; Penner, N; Amir, E; Laupacis, A; Sabharwal, M; Chan, K K W

2017-10-01

The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 to address uneven drug coverage and lack of transparency with respect to the various provincial cancer drug review processes in Canada. We evaluated the impact of the pcodr on provincial decision concordance and time from Notice of Compliance (noc) to drug funding. In a retrospective review, Health Canada's Drug Product Database was used to identify new indications for cancer drugs between January 2003 and May 2014, and provincial formulary listings for drug-funding dates and decisions between 1 January 2003 and 31 December 2014 were retrieved. Multiple linear models and quantile regressions were used to evaluate changes in time to decision-making before and after the implementation of the pcodr. Agreement of decisions between provinces was evaluated using kappa statistics. Data were available from 9 provinces (all Canadian provinces except Quebec), identifying 88 indications that represented 51 unique cancer drugs. Two provinces lacked available data for all 88 indications at the time of data collection. Interprovincial concordance in drug funding decisions significantly increased after the pcodr's implementation (Brennan-Prediger coefficient: 0.54 pre-pcodr vs. 0.78 post-pcodr; p = 0.002). Nationwide, the median number of days from Health Canada's noc date to the date of funding significantly declined (to 393 days from 522 days, p < 0.001). Exploratory analyses excluding provinces with incomplete data did not change the results. After the implementation of the pcodr, greater concordance in cancer drug funding decisions between provinces and decreased time to funding decisions were observed.

Implementing the EU Floods Directive (2007/60/EC) in Austria: Flood Risk Management Plans

NASA Astrophysics Data System (ADS)

Neuhold, Clemens

2013-04-01

he Directive 2007/60/EC of the European Parliament and of the Council of 23 October 2007 on the assessment and management of flood risks (EFD) aims at the reduction of the adverse consequences for human health, the environment, cultural heritage and economic activity associated with floods in the Community. This task is to be achieved based on three process steps (1) preliminary flood risk assessment (finalised by the end of 2011), (2) flood hazard maps and flood risk maps (due 2013) and (3) flood risk management plans (due 2015). Currently, an interdisciplinary national working group is defining the methodological framework for flood risk management plans in Austria supported by a constant exchange with international bodies and experts. Referring to the EFD the components of the flood risk management plan are (excerpt): 1. conclusions of the preliminary flood risk assessment 2. flood hazard maps and flood risk maps and the conclusions that can be drawn from those maps 3. a description of the appropriate objectives of flood risk management 4. a summary of measures and their prioritisation aiming to achieve the appropriate objectives of flood risk management The poster refers to some of the major challenges in this process, such as the legal provisions, coordination of administrative units, definition of public relations, etc. The implementation of the EFD requires the harmonisation of legal instruments of various disciplines (e.g. water management, spatial planning, civil protection) enabling a coordinated - and ideally binding - practice of flood risk management. This process is highly influenced by the administrative organisation in Austria - federal, provincial and municipality level. The Austrian approach meets this organisational framework by structuring the development of the flood risk management plan into 3 time-steps: (a) federal blueprint, (b) provincial editing and (c) federal finishing as well as reporting to the European Commission. Each time-step addresses different administrative levels and spatial scales accompanied by the active involvement of interested parties.

Relationship between air quality and economic development in the provincial capital cities of China.

PubMed

Chen, Nengcheng; Xu, Lei

2017-01-01

Air pollution in China has become increasingly severe with rapid economic growth in recent years. We analyzed the relationship between the gross regional product (GRP) per capita and the Integrated Air Pollution Index (IAPI) in all the provincial capital cities in China from 2003 to 2014 and clustered them into six urban development patterns. These patterns are as follows: inverse U-shaped, N-1-shaped, N-2-shaped, U-shaped, linear decline, and stable. The majority of the provincial capitals are N-1, N-2, and U types, suggesting that the air quality is deteriorating currently or will deteriorate in the future. Meteorological conditions and industrial structure are taken into consideration when testing the environmental Kuznets curve (EKC) hypothesis between the economy and air pollutant concentration. Results show that there exists no direct relationship between three main pollutants and GRP per capita, while an inverse U-shaped relationship with the secondary industry and a U-shaped relationship with the tertiary industry. These results will be a meaningful reference for policy makers to develop policies that coordinate the environmental protection and economic development.

A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada

PubMed Central

Gagnon, Marc-André; Mintzes, Barbara; Lexchin, Joel

2016-01-01

Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians. PMID:27585023

A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada.

PubMed

Morgan, Steven G; Gagnon, Marc-André; Mintzes, Barbara; Lexchin, Joel

2016-08-01

Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians. Copyright © 2016 Longwoods Publishing.

Examining drivers of the emissions embodied in trade

PubMed Central

Wu, Leying; Wang, Zheng

2017-01-01

Emissions embodied in provincial trade (EEPT) have important effects on provinces’ responsibilities for carbon emission reductions. Based on a multi-regional input-output model, we calculated EEPT for China’s 30 provinces in 2002, 2007 and 2010, and we attempted to determine the drivers of EEPT. The results showed that, during this period, the ratio of EEPT to production-based emissions increased over time, reaching 40.24% in 2010. In consideration of its important role in carbon emissions, we analyzed the factors attributable to EEPT through structure decomposition analysis. The decomposition results showed that final demand and carbon emission intensity were two major factors in EEPT, while the final demand in other provinces and the carbon emission intensity in the local province were major factors for Emissions embodied in provincial exports and the final demand in the local province and the carbon emission intensity in other provinces were major factors for Emissions embodied in provincial imports. Regarding the differences among the EEPT of different provinces, changes in the structure of trade were the primary reason. PMID:28426769

An epistemic community comes and goes? Local and national expressions of heart health promotion in Canada

PubMed Central

Eyles, John; Robinson, Kerry; Elliott, Susan

2009-01-01

Background The objective of this study is to examine the existence and shape of epistemic communities for (heart) health promotion at the international, national, provincial and regional levels in Canada. Epistemic community may be defined as a network of experts with an authoritative claim to policy relevant knowledge in their area of expertise. Methods An interpretive policy analysis was employed using 60 documents (48 provincial, 8 national and 4 international) and 66 interviews (from 5 Canadian provinces). These data were entered into NUD*IST, a qualitative software analysis package, to assist in the development of codes and themes. These codes form the basis of the results. Results A scientific and policy epistemic community was identified at the international and Canadian federal levels. Provincially and regionally, the community is present as an idea but its implementation varies between jurisdictions. Conclusion The importance of economic, political and cultural factors shapes the presence and shape of the epistemic community in different jurisdictions. The community waxes and wanes but appears robust. PMID:19236697

Exploring work-life issues in provincial corrections settings.

PubMed

Almost, Joan; Doran, Diane; Ogilvie, Linda; Miller, Crystal; Kennedy, Shirley; Timmings, Carol; Rose, Don N; Squires, Mae; Lee, Charlotte T; Bookey-Bassett, Sue

2013-01-01

Correctional nurses hold a unique position within the nursing profession as their work environment combines the demands of two systems, corrections and health care. Nurses working within these settings must be constantly aware of security issues while ensuring that quality care is provided. The primary role of nurses in correctional health care underscores the importance of understanding nurses' perceptions about their work. The purpose of this study was to examine the work environment of nurses working in provincial correctional facilities. A mixed-methods design was used. Interviews were conducted with 13 nurses and healthcare managers (HCMs) from five facilities. Surveys were distributed to 511 nurses and HCMs in all provincial facilities across the province of Ontario, Canada. The final sample consisted of 270 nurses and 27 HCMs with completed surveys. Participants identified several key issues in their work environments, including inadequate staffing and heavy workloads, limited control over practice and scope of practice, limited resources, and challenging workplace relationships. Work environment interventions are needed to address these issues and subsequently improve the recruitment and retention of correctional nurses.

Mapping ecosystem services for land use planning, the case of Central Kalimantan.

PubMed

Sumarga, Elham; Hein, Lars

2014-07-01

Indonesia is subject to rapid land use change. One of the main causes for the conversion of land is the rapid expansion of the oil palm sector. Land use change involves a progressive loss of forest cover, with major impacts on biodiversity and global CO2 emissions. Ecosystem services have been proposed as a concept that would facilitate the identification of sustainable land management options, however, the scale of land conversion and its spatial diversity pose particular challenges in Indonesia. The objective of this paper is to analyze how ecosystem services can be mapped at the provincial scale, focusing on Central Kalimantan, and to examine how ecosystem services maps can be used for a land use planning. Central Kalimantan is subject to rapid deforestation including the loss of peatland forests and the provincial still lacks a comprehensive land use plan. We examine how seven key ecosystem services can be mapped and modeled at the provincial scale, using a variety of models, and how large scale ecosystem services maps can support the identification of options for sustainable expansion of palm oil production.

Listening to Improve: Transforming Patient Relations Measurement and Reporting in Ontario.

PubMed

Sullivan-Taylor, Patricia; Frohlich, Rachel; Singh, Anita; Greenberg, Anna

2017-01-01

Effective patient relations are important to improve patient experience and deliver better care. Policy and legislative changes in Ontario have increased accountabilities for patient relations and expanded Health Quality Ontario (HQO)'s mandate. In response, HQO collaborated with patients, health sector organizations, associations and the Ministry of Health and Long-Term Care to co-design a patient relations measurement and reporting approach. Informed by an environmental scan, broad consultations, a multi-sector survey and a provincial advisory group, the approach includes standardized patient relations indicators to support measurement and public reporting across the hospital, home and long-term care sectors. Pilot testing with 29 sites across three sectors will inform province-wide implementation.

Width-Dependent Optical Properties for Zigzag-Edge Silicene Nanoribbons

NASA Astrophysics Data System (ADS)

Bao, Hai-Rui; Liao, Wen-Hu; Zhang, Xin-Cheng; Zuo, Min

2018-01-01

Not Available Supported by the National Natural Science Foundation of China under Grant Nos 11664010 and 11264013, the Hunan Provincial Natural Science Foundation of China under Grant Nos 2017JJ2217 and 12JJ4003, the Scientific Research Fund of Hunan Provincial Education Department of China under Grant No 14B148, the Science and Technology Innovative Research Team in Higher Educational Institutions of Hunan Province, the Innovation Project for Postgraduate of Hunan Province under Grant No CX2015B549, and the Research Program of Jishou University under Grant Nos 15JDY026 and Jdy16021.

Urban-Rural and Provincial Disparities in Child Malnutrition in China.

PubMed

Wu, Yichao; Qi, Di

2016-10-01

This article investigates how the nutritional deprivation and inequality among children in China by provinces and urban/rural areas has changed over time from 1991 to 2009 using the China Health and Nutrition Survey data. The children who were undernourished in stunting and underweight have declined over years, but provincial disparities were significant and urban children performed better than the rural peers. The nutritional deprivation of children has been alleviated in China over time, but more efforts should be made by the government to improve the nutritional condition in less developed provinces and for those children who are severely undernourished.

[Accidents at work in construction workers: a peculiar utilization of the information flow INAIL-ISPESL-Regions].

PubMed

Madeo, G; Giaimo, M

2007-01-01

Indicators generally used to describe the work accident risk, i.e. frequency and injuries severity, are not suitable for comparison among single companies in order to point out those with major risk. We propose a method to draw out construction companies with higher risk of occupational injuries in the period 2003-2005 from INAIL-ISPESL-Regioni database. These companies will be object of specific interventions for the prevention, training and supervision from Prevention and Safety in Working Environments Services, from Provincial Labor Directions and Provincial Territorial Construction Committees.

Integration of mental health into primary care in Kenya

PubMed Central

JENKINS, RACHEL; KIIMA, DAVID; NJENGA, FRANK; OKONJI, MARX; KINGORA, JAMES; KATHUKU, DAMMAS; LOCK, SARAH

2010-01-01

Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes. PMID:20671901

Awareness of occupational skin disease in the service sector.

PubMed

Holness, D L; Kudla, I; Brown, J; Miller, S

2017-06-01

Occupational skin disease (OSD) is a common occupational disease. Although primary prevention strategies are known, OSDs remain prevalent in a variety of work environments including the service sector (restaurant/food services, retail/wholesale, tourism/hospitality and vehicle sales and service). To obtain information about awareness and prevention of OSD in the service sector. Focus groups and a survey were conducted with two groups. The first consisted of staff of the provincial health and safety association for the service sector and the second group comprised representatives from sector employers. Focus groups highlighted key issues to inform the survey that obtained information about perceptions of awareness and prevention of OSD and barriers to awareness and prevention. Both provincial health and safety association staff and sector employer representatives highlighted low awareness and a low level of knowledge of OSD in the sector. Barriers to awareness and prevention included a low reported incidence of OSD, low priority, lack of training materials, lack of time and cost of training, lack of management support and workplace culture. A starting point for improving prevention of OSD in the service sector is increased awareness. Identification of the barriers to awareness and prevention will help to shape an awareness campaign and prevention strategies. Building on existing experience in Europe will be important. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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

Hurlbut, David; Zhou, Ella; Bird, Lori

A strategically planned transmission network is an important source of flexibility for the integration of large-scale renewable energy (RE). Such a network can offer access to a broad geographic diversity of resources, which can reduce flexibility needs and facilitate sharing between neighboring balancing areas. This report builds on two previous NREL technical reports - Advancing System Flexibility for High Penetration Renewable Integration (Milligan et al. 2015) and 'Renewables-Friendly' Grid Development Strategies (Hurlbut et al. 2015) - which discuss various flexibility options and provide an overview of U.S. market models and grid planning. This report focuses on addressing issues with cross-regional/provincialmore » transmission in China with the aim of integrating renewable resources that are concentrated in remote areas and require inter-regional/provincial power exchange.« less

Emergency health planning.

PubMed

HARDMAN, A C

1962-12-01

This paper outlines the development of emergency health planning as a function of government. Ten provinces have the basic responsibility for the organization, preparation and operation of medical, nursing, hospital and public health services in an emergency. The Department of National Health and Welfare is responsible for the provision of advice and assistance to the provincial and municipal governments in such matters. Eight provinces have now hired full-time planning staffs to co-ordinate the health planning of the Provincial Departments of Health and Provincial Emergency Measures Organization.Four major programs have been established. The first program provides for the continuity of leadership and guidance by health authorities at the federal, provincial and municipal level. Essential records have been developed and emergency legislation prepared. This program, however, will be of little use unless health services are organized at the municipal level. In this organizational program, advice and assistance have been provided to existing hospitals and departments of health in the conduct of disaster planning. The efforts of these agencies are co-ordinated by municipal health authorities into a community disaster plan. The third program deals with information and education of the general public and the health workers. This program is designed to make the family unit self-sufficient for up to seven days and the health worker prepared to undertake his emergency role. The first three programs are directed to the organization and training of manpower; the fourth program provides the necessary supplies. From the national medical stockpile of $18,000,000, some $12,000,000 has been received, packaged for long-term storage and distributed to regional depots across the country. To ensure their ready availability in time of emergency an agreement has been reached with seven provinces for the release of hospital disaster kits.

Incapacity in Canada: review of laws and policies on research involving decisionally impaired adults.

PubMed

Wildeman, Sheila; Dunn, Laura B; Onyemelukwe, Cheluchi

2013-04-01

In Canada, as in the United States, the legal frameworks governing research involving adults incapable of providing informed consent are beset by gaps and ambiguities. In both countries, federal laws and policies relevant to the regulation of research involving decisionally incapable adults interact in complex ways with provincial or state laws. To alert researchers to these complexities and to urge law reform, this review provides a comprehensive account of the federal and provincial/ territorial legal frameworks relevant to research involving decisionally incapable adults in Canada. We identified the federal and provincial/territorial laws and policies pertinent to this review by updating previous work on substitute decision-making about research in Canada and then performing keyword searches on a Canadian legal information database (CanLii) to identify further laws of relevance. Our analysis of identified laws focused on three questions: 1) What (if any) preconditions-including permissible risk and/or benefit thresholds-are imposed on research involving persons who lack capacity to consent? 2) What provisions (if any) are in place for identification of the legally authorized representative for research decision making? and 3) What factors, if any, are stipulated as mandatory relevant considerations for the legally authorized representative's decision-making process? Across Canada, laws relating to substitute decision-making are highly variable, and often ambiguous or uncertain, on each of the matters targeted in our analysis. Researchers and research institutions should be aware of federal and provincial/territorial legal requirements for research involving persons who lack capacity to consent in Canada. The relevant governments should undertake coordinated efforts at law reform to clarify, and potentially harmonize, these requirements. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Restructuring health services in Canada: challenges for policy makers, planners and managers in the eighties.

PubMed

Crichton, A

1985-11-01

Is downsizing the latest jargon word applied to rationalization, a new concept or a different manifestation of a long term trend in health services management? At present, Canada is struggling to implement feasible reductions of expansionary pressures in the health care system. While provincial governments tend to see the issue as one of controlling chronic excess demand, federal government is still concerned to ensure free access to care on an equitable basis. Thus the problems of downsizing can be expressed by the provinces in terms of an ideological struggle with an unfeeling central government which does not understand their problems; although all know they are really about the feasibility of continuing to provide a service to meet demand. The present economic recession enables provincial governments to appeal to their voters for supporting a new way. Earlier, the appeal was to consumers to become involved in health service organization management and this policy succeeded, to a degree, where there were fluorishing grass roots communities; albeit that the service continued to be driven by professionals. Now the appeal is to taxpayers for their strong support in cost cutting. This has been more successful. Provincial governments are now permitted to 'touch the untouchables', that is to downsize the medical profession and previously sacrosanct health care institutions. They also are exploring the feasibility of introducing a two-tier system which would provide basic care for everyone and extra care for those able to pay, thus side-stepping federal conditions. By reorganizing support in this way, provincial governments have extended the range of policy choices, and two types of planning, the rational and the political, have now become combined into strategic management activity.

Arsenic methylation and skin lesions in migrant and native adult women with chronic exposure to arsenic from drinking groundwater.

PubMed

Wei, Binggan; Yu, Jiangping; Yang, Linsheng; Li, Hairong; Chai, Yuanqing; Xia, Yajuan; Wu, Kegong; Gao, Jianwei; Guo, Zhiwei; Cui, Na

2017-02-01

In order to figure out the prevalence of skin lesions and methylation capacity for migrant and native adult women in an endemic area for arsenic poisoning in Inner Mongolia, China, 207 adult women were selected for study subjects. The results showed that the prevalence of skin lesions for the external group, provincial group and native group was 36.54, 26.15 and 35.56 %, respectively. The nail content of arsenic and urinary concentrations of dimethylarsenic (DMA), monomethylarsenic (MMA) and inorganic arsenic (iAs) were significantly higher in women with skin lesions than in those without skin lesions. The highest urinary concentrations of DMA, MMA and iAs were 213.93, 45.72 and 45.01 μg/L in the native group. The arsenic methylation capacity index revealed that the external group had the greatest capacity, while the native group had the lowest. The odds ratios of skin lesions in relation to arsenic metabolites and arsenic methylation capacity varied widely among the three groups. Urinary MMA and iAs concentrations were positively associated with risk of skin lesions in the three groups of adult women, while primary and secondary methylation capacities were negatively related to risk of skin lesions in native and provincial groups. The external group might be more susceptible to MMA and iAs, while the provincial and native groups were more tolerance to MMA and iAs. Lower primary and secondary arsenic methylation capacities increased the risk of skin lesions in native and provincial groups. Moreover, higher nail arsenic concentration increased the risk of skin lesions of adult women.

[The running status of Chinese Measles Laboratory Network in 2008].

PubMed

Zhang, Yan; Xu, Song-Tao; Jiang, Xiao-Hong

2009-04-01

To evaluate the running status of Measles laboratory network of China (Hong Kong, Macao and Taiwan were excluded) in 2008. To analyze the database of Measles laboratory network surveillance of the year 2008, and the database of serologic and virologic surveillance of National laboratory for Measles in Chinese Centers for Disease Control and Prevention(CCDC), then the indicators of the running of Measles laboratory network of China were analyzed. 1, serologic surveillance: 107,160 Measles sera samples were collected between Feburary and September of 2008, and the collection rate was 77.93%; 53 778 samples were qualified and positive for IgM, the positive percentage was 50.2%. 2, Virologic surveillance: 287 Measles viral isolates were isolated by 18 provincial Measles laboratories in 2008, all were certified as H1a genotype, H1a genotype was still the predominant genotype circulating in China; 29 Rubella viral isolates were isolated by 4 provincial Measles laboratories in 2008, all belonged to 1E genotype. 3, Laboratory quality control: National laboratory for Measles passed the proficiency test and on-site review in 2008; all provincial Measles laboratories passed the sera samples recheck and proficiency test hold by National laboratory for Measles in 2008; Tianjin, Shanxi, Shandong, Zhejiang, Jilin, Hubei, provincial Measles laboratory passed the on-site review by WHO. The running status of Chinese Measles laboratory network was good in 2008, and good laboratory quality control system was also set up, methods such as specimens collection, serologic detection, cell culture and viral isolation, etc, were standardized, and applied to Chinese Measles laboratory network, and it provided important scientific basis for eradication Measles in the year of 2012.

Mental health issues from rising sea level in a remote coastal region of the Solomon Islands: current and future.

PubMed

Asugeni, James; MacLaren, David; Massey, Peter D; Speare, Rick

2015-12-01

There is little published research about mental health and climate change in the Pacific, including Solomon Islands. Solomon Islands has one of the highest rates of sea-level rise globally. The aim of this research was to document mental health issues related to sea-level rise for people in East Malaita, Solomon Islands. A cross-sectional study was carried out in six low-lying villages in East Malaita, Solomon Islands. The researcher travelled to villages by dugout canoe. In addition to quantitative, closed-ended questions, open-ended questions with villagers explored individual and community responses to rising sea level. Of 60 people asked, 57 completed the questionnaire. Of these, 90% reported having seen a change in the weather patterns. Nearly all participants reported that sea-level rise is affecting them and their family and is causing fear and worry on a personal and community level. Four themes emerged from the qualitative analysis: experience of physical impacts of climate change; worry about the future; adaptation to climate change; government response needed. Given predictions of ongoing sea-level rise in the Pacific it is essential that more research is conducted to further understand the human impact of climate change for small island states which will inform local, provincial and national-level mental health responses. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Utilisation and costs of nursing agencies in the South African public health sector, 2005–2010

PubMed Central

Rispel, Laetitia C.; Angelides, George

2014-01-01

Background Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Results Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year, a total of 5369 registered nurses could have been employed in lieu of nursing agency expenditure. Conclusions The study findings should inform workforce planning in South Africa. There is a need for uniform policies and improved management of commercial nursing agencies in the public health sector. PMID:25537936

Utilisation and costs of nursing agencies in the South African public health sector, 2005-2010.

PubMed

Rispel, Laetitia C; Angelides, George

2014-01-01

Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6-2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year, a total of 5369 registered nurses could have been employed in lieu of nursing agency expenditure. The study findings should inform workforce planning in South Africa. There is a need for uniform policies and improved management of commercial nursing agencies in the public health sector.

Feasibility study report for distribution dispatching center project 2nd stage for the Provincial Electricity Authority (PEA), Bangkok, Thailand, June 1998. Export trade information

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

NONE

The study concerns the Provincial Electricity Authority, a state agency within the Ministry of Interior that supplies electricity to 73 of Thailand`s provinces. The primary objective of this study is to help increase the ability of the Authority to meet the rapidly increasing demand for electric power within the Kingdom of Thailand in a reliable, safe and economic manner. This is Volume 1 and it consists of the following: (1) introduction; (2) assessment; (3) conceptual design; (4) economic and financial evaluation; (5) project plan; (6) Thailand impact; (7) industry review; (8) conclusion; and appendices.

Thermal Entanglement in the Pure Dzyaloshinskii-Moriya Model with Magnetic Field

NASA Astrophysics Data System (ADS)

Li, Da-Chuang; Li, Xiao-Man; Li, Hu; Tao, Rui; Yang, Ming; Cao, Zhuo-Liang

2015-05-01

Not Available Supported by the National Natural Science Foundation of China under Grant Nos 11204061, 11374085, 11274010 and 11204002, the Anhui Provincial Natural Science Foundation under Grant No 1408085MA16, the China Postdoctoral Science Foundation under Grant No 20110490825, the Key Project of the Ministry of Education of China under Grant No 211080, the Key Program of the Education Department of Anhui Province under Grant Nos KJ2012A244 and KJ2012A020, the Program of Hefei Normal University under Grant Nos 2012jd17, 2013jd03 and 2014136KJC02, and the Excellent Young Talents Support Plan of Anhui Provincial Universities.

Authorities and organizations involved with geographic names - 1989: United States, Canada, Mexico

USGS Publications Warehouse

Orth, Donald J.

1989-01-01

There is a need for accurate and standard geographic names usage in all levels of government, industry, commerce, communications, education, and research. There is also a growing number of organizations in North America that are, fully or partly, involved in the scholarly study of geographic names. This report is a list of official national, State/Provincial, and regional provincial authorities concerned with name standardization, and of organizations involved with the study of geographic names, in the United States, Canada, and Mexico. The appendixes are copies of documents that provide additional information about the organization, policies, procedures, and publications of some of these organizations.

Provincial geology and the Industrial Revolution.

PubMed

Veneer, Leucha

2006-06-01

In the early nineteenth century, geology was a new but rapidly growing science, in the provinces and among the gentlemen scientists of London, Oxford and Cambridge. Industry, particularly mining, often motivated local practical geologists, and the construction of canals and railways exposed the strata for all to see. The most notable of the early practical men of geology was the mineral surveyor William Smith; his geological map of England and Wales, published in 1815, was the first of its kind. He was not alone. The contributions of professional men, and the provincial societies with which they were connected, are sometimes underestimated in the history of geology.

Electricity reform and sustainable development in China

NASA Astrophysics Data System (ADS)

Williams, James H.; Kahrl, Fredrich

2008-10-01

Reducing the environmental impact of supplying electricity is a key to China's sustainable development, and a focus of both domestic and international concerns with greenhouse gas emissions. The environmental performance of the electricity sector is strongly affected by its institutional arrangements: regulatory frameworks, wholesale markets, pricing mechanisms, planning and coordination, and enforcement and incentive mechanisms. These arrangements are set to change as electricity reforms inaugurated in 2002, but sidetracked by several years of supply shortages, are being resumed. In this paper we examine the impact of electricity reform on environmental sustainability by analyzing case studies of four environmental initiatives in the electricity sector: retirement of inefficient generators, installation of pollution control equipment, renewable energy development, and efforts to promote energy efficiency. We find that implementation of these policies falls short of objectives for two main underlying reasons: conflicting priorities between central and provincial governments, and ineffective regulation. Sustainability will be best served not by redoubling short-term supply-oriented, market-based reforms, but by better aligning central and provincial government incentives, and by developing competent, independent regulation at the provincial level. China's central government and sub-national governments in industrialized countries can both contribute to the latter goal.

Study of ecological compensation in complex river networks based on a mathematical model.

PubMed

Wang, Xiao; Shen, Chunqi; Wei, Jun; Niu, Yong

2018-05-31

Transboundary water pollution has resulted in increasing conflicts between upstream and downstream administrative districts. Ecological compensation is an efficient means of restricting pollutant discharge and achieving sustainable utilization of water resources. The tri-provincial region of Taihu Basin is a typical river networks area. Pollutant flux across provincial boundaries in the Taihu Basin is hard to determine due to complex hydrologic and hydrodynamic conditions. In this study, ecological compensation estimation for the tri-provincial area based on a mathematical model is investigated for better environmental management. River discharge and water quality are predicted with the one-dimensional mathematical model and validated with field measurements. Different ecological compensation criteria are identified considering the notable regional discrepancy in sewage treatment costs. Finally, the total compensation payment is estimated. Our study indicates that Shanghai should be the receiver of payment from both Jiangsu and Zhenjiang in 2013, with 305 million and 300 million CNY, respectively. Zhejiang also contributes more pollutants to Jiangsu, and the compensation to Jiangsu is estimated as 9.3 million CNY. The proposed ecological compensation method provides an efficient way for solving the transboundary conflicts in a complex river networks area and is instructive for future policy-making.

[The activity of the State Sanitary Inspectorate after implementation of the act of January, 23 2009 "Amending certain acts regarding reorganization and redistribution of competences of the public administration at the provincial level"].

PubMed

Rudaś, Dariusz; Skórczewski, Krzysztof

2011-01-01

The restructuring of the State Sanitary Inspectorate was determined by the need to adjust the existing system to the new structure- and task-oriented standards introduced by the administrative reforms at the provincial level. This brought about a lot of changes in the way State County Sanitary Inspectors operate. For first few months after the enforcement of the Act of January 23.2009 amending certain acts regarding reorganization and redistribution of competences of the public administration at the provincial level (Journal of Laws, No. 92, item. 753, 2009) brought about a lot of ambiguities and expectations. Such unresolved issues are typical for the initial or transition period after implementation of a new law. The approach to the operation of the State Sanitary Inspectorate at the county level depicted in the article lays the emphasis on the challenges in the legal and task-oriented domain that arose after coming into force of the aforementioned amendment. By way of conclusion, the authors of the article briefly summaries the practical outcomes of the transformations undergone by the State Sanitary Inspectorate at the county level.

A simple simulation model as a tool to assess alternative health care provider payment reform options in Vietnam.

PubMed

Cashin, Cheryl; Phuong, Nguyen Khanh; Shain, Ryan; Oanh, Tran Thi Mai; Thuy, Nguyen Thi

2015-01-01

Vietnam is currently considering a revision of its 2008 Health Insurance Law, including the regulation of provider payment methods. This study uses a simple spreadsheet-based, micro-simulation model to analyse the potential impacts of different provider payment reform scenarios on resource allocation across health care providers in three provinces in Vietnam, as well as on the total expenditure of the provincial branches of the public health insurance agency (Provincial Social Security [PSS]). The results show that currently more than 50% of PSS spending is concentrated at the provincial level with less than half at the district level. There is also a high degree of financial risk on district hospitals with the current fund-holding arrangement. Results of the simulation model show that several alternative scenarios for provider payment reform could improve the current payment system by reducing the high financial risk currently borne by district hospitals without dramatically shifting the current level and distribution of PSS expenditure. The results of the simulation analysis provided an empirical basis for health policy-makers in Vietnam to assess different provider payment reform options and make decisions about new models to support health system objectives.

Getting the big picture: the macro-politics of information system development (and failure) in a Canadian hospital.

PubMed

Balka, E

2003-01-01

While recognized that global actors influence health information system design, studies of health informatics have largely focused on micro politics of technology design and implementation. Here a problematic patient care information system (PCIS) is discussed in relation to federal and provincial policies and corporate strategies to demonstrate that our understanding of health informatics can be enhanced by linking micro studies of health informatics to larger macro contexts. Interviews and document study. Although the extent to which federal initiatives influenced (or failed to influence) provincial and hospital initiatives remains debateable, events initiated at one level (the hospital's decision to implement software, initiated at the organizational level) are influenced (perhaps indirectly) by developments in other contexts (federal/macro changes gave an initiative more weight; provincial initiatives such as the Labour Accord altered the industrial relations environment in which system development occurred). Micro-studies of work practice, invaluable in addressing interactions between technologies, users and work practices, often fail to account for the historic reach of global actors, although it is often these historic circumstances that contribute to present-day interactions between user, information system and organization, and that find expression - often indirectly - in daily work practices.

Provincialization of terrestrial faunas following the end-Permian mass extinction.

PubMed

Sidor, Christian A; Vilhena, Daril A; Angielczyk, Kenneth D; Huttenlocker, Adam K; Nesbitt, Sterling J; Peecook, Brandon R; Steyer, J Sébastien; Smith, Roger M H; Tsuji, Linda A

2013-05-14

In addition to their devastating effects on global biodiversity, mass extinctions have had a long-term influence on the history of life by eliminating dominant lineages that suppressed ecological change. Here, we test whether the end-Permian mass extinction (252.3 Ma) affected the distribution of tetrapod faunas within the southern hemisphere and apply quantitative methods to analyze four components of biogeographic structure: connectedness, clustering, range size, and endemism. For all four components, we detected increased provincialism between our Permian and Triassic datasets. In southern Pangea, a more homogeneous and broadly distributed fauna in the Late Permian (Wuchiapingian, ∼257 Ma) was replaced by a provincial and biogeographically fragmented fauna by Middle Triassic times (Anisian, ∼242 Ma). Importantly in the Triassic, lower latitude basins in Tanzania and Zambia included dinosaur predecessors and other archosaurs unknown elsewhere. The recognition of heterogeneous tetrapod communities in the Triassic implies that the end-Permian mass extinction afforded ecologically marginalized lineages the ecospace to diversify, and that biotic controls (i.e., evolutionary incumbency) were fundamentally reset. Archosaurs, which began diversifying in the Early Triassic, were likely beneficiaries of this ecological release and remained dominant for much of the later Mesozoic.

Provincialization of terrestrial faunas following the end-Permian mass extinction

PubMed Central

Sidor, Christian A.; Vilhena, Daril A.; Angielczyk, Kenneth D.; Huttenlocker, Adam K.; Nesbitt, Sterling J.; Peecook, Brandon R.; Steyer, J. Sébastien; Smith, Roger M. H.; Tsuji, Linda A.

2013-01-01

In addition to their devastating effects on global biodiversity, mass extinctions have had a long-term influence on the history of life by eliminating dominant lineages that suppressed ecological change. Here, we test whether the end-Permian mass extinction (252.3 Ma) affected the distribution of tetrapod faunas within the southern hemisphere and apply quantitative methods to analyze four components of biogeographic structure: connectedness, clustering, range size, and endemism. For all four components, we detected increased provincialism between our Permian and Triassic datasets. In southern Pangea, a more homogeneous and broadly distributed fauna in the Late Permian (Wuchiapingian, ∼257 Ma) was replaced by a provincial and biogeographically fragmented fauna by Middle Triassic times (Anisian, ∼242 Ma). Importantly in the Triassic, lower latitude basins in Tanzania and Zambia included dinosaur predecessors and other archosaurs unknown elsewhere. The recognition of heterogeneous tetrapod communities in the Triassic implies that the end-Permian mass extinction afforded ecologically marginalized lineages the ecospace to diversify, and that biotic controls (i.e., evolutionary incumbency) were fundamentally reset. Archosaurs, which began diversifying in the Early Triassic, were likely beneficiaries of this ecological release and remained dominant for much of the later Mesozoic. PMID:23630295

North of the 46° parallel: Obstacles and challenges to recycling in Ontario's rural and northern communities.

PubMed

Lakhan, Calvin

2015-10-01

This study examines the economic challenges of recycling in Ontario's rural and northern areas. Specifically, this study quantifies the economic and diversion impact of operating recycling programs in these regions. Using a systems based cost model, focus is placed on analyzing: (1) What would happen to provincial recycling costs and diversion levels if recycling programs were eliminated in "high cost" northern and rural communities? (2) Is it possible to increase the provincial recycling rate by focusing investments in low cost, high performance regions (while simultaneously eliminating recycling programs in rural and northern areas)? (3) How would the mix of material recovered change if recycling programs were eliminated in rural and northern areas? The results of this analysis show that eliminating recycling programs in high cost regions significantly decreased system costs without negatively impacting overall recycling rates. This study also found that it was possible to increase the provincial recycling rate while simultaneously reducing program costs by targeting specific regions for recovery. The findings of this study suggest that Ontario reevaluate whether rural and northern municipalities be legislatively required to operate household recycling programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessing knowledge and application of emergency risk communication principles among public health workers in China.

PubMed

Cope, James R; Frost, Melinda; Richun, Li; Xie, Ruiqian

2014-06-01

Since 2003, the Chinese National Health and Family Planning Commission (formerly the Ministry of Health) has implemented changes to more effectively communicate risk during public health emergencies. In spite of ongoing improvements, provincial and sub-provincial leaders face barriers, such as established modes of operation, lack of training, shortage of trained risk communicators, and limited understanding and willingness of recipients to mitigate risks. We assessed the current status of and barriers to risk communication knowledge and practice among public health practitioners in China. We designed the survey questionnaire to capture information related to the risk communication core capacities required by international health regulations and common risk communication principles. Our findings showed that risk communication training has successfully developed an awareness of risk communication principles and the ability to implement those principles in practice in China. Future efforts should focus on areas such as a dedicated risk communication workforce, requirements that public health agencies develop a risk communication plan, and additional training for public health practitioners and their partners. It is critical that the infectious diseases prevention and control law be amended to grant provincial and local public health agencies more autonomy to release information.

Influence of oxygen doping on resistive-switching characteristic of a-Si/c-Si device

NASA Astrophysics Data System (ADS)

Zhang, Jiahua; Chen, Da; Huang, Shihua

2017-12-01

The influence of oxygen doping on resistive-switching characteristics of Ag/a-Si/p+-c-Si device was investigated. By oxygen doping in the growth process of amorphous silicon, the device resistive-switching performances, such as the ON/OFF resistance ratios, yield and stability were improved, which may be ascribed to the significant reduction of defect density because of oxygen incorporation. The device I-V characteristics are strongly dependent on the oxygen doping concentration. As the oxygen doping concentration increases, the Si-rich device gradually transforms to an oxygen-rich device, and the device yield, switching characteristics, and stability may be improved for silver/oxygen-doped a-Si/p+-c-Si device. Finally, the device resistive-switching mechanism was analyzed. Project supported by the Zhejiang Provincial Natural Science Foundation of China (No. LY17F040001), the Open Project Program of Surface Physics Laboratory (National Key Laboratory) of Fudan University (No. KF2015_02), the Open Project Program of National Laboratory for Infrared Physics, Chinese Academy of Sciences (No. M201503), the Zhejiang Provincial Science and Technology Key Innovation Team (No. 2011R50012), and the Zhejiang Provincial Key Laboratory (No. 2013E10022).

The development of floristic provinciality during the Middle and Late Paleozoic

USGS Publications Warehouse

Wnuk, C.

1996-01-01

Phytogeographic reconstructions have been published for most Paleozoic series since the Pr??i??doli??, but there have been few attempts to synthesize this data into a comprehensive review of the characteristics and causes of the changing phytogeographic patterns for the whole Paleozoic history of the vascular flora. Existing floristic analyses have been compiled in this manuscript and the resulting data are used to reconstruct the evolution of floristic provinces since the Silurian. The earliest plant fossil records indicate that provinciality was characteristic of terrestrial vascular plant distributions right from the beginning of terrestrial colonization by vascular plants. This interpretation differs markedly from the views of many workers who still maintain that pre-Upper Carboniferous floras were uniform and cosmopolitan in distribution. Three of the four major phytogeographic units, i.e. Angara, Euramerica, and Gondwana, can be recognized in the earliest fossil floras. The fourth unit, Cathaysia, differentiated from Euramerica during the late Upper Carboniferous. Phytogeographic differentiation occurs in direct response to climatic gradients and physiographic barriers. As these gradients and barriers change, provincial boundaries expand and contract, fragment, reassemble and reassort. Phytogeographic units are dynamic through time. ?? 1996 Elsevier Science B.V. All rights reserved.

Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies.

PubMed

Grod, J P; Sikorski, D; Keating, J C

2001-10-01

To determine the presence or absence of claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or are intrinsically untestable. A survey of patient education and promotional material produced by national, state, and provincial societies and research agencies in Canada and the United States. Patient brochures were solicited from the 3 largest provincial, 3 largest state, and the 3 largest national professional associations in the United States and Canada. Similar requests were made of 2 research agencies supported by the national associations. Brochures were reviewed for the presence or absence of unsubstantiated claims. Of the 11 organizations sampled, 9 distribute patient brochures. Of these 9 organizations, all distribute patient brochures that make claims for chiropractic services that have not been scientifically validated. The largest professional associations in the United States and Canada distribute patient brochures that make claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or that are intrinsically untestable. These assertions are self-defeating because they reinforce an image of the chiropractic profession as functioning outside the boundaries of scientific behavior.

A high-resolution regional emission inventory of atmospheric mercury and its comparison with multi-scale inventories: a case study of Jiangsu, China

NASA Astrophysics Data System (ADS)

Zhong, Hui; Zhao, Yu; Muntean, Marilena; Zhang, Lei; Zhang, Jie

2016-12-01

A better understanding of the discrepancies in multi-scale inventories could give an insight into their approaches and limitations as well as provide indications for further improvements; international, national, and plant-by-plant data are primarily obtained to compile those inventories. In this study we develop a high-resolution inventory of Hg emissions at 0.05° × 0.05° for Jiangsu, China, using a bottom-up approach and then compare the results with available global/national inventories. With detailed information on individual sources and the updated emission factors from field measurements applied, the annual Hg emissions of anthropogenic origin in Jiangsu in 2010 are estimated at 39 105 kg, of which 51, 47, and 2 % were Hg0, Hg2+, and Hgp, respectively. This provincial inventory is thoroughly compared to three downscaled national inventories (NJU, THU, and BNU) and two global ones (AMAP/UNEP and EDGARv4.tox2). Attributed to varied methods and data sources, clear information gaps exist in multi-scale inventories, leading to differences in the emission levels, speciation, and spatial distributions of atmospheric Hg. The total emissions in the provincial inventory are 28, 7, 19, 22, and 70 % larger than NJU, THU, BNU, AMAP/UNEP, and EDGARv4.tox2, respectively. For major sectors, including power generation, cement, iron and steel, and other coal combustion, the Hg contents (HgC) in coals/raw materials, abatement rates of air pollution control devices (APCDs) and activity levels are identified as the crucial parameters responsible for the differences in estimated emissions between inventories. Regarding speciated emissions, a larger fraction of Hg2+ is found in the provincial inventory than national and global inventories, resulting mainly from the results by the most recent domestic studies in which enhanced Hg2+ were measured for cement and iron and steel plants. Inconsistent information on large power and industrial plants is the main source of differences in spatial distribution of emissions between the provincial and other inventories, particularly in southern and northwestern Jiangsu, where intensive coal combustion and industry are located. Quantified with Monte Carlo simulation, uncertainties in the provincial inventory are smaller than those of the NJU national inventory, resulting mainly from the more accurate activity data of individual plants and the reduced uncertainties in HgC in coals/raw materials.

The experience of community health workers training in Iran: a qualitative study

PubMed Central

2012-01-01

Background The role of Community Health Workers (CHWs) in improving access to basic healthcare services, and mobilising community actions on health is broadly recognised. The Primary Health Care (PHC) approach, identified in the Alma Ata conference in 1978, stressed the role of CHWs in addressing community health needs. Training of CHWs is one of the key aspects that generally seeks to develop new knowledge and skills related to specific tasks and to increase CHWs’ capacity to communicate with and serve local people. This study aimed to analyse the CHW training process in Iran and how different components of training have impacted on CHW performance and satisfaction. Methods Data were collected from both primary and secondary sources. Training policies were reviewed using available policy documents, training materials and other relevant documents at national and provincial levels. Documentary analysis was supplemented by individual interviews with ninety-one Iranian CHWs from 18 provinces representing a broad range of age, work experience and educational levels, both male and female. Results Recognition of the CHW program and their training in the national health planning and financing facilitates the implementation and sustainability of the program. The existence of specialised training centres managed by district health network provides an appropriate training environment that delivers comprehensive training and increases CHWs’ knowledge, skills and motivation to serve local communities. Changes in training content over time reflect an increasing number of programs integrated into PHC, complicating the work expected of CHWs. In-service training courses need to address better local needs. Conclusion Although CHW programs vary by country and context, the CHW training program in Iran offers transferable lessons for countries intending to improve training as one of the key elements in their CHW program. PMID:22938138

Association between floods and infectious diarrhea and their effect modifiers in Hunan province, China: A two-stage model.

PubMed

Liu, Zhidong; Zhang, Feifei; Zhang, Ying; Li, Jing; Liu, Xuena; Ding, Guoyong; Zhang, Caixia; Liu, Qiyong; Jiang, Baofa

2018-06-01

Understanding the potential links between floods and infectious diarrhea is important under the context of climate change. However, little is known about the risk of infectious diarrhea after floods and what factors could modify these effects in China. This study aims to quantitatively examine the relationship between floods and infectious diarrhea and their effect modifiers. Weekly number of infectious diarrhea cases from 2004 to 2011 during flood season in Hunan province were supplied by the National Notifiable Disease Surveillance System. Flood and meteorological data over the same period were obtained. A two-stage model was used to estimate a provincial average association and their effect modifiers between floods and infectious diarrhea, accounting for other confounders. A total of 134,571 cases of infectious diarrhea were notified from 2004 to 2011. After controlling for seasonality, long-term trends, and meteorological factors, floods were significantly associated with infectious diarrhea in the provincial level with a cumulative RR of 1.22 (95% CI: 1.05, 1.43) with a lagged effect of 0-1 week. Geographic locations and economic levels were identified as effect modifiers, with a higher impact of floods on infectious diarrhea in the western and regions with a low economic level of Hunan. Our study provides strong evidence of a positive association between floods and infectious diarrhea in the study area. Local control strategies for public health should be taken in time to prevent and reduce the risk of infectious diarrhea after floods, especially for the vulnerable regions identified. Copyright © 2018 Elsevier B.V. All rights reserved.

Implementation of the Xpert MTB/RIF assay for tuberculosis in Mongolia: a qualitative exploration of barriers and enablers.

PubMed

Rendell, Nicole L; Bekhbat, Solongo; Ganbaatar, Gantungalag; Dorjravdan, Munkhjargal; Pai, Madhukar; Dobler, Claudia C

2017-01-01

The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia's National Tuberculosis Program. Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia's capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software. Eight laboratory staff (five from the National Tuberculosis Reference Laboratory in Ulaanbaatar and three from provincial laboratories) and sixteen tuberculosis physicians (five from the Mongolian National Center for Communicable Diseases in Ulaanbaatar, four from district tuberculosis clinics in Ulaanbaatar and seven from provincial tuberculosis clinics) were interviewed. Major barriers to Xpert MTB/RIF implementation identified were: lack of awareness of program guidelines; inadequate staffing arrangements; problems with cartridge supply management; lack of local repair options for the Xpert machines; lack of regular formal training; paper based system; delayed treatment initiation due to consensus meeting and poor sample quality. Enablers to Xpert MTB/RIF implementation included availability of guidelines in the local language; provision of extra laboratory staff, shift working arrangements and additional modules; capacity for troubleshooting internally; access to experts; opportunities for peer learning; common understanding of diagnostic algorithms and decentralised testing. Our study identified a number of barriers and enablers to implementation of Xpert MTB/RIF in the Mongolian National Tuberculosis Program. Lessons learned from this study can help to facilitate implementation of Xpert MTB/RIF in other Mongolian locations as well as other low-and middle-income countries.

Impact of provincial characteristics on the number of traffic accident victims on interurban roads in Spain.

PubMed

Sánchez González, María Pilar; Escribano Sotos, Francisco; Tejada Ponce, Ángel

2018-02-21

This study has two aims. The first is to determine how various factors impact on the number of fatalities, serious injuries and slight injuries adjusted for the level of traffic on interurban roads in Spain. The second is to establish the number of victims per million vehicle-kilometres (veh-km) travelled on interurban roads in each province resulting from the effect of its specific characteristics. To this end, we developed six fixed effect panel data models with panel corrected standard errors for the 1999-2015 period. Our results show that while the proportion of high capacity roads, the unemployment rate and the motorization rate contribute to a reduction in the number of fatalities, serious injuries and slight injuries adjusted for level of traffic, the penalty-points licence system is effective in reducing the number of fatalities and serious injuries but not the number of slight injuries. Furthermore, the specific conditions in Ávila, Toledo, Madrid, Santa Cruz de Tenerife, Las Palmas de Gran Canaria, the Balearic Islands, Lleida and all the provinces on the Mediterranean coast cause a higher number of victims per million veh-km travelled than in the remaining provinces. Thus, greater public investment and more socially responsible behaviour are essential tools for reducing the number of traffic accident victims on Spanish interurban roads. Moreover, the provincial institutions emerge as key agents in improving road safety, due to their greater knowledge of the specific conditions and factors affecting each province. Copyright © 2018 Elsevier Ltd. All rights reserved.

The provincial health office as performance manager: change in the local healthcare system after Thailand's universal coverage reforms.

PubMed

Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai

2012-01-01

This paper examines the implementation of Thailand's universal coverage healthcare reforms in a rural province, using data from field studies undertaken in 2003-2005 and 2008-2011. We focus on the strand of policy that aimed to develop primary care by allocating funds to contracting units for primary care (CUPs) responsible for managing local service networks. The two studies document a striking change in the balance of power in the local healthcare system over the 8-year period. Initially, the newly formed CUPs gained influence as 'power followed the money', and the provincial health offices (PHOs), which had commanded the service units, were left with a weaker co-ordination role. However, the situation changed as a new insurance purchaser, the National Health Security Office, took financial control and established regional outposts. National Health Security Office outposts worked with PHOs to develop rationalised management tools-strategic plans, targets, KPIs and benchmarking-that installed the PHOs as performance managers of local healthcare systems. New lines of accountability and changed budgetary systems reduced the power of the CUPs to control resource allocation and patterns of services within CUP networks. Whereas some CUPs fought to retain limited autonomy, the PHO has been able to regain much of its former control. We suggest that implementation theory needs to take a long view to capture the complexity of a major reform initiative and argue for an analysis that recognises the key role of policy networks and advocacy coalitions that span national and local levels and realign over time. Copyright © 2012 John Wiley & Sons, Ltd.

[Role of GeneXpert MTB/RIF test in the screening for pulmonary tuberculosis at the General Referral Provincial Hospital of Bukavu, in the East of the Democratic Republic of the Congo: balance after 10 months of use].

PubMed

Lupande, David; Kaishusha, David; Mihigo, Carine; Itongwa, Moise; Yenga, Gustave; Katchunga, Philippe

2017-01-01

In sub-Saharan Africa, diagnostic methods for tuberculosis are inadequate and are essentially based on microscopy. They constitute a real obstacle to the control of tuberculosis. This study aimed to evaluate the performance of GeneXpert MTB/RIF test compared to classical Ziehl-Neelsen staining at the the general referral provincial hospital of Bukavu, in the east of the Democratic Republic of the Congo after 10 months of use. The results of Ziehl-Neelsen staining and GeneXpert MTB/RIF molecular biology test performed in 452 patients with suspected tuberculosis were collected. This study compares the validity of these different diagnostic tests in the detection of tuberculosis. In the entire group, the frequency of the pulmonary tuberculosis was 16.3%. The positivity rate was significantly higher in GeneXpert MTB/RIF test than in Ziehl-Neelsen staining in the entire group (15.9% vs 9.3%, p = 0.03) and in HIV seropositive patients (52.0% vs 24.0%; p = 0.007). However, the sensitivity of GeneXpert MTB/RIF test compared to that in Ziehl-Neelsen staining wasn't maximum (95.2%). Finally, GeneXpert MTB/RIF test detected rifampicin resistance in 20.8%. This study confirms the superiority of GeneXpert MTB/RIF test compared to Ziehl-Neelsen staining in the detection of tuberculosis and in the prediction of multi-resistance. Its systematic use coupled with Ziehl-Neelsen staining would better control tuberculosis in sub-Saharan Africa.

Ruptured uterus in pregnancy: a Canadian hospital's experience.

PubMed Central

Fedorkow, D M; Nimrod, C A; Taylor, P J

1987-01-01

Between 1966 and 1985, 15 cases of complete rupture of the uterus in pregnancy were identified among 52,854 deliveries at Foothills Provincial General Hospital, Calgary, for an incidence rate of 0.3 per 1000 deliveries. Previous cesarean section (in seven patients) was not the only predisposing factor: a history of dilatation and curettage (in two patients) or laparoscopy (in one) were also implicated. Long, obstructed labour did not appear to be a factor. Rupture also occurred in patients at low risk. The most frequent immediate complication was hypotension, in five patients. The rupture site was repaired in 11 of the patients; the other 4 underwent hysterectomy. Close surveillance and prompt intervention are the keys to good fetal and maternal outcome. PMID:3594331

HIV point of care diagnosis: preventing misdiagnosis experience from a pilot of rapid test algorithm implementation in selected communes in Vietnam.

PubMed

Nguyen, Van Thi Thuy; Best, Susan; Pham, Hong Thang; Troung, Thi Xuan Lien; Hoang, Thi Thanh Ha; Wilson, Kim; Ngo, Thi Hong Hanh; Chien, Xuan; Lai, Kim Anh; Bui, Duc Duong; Kato, Masaya

2017-08-29

In Vietnam, HIV testing services had been available only at provincial and district health facilities, but not at the primary health facilities. Consequently, access to HIV testing services had been limited especially in rural areas. In 2012, Vietnam piloted decentralization and integration of HIV services at commune health stations (CHSs). As a part of this pilot, a three-rapid test algorithm was introduced at CHSs. The objective of this study was to assess the performance of a three-rapid test algorithm and the implementation of quality assurance measures to prevent misdiagnosis, at primary health facilities. The three-rapid test algorithm (Determine HIV-1/2, followed by ACON HIV 1/2 and DoubleCheckGold HIV 1&2 in parallel) was piloted at CHSs from August 2012 to December 2013. Commune health staff were trained to perform HIV testing. Specimens from CHSs were sent to the provincial confirmatory laboratory (PCL) for confirmatory and validation testing. Quality assurance measures were undertaken including training, competency assessment, field technical assistance, supervision and monitoring and external quality assessment (EQA). Data on HIV testing were collected from the testing logbooks at commune and provincial facilities. Descriptive analysis was conducted. Sensitivity and specificity of the rapid testing algorithm were calculated. A total of 1,373 people received HIV testing and counselling (HTC) at CHSs. Eighty people were diagnosed with HIV infection (5.8%). The 755/1244 specimens reported as HIV negative at the CHS were sent to PCL and confirmed as negative, and all 80 specimens reported as HIV positive at CHS were confirmed as positive at the PCL. Forty-nine specimens that were reactive with Determine but negative with ACON and DoubleCheckGold at the CHSs were confirmed negative at the PCL. The results show this rapid test algorithm to be 100% sensitive and 100% specific. Of 21 CHSs that received two rounds of EQA panels, 20 CHSs submitted accurate results. Decentralization of HIV confirmatory testing to CHS is feasible in Vietnam. The results obtained from this pilot provided strong evidence of the feasibility of HIV testing at primary health facilities. Quality assurance measures including training, competency assessment, regular monitoring and supervision and an EQA scheme are essential for prevention of misdiagnosis.

Economic impacts from PM2.5 pollution-related health effects in China's road transport sector: A provincial-level analysis.

PubMed

Tian, Xu; Dai, Hancheng; Geng, Yong; Wilson, Jeffrey; Wu, Rui; Xie, Yang; Hao, Han

2018-06-01

Economic impact assessments of air pollution-related health effects from a sectoral perspective in China is still deficient. This study evaluates the PM 2.5 pollution-related health impacts of the road transport sector on China's economy at both national and provincial levels in 2030 under various air mitigation technologies scenarios. Health impacts are estimated using an integrated approach that combines the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model, a computable general equilibrium (CGE) model and a health model. Results show that at a national level, the road transport sector leads to 163.64 thousand deaths per year, increases the per capita risk of morbidity by 0.37% and accounts for 1.43 billion Yuan in health care expenditures. We estimate 442.90 billion Yuan of the value of statistical life loss and 2.09 h/capita of work time loss in 2015. Without additional control measures, air pollution related to the transport sector will cause 177.50 thousand deaths in 2030, a 0.40% per capita increase in the risk of morbidity, accounting for 4.12 billion Yuan in health care expenditures, 737.15 billion Yuan of statistical life loss and 2.23 h/capita of work time loss. Based on our model, implementing the most strict control strategy scenario would decrease mortality by 42.14%, morbidity risk by 42.14%, health care expenditures by 41.94%, statistical life loss by 26.22% and hours of work time loss by 42.65%, comparing with the no control measure scenario. In addition, PM 2.5 pollution from the road transport sector will cause 0.68% GDP loss in 2030. At a provincial level, GDP losses in 14 out of 30 provinces far exceed the national rate. Henan (1.20%), Sichuan (1.07%), Chongqing (0.99%), Hubei (0.94%), and Shandong (0.90%) would experience the highest GDP loss in 2030. Implementing control strategies to reduce PM 2.5 pollution in the road transport sector could bring positive benefits in half of the Chinese provinces especially in provinces that suffer greater health impacts from the road transport sector (such as Henan and Sichuan). Copyright © 2018 Elsevier Ltd. All rights reserved.

Landscapes of promise: An examination of students' journals written during a cross-cultural wilderness experience

NASA Astrophysics Data System (ADS)

Freund, Judith Ann

1997-12-01

This paper is an examination of nature journals written by ten American and ten Russian high school students during a cross-cultural exchange that provided experiences in selected national wilderness areas designated by the respective countries. The students participated in a backpacking excursion in the Lee Metcalf Wilderness Area of Montana in the summer of 1994, and a camping experience in the wilderness areas in the provincial region of Penza, Russia in the summer of 1995. The examination of the journals focuses on the following areas: aesthetic "peak" experiences; spiritual inspiration derived from experiences in nature; attitudes toward the preservation of wildlife; and environmental ethics. The students' attitudes toward the environment is compared using student-identified cultural values of both the Russian and the American students. Also discussed is the viability of the students' reflections as natural history journal-writing, with references to selected natural history authors, including Henry David Thoreau, Aldo Leopold and Anne Dillard. Because the experience focused on wilderness preservation students were invited to speculate about how to develop and reinforce essential attitudes that are respectful of ecology. Conclusions they reached included the necessity to economic security at some level and the notion that direct experience in the environment is essential to developing an attitude that will engender an ethics of caring within their--as well as other--cultural groups.

Quantum Standard Teleportation Based on the Generic Measurement Bases

NASA Astrophysics Data System (ADS)

Hao, San-Ru; Hou, Bo-Yu; Xi, Xiao-Qiang; Yue, Rui-Hong

2003-10-01

We study the quantum standard teleportation based on the generic measurement bases. It is shown that the quantum standard teleportation does not depend on the explicit expression of the measurement bases. We have given the correspondence relation between the measurement performed by Alice and the unitary transformation performed by Bob. We also prove that the single particle unknown states and the two-particle unknown cat-like states can be exactly transmitted by means of the generic measurement bases and the correspondence unitary transformations. The project supported in part by National Natural Science Foundation of China, the Hunan Provincial Natural Science Foundation of China, and the Scientific Research Fund of Hunan Provincial Education Department

Use of Lean response to improve pandemic influenza surge in public health laboratories.

PubMed

Isaac-Renton, Judith L; Chang, Yin; Prystajecky, Natalie; Petric, Martin; Mak, Annie; Abbott, Brendan; Paris, Benjamin; Decker, K C; Pittenger, Lauren; Guercio, Steven; Stott, Jeff; Miller, Joseph D

2012-01-01

A novel influenza A (H1N1) virus detected in April 2009 rapidly spread around the world. North American provincial and state laboratories have well-defined roles and responsibilities, including providing accurate, timely test results for patients and information for regional public health and other decision makers. We used the multidisciplinary response and rapid implementation of process changes based on Lean methods at the provincial public health laboratory in British Columbia, Canada, to improve laboratory surge capacity in the 2009 influenza pandemic. Observed and computer simulating evaluation results from rapid processes changes showed that use of Lean tools successfully expanded surge capacity, which enabled response to the 10-fold increase in testing demands.

[How do we heal the Argentine health care system?].

PubMed

Tobar, Federico

2002-04-01

This article proposes a set of measures to reform the Argentine health care system and turn the country's current crisis into an opportunity for progressive, sustainable change. The proposal consists of a model for the intergovernmental division of health responsibilities. The national government would be responsible for strengthening its leadership role and for developing national insurance for low-prevalence high-cost diseases. With the provincial governments, the insurance role would be strengthened, with public health insurance making certain that there is universal coverage. Public hospitals would function as autonomous entities financed by social insurance, private insurance, and provincial public insurance. Municipalities would have an active role in disease prevention and health promotion, principally through primary care.

Calgary Laboratory Services

PubMed Central

2015-01-01

Calgary Laboratory Services provides global hospital and community laboratory services for Calgary and surrounding areas (population 1.4 million) and global academic support for the University of Calgary Cumming School of Medicine. It developed rapidly after the Alberta Provincial Government implemented an austerity program to address rising health care costs and to address Alberta’s debt and deficit in 1994. Over roughly the next year, all hospital and community laboratory test funding within the province was put into a single budget, fee codes for fee-for-service test billing were closed, roughly 40% of the provincial laboratory budget was cut, and roughly 40% of the pathologists left the province of Alberta. In Calgary, in the face of these abrupt changes in the laboratory environment, private laboratories, publicly funded hospital laboratories and the medical school department precipitously and reluctantly merged in 1996. The origin of Calgary Laboratory Services was likened to an “unhappy shotgun marriage” by all parties. Although such a structure could save money by eliminating duplicated services and excess capacity and could provide excellent city-wide clinical service by increasing standardization, it was less clear whether it could provide strong academic support for a medical school. Over the past decade, iterations of the Calgary Laboratory Services model have been implemented or are being considered in other Canadian jurisdictions. This case study analyzes the evolution of Calgary Laboratory Services, provides a metric-based review of academic performance over time, and demonstrates that this model, essentially arising as an unplanned experiment, has merit within a Canadian health care context. PMID:28725754

Understanding optimal approaches to patient and caregiver engagement in the development of cancer practice guidelines: a mixed methods study.

PubMed

Brouwers, Melissa C; Vukmirovic, Marija; Spithoff, Karen; Makarski, Julie

2017-03-09

Practice guidelines (PGs) can assist health care practitioners and patients to make decisions about health care options. A key component of high quality PGs is the consideration of patient values and preferences. A mixed methods study was conducted to understand optimal approaches to patient engagement in the development of cancer PGs. Cancer patients, survivors, family members and caregivers were recruited from cancer clinics, follow-up clinics, community support programs, a provincial patient and family advisory committee, and a provincial cancer PG development program. Participants attended a workshop, completed a survey, or participated in a telephone interview, to provide information about PG awareness, attitudes, information needs, training, engagement approaches and barriers and facilitators. Forty-one participants (12 workshop attendees, 21 survey respondents and 8 interviewees) provided data. For those with no PG development experience, fewer than half were previously aware of PGs but perceived several benefits to the inclusion of this perspective. Common barriers to participation across the groups were time commitment, duration of the PG development process, and financial costs. Positive beliefs about the contributions that could be made and practical considerations (e.g., orientation and training, defined roles and expectations) were identified as key features in the successful integration of patients into the PG development process. There was no single model of engagement favored over another. Study results align with similar studies in other contexts and with international patient engagement efforts. Findings are being used to test new patient engagement models in a programmatic PG development initiative in Ontario, Canada.

Longitudinal Rates of Colon Cancer Screening Use in Winnipeg, Canada: The Experience of a Universal Health-Care System with an Organized Colon Screening Program.

PubMed

Decker, Kathleen M; Demers, Alain A; Nugent, Zoann; Biswanger, Natalie; Singh, Harminder

2015-12-01

We examined trends in colorectal cancer (CRC) screening (fecal occult blood test (FOBT), colonoscopy, and flexible sigmoidoscopy (FS)) and differences in CRC screening by income in a population with an organized CRC screening program and universal health-care coverage. Individuals who had an FOBT, colonoscopy, or FS were identified from the provincial Physician Claims database and the population-based colon cancer screening registry. Trends in age-standardized rates were determined. Logistic regression was performed to explore the association between CRC screening and income quintiles by year. Up-to-date CRC screening (FOBT, colonoscopy, or FS) increased over time for men and women, all age groups, and all income quintiles. Up-to-date CRC screening was very high among 65- to 69- and 70- to 74-year-olds (70% and 73%, respectively). There was a shift toward the use of an FOBT for CRC screening for individuals in the lower income quintiles. The disparity in colonoscopy/FS coverage by income quintile was greater in 2012 than in 1995. Overall, there was no reduction in disparities by income in up-to-date CRC screening nor did the rate of increase in up-to-date CRC screening or FOBT use change after the introduction of the organized provincial CRC screening program. CRC screening is increasing over time for both men and women and all age groups. However, a disparity in up-to-date CRC screening by income persisted even with an organized CRC screening program in a universal health-care setting.

Effects of Soundscapes on Perceived Crowding and Encounter Norms

NASA Astrophysics Data System (ADS)

Kim, Sang-Oh; Shelby, Bo

2011-07-01

Soundscapes in recreation settings are becoming an important issue, but there are few studies of the effects of sounds on recreation experiences, especially crowding perceptions and encounter norms. This study compared effects of six types of sounds (an airplane, a truck engine, children playing, birds, water, and a control) on perceived crowding (PC) and encounter norms for hikers. Data were collected from 47 college students through lab experiments using simulated images, with moving hikers inserted in the original photo taken in the Jungmeori area of Mudeungsan Provincial Park in Korea. Overall, the motor-made sounds of the airplane and truck engine increased PC and decreased acceptability ratings, and the natural sounds of birds and water decreased PC and increased acceptability ratings. Ratings of the sound of children playing were similar to those in the control (i.e., no sound). In addition, as numbers of hikers increased, the overall effects of sounds decreased, and there were few significant differences in PC or acceptability ratings at the highest encounter levels. Theoretical and methodological implications are discussed.

Effects of soundscapes on perceived crowding and encounter norms.

PubMed

Kim, Sang-Oh; Shelby, Bo

2011-07-01

Soundscapes in recreation settings are becoming an important issue, but there are few studies of the effects of sounds on recreation experiences, especially crowding perceptions and encounter norms. This study compared effects of six types of sounds (an airplane, a truck engine, children playing, birds, water, and a control) on perceived crowding (PC) and encounter norms for hikers. Data were collected from 47 college students through lab experiments using simulated images, with moving hikers inserted in the original photo taken in the Jungmeori area of Mudeungsan Provincial Park in Korea. Overall, the motor-made sounds of the airplane and truck engine increased PC and decreased acceptability ratings, and the natural sounds of birds and water decreased PC and increased acceptability ratings. Ratings of the sound of children playing were similar to those in the control (i.e., no sound). In addition, as numbers of hikers increased, the overall effects of sounds decreased, and there were few significant differences in PC or acceptability ratings at the highest encounter levels. Theoretical and methodological implications are discussed.

Under-5 mortality in 2851 Chinese counties, 1996–2012: a subnational assessment of achieving MDG 4 goals in China

PubMed Central

Wang, Yanping; Li, Xiaohong; Zhou, Maigeng; Luo, Shusheng; Liang, Juan; Liddell, Chelsea A; Coates, Matthew M; Gao, Yanqiu; Wang, Linhong; He, Chunhua; Kang, Chuyun; Liu, Shiwei; Dai, Li; Schumacher, Austin E; Fraser, Maya S; Wolock, Timothy M; Pain, Amanda; Levitz, Carly E; Singh, Lavanya; Coggeshall, Megan; Lind, Margaret; Li, Yichong; Li, Qi; Deng, Kui; Mu, Yi; Deng, Changfei; Yi, Ling; Liu, Zheng; Ma, Xia; Li, Hongtian; Mu, Dezhi; Zhu, Jun; Murray, Christopher J L; Wang, Haidong

2017-01-01

Summary Background In the past two decades, the under-5 mortality rate in China has fallen substantially, but progress with regards to the Millennium Development Goal (MDG) 4 at the subnational level has not been quantified. We aimed to estimate under-5 mortality rates in mainland China for the years 1970 to 2012. Methods We estimated the under-5 mortality rate for 31 provinces in mainland China between 1970 and 2013 with data from censuses, surveys, surveillance sites, and disease surveillance points. We estimated under-5 mortality rates for 2851 counties in China from 1996 to 2012 with the reported child mortality numbers from the Annual Report System on Maternal and Child Health. We used a small area mortality estimation model, spatiotemporal smoothing, and Gaussian process regression to synthesise data and generate consistent provincial and county-level estimates. We compared progress at the county level with what was expected on the basis of income and educational attainment using an econometric model. We computed Gini coefficients to study the inequality of under-5 mortality rates across counties. Findings In 2012, the lowest provincial level under-5 mortality rate in China was about five per 1000 livebirths, lower than in Canada, New Zealand, and the USA. The highest provincial level under-5 mortality rate in China was higher than that of Bangladesh. 29 provinces achieved a decrease in under-5 mortality rates twice as fast as the MDG 4 target rate; only two provinces will not achieve MDG 4 by 2015. Although some counties in China have under-5 mortality rates similar to those in the most developed nations in 2012, some have similar rates to those recorded in Burkina Faso and Cameroon. Despite wide differences, the inter-county Gini coefficient has been decreasing. Improvement in maternal education and the economic boom have contributed to the fall in child mortality; more than 60% of the counties in China had rates of decline in under-5 mortality rates significantly faster than expected. Fast reduction in under-5 mortality rates have been recorded not only in the Han population, the dominant ethnic majority in China, but also in the minority populations. All top ten minority groups in terms of population sizes have experienced annual reductions in under-5 mortality rates faster than the MDG 4 target at 4·4%. Interpretation The reduction of under-5 mortality rates in China at the country, provincial, and county level is an extraordinary success story. Reductions of under-5 mortality rates faster than 8·8% (twice MDG 4 pace) are possible. Extremely rapid declines seem to be related to public policy in addition to socioeconomic progress. Lessons from successful counties should prove valuable for China to intensify efforts for those with unacceptably high under-5 mortality rates. Funding National “Twelfth Five-Year” Plan for Science and Technology Support, National Health and Family Planning Commission of The People’s Republic of China, Program for Changjiang Scholars and Innovative Research Team in University, the National Institute on Aging, and the Bill & Melinda Gates Foundation. PMID:26510780

Comparison of vegetation conditions along two backcountry trails in Mount Robson Provincial Park, British Columbia (Canada).

PubMed

Nepal, Sanjay K; Way, Paul

2007-01-01

Vegetation conditions, i.e., plant cover, species richness, and the presence of exotic species, are compared along a high-use trail (Berg Lake Trail--BLT) and a low use trail (Mt. Fitzwilliam Trail--FWT) in Canada's Mt. Robson Provincial Park. We established 71 paired quadrats (1 m x 1 m), and assessed the amount of vegetation cover and species richness by four main lifeforms, i.e., woody species, herbaceous species, ferns, and moss, lichen and fungi. The following hypotheses were tested: (1) differences exist between control and trailside quadrats in vegetation cover, species richness and floristic diversity, and (2) differences exist between the high and low-use trails in the above-mentioned three parameters. Results show that for the majority of variables the differences between the control and trailside quadrats are statistically not significant. Variables showing significant differences are relative vegetation cover (for BLT only), exposed soil (BLT and FWT), herbaceous cover (FWT), moss, lichen and fungi cover (BLT), overall species richness (BLT), and herbaceous species richness (BLT). Ruderal and exotic species are present but only on trailside quadrats of the high-use trail. Results indicate that the Park administration's strategy to disperse use in the Mt. Robson Provincial Park should be examined critically, and some guidelines for acceptability of changes should be developed.

Fitness to drive in patients with brain tumours: the influence of mandatory reporting legislation on radiation oncologists in Canada.

PubMed

Louie, A V; D'Souza, D P; Palma, D A; Bauman, G S; Lock, M; Fisher, B; Patil, N; Rodrigues, G B

2012-06-01

Certain jurisdictions in Canada legally require that physicians report unfit drivers. Physician attitudes and patterns of practice have yet to be evaluated in Canada for patients with brain tumours. We conducted a survey of 97 radiation oncologists, eliciting demographics, knowledge of reporting laws, and attitudes on reporting guidelines for unfit drivers. Eight scenarios with varying disability levels were presented to determine the likelihood of a patient being reported as unfit to drive. Statistical comparisons were made using the Fisher exact test. Of physicians approached, 99% responded, and 97 physicians participated. Most respondents (87%) felt that laws in their province governing the reporting of medically unfit drivers were unclear. Of the responding physicians, 23 (24%) were unable to correctly identify whether their province had mandatory reporting legislation. Physicians from provinces without mandatory reporting legislation were significantly less likely to consider reporting patients to provincial authorities (p = 0.001), and for all clinical scenarios, the likelihood of reporting significantly depended on the physician's provincial legal obligations. The presence of provincial legislation is of primary importance in determining whether physicians will report brain tumour patients to drivers' licensing authorities. In Canada, clear guidelines have to be developed to help in the assessment of whether brain tumour patients should drive.

Uncovering regional disparity of China's water footprint and inter-provincial virtual water flows.

PubMed

Dong, Huijuan; Geng, Yong; Fujita, Tsuyoshi; Fujii, Minoru; Hao, Dong; Yu, Xiaoman

2014-12-01

With rapid economic development in China, water crisis is becoming serious and may impede future sustainable development. The uneven distribution of water resources further aggravates such a problem. Under such a circumstance, the concepts of water footprint and virtual water have been proposed in order to respond water scarcity problems. This paper focuses on studying provincial disparity of China's water footprints and inter-provincial virtual water trade flows by adopting inter-regional input-output (IRIO) method. The results show that fast developing areas with larger economic scales such as Guangdong, Jiangsu, Shandong, Zhejiang, Shanghai and Xinjiang had the largest water footprints. The most developed and water scarce areas such as Shanghai, Beijing, Tianjin and Shandong intended to import virtual water, a rational choice for mitigating their water crisis. Xinjiang, Jiangsu, Heilongjiang, Inner Mongolia, Guangxi and Hunan, had the largest per GDP water intensities and were the main water import regions. Another key finding is that agriculture water footprint was the main part in water footprint composition and water export trade. On the basis of these findings, policy implications on agriculture geographical dispersion, consumption behavior changes, trade structure adjustment and water use efficiency improvement are further discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

Lessons learned from the implementation of a provincial breastfeeding policy in Nova Scotia, Canada and the implications for childhood obesity prevention.

PubMed

Kirk, Sara F L; Sim, Sarah Meaghan; Hemmens, Erin; Price, Sheri L

2012-04-01

Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a provincial breastfeeding policy. This paper describes the process and outcomes of an evaluation into the implementation of the policy. This evaluation comprised focus groups held with members of provincial and district level breastfeeding committees who were tasked with promoting, protecting and supporting breastfeeding in their districts. Five key themes were identified, which were an unsupportive culture of breastfeeding; the need for strong leadership; the challenges in engaging physicians in dialogue around breastfeeding; lack of understanding around the International Code of Marketing of Breast-milk Substitutes; and breastfeeding as a way to address childhood obesity. Recommendations for other jurisdictions include the need for a policy, the value of leadership, the need to integrate policy with other initiatives across sectors and the importance of coordination and support at multiple levels. Finally, promotion of breastfeeding offers a population-based strategy for addressing the childhood obesity epidemic and should form a core component of any broader strategies or policies for childhood obesity prevention.

Lessons Learned from the Implementation of a Provincial Breastfeeding Policy in Nova Scotia, Canada and the Implications for Childhood Obesity Prevention

PubMed Central

Kirk, Sara F. L.; Sim, Sarah Meaghan; Hemmens, Erin; Price, Sheri L.

2012-01-01

Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a provincial breastfeeding policy. This paper describes the process and outcomes of an evaluation into the implementation of the policy. This evaluation comprised focus groups held with members of provincial and district level breastfeeding committees who were tasked with promoting, protecting and supporting breastfeeding in their districts. Five key themes were identified, which were an unsupportive culture of breastfeeding; the need for strong leadership; the challenges in engaging physicians in dialogue around breastfeeding; lack of understanding around the International Code of Marketing of Breast-milk Substitutes; and breastfeeding as a way to address childhood obesity. Recommendations for other jurisdictions include the need for a policy, the value of leadership, the need to integrate policy with other initiatives across sectors and the importance of coordination and support at multiple levels. Finally, promotion of breastfeeding offers a population-based strategy for addressing the childhood obesity epidemic and should form a core component of any broader strategies or policies for childhood obesity prevention. PMID:22690194

Working conditions that contribute to absenteeism among nurses in a provincial hospital in the Limpopo Province.

PubMed

Nyathi, M; Jooste, K

2008-03-01

Absenteeism results in an increased workload for nurses who stand in for colleagues and can lead to situations in which a lack of motivation among nurses and a lowering of the quality of patient care may occur. The researcher observed that certain conditions, such as inflexible working schedules, were given as reasons for the absenteeism in units in a provincial hospital. A non-experimental, descriptive, quantitative study was undertaken. The purpose of the article was to describe the working conditions that contribute to absenteeism among the professional and sub-professional nurses at a provincial hospital in the Limpopo province of South Africa. The sample included 107 professional nurses and 163 sub-professional nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data, which was analysed by using descriptive and inferential statistics. The findings of this study indicated that personal and managerial characteristics, and organisational and working conditions may lead to absenteeism in the workplace. This article focuses on the working conditions that are constraints, namely inadequate group cohesion, inadequate delegation of autonomy, role ambiguity, ineffective routinisation and the effect of the workload in the workplace. Recommendations are made for improving working conditions to combat absenteeism among nurses. The limitations of this study are highlighted.

Everybody's business: economic surveillance of public health services in Alberta, Canada.

PubMed

Jacobs, Philip; Moffatt, Jessica; Ohinmaa, Arto; Jonsson, Egon

2013-02-01

To address public health risk factors, governments conduct interventions in many different ministries, including non-health ministries. In order to understand the scope and cost of public health in Alberta, we developed a survey of government public health interventions. We included any government ministry or public organization, which includes health as a stated objective. A grey literature search was initially conducted, followed by 69 consultations with federal, provincial and municipal organizations. We captured information related to (i) the type of public health service provided; (ii) the associated costs (if available); and (iii) any additional ministry that may collaborate on the initiative. This information was then presented to lead ministry personnel for validation and verification. We covered 15 areas of public health and identified 23 federal and 21 provincial agencies and departments that were providing these services. Public health spending on current operations amounted to $327 per capita, of which 60.5% came from provincial non-health ministries. Capital expenditures were $256 per capita, of which 32.5% were from the federal government. Public health expenses by non-health ministries were greater than those for health ministries. Capital expenses were much greater than non-capital expenses. In order to measure the full impact of government public health, it is necessary to take a cross-ministerial approach.

Genetic counseling for schizophrenia: a review of referrals to a provincial medical genetics program from 1968–2007

PubMed Central

Hunter, MJ; Hippman, Catriona; Honer, William G; Austin, Jehannine C.

2014-01-01

Purpose Recent studies have shown that individuals with schizophrenia and their family members are interested in genetic counseling, but few have received this service. We conducted an exploratory, retrospective study to describe (a) the population of individuals who were referred to the provincial program for genetic counseling for a primary indication of schizophrenia, and (b) trends in number of referrals between 1968 and 2007. Methods Referrals for a primary indication of schizophrenia were identified through the provincial program database. Charts were reviewed and the following information was recorded: discipline of referring physician, demographics, psychiatric diagnosis, referred individual’s and partner’s (if applicable) family history, and any current pregnancy history. Data were characterized using descriptive statistics. Results Between 1968 and 2007, 288 referrals were made for a primary indication of schizophrenia. Most referrals were made: (a) for individuals who had a first-degree family member with schizophrenia, rather than for affected individuals, (b) for preconception counseling, and (c) by family physicians (69%), with only 2% by psychiatrists. Conclusions In British Columbia, individuals affected with schizophrenia and their family members are rarely referred for psychiatric genetic counseling. There is a need to identify barriers to psychiatric genetic counseling and develop strategies to improve access. PMID:20034078

Relationship between Air Pollutants and Economic Development of the Provincial Capital Cities in China during the Past Decade

PubMed Central

Luo, Yunpeng; Chen, Huai; Zhu, Qiu'an; Peng, Changhui; Yang, Gang; Yang, Yanzheng; Zhang, Yao

2014-01-01

With the economic development of China, air pollutants are also growing rapidly in recent decades, especially in big cities of the country. To understand the relationship between economic condition and air pollutants in big cities, we analysed the socioeconomic indictorssuch as Gross Regional Product per capita (GRP per capita), the concentration of air pollutants (PM10, SO2, NO2) and the air pollution index (API) from 2003 to 2012 in 31 provincial capitals of mainland China. The three main industries had a quadratic correlation with NO2, but a negative relationship with PM10 and SO2. The concentration of air pollutants per ten thousand yuan decreased with the multiplying of GRP in the provinical cities. The concentration of air pollutants and API in the provincial capital cities showed a declining trend or inverted-U trend with the rise of GRP per capita, which provided a strong evidence for the Environmental Kuznets Curve (EKC), that the environmental quality first declines, then improves, with the income growth. The results of this research improved our understanding of the alteration of atmospheric quality with the increase of social economy and demonstrated the feasibility of sustainable development for China. PMID:25083711

NURSES INFECTION PREVENTION PRACTICES IN HANDLING INJECTIONS: A CASE OF RIFT VALLEY PROVINCIAL HOSPITAL IN KENYA.

PubMed

Chemoiwa, R K; Mukthar, V K; Maranga, A K; Kulei, S J

2014-10-01

To analyse the infection prevention practices in handling of injections by nurses in Rift Valley Provincial Hospital in Kenya. A cross-sectional observational study. Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. A sample of 386 injection procedures attributed to the nurses in Rift Valley Provincial Hospital was considered for this study. The study established that among all the injections administered in this study, 43.7% (386) adhered to aseptic techniques. Over seventy five percent (76.9%, n = 386) of the observed injections procedures did not involve the hand-washing, 53.4% (n = 206) did not involve swabbing of a vial rubber cap with alcohol swabs and 95.1%(n = 263) involved using of multidose drug in more than one designated patient. Over ninety five percent (95.6%, n = 364) of the observed procedures involved use of sterile the syringe bit of the devices only while the rest used either clean or contaminated syringes. Around forty percent (42.2%, n = 316) of the injections preparation was done elsewhere (not at the patient bedside) before administration. Slightly over thirty five percent (36.6%, n = 386) of the injections were administered immediately upon reconstitution(at the right time). The study also established the use of aseptic techniques to reconstitute and administer was significantly related to the number of nurses to patients ratio per shift (X2(1) = 3.5: p = 0.04). The findings of this study indicate that patient safety in public hospital is still relatively low. The adherence to basic infection prevention procedures/aseptic techniques in handling of injections by health workers is still a concern. The adherence to aseptic techniques in handling injections is significantly associated with the nurses to patients ratios. Therefore, it is imperative to improve nurse to patient ratio in public health facilities in Kenya.

Linkage of the Canadian Study of Health and Aging to provincial administrative health care databases in Nova Scotia.

PubMed

Yip, A M; Kephart, G; Rockwood, K

2001-01-01

The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health services use by demographic and health status characteristics in the Nova Scotia community cohort.

Biowaste home composting: experimental process monitoring and quality control.

PubMed

Tatàno, Fabio; Pagliaro, Giacomo; Di Giovanni, Paolo; Floriani, Enrico; Mangani, Filippo

2015-04-01

Because home composting is a prevention option in managing biowaste at local levels, the objective of the present study was to contribute to the knowledge of the process evolution and compost quality that can be expected and obtained, respectively, in this decentralized option. In this study, organized as the research portion of a provincial project on home composting in the territory of Pesaro-Urbino (Central Italy), four experimental composters were first initiated and temporally monitored. Second, two small sub-sets of selected provincial composters (directly operated by households involved in the project) underwent quality control on their compost products at two different temporal steps. The monitored experimental composters showed overall decreasing profiles versus composting time for moisture, organic carbon, and C/N, as well as overall increasing profiles for electrical conductivity and total nitrogen, which represented qualitative indications of progress in the process. Comparative evaluations of the monitored experimental composters also suggested some interactions in home composting, i.e., high C/N ratios limiting organic matter decomposition rates and final humification levels; high moisture contents restricting the internal temperature regime; nearly horizontal phosphorus and potassium evolutions contributing to limit the rates of increase in electrical conductivity; and prolonged biowaste additions contributing to limit the rate of decrease in moisture. The measures of parametric data variability in the two sub-sets of controlled provincial composters showed decreased variability in moisture, organic carbon, and C/N from the seventh to fifteenth month of home composting, as well as increased variability in electrical conductivity, total nitrogen, and humification rate, which could be considered compatible with the respective nature of decreasing and increasing parameters during composting. The modeled parametric kinetics in the monitored experimental composters, along with the evaluation of the parametric central tendencies in the sub-sets of controlled provincial composters, all indicate that 12-15 months is a suitable duration for the appropriate development of home composting in final and simultaneous compliance with typical reference limits. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Gateway Paper--preventive and promotive programs in Pakistan and health reforms in Pakistan.

PubMed

Nishtar, Sania

2006-12-01

Pakistan's public health interventions include a range of programs lead by the federal government with implementation arms at the provincial and district levels. Some of the programs are disease specific such as the respective programs on HIV/AIDS, Malaria, Tuberculosis, non-communicable diseases and Hepatitis; others are specific to life cycle domains such as in the case of maternal and child health whereas still others such as the National Program for Family Planning and Primary Healthcare and the National Expanded Program for Immunization are cross-cutting. Although these programs have contributed to improving health outcomes at intermediate outcomes level, a number of critical impediments to maximizing their impact have been noted. These include lack of integration, institutional impediments to the implementation of programs with particular reference to problems at the federal/provincial level and unrealized implications of federal programs at the provincial level are amongst the foremost. These have been further compounded by the addition of another service delivery tier in Pakistan's health system through the introduction of the devolution initiative. Furthermore, the unsustainable and under-utilized BHUs which serve as the service delivery base of these programs add to the problems. The Gateway Paper makes a number of recommendations to obviate these issues such as recommendations to integrate programs, strengthen surveillance systems, and with reference to obviating issues to implementation, emphasis is laid on decentralizing decision-making and central control, institutionalizing managerial audit, and prioritizing specific governance and management reforms. The Paper also stresses on the need for establishing a national coordination mechanism for fostering federal/provincial harmony and ensuring the creation of appropriate counterpart institutional arrangements in the provinces and districts. Recommendations on restructuring BHUs at a management, oversight, quality related and community participation level will play a vital role in determining the manner in which the efficiency of these public health programs can be enhanced.

Contingency plan implementation.

PubMed

Neurath, D; Cober, N; Owens, W; Giulivi, A

2012-06-01

Although the National blood system in Canada reduces the risk of inventory shortages the possibility of a blood supply shortage still exists. The Ontario Ministry of Health and Long-Term Care developed a provincial plan to manage blood transfusion needs and inventory in the event of a National blood shortage. The Ontario plan was developed to align with the National plan as well as other provincial plans in order to ensure consistency in blood management strategies across the country. The Ontario plan was released in 2008, along with a toolkit to aid hospitals in developing their facility specific plans. In the Champlain region of Ontario, a group of 16 hospitals worked collaboratively to develop a regional blood shortage plan. A provincial blood shortage simulation exercise was held in 2010 to test out these plans. The Director of Transfusion Medicine of the largest facility in the group of 16 hospitals (The Ottawa Hospital) took the lead in the development of the regional blood shortage management plan. Working groups from all 16 sites contributed to the plan development. The proposed plan was presented to the Medical Advisory Committee for approval. The plan consists of activities relating to the severity of the supply shortage as defined by Amber, Red, Recovery and Green phases. The plan includes a communication plan for notifying stakeholders including patients whose treatment may be affected. Inventory management and triage guidelines are provided to reduce the demand for blood and to conserve inventory for those patients whose need is prioritized as highest. The regional blood shortage management plan was tested successfully during the provincial simulation exercise. Where regional hospitals work together to provide healthcare, it is beneficial to develop a standardized plan to provide guidance to hospital personnel in response to a blood supply shortage. A consistent plan will ensure patient care is provided in a consistent manner across a health region. Mock or simulation exercises can aid in testing plans and raising the awareness of stakeholders. Copyright © 2012 Elsevier Ltd. All rights reserved.

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

PubMed

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes involved in developing CHW programmes at scale, and specifically the negotiated and multilevel nature of leadership and governance in such programmes, spanning analytic, managerial, technical and political roles.

Capacity and principles of participation of the provincial fund of environmental protection and water management in Cracow in Cracow program of elimination of low emission sources

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

Bolek, K.; Sarzynski, H.

1995-12-31

In general, the principles of environmental protection was determined by Law issued January 31, 1980. Certain detailed solutions have been included in several amendments in subsequent years and the uniformed text of the Law on Environmental Protection and Creation was published in 1994. The Provincial Fund of Environmental Protection and Water Management was established in 1989 but until 1993 the Fund has no legal status. The main purpose of the creation of such fund was to assign certain financial means to the defined tasks related to environmental protection. This way the fund accumulates financial means from the fees paid formore » the usage of the natural environmental for business purposes and from penalties becoming due in the case of non-observance of the environmental protection standards. On the other hand, the Fund spends money for tasks in the field of environmental protection requiring urgent implementation. It should be added that - after few amendments brought into force - the Provincial Funds are able to assign a greater amount of money to the implementation of these tasks. The basic purposes of Provincial Fund activity, defined by Law, determine the policy and criteria of the selection of undertaking. This is also a base for making programs of activity and for creation of the list of priorities. The environmental protection problems in the individual provinces are different. Therefore, the scope of works partly financed by the Fund is very differentiated both in essence and in the method of financing. The former system of subsidies is now being replaced with a wide range of partial financing of undertakings in the field of environmental protection. The system of selection of these undertakings has been changed essentially. The selection of tasks and methods of their financing is based on economic criteria.« less

[The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

PubMed

Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

2016-11-11

Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems. Conclusion: This system established is appropriate at current time, and it can effectively evaluate the performance of the Chinese provincial Blindness prevention technical guidance group. (Chin J Ophthalmol, 2016, 52:814-824) .

How Health in All Policies are developed and implemented in a developing country? A case study of a HiAP initiative in Iran.

PubMed

Khayatzadeh-Mahani, Akram; Sedoghi, Zeynab; Mehrolhassani, Mohammad Hossein; Yazdi-Feyzabadi, Vahid

2016-12-01

Population health is influenced by many factors beyond the control of health system which should be addressed by other sectors through inter-sectoral collaboration (ISC). Countries have adopted diverse initiatives to operationalize ISC for health such as establishment of Councils of Health and Food Security (CHFSs) and development of provincial Health Master Plans (HMPs) in Iran. The literature, however, provides meager information on how these initiatives have been moved into the top policy agenda, how and by whom they have been formulated and what factors enable or inhibit their implementation. In addressing these knowledge gaps, we employed a qualitative case study approach, incorporating mixed methods: in-depth interviews and a textual analysis of policy documents. Iran founded the Supreme Council of Health and Food Security (SCHFS) at national level in 2006 followed by provincial and district CHFSs to ensure political commitment to ISC for health and Health in All Policies (HiAPs). In 2009, the SCHFS mandated all provincial CHFSs across the country to develop provincial HMP to operationalize the HiAP approach and Kerman was among the first provinces which responded to this call. We selected Kerman province HMP as a case study to investigate the research questions raised in this study. The study revealed two types of leverage, which played crucial role in agenda setting, policy formulation and implementation of HMP including politics (political commitment) and policy entrepreneurs. The multiple streams model was found to be informative for thinking about different stages of a policy cycle including agenda setting, policy formulation and policy implementation. It was also found to be a useful framework in analyzing HiAP initiatives as these policies do not smoothly and readily reach the policy agenda. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Fish faunal provinces of the conterminous United States of America reflect historical geography and familial composition.

PubMed

Matamoros, Wilfredo A; Hoagstrom, Christopher W; Schaefer, Jacob F; Kreiser, Brian R

2016-08-01

Although the conterminous USA has a long history of ichthyological exploration, the description of biogeographical provinces has been ad hoc. In this study we quantitatively determined fish faunal provinces and interpreted them in the context of the geological history of North America. We also evaluated influences of major river basin occupancy and contemporary environmental factors on provincial patterns. Our data set comprised 794 native fishes, which we used to generate a presence and absence matrix for U.S. Geological Survey (USGS) four-digit hydrologic units. Three nested data sets were analysed separately: primary freshwater families, continental freshwater families (including primary and secondary families) and all freshwater families (including primary, secondary and peripheral families). We used clustering analysis to delimit faunal breaks and one-way analysis of similarity (ANOSIM) to determine significance among clusters (i.e. provinces). We used an indicator-species analysis to identify species that contributed most to province delineations and a similarity-percentage (SIMPER) analysis to describe the relative influence of representatives from each category (i.e. primary, secondary, peripheral) on provincial boundaries. Lastly, we used a parsimony redundancy analysis to determine the roles of historical (i.e. major river basin) and contemporary environmental factors in shaping provinces. Analysis of the nested data sets revealed lessening provincial structure with inclusion of more families. There were 10 primary freshwater provinces, 9 continental freshwater provinces and 7 all freshwater provinces. Major basin occupancy, but not contemporary environmental factors, explained substantial variance in faunal similarities among provinces. However, provincial boundaries did not conform strictly to modern river basins, but reflected river-drainage connections of the Quaternary. Provinces represent broad-scale patterns of endemism and provide a starting point for future studies. Relative malleability of province boundaries in the continental interior highlights this region as biogeographically diverse and dynamic. Interior-core provinces of this region (Central Gulf Coastal Plains, Northern Interior) have not been recognized previously and warrant further study. © 2015 Cambridge Philosophical Society.

Development of a high-resolution emission inventory and its evaluation and application through air quality modeling for Jiangsu Province, China

NASA Astrophysics Data System (ADS)

Zhao, Yu; Zhou, Yaduan; Mao, Pan; Zhang, Jie

2017-04-01

Improved emission inventories combining detailed source information are crucial for better understanding the atmospheric chemistry and effectively making emission control policies using air quality simulation, particularly at regional or local scales. With the downscaled inventories directly applied, chemical transport model might not be able to reproduce the authentic evolution of atmospheric pollution processes at small spatial scales. Using the bottom-up approach, a high-resolution emission inventory was developed for Jiangsu China, including SO2, NOx, CO, NH3, volatile organic compounds (VOCs), total suspended particulates (TSP), PM10, PM2.5, black carbon (BC), organic carbon (OC), and CO2. The key parameters relevant to emission estimation for over 6000 industrial sources were investigated, compiled and revised at plant level based on various data sources and on-site survey. As a result, the emission fractions of point sources were significantly elevated for most species. The improvement of this provincial inventory was evaluated through comparisons with other inventories at larger spatial scales, using satellite observation and air quality modeling. Compared to the downscaled Multi-resolution Emission Inventory for China (MEIC), the spatial distribution of NOX emissions in our provincial inventory was more consistent with summer tropospheric NO2 VCDs observed from OMI, particularly for the grids with moderate emission levels, implying the improved emission estimation for small and medium industrial plants by this work. Three inventories (national, regional, and provincial by this work) were applied in the Models-3/Community Multi-scale Air Quality (CMAQ) system for southern Jiangsu October 2012, to evaluate the model performances with different emission inputs. The best agreement between available ground observation and simulation was found when the provincial inventory was applied, indicated by the smallest normalized mean bias (NMB) and normalized mean errors (NME) for all the concerned species SO2, NO2, O3 and PM2.5. The result thus implied the advantage of improved emission inventory at local scale for high resolution air quality modeling. Under the unfavorable meteorology in which horizontal and vertical movement of atmosphere was limited, the simulated SO2 concentrations at downtown Nanjing (the capital city of Jiangsu) using the regional or national inventories were much higher than observation, implying the overestimated urban emissions when economy or population densities were applied to downscale or allocate the emissions. With more accurate spatial distribution of emissions at city level, the simulated concentrations using the provincial inventory were much closer to observation. Sensitivity analysis of PM2.5 and O3 formation was conducted using the improved provincial inventory through the Brute Force method. Iron & steel and cement plants were identified as important contributors to the PM2.5 concentrations in Nanjing. The O3 formation was VOCs-limited in southern Jiangsu, and the concentrations were negatively correlated with NOX emissions in urban areas owing to the accumulated NOx from transportation. More evaluations are further suggested for the impacts of speciation and temporal and vertical distribution of emissions on air quality modeling at regional or local scales in China.

Development of a high-resolution emission inventory and its evaluation and application through air quality modeling for Jiangsu Province, China

NASA Astrophysics Data System (ADS)

Zhou, Yaduan; Zhao, Yu; Mao, Pan; Zhang, Qiang; Zhang, Jie; Qiu, Liping; Yang, Yang

2017-01-01

Improved emission inventories combining detailed source information are crucial for better understanding of the atmospheric chemistry and effectively making emission control policies using air quality simulation, particularly at regional or local scales. With the downscaled inventories directly applied, chemical transport models might not be able to reproduce the authentic evolution of atmospheric pollution processes at small spatial scales. Using the bottom-up approach, a high-resolution emission inventory was developed for Jiangsu China, including SO2, NOx, CO, NH3, volatile organic compounds (VOCs), total suspended particulates (TSP), PM10, PM2.5, black carbon (BC), organic carbon (OC), and CO2. The key parameters relevant to emission estimation for over 6000 industrial sources were investigated, compiled, and revised at plant level based on various data sources and on-site surveys. As a result, the emission fractions of point sources were significantly elevated for most species. The improvement of this provincial inventory was evaluated through comparisons with other inventories at larger spatial scales, using satellite observation and air quality modeling. Compared to the downscaled Multi-resolution Emission Inventory for China (MEIC), the spatial distribution of NOx emissions in our provincial inventory was more consistent with summer tropospheric NO2 VCDs observed from OMI, particularly for the grids with moderate emission levels, implying the improved emission estimation for small and medium industrial plants by this work. Three inventories (national, regional, and provincial by this work) were applied in the Models-3 Community Multi-scale Air Quality (CMAQ) system for southern Jiangsu October 2012, to evaluate the model performances with different emission inputs. The best agreement between available ground observation and simulation was found when the provincial inventory was applied, indicated by the smallest normalized mean bias (NMB) and normalized mean errors (NME) for all the concerned species SO2, NO2, O3, and PM2.5. The result thus implied the advantage of improved emission inventory at local scale for high-resolution air quality modeling. Under the unfavorable meteorology in which horizontal and vertical movement of atmosphere was limited, the simulated SO2 concentrations at downtown Nanjing (the capital city of Jiangsu) using the regional or national inventories were much higher than those observed, implying that the urban emissions were overestimated when economy or population densities were applied to downscale or allocate the emissions. With more accurate spatial distribution of emissions at city level, the simulated concentrations using the provincial inventory were much closer to observation. Sensitivity analysis of PM2.5 and O3 formation was conducted using the improved provincial inventory through the brute force method. Iron and steel plants and cement plants were identified as important contributors to the PM2.5 concentrations in Nanjing. The O3 formation was VOC-limited in southern Jiangsu, and the concentrations were negatively correlated with NOx emissions in urban areas owing to the accumulated NOx from transportation. More evaluations are further suggested for the impacts of speciation and temporal and vertical distribution of emissions on air quality modeling at regional or local scales in China.

Stakeholders’ analysis of the medical tourism industry: development strategies in Isfahan

PubMed Central

Jabbari, Alireza; Ferdosi, Masoud; Keyvanara, Mahmoud; Agharahimi, Zahra

2013-01-01

Introduction: Policy makers and decision makers must identify the stakeholders in medical tourism, who will be affected by and/or affect this industry, and determine their status for partnership. The aim of this study was to identify the main stakeholders in Isfahan's medical tourism, analyze them, and provide strategies for developing this industry. Materials and Methods: A qualitative study was conducted in 2011. At first, the key stakeholders in medical tourism were identified in accordance with the experts’ idea and literature review. Then we interviewed the key stakeholders. Data analysis was conducted using the stakeholders’ analyses, which helped in developing strategies. Results: The result showed that the key stakeholders were made up of nine groups. They included the provincial governance of Isfahan, the Cultural Heritage and Tourism Organization of Isfahan, the Chamber of Commerce, the Medical Council, the Isfahan University of Medical Sciences, health service providers, tourism services providers, investors, and the Tosea Saderat Bank. The rate of knowledge of the Cultural Heritage and Tourism Organization of Isfahan, clinic and international relationship of Isfahan University of Medical Sciences from government policy about medical tourism were very much. Private Hospitals, the Medical Council, investors, and the University of Medical Sciences had great power. Private hospitals, clinics, the Cultural Heritage and Tourism Organization of Isfahan, and the University of Medical Sciences were in the supporter position. The effected strategies were the included strategies, focused on increasing power; increasing support, and on maintaining the position. Conclusion: There are different stakeholders in the medical tourism industry. Thus, policy makers can plan, make a policy and decision, and use effective strategies to develop medical tourism by designing a medical tourism stakeholders’ network, a medical tourism provincial council, and clarify the roles and responsibilities of stakeholders. PMID:24251280

Technical efficiency of rural primary health care system for diabetes treatment in Iran: a stochastic frontier analysis.

PubMed

Qorbani, Mostafa; Farzadfar, Farshad; Majdzadeh, Reza; Mohammad, Kazem; Motevalian, Abbas

2017-01-01

Our aim was to explore the technical efficiency (TE) of the Iranian rural primary healthcare (PHC) system for diabetes treatment coverage rate using the stochastic frontier analysis (SFA) as well as to examine the strength and significance of the effect of human resources density on diabetes treatment. In the SFA model diabetes treatment coverage rate, as a output, is a function of health system inputs (Behvarz worker density, physician density, and rural health center density) and non-health system inputs (urbanization rate, median age of population, and wealth index) as a set of covariates. Data about the rate of self-reported diabetes treatment coverage was obtained from the Non-Communicable Disease Surveillance Survey, data about health system inputs were collected from the health census database and data about non-health system inputs were collected from the census data and household survey. In 2008, rate of diabetes treatment coverage was 67% (95% CI: 63%-71%) nationally, and at the provincial level it varied from 44% to 81%. The TE score at the national level was 87.84%, with considerable variation across provinces (from 59.65% to 98.28%).Among health system and non-health system inputs, only the Behvarz density (per 1000 population)was significantly associated with diabetes treatment coverage (β (95%CI): 0.50 (0.29-0.70), p  < 0.001). Our findings show that although the rural PHC system can considered efficient in diabetes treatment at the national level, a wide variation exists in TE at the provincial level. Because the only variable that is predictor of TE is the Behvarz density, the PHC system may extend the diabetes treatment coverage by using this group of health care workers.

How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study.

PubMed

Norris, Jill M; White, Deborah E; Nowell, Lorelli; Mrklas, Kelly; Stelfox, Henry T

2017-08-01

Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various stakeholders.

Implementation of the Xpert MTB/RIF assay for tuberculosis in Mongolia: a qualitative exploration of barriers and enablers

PubMed Central

Bekhbat, Solongo; Ganbaatar, Gantungalag; Dorjravdan, Munkhjargal; Pai, Madhukar; Dobler, Claudia C.

2017-01-01

Objective The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia’s National Tuberculosis Program. Methods Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia’s capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software. Results Eight laboratory staff (five from the National Tuberculosis Reference Laboratory in Ulaanbaatar and three from provincial laboratories) and sixteen tuberculosis physicians (five from the Mongolian National Center for Communicable Diseases in Ulaanbaatar, four from district tuberculosis clinics in Ulaanbaatar and seven from provincial tuberculosis clinics) were interviewed. Major barriers to Xpert MTB/RIF implementation identified were: lack of awareness of program guidelines; inadequate staffing arrangements; problems with cartridge supply management; lack of local repair options for the Xpert machines; lack of regular formal training; paper based system; delayed treatment initiation due to consensus meeting and poor sample quality. Enablers to Xpert MTB/RIF implementation included availability of guidelines in the local language; provision of extra laboratory staff, shift working arrangements and additional modules; capacity for troubleshooting internally; access to experts; opportunities for peer learning; common understanding of diagnostic algorithms and decentralised testing. Conclusion Our study identified a number of barriers and enablers to implementation of Xpert MTB/RIF in the Mongolian National Tuberculosis Program. Lessons learned from this study can help to facilitate implementation of Xpert MTB/RIF in other Mongolian locations as well as other low-and middle-income countries. PMID:28717600

Strengthening the capacity for health promotion in South Africa through international collaboration.

PubMed

Van den Broucke, Stephan; Jooste, Heila; Tlali, Maki; Moodley, Vimla; Van Zyl, Greer; Nyamwaya, David; Tang, Kwok-Cho

2010-06-01

This paper describes a project to strengthen the capacity for health promotion in two Provinces in South Africa. The project draws on the key health promotion capacity dimensions of partnership and networking, infrastructure, problem-solving capacity, and knowledge transfer. The project was carried out in a partnership between the Provinces, the Ministry of Health of South Africa, the government of Flanders, Belgium, and the World Health Organization (WHO). The project aimed to: (i) integrate health promotion into national, Provincial and district level health policy plans (ii) strengthen the health promotion capacity in the two Provinces; and (iii) support the development of tools to monitor and evaluate health promotion interventions. Starting from a situation analysis and identification of priority health issues and existing actions in each Province, capacity-building workshops were organized for senior participants from various sectors. Community-based health promotion interventions were then planned and implemented in both Provinces. A systematic evaluation of the project involving an internal audit of project activities and results based on document analysis, site visits, focus groups and interviews with key persons demonstrated that stakeholders in both Provinces saw an increase of capacity in terms of networking, knowledge transfer, problem solving, and to a lesser extent infrastructure. Health promotion had been well integrated in the Provincial health plans, and roll-out processes with local stakeholders had started after the conclusion of the project. The development of tools for monitoring and evaluation of health promotion was less well achieved. The project illustrates how capacities to deliver health promotion interventions in a developing country can be enhanced through international collaboration. The conceptual model of capacity building that served as a basis for the project provided a useful framework to plan, identify and assess the key components of health promotion capacity in an African context.

The cascade of HIV care in British Columbia, Canada, 1996–2011: a population-based retrospective cohort study

PubMed Central

Nosyk, Bohdan; Montaner, Julio S G; Colley, Guillaume; Lima, Viviane D; Chan, Keith; Heath, Katherine; Yip, Benita; Samji, Hasina; Gilbert, Mark; Barrios, Rolando; Gustafson, Réka; Hogg, Robert S

2014-01-01

Summary Background The cascade of HIV care has become a focal point for implementation efforts to maximise the individual and public health benefits of antiretroviral therapy. We aimed to characterise longitudinal changes in engagement with the cascade of HIV care in British Columbia, Canada, from 1996 to 2011. Methods We used estimates of provincial HIV prevalence from the Public Health Agency of Canada and linked provincial population-level data to define, longitudinally, the numbers of individuals in each of the eight stages of the cascade of HIV care (HIV infected, diagnosed, linked to HIV care, retained in HIV care, highly active antiretroviral therapy (HAART) indicated, on HAART, adherent to HAART, and virologically suppressed) in British Columbia from 1996 to 2011. We used sensitivity analyses to determine the sensitivity of cascade-stage counts to variations in their definitions. Findings 13 140 people were classified as diagnosed with HIV/AIDS in British Columbia during the study period. We noted substantial improvements over time in the proportions of individuals at each stage of the cascade of care. Based on prevalence estimates, the proportion of unidentified HIV-positive individuals decreased from 49·0% (estimated range 36·2–57·5%) in 1996 to 29·0% (11·6–40·7%) in 2011, and the proportion of HIV-positive people with viral suppression reached 34·6% (29·0–43·1%) in 2011. Interpretation Careful mapping of the cascade of care is crucial to understanding what further efforts are needed to maximise the beneficial effects of available interventions and so inform efforts to contain the spread of HIV/AIDS. Funding British Columbia Ministry of Health, US National Institute on Drug Abuse (National Institutes of Health). PMID:24076277

Stakeholders' analysis of the medical tourism industry: development strategies in Isfahan.

PubMed

Jabbari, Alireza; Ferdosi, Masoud; Keyvanara, Mahmoud; Agharahimi, Zahra

2013-01-01

Policy makers and decision makers must identify the stakeholders in medical tourism, who will be affected by and/or affect this industry, and determine their status for partnership. The aim of this study was to identify the main stakeholders in Isfahan's medical tourism, analyze them, and provide strategies for developing this industry. A qualitative study was conducted in 2011. At first, the key stakeholders in medical tourism were identified in accordance with the experts' idea and literature review. Then we interviewed the key stakeholders. Data analysis was conducted using the stakeholders' analyses, which helped in developing strategies. The result showed that the key stakeholders were made up of nine groups. They included the provincial governance of Isfahan, the Cultural Heritage and Tourism Organization of Isfahan, the Chamber of Commerce, the Medical Council, the Isfahan University of Medical Sciences, health service providers, tourism services providers, investors, and the Tosea Saderat Bank. The rate of knowledge of the Cultural Heritage and Tourism Organization of Isfahan, clinic and international relationship of Isfahan University of Medical Sciences from government policy about medical tourism were very much. Private Hospitals, the Medical Council, investors, and the University of Medical Sciences had great power. Private hospitals, clinics, the Cultural Heritage and Tourism Organization of Isfahan, and the University of Medical Sciences were in the supporter position. The effected strategies were the included strategies, focused on increasing power; increasing support, and on maintaining the position. There are different stakeholders in the medical tourism industry. Thus, policy makers can plan, make a policy and decision, and use effective strategies to develop medical tourism by designing a medical tourism stakeholders' network, a medical tourism provincial council, and clarify the roles and responsibilities of stakeholders.

Lifetime risk of stroke in young-aged and middle-aged Chinese population: the Chinese Multi-Provincial Cohort Study

PubMed Central

Wang, Ying; Liu, Jing; Wang, Wei; Wang, Miao; Qi, Yue; Xie, Wuxiang; Li, Yan; Sun, Jiayi; Liu, Jun; Zhao, Dong

2016-01-01

Objective: Stroke is a major cause of premature death in China. Early prevention of stroke requires a more effective method to differentiate the stroke risk among young-aged and middle-aged individuals than the 10-year risk of cardiovascular disease. This study aimed to establish a lifetime stroke risk model and risk charts for the young-aged and middle-aged population in China. Methods: The Chinese Multi-Provincial Cohort Study participants (n = 21 953) aged 35–84 years without cardiovascular disease at baseline were followed for 18 years (263 016 person-years). Modified Kaplan–Meier method was used to estimate the mean lifetime stroke risk up to age of 80 years and the lifetime stroke risk according to major stroke risk factors for the population aged 35–60 years. Results: A total of 917 participants developed first-ever strokes. For the participants aged 35–40 years (98 stroke cases), the lifetime stroke risk was 18.0 and 14.7% in men and women, respectively. Blood pressure most effectively discriminated the lifetime stroke risk. The lifetime risk of stroke for the individuals with all risk factors optimal was 8–10 times lower compared with those with two or more high risk factors at age 35–60 years at baseline. Conclusion: In young-aged and middle-aged population, the lifetime stroke risk will keep very low if major risk factors especially blood pressure level is at optimal levels, but the risk substantially increases even with a slight elevation of major risk factors, which could not be identified using 10-year risk estimation. PMID:27512963

Use of SERTS (Socio-Economic, health Resources and Technologic Supplies) models to estimate cancer survival at provincial geographical level.

PubMed

Vercelli, Marina; Lillini, Roberto; Capocaccia, Riccardo; Quaglia, Alberto

2012-12-01

The main aim of this work is to compute expected cancer survival for Italian provinces by Socio-Economic and health Resources and Technologic Supplies (SERTS) models, based on demographic, socioeconomic variables and information describing the health care system (SEH). Five-year age-standardised relative survival rates by gender for 11 cancer sites and all cancers combined of patients diagnosed in 1995-1999, were obtained from the Italian Association of Cancer Registries (CRs) database. The SEH variables describe at provincial level macro-economy, demography, labour market, health resources in 1995-2005. A principal components factor analysis was applied to the SEH variables to control their strong mutual correlation. For every considered cancer site, linear regression models were estimated considering the 5-RS% as dependent variable and the principal components factors of the SEH variables as independent variables. The model composition was correlated to the characteristics of take in charge of patients. SEH factors were correlated with the observed survival for all cancer combined and colon-rectum in both sexes, prostate, kidney and non Hodgkin's lymphomas in men, breast, corpus uteri and melanoma in women (R(2) from 40% to 85%). In the provinces without any CR the survival was very similar with that of neighbouring provinces with analogous social, economic and health characteristics. The SERTS models allowed us to interpret the survival outcome of oncologic patients with respect to the role of the socio-economic and health related system characteristics, stressing how the peculiarities of the take in charge at the province level could address the decisions regarding the allocation of resources. Copyright © 2012 Elsevier Ltd. All rights reserved.

Geographical distribution and evolution of deaths in hospitals in Spain, 1996-2015.

PubMed

Jiménez-Puente, A; García Alegría, J

2018-05-05

The location where death occurs varies widely among societies. The aim of this study was to describe the evolution in the hospital mortality rate (HMR) in Spain over the course of 20years and its distribution by province during a more recent period and to explore its relationship with potential explanatory variables. This was an ecological study. The population mortality rates were obtained from the Natural Population Movement (Movimiento Natural de la Población), and the hospital mortality rates were obtained from the Specialised Care Information System (Sistema de Información en Atención Especializada), which includes information from all hospitals in Spain. We calculated the mortality rates for patients who were not surveyed and the HMR at the national level between 1996 and 2015 and for provinces between 2013 and 2015. The relationship between the provincial distribution of HMR and various demographic, socioeconomic and healthcare variables were analysed through simple and multiple linear regression. The HMR in Spain increased from 49% in 1996 to 56% in 2007, having remained stable from 1996 to 2015. The variation among provinces was 40% to 70%. The multivariate analysis showed a higher HMR in the less rural provinces and in those with a larger availability of hospital beds. There is considerable provincial heterogeneity in Spain in terms of the probability of dying in hospital or at home. This result could be partly explained by demographics (percentage of rural population) and the healthcare structure (number of hospital beds per population). Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Auditing chronic disease care: Does it make a difference?

PubMed Central

van Vuuren, Unita; De Sa, Angela; Govender, Srini; Murie, Katie; Schlemmer, Arina; Gunst, Colette; Namane, Mosedi; Boulle, Andrew; de Vries, Elma

2015-01-01

Background An integrated audit tool was developed for five chronic diseases, namely diabetes, hypertension, asthma, chronic obstructive pulmonary disease and epilepsy. Annual audits have been done in the Western Cape Metro district since 2009. The year 2012 was the first year that all six districts in South Africa's Western Cape Province participated in the audit process. Aim To determine whether clinical audits improve chronic disease care in health districts over time. Setting Western Cape Province, South Africa. Methods Internal audits were conducted of primary healthcare facility processes and equipment availability as well as a folder review of 10 folders per chronic condition per facility. Random systematic sampling was used to select the 10 folders for the folder review. Combined data for all facilities gave a provincial overview and allowed for comparison between districts. Analysis was done comparing districts that have been participating in the audit process from 2009 to 2010 (‘2012 old’) to districts that started auditing recently (‘2012 new’). Results The number of facilities audited has steadily increased from 29 in 2009 to 129 in 2012. Improvements between different years have been modest, and the overall provincial average seemed worse in 2012 compared to 2011. However, there was an improvement in the ‘2012 old’ districts compared to the ‘2012 new’ districts for both the facility audit and the folder review, including for eight clinical indicators, with ‘2012 new’ districts being less likely to record clinical processes (OR 0.25, 95% CI 0.21–0.31). Conclusion These findings are an indication of the value of audits to improve care processes over the long term. It is hoped that this improvement will lead to improved patient outcomes. PMID:26245615

Use of Lean Response to Improve Pandemic Influenza Surge in Public Health Laboratories

PubMed Central

Chang, Yin; Prystajecky, Natalie; Petric, Martin; Mak, Annie; Abbott, Brendan; Paris, Benjamin; Decker, K.C.; Pittenger, Lauren; Guercio, Steven; Stott, Jeff; Miller, Joseph D.

2012-01-01

A novel influenza A (H1N1) virus detected in April 2009 rapidly spread around the world. North American provincial and state laboratories have well-defined roles and responsibilities, including providing accurate, timely test results for patients and information for regional public health and other decision makers. We used the multidisciplinary response and rapid implementation of process changes based on Lean methods at the provincial public health laboratory in British Columbia, Canada, to improve laboratory surge capacity in the 2009 influenza pandemic. Observed and computer simulating evaluation results from rapid processes changes showed that use of Lean tools successfully expanded surge capacity, which enabled response to the 10-fold increase in testing demands. PMID:22257385

The effect of socioeconomic status and social inclusion on the mental health of Chinese migrants: A comparison between interprovincial and intra-provincial migrants.

PubMed

Yi, Yingying; Liang, Ying

2017-07-01

This article sought to explore the impacts of socioeconomic status and social inclusion on intra-provincial and interprovincial migrants' mental health by constructing the Bayesian structural equation model. A total of 14,584 migrants aged 15-59 years living in eight cities of China were selected. It was found that the impacts of socioeconomic status and social inclusion on mental health were converse for these two groups. And the manifest variables coefficients of socioeconomic status and social inclusion were also converse. Therefore, governments should make some policies to further improve the mental health of migrants, including strengthening the community cohesion, social atmosphere, and governmental support.

The Leap of a Provincial SME into the Global Market Using E-commerce: The Success of Adequate Planning

NASA Astrophysics Data System (ADS)

Sainz de Abajo, Beatriz; García Salcines, Enrique; Burón Fernández, F. Javier; López Coronado, Miguel; de Castro Lozano, Carlos

The leap into the global market is not easy when it involves a provincial family business. This article demonstrates how adequate planning is fundamental in a small and medium-sized enterprise (SME) with the tight budget they have available to them, in order to be able to differentiate themselves in a highly competitive market, taking into accounts the benefits and risks involved. The Information Technology (IT) tools put in place will give the necessary support and allow for the possibility of increasing and improving the infrastructure as the company requires. An adequate strategy for the future to increases sales would be e-marketing techniques as well as the current promotions which contribute to diffusing the brand.

Etude de faisabilite de l'insertion d'une membrane elastomere a renfort textile dans l'aspirateur d'une centrale hydroelectrique

NASA Astrophysics Data System (ADS)

Delorme, Rolland

The generation of electrical energy in Quebec, estimated to 200 TWh, comes from hydroelectric generating stations for 96 % which are at the heart of provincial ecological and economic challenges. An important amount of research has been devoted to improving the hydrodynamic profile of hydraulic turbines to maximize their energy efficiency. However, few studies have focused on the draft tube in hydroelectric power plants, which is the duct where water flows out after crossing the turbine. Recent calculations performed by Alstom Power & Transport Canada Inc. revealed that the shape modulation of the draft tube could increase the hydroelectric generating station performance. The goal of this research was to assess the feasibility of this shape modification in existing draft tubes with inflatable composite membranes. The study consisted first of building an experimental setup to test the inflation of at membranes made up of a fiberglass-reinforced rubber composite. The inflated membranes were digitized with an optical equipment enabling 3D representations of their deflections. The second part of the study aimed at building finite element models reproducing the same experiments and enabling the design of more complicated membranes. The study confirmed the technical feasibility of designing and manufacturing such a membrane for the targeted application. However the large-scale roll-out will require to manufacture 3D membranes with the proper anchoring system. Keywords: reinforced rubber composite, reinforced elastomer composite, textile reinforcement, finite element modeling, mechanical behavior.

Feedforward interview technique in obstetrics and gynaecology residents: a fact or fallacy.

PubMed

Sami, Shehla; Ahmad, Amina

2015-01-01

To determine the role of Feedforward Interview (FFI) technique in motivating residents of Obstetrics and Gynaecology for better learning and performance. An explorative study with mixed method approach being employed. Department of Obstetrics and Gynaecology, Sandeman (Provincial) Hospital, Quetta, from November 2010 till May 2013. Feedforward interview technique was complimented by survey questionnaire employing similar philosophy of FFI to triangulate data through two methods. Survey questionnaire was filled-up by 21 residents and analysed by SPSS version 17. Fourteen of these participants were identified for in-depth Feedforward Interviews (FFI), based on nonprobability purposive sampling after informed consent, and content analysis was done. Feedforward interview technique enabled majority of residents in recalling minimum of 3 positive experiences, mainly related to surgical experiences, which enhanced their motivation to aspire for further improvement in this area. Hard work was the main personal contributing factor both in FFI and survey. In addition to identifying clinical experiences enhancing desire to learn, residents also reported need for more academic support as an important factor which could also boost motivation to attain better performance. Feedforward interview technique not only helps residents in recalling positive learning experiences during their training but it also has a significant influence on developing insight about one's performance and motivating residents to achieve higher academic goals.

Food marketing in recreational sport settings in Canada: a cross-sectional audit in different policy environments using the Food and beverage Marketing Assessment Tool for Settings (FoodMATS).

PubMed

Prowse, Rachel J L; Naylor, Patti-Jean; Olstad, Dana Lee; Carson, Valerie; Storey, Kate; Mâsse, Louise C; Kirk, Sara F L; Raine, Kim D

2018-05-31

Children's recreational sport settings typically sell energy dense, low nutrient products; however, it is unknown whether the same types of food and beverages are also marketed in these settings. Understanding food marketing in sports settings is important because the food industry often uses the promotion of physical activity to justify their products. This study aimed to document the 'exposure' and 'power' of food marketing present in public recreation facilities in Canada and assess differences between provinces with and without voluntary provincial nutrition guidelines for recreation facilities. Food marketing was measured in 51 sites using the Food and beverage Marketing Assessment Tool for Settings (FoodMATS). The frequency and repetition ('exposure') of food marketing and the presence of select marketing techniques, including child-targeted, sports-related, size, and healthfulness ('power'), were assessed. Differences in 'exposure' and 'power' characteristics between sites in three guideline provinces (n = 34) and a non-guideline province (n = 17) were assessed using Pearson's Chi squared tests of homogeneity and Mann-Whitney U tests. Ninety-eight percent of sites had food marketing present. The frequency of food marketing per site did not differ between guideline and non-guideline provinces (median = 29; p = 0.576). Sites from guideline provinces had a significantly lower proportion of food marketing occasions that were "Least Healthy" (47.9%) than sites from the non-guideline province (73.5%; p < 0.001). Use of child-targeted and sports-related food marketing techniques was significantly higher in sites from guideline provinces (9.5% and 10.9%, respectively), than in the non-guideline province (1.9% and 4.5% respectively; p values < 0.001). It was more common in the non-guideline province to use child-targeted and sports-related techniques to promote "Least Healthy" items (100.0% and 68.4%, respectively), compared to the guideline provinces (59.3% and 52.0%, respectively). Recreation facilities are a source of children's exposure to unhealthy food marketing. Having voluntary provincial nutrition guidelines that recommend provision of healthier foods was not related to the frequency of food marketing in recreation facilities but was associated with less frequent marketing of unhealthy foods. Policy makers should provide explicit food marketing regulations that complement provincial nutrition guidelines to fulfill their ethical responsibility to protect children and the settings where children spend time.

Immunization delivery in British Columbia

PubMed Central

Omura, John; Buxton, Jane; Kaczorowski, Janusz; Catterson, Jason; Li, Jane; Derban, Andrea; Hasselback, Paul; Machin, Shelagh; Linekin, Michelle; Morgana, Tamsin; O’Briain, Barra; Scheifele, David; Dawar, Meena

2014-01-01

Abstract Objective To explore the experiences of family physicians and pediatricians delivering immunizations, including perceived barriers and supports. Design Qualitative study using focus groups. Setting Ten cities throughout British Columbia. Participants A total of 46 family physicians or general practitioners, 10 pediatricians, and 2 residents. Methods A semistructured dialogue guide was used by a trained facilitator to explore participants’ experiences and views related to immunization delivery in British Columbia. Verbatim transcriptions were independently coded by 2 researchers. Key themes were analyzed and identified in an iterative manner using interpretive description. Main findings Physicians highly valued vaccine delivery. Factors facilitating physician-delivered immunizations included strong beliefs in the value of vaccines and having adequate information. Identified barriers included the large time commitment and insufficient communication about program changes, new vaccines, and the adult immunization program in general. Some physicians reported good relationships with local public health, while others reported the opposite experience, and this varied by geographic location. Conclusion These findings suggest that physicians are supportive of delivering vaccines. However, there are opportunities to improve the sustainability of physician-delivered immunizations. While compensation schemes remain under the purview of the provincial governments, local public health authorities can address the information needs of physicians. PMID:24627403

Telecommunications, health care, and legal liability

NASA Astrophysics Data System (ADS)

Levy, Chris

1990-06-01

Regulation of health care telecommunications is fragmented in Canada. Further neither the legislative nor the administrative nor the judicial processes have managed to respond successfully to the impact of telecommunications technology. The result is a legal environment that is necessarily speculative for both telecommunications service providers and health care personnel and facilities. Critical issues include ensuring confidentiality for sensitive patient records and health information liability of telecommunications service providers for inaccurate transmission liability of health care providers for use or non-use of telecommunications services. Limitation of legal liability for both telecommunications and health care service providers is likely to be most effective when based on contract but the creation of the necessary contracts is potentially unduly cumbersome both legally and practically. 1. CONSTITUTIONAL ASPECTS Telecommunications systems that are empowered to operate or connect cross provincial or international boundaries are subject to federal regulation bu the scheme is incomplete in respect of a system set up as a provincial agency. Health care on the other hand is very much a matter of provincial rather than federal authority as a matter of strict law but the fiscal strength of the federal government enables it to provide money to the provinces for financing health care and to4 use this as a device for securing compliance with certain federal standards. Nevertheless the political willingness of the federal health authorities to impose standards on the provinces

Emotional tone of ontario newspaper articles on the health effects of industrial wind turbines before and after policy change.

PubMed

Deignan, Benjamin; Hoffman-Goetz, Laurie

2015-01-01

Newspapers are often a primary source of health information for the public about emerging technologies. Information in newspapers can amplify or attenuate readers' perceptions of health risk depending on how it is presented. Five geographically distinct wind energy installations in Ontario, Canada were identified, and newspapers published in their surrounding communities were systematically searched for articles on health effects from industrial wind turbines from May 2007 to April 2011. The authors retrieved 421 articles from 13 community, 2 provincial, and 2 national newspapers. To measure the emotional tone of the articles, the authors used a list of negative and positive words, informed from previous studies as well as from a random sample of newspaper articles included in this study. The majority of newspaper articles (64.6%, n = 272) emphasized negative rather than positive/neutral tone, with community newspapers publishing a higher proportion of negative articles than provincial or national newspapers, χ(2)(2) = 15.1, p < .001. Articles were more likely to be negative when published 2 years after compared with 2 years before provincial legislation to reduce dependence on fossil fuels (the Green Energy Act), χ(2)(3) = 9.7, p < .05. Repeated public exposure to negative newspaper content may heighten readers' health risk perceptions about wind energy.

Effect of smoke-free patio policy of restaurants and bars on exposure to second-hand smoke.

PubMed

Azagba, Sunday

2015-07-01

While there is increasing support for restricting smoking in restaurant and bar patios, there is limited evidence on the effectiveness of this policy. This study examined the effect of smoke-free patio policy of restaurants and bars on adult second-hand smoke (SHS) exposure. Data were drawn from the 2005-2012 Canadian Tobacco Use Monitoring Survey (n=89,743), a repeated cross-sectional survey of youth and adult. Regression analysis, a quasi-experimental design was used to examine the effect of provincial smoke-free patio policy on self-reported exposure to SHS. Analyses suggest that exposure to SHS on patios of bars and restaurants declined following the adoption of provincial smoke-free patio policy. Relative to pre-policy SHS exposure, regression results showed a reduction in the probability of SHS exposure of up to 25% in Alberta. Similarly, in Nova Scotia, the probability of SHS exposure declined by up to 21%. Analyses stratified by smoking status found similar significant effect on both smokers and non-smokers. Findings suggest that provincial patio smoking ban on bars and restaurants had the intended effect of protecting non-smokers from SHS exposure. This study is consistent with a large body of evidence showing that a strong smoke-free legislation is an effective public health measure. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Ecological analysis of the health effects of income inequality in Argentina.

PubMed

De Maio, Fernando G

2008-05-01

Despite a large body of empirical literature, a consensus has not been reached concerning the health effects of income inequality. This study contributes to ongoing debates by examining the robustness of the income inequality-population health relationship in Argentina, using five different income inequality indexes (each sensitive to inequalities in differing parts of the income spectrum) and five measures of population health. Cross-sectional, ecological study. Income and self-reported morbidity data from Argentina's 2001 Encuesta de Condiciones de Vida (Survey of living conditions) were analysed at the provincial level. Provincial rates of male/female life expectancy and infant mortality were drawn from the Instituto Nacional de Estadistica y Censos database. Life expectancy was correlated in the expected direction with provincial-level income inequality (operationalized as the Gini coefficient) for both males (r=-0.55, P<0.01) and females (r=-0.61, P<0.01), but this association was not robust for all five income inequality indexes. In contrast, infant mortality, self-reported poor health and self-reported activity limitation were not correlated with any of the income inequality indexes. This study adds further complexity to the literature on the health effects of income inequality by highlighting the important effects of operational definitions. Mortality and morbidity data cannot be used as reasonably interchangeable variables (a common practice in this literature), and the choice of income inequality indicator may influence the results.

Shenzhen, PRC

NASA Image and Video Library

2009-09-21

Shenzhen is a city of sub-provincial administrative status in southern China Guangdong province, immediately north of Hong Kong, and located in the Pearl River Delta. This image was acquired by NASA Terra spacecraft.

[Ecotourism exploitation model in Bita Lake Natural Reserve of Yunnan].

PubMed

Yang, G; Wang, Y; Zhong, L

2000-12-01

Bita lake provincial natural reserve is located in Shangri-La region of North-western Yunnan, and was set as a demonstrating area for ecotourism exploitation in 1998. After a year's exploitation construction and half a year's operation as a branch of the 99' Kunming International Horticulture Exposition to accept tourists, it was proved that the ecotourism demonstrating area attained four integrated functions of ecotourism, i.e., tourism, protection, poverty clearing and environment education. Five exploitation and management models including function zoned exploitation model, featured tourism communication model signs system designing model, local Tibetan family reception model and environmental monitoring model, were also successful, which were demonstrated and spreaded to the whole province. Bita lake provincial natural reserve could be a good sample for the ecotourism exploitation natural reserves of the whole country.

New distribution records for Canadian Aleocharinae (Coleoptera, Staphylinidae), and new synonymies for Trichiusa.

PubMed

Klimaszewski, Jan; Godin, Benoit; Langor, David; Bourdon, Caroline; Lee, Seung-Il; Horwood, Denise

2015-01-01

Fifty-four new Canadian provincial records of aleocharine beetles (Staphylinidae), including three new Canadian records and one new North American record, are presented. Of these, 33 are new provincial records for Saskatchewan, 14 for Alberta, two for British Columbia, three for Manitoba, two for the Northwest Territories and one for the Yukon Territory. The following are new Canadian records: Trichiusapilosa Casey [formerly reported from Nova Scotia and Ontario as Trichiusapostica Casey], Acrotonarecondita (Erichson) and the adventive Palaearctic Athetanigra (Kraatz), which is also a new North American record. Bionomics information and new locality records are provided. The following new synonyms of Trichiusapilosa Casey are established: Trichiusaatra Casey, Trichiusamonticola Casey, Trichiusaparviceps Casey, and Trichiusapostica Casey. The numbers of Aleocharinae remaining to be discovered in Canadian provinces and territories are discussed.

Projects in eastern Canada encounter strong opposition. [Hydroelectric power plants planned

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

Carr, F.H.

1993-09-13

At the end of August, Quebec's provincial utility submitted a long-awaited environmental impact statement on its proposed Great Whale project near Hudson Bay. It faces opposition, as does a big project planned in Labrador. Hydro-Quebec's EIS says its $10-billion, 3,210-Mw project [open quotes]would have impacts that are generally moderate and localized, and that can be mitigated,[close quotes] according to a utility spokeswoman. But environmental and Native American groups opposed to the project say its three powerhouses on the Great Whale River and 600 sq miles of new impoundments would destroy hunting and fishing areas and mar the environment. Five federalmore » and provincial review panels will determine over the next several weeks if the EIS meets their requirements.« less

76 FR 28414 - Provincial Advisory Committees Charter Re-Establishment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... recommendations to promote integration and coordination of forest management activities between Federal and non... implementation to promote integration and coordination of forest management activities between Federal and non...

The pitcher plant flesh fly exhibits a mixture of patchy and metapopulation attributes.

PubMed

Rasic, Gordana; Keyghobadi, Nusha

2012-01-01

We investigated the pattern of spatial genetic structure and the extent of gene flow in the pitcher plant flesh fly Fletcherimyia fletcheri, the largest member of the inquiline community of the purple pitcher plant Sarracenia purpurea. Using microsatellite loci, we tested the theoretical predictions of different hypothesized population models (patchy population, metapopulation, or isolated populations) among 11 bogs in Algonquin Provincial Park (Canada). Our results revealed that the pitcher plant flesh fly exhibits a mixture of patchy and metapopulation characteristics. There is significant differentiation among bogs and limited gene flow at larger spatial scales, but local populations do not experience frequent local extinctions/recolonizations. Our findings suggest a strong dispersal ability and stable population sizes in F. fletcheri, providing novel insights into the ecology of this member of a unique ecological microcosm.

Renewable energy opportunities in China

NASA Astrophysics Data System (ADS)

Wallace, William L.; Simon Tsuo, Y.

1996-01-01

Rapid growth in economic development coupled with the absence of an electric grid in large areas of rural China have created a need for new energy sources both in urban centers and the rural countryside. Electric capacity expansion plans call for increased use of coal-fired steam turbines for electricity production that will contribute to increased concerns over environmental pollution. China is rich in renewable energy resources, strategically located in areas of greatest need and economic viability. China is also already one of the world's largest users of renewables, especially hydro, wind, biomass, and solar thermal, and has significant experience with photovoltaics, geothermal and other technologies. The use of renewable energy is being encouraged in expanded programs at the central and provincial government levels, with growing private sector involvement. These conditions create opportunities for U.S. business participation in renewable energy markets in China.

Gamble While You Gamble: Electronic Games in Ontario Charitable Gaming Centres.

PubMed

Harrigan, Kevin; Brown, Dan; MacLaren, Vance

Electronic Bingo games have recently appeared in Ontario Charitable Gaming Centres. Here we summarize the characteristics of this novel form of electronic gambling, and give a detailed characterization of one game. We contend that these games have structural characteristics that make them similar to modern Electronic Gaming Machines (EGMs) that feature multiline slots games. These features include a fast and continuous gaming experience, with player adjustable win size and reinforcement rate, a high frequency of losses disguised as wins, and highly salient near misses. Some of these games also have bonus rounds and provide players with a list of recent wins. We conclude that provincial and state gaming authorities should be aware that the placement of Bingo EGMs in existing Bingo facilities may increase problem gambling among an already well-established community of Bingo enthusiasts.

77 FR 50979 - Northwest Forest Plan Provincial Advisory Committees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... of the recreation and tourism sectors; 14. Three to five representatives of the following interests... community. The PACs may invite a representative of the State Community Economic [[Page 50980...

Heterogeneity in Spinal Bone Mineral Density Among Young Adults From Three Eastern Provincial Capital Cities in Mainland China.

PubMed

Cheng, Xiao-Guang; Li, Kai; Ou, Shan-Xing; Tang, Guang-Yu; Wang, Qian-Qian; Wang, Chao; Wang, Ling; Tian, Wei

This study compares spinal volumetric bone mineral density (vBMD) with spinal areal bone mineral density (aBMD) among young adults from 3 eastern provincial capital cities in Mainland China. A total of 416 young adults (age range: 20-40 yr) from 3 eastern provincial capital cities (Beijing, Shanghai, and Guangzhou) in Mainland China were recruited in this study. From each subject, the vBMD of the lumbar spine was measured by the Mindways quantitative computed tomography system. Moreover, the aBMD of the lumbar spine, measured by the dual-energy X-ray absorptiometry, was extracted from a previous multicenter large-scale study, and the 420 participants were matched by age, gender, height, weight, as well as geographic territory. The vBMD and the aBMD values were further compared and analyzed. Generally, the bone mineral density (BMD) results were significantly different among participants from the 3 cities (p <0.05). Specifically, both vBMD and aBMD values of participants from Beijing were significantly different from those from Guangzhou (p <0.05). Additionally, a statistically significant difference in aBMD values was also found between participants from Beijing and Shanghai (p <0.05). However, no significant differences were found between participants from Shanghai and Guangzhou in terms of the aBMD and vBMD values (p 1  > 0.05 and p 2  > 0.05). Interestingly, the overall mean vBMD value was 5.9% greater in women than those in men for all the 3 cities (p <0.001). This study demonstrated an overall heterogeneity in spinal BMD among young adults from 3 eastern provincial capital cities in Mainland China. Specifically, the taller and heavier young adults from the northern part of China have smaller spinal vBMD but higher spinal aBMD values than those who were shorter and lighter from the southern part of China. Copyright © 2016 International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Are cannabis prevalence estimates comparable across countries and regions? A cross-cultural validation using search engine query data.

PubMed

Steppan, Martin; Kraus, Ludwig; Piontek, Daniela; Siciliano, Valeria

2013-01-01

Prevalence estimation of cannabis use is usually based on self-report data. Although there is evidence on the reliability of this data source, its cross-cultural validity is still a major concern. External objective criteria are needed for this purpose. In this study, cannabis-related search engine query data are used as an external criterion. Data on cannabis use were taken from the 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD). Provincial data came from three Italian nation-wide studies using the same methodology (2006-2008; ESPAD-Italia). Information on cannabis-related search engine query data was based on Google search volume indices (GSI). (1) Reliability analysis was conducted for GSI. (2) Latent measurement models of "true" cannabis prevalence were tested using perceived availability, web-based cannabis searches and self-reported prevalence as indicators. (3) Structure models were set up to test the influences of response tendencies and geographical position (latitude, longitude). In order to test the stability of the models, analyses were conducted on country level (Europe, US) and on provincial level in Italy. Cannabis-related GSI were found to be highly reliable and constant over time. The overall measurement model was highly significant in both data sets. On country level, no significant effects of response bias indicators and geographical position on perceived availability, web-based cannabis searches and self-reported prevalence were found. On provincial level, latitude had a significant positive effect on availability indicating that perceived availability of cannabis in northern Italy was higher than expected from the other indicators. Although GSI showed weaker associations with cannabis use than perceived availability, the findings underline the external validity and usefulness of search engine query data as external criteria. The findings suggest an acceptable relative comparability of national (provincial) prevalence estimates of cannabis use that are based on a common survey methodology. Search engine query data are a too weak indicator to base prevalence estimations on this source only, but in combination with other sources (waste water analysis, sales of cigarette paper) they may provide satisfactory estimates. Copyright © 2012. Published by Elsevier B.V.

The hospital costs of treating work-related sawmill injuries in British Columbia.

PubMed

Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

2007-05-01

This study estimates the hospital costs of treating work-related injury among a cohort of sawmill workers in British Columbia. Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5,876 actively employed sawmill workers. Injury cases were identified as work-related from these records using ICD-9 external cause of injury codes that indicate place of occurrence and the responsibility of payment schedule that identifies workers' compensation as being responsible for payment. The hospitals in British Columbia have a standard ward rate chart prepared annually by the provincial Ministry of Health to bill and collect payment from agency like workers' compensation agency. Costs were calculated from the hospital perspective using this billing chart. All costs were expressed in 1995 Canadian dollars. The workers' compensation claim records for this study population were extracted and matched with the hospitalised work-related injury records. Costs were also calculated for work-related hospitalisations that the hospital did not appear to be reimbursed for by the workers' compensation system. There were 173 injuries requiring hospitalisation during the 10-year followup period. The median stay in hospitals was 3 days and the median hospital costs were $847. The most costly cause of injury categories were fire, flame, natural and environmental and struck against with median costs of $10,575 and $1,206, respectively, while the least costly category was cutting and piercing with median costs of $296. The most costly nature of injury categories were burns and fracture of lower limb with median costs of $10,575 and $1,800, respectively, while the least costly category was dislocation, sprains and strains with median costs of $437. The total hospital costs for all the work-related injuries were $434,990. Out of a total hospital cost of $434,990 for the 173 work-related injuries, the provincial compensation agency apparently did not compensate $50,663 (12%). Prevention of work-related injuries can save significant amount of health care resources. Substantial costs remain uncompensated by the provincial compensation agency and are thus transferred to the provincial health care system annually.

British Columbia Ministry of Health Patients as Partners: A transformational approach.

PubMed

Bar, Sherry; Grant, Kristen; Asuri, Sirisha; Holms, Shannon

2018-03-01

Patients as Partners is a quality improvement initiative of the British Columbia Ministry of Health (the Ministry) that aims to bring patient voice, choice, and representation to the forefront of healthcare through collaboration with patients, families, non-governmental organizations, funded partners, regional health authorities, and healthcare providers. A spectrum of patient engagement activities, including capacity building and self-management support, occur through partnerships at the individual patient and provider, community, and system levels. These activities ensure patient priorities are identified and embed a patient-centred care approach into provincial policies and projects. Multi-/interdisciplinary collaborations in the healthcare sector occur through participation in working groups, advisory committees, and engagement events. Ongoing improvements include enhancing measurement strategies and leveraging opportunities around gaps. The Ministry was honoured with the International Association of Public Participation Award as the 2016 Canadian Organization of the Year in recognition of improving healthcare through patient and public education.

Supporting the Establishment of Climate-Resilient Rural Livelihoods in Mongolia with EO Services

NASA Astrophysics Data System (ADS)

Grosso, Nuno; Patinha, Carla; Sainkhuu, Tserendash; Bataa, Mendbayar; Doljinsuren, Nyamdorj

2016-08-01

The work presented here shows the results from the project "Climate-Resilient Rural Livelihoods in Mongolia", included in the EOTAP (Earth Observation for a Transforming Asia Pacific) initiative, a collaboration between the European Space Agency (ESA) and the Asian Development Bank (ADB), developed in cooperation with the Ministry of Food and Agriculture of Mongolia.The EO services developed within this EOTAP project primarily aimed at enriching the existing environmental database maintained by the National Remote Sensing Center (NRSC) in Mongolia and sustaining the collaborative pasture management practices introduced by the teams within the Ministry of Food and Agriculture of Mongolia. The geographic area covered by the EOTAP services is Bayankhongor province, in western Mongolia region, with two main services: drought monitoring at the provincial level for the year 2014 and Land Use/Land Cover (LULC) and changes mapping for three districts of this province (Buutsagaan, Dzag and Khureemaral) for the years 2013, 2014.

Gap Analysis for Chinese Drug Control Institutes to Achieve the Standards of World Health Organization Medicine Prequalification.

PubMed

Mao, Xin; Yang, Yue

2017-02-01

The study aims to explore the challenges and the gaps faced by Chinese Drug Control Institutes in achieving the standards of World Health Organization (WHO) Medicine Prequalification. The study was undertaken with 6 Provincial Drug Control Institutes in China from November 2012 to November 2013. The study assessed key elements required to comply with WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL). For GPPQCL, the study found gaps in quality management system, control of documentation, data-processing equipment, premises and equipment, contracts, reagents (water), reference substances and reference materials, calibration, verification of performance and qualification of equipment, instruments and other devices, analytical worksheet, evaluation of test results, personnel, and validation of analytical procedures. The study indicates that gaps are attributed to differences between the standards of Chinese Accreditation Standards and WHO-GPPQCL. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Changing Curriculum: A Critical Inquiry into the Revision of the British Columbia Science Curriculum For Grades K-9

NASA Astrophysics Data System (ADS)

Searchfield, Mary A.

In 2010 British Columbia's Ministry of Education started the process of redesigning the provincial school curriculum, Kindergarten to Grade 12. Mandatory implementation of the new curriculum was set for the 2016/17 school year for Grades K-9, and 2017/18 for Grades 10-12. With a concerted emphasis on personalized learning and through the frame of a Know-Do-Understand curriculum model, the new curriculum aims to meet the needs of today's learners, described as living in a technology-rich, fast-paced and ever-changing world, through a concept-based and competency-driven emphasis. This thesis is a critical analysis of the BC K-9 Science curriculum as written and published, looking specifically at how science is treated as a form of knowledge, its claimed presentation as a story, and on whether the intentions claimed by the designers are matched in the curriculum's final form.

26 CFR 301.7701-2 - Business entities; definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Hlutafelag India, Public Limited Company Indonesia, Perseroan Terbuka Ireland, Public Limited Company Israel... provincial law). (2) With regard to India, a company deemed to be a public limited company solely by...

26 CFR 301.7701-2 - Business entities; definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., Hlutafelag India, Public Limited Company Indonesia, Perseroan Terbuka Ireland, Public Limited Company Israel... provincial law). (2) With regard to India, a company deemed to be a public limited company solely by...

26 CFR 301.7701-2 - Business entities; definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., Hlutafelag India, Public Limited Company Indonesia, Perseroan Terbuka Ireland, Public Limited Company Israel... provincial law). (2) With regard to India, a company deemed to be a public limited company solely by...

26 CFR 301.7701-2 - Business entities; definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., Hlutafelag India, Public Limited Company Indonesia, Perseroan Terbuka Ireland, Public Limited Company Israel... provincial law). (2) With regard to India, a company deemed to be a public limited company solely by...

26 CFR 301.7701-2 - Business entities; definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., Hlutafelag India, Public Limited Company Indonesia, Perseroan Terbuka Ireland, Public Limited Company Israel... provincial law). (2) With regard to India, a company deemed to be a public limited company solely by...

77 FR 40565 - Northwest Forest Plan Provincial Advisory Committees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

.... Addresses: 215 Melody Lane, Wenatchee, WA, 98801. For Further Information Contact: Robin DeMario, 509-664... Highway 12, Naches, WA. For Further Information Contact: Robin DeMario, 509-664-9292. Deschutes PAC...

77 FR 16802 - Deschutes Provincial Advisory Committee (DPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

..., 2012 to review the annual program of work, finalize key items for the fall field meetings, and listen... open to the public. FOR FURTHER INFORMATION CONTACT: Michael Keown, Province Liaison, Sisters Ranger...

Translations on Environmental Quality, Number 153

DTIC Science & Technology

1977-11-16

incidence. Provincial officials have taken the proper measures but to date, results have been negative, the ministry reports. [Text] [Barcelona LA VANGUARDIA in Spanish 30 Sep 77 p 13] 11,464 CSO: 5000 END 66

76 FR 35185 - Deschutes Provincial Advisory Committee (DPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... (1001 SW. Emkay Drive, Bend, Oregon) from 9 a.m. until noon. All Deschutes Province Advisory Committee... Ranger District, Pine Street and Highway 20, Sisters, Oregon 97759, Phone (541) 549-7735. John Allen...

Thailand Momentum on Policy and Practice in Local Legislation on Dengue Vector Control

PubMed Central

Bhumiratana, Adisak; Intarapuk, Apiradee; Chujun, Suriyo; Kaewwaen, Wuthichai; Sorosjinda-Nunthawarasilp, Prapa; Koyadun, Surachart

2014-01-01

Over a past decade, an administrative decentralization model, adopted for local administration development in Thailand, is replacing the prior centralized (top-down) command system. The change offers challenges to local governmental agencies and other public health agencies at all the ministerial, regional, and provincial levels. A public health regulatory and legislative framework for dengue vector control by local governmental agencies is a national topic of interest because dengue control program has been integrated into healthcare services at the provincial level and also has been given priority in health plans of local governmental agencies. The enabling environments of local administrations are unique, so this critical review focuses on the authority of local governmental agencies responsible for disease prevention and control and on the functioning of local legislation with respect to dengue vector control and practices. PMID:24799896

A comprehensive approach in high-grade glioma management: position statement from the Neuro-Oncology Scientific Club (NOSC), Shiraz, Iran

PubMed Central

Ansari, Mansour; Mosalaei, Ahmad; Ahmadloo, Niloufar; Rasekhi, Alireza; Geramizadeh, Bita; Razmkon, Ali; Anvari, Kazem; Afarid, Mohammad; Dadras, Ali; Nafarieh, Leila; Mohammadianpanah, Mohammad; Nasrolahi, Hamid; Hamedi, Seyed Hasan; Omidvari, Shapour; Nami, Mohammad

2017-01-01

Establishing a robust teamwork model in the practice of neuro-oncology requires continued interdisciplinary efforts. The Neuro-Oncology Scientific Club (NOSC) initiative is an interdisciplinary clinical forum promoting the comprehensive approach across involved disciplines in the management of central nervous system (CNS) malignancies. With its provincial founding panels and national steering board, NOSC has been operational in Iran since 2011. This initiative has pursued its mission through interval strategic meetings, tumor boards, case discussions as well as publishing neuro-oncology updates, case study periodicals, and newsletters. A provincial meeting of NOSC in Shiraz put together insights from international practice guidelines, emerging evidence, and expert opinions to draw a position statement on high-grade glioma management in adults. The present report summarizes key highlights from the above clinical forum. PMID:28325997

A comprehensive approach in high-grade glioma management: position statement from the Neuro-Oncology Scientific Club (NOSC), Shiraz, Iran.

PubMed

Ansari, Mansour; Mosalaei, Ahmad; Ahmadloo, Niloufar; Rasekhi, Alireza; Geramizadeh, Bita; Razmkon, Ali; Anvari, Kazem; Afarid, Mohammad; Dadras, Ali; Nafarieh, Leila; Mohammadianpanah, Mohammad; Nasrolahi, Hamid; Hamedi, Seyed Hasan; Omidvari, Shapour; Nami, Mohammad

2017-01-01

Establishing a robust teamwork model in the practice of neuro-oncology requires continued interdisciplinary efforts. The Neuro-Oncology Scientific Club (NOSC) initiative is an interdisciplinary clinical forum promoting the comprehensive approach across involved disciplines in the management of central nervous system (CNS) malignancies. With its provincial founding panels and national steering board, NOSC has been operational in Iran since 2011. This initiative has pursued its mission through interval strategic meetings, tumor boards, case discussions as well as publishing neuro-oncology updates, case study periodicals, and newsletters. A provincial meeting of NOSC in Shiraz put together insights from international practice guidelines, emerging evidence, and expert opinions to draw a position statement on high-grade glioma management in adults. The present report summarizes key highlights from the above clinical forum.

Analyzing remote sensing geobotanical trends in Quetico Provincial Park, Ontario, Canada, using digital elevation data

NASA Technical Reports Server (NTRS)

Warner, Timothy A.; Campagna, David J.; Levandowski, Don W.; Cetin, Haluk; Evans, Carla S.

1991-01-01

A 10 x 13-km area in Quetico Provincial Park, Canada has been studied using a digital elevation model to separate different drainage classes and to examine the influence of site factors and lithology on vegetation. Landsat Thematic Mapper data have been classified into six forest classes of varying deciduous-coniferous cover through nPDF, a procedure based on probability density functions. It is shown that forests growing on mafic lithologies are enriched in deciduous species, compared to those growing on granites. Of the forest classes found on mafics, the highest coniferous component was on north facing slopes, and the highest deciduous component on south facing slopes. Granites showed no substantial variation between site classes. The digital elevation derived site data is considered to be an important tool in geobotanical investigations.

Net migration estimation in an extended, multiregional gravity model.

PubMed

Foot, D K; Milne, W J

1984-02-01

A multi-regional framework is developed in order to analyze net migration over time to all 10 Canadian provinces within an integrated system of equations. "An extended gravity model is the basis for the equation specification and the use of constrained econometric estimation techniques allows for the provincial interdependence of the migration decision while at the same time ensuring that an important system-wide requirement is respected." The model is estimated using official Canadian data for the 1960s and 1970s. "The results suggest the predominance of the push factor for interprovincial migration for most provinces, although net migration to the Atlantic provinces is also shown to be subject to pull forces from the rest of the country." The effects of wage rate variables, unemployment, and political disturbances in Quebec on inter-provincial migration are noted. excerpt

Impacts of transportation routes on landscape diversity: a comparison of different route types and their combined effects.

PubMed

Su, Shiliang; Xiao, Rui; Li, Delong; Hu, Yi'na

2014-03-01

A comparison of different transportation route types and their combined effects on landscape diversity was conducted within Tiaoxi watershed (China) between 1994 and 2005. Buffer analysis and Mann-Kendall's test were used to quantify the relationships between distance from transportation routes (railway, highway, national, and provincial road) and a family of landscape diversity parameters (Simpson's diversity index, Simpson's evenness index, Shannon's diversity index, and Shannon's evenness index). One-way ANOVA was further applied to compare influences from different route types and their combined effects. Five other landscape metrics (patch density, edge density, area-weighted mean shape index, connectance index, and Euclidean nearest neighbor distance) were also calculated to analyze the associations between landscape diversity and landscape pattern characteristics. Results showed that transportation routes exerted significant impacts on landscape diversity. Impact from railway was comparable to that from highway and national road but was more significant than that from provincial road. The spatial influential range of railway and national road was wider than that of highway and provincial road. Combined effects of routes were nonlinear, and impacts from different route types were more complex than those from the same type. The four landscape diversity metrics were comparably effective at the buffer zone scale. In addition, landscape diversity can be alternatively used to indicate fragmentation, connectivity, and isolation at route buffer scale. This study demonstrates an applicable approach to quantitatively characterize the impacts from transportation routes on landscape patterns and has potential to facilitate route network planning.

Using administrative databases in the surveillance of depressive disorders--case definitions.

PubMed

Alaghehbandan, Reza; Macdonald, Don; Barrett, Brendan; Collins, Kayla; Chen, Yue

2012-12-01

The objective of this study was to assess the usefulness of provincial administrative databases in carrying out surveillance on depressive disorders. Electronic medical records (EMRs) at 3 family practice clinics in St. John's, NL, Canada, were audited; 253 depressive disorder cases and 257 patients not diagnosed with a depressive disorder were selected. The EMR served as the "gold standard," which then was compared to these same patients investigated through the use of various case definitions applied against the provincial hospital and physician administrative databases. Variables used in the development of the case definitions were depressive disorder diagnoses (either in hospital or physician claims data), date of diagnosis, and service provider type [general practitioner (GP) vs. psychiatrist]. Of the 120 case definitions investigated, 26 were found to have a kappa statistic greater than 0.6, of which 5 case definitions were considered the most appropriate for surveillance of depressive disorders. Of the 5 definitions, the following case definition, with a 77.5% sensitivity and 93% specificity, was found to be the most valid ([ ≥1 hospitalizations OR ≥1 psychiatrist visit related to depressive disorders any time] OR ≥2 GP visits related to depressive disorders within the first 2 years of diagnosis). This study found that provincial administrative databases may be useful for carrying out surveillance on depressive disorders among the adult population. The approach used in this study was simple and resulted in rather reasonable sensitivity and specificity.

Spatial Integration Analysis of Provincial Historical and Cultural Heritage Resources Based on Geographic Information System (gis) — a Case Study of Spatial Integration Analysis of Historical and Cultural Heritage Resources in Zhejiang Province

NASA Astrophysics Data System (ADS)

Luo, W.; Zhang, J.; Wu, Q.; Chen, J.; Huo, X.; Zhang, J.; Zhang, Y.; Wang, T.

2017-08-01

In China historical and cultural heritage resources include historically and culturally famous cities, towns, villages, blocks, immovable cultural relics and the scenic spots with cultural connotation. The spatial distribution laws of these resources are always directly connected to the regional physical geography, historical development and historical traffic geography and have high research values. Meanwhile, the exhibition and use of these resources are greatly influenced by traffic and tourism and other plans at the provincial level, and it is of great realistic significance to offer proposals on traffic and so on that are beneficial to the exhibition of heritage resources based on the research of province distribution laws. This paper takes the spatial analysis of Geographic Information System (GIS) as the basic technological means and all historical and cultural resources in China's Zhejiang Province as research objects, and finds out in the space the accumulation areas and accumulation belts of Zhejiang Province's historic cities and cultural resources through overlay analysis and density analysis, etc. It then discusses the reasons of the formation of these accumulation areas and accumulation belts by combining with the analysis of physical geography and historical geography and so on, and in the end, linking the tourism planning and traffic planning at the provincial level, it provides suggestions on the exhibition and use of accumulation areas and accumulation belts of historic cities and cultural resources.

Pollution Emissions, Environmental Policy, and Marginal Abatement Costs.

PubMed

He, Ling-Yun; Ou, Jia-Jia

2017-12-05

Pollution emissions impose serious social negative externalities, especially in terms of public health. To reduce pollution emissions cost-effectively, the marginal abatement costs (MACs) of pollution emissions must be determined. Since the industrial sectors are the essential pillars of China's economic growth, as well as leading energy consumers and sulfur dioxide (SO₂) emitters, estimating MACs of SO₂ emissions at the industrial level can provide valuable information for all abatement efforts. This paper tries to address the critical and essential issue in pollution abatement: How do we determine the MACs of pollution emissions in China? This paper first quantifies the SO₂ emission contribution of different industrial sectors in the Chinese economy by an Input-Output method and then estimates MACs of SO₂ for industrial sectors at the national level, provincial level, and sectoral level by the shadow price theory. Our results show that six sectors (e.g., the Mining and Washing of Coal sector) should be covered in the Chinese pollution emission trading system. We have also found that the lowest SO₂ shadow price is 2000 Yuan/ton at the national level, and that shadow prices should be set differently at the provincial level. Our empirical study has several important policy implications, e.g., the estimated MACs may be used as a pricing benchmark through emission allowance allocation. In this paper, the MACs of industrial sectors are calculated from the national, provincial and sectoral levels; therefore, we provide an efficient framework to track the complex relationship between sectors and provinces.

[An analysis of the first law on contraception in Argentina. The Responsible Procreation Programme in the province of La Pampa].

PubMed

Herminia di Liscia, María

2012-01-01

The passage of a Law requires previous negotiation processes that consider the background, arguments, support and the appropriate terminology for approaching the issue. The legal domain is a discursive field in which a dual struggle develops: to establish designations and to introduce that which the law establishes into everyday practice. Hence, conflictive processes are unleashed in which social agents are confronted by political parties, by institutions and by their own political and subjective identities. This article analyses the development of the "1363 Law", which was passed in November 1991 in the legislature of La Pampa province (Argentina). This Law created a provincial programme for responsible procreation, the first provincial legislation on contraception to be established. Although reproduction also involves males, special account is taken of speeches referring to females, given that the culture superimposes maternity on the female identity and references are therefore weighted towards the condition of women. We use the particularity of this case and its analytical potential in order to understand others, using as empirical material the parliamentary debate and interviews with the author of the Law and with key informants. We address the following questions: What was the national and provincial context in which the Law on responsible procreation was framed? What were the strategies adopted to achieve it? How was contraception articulated within the Peronist worldview of women? What meanings did the term "responsible procreation" bring into play? Finally, we present a brief assessment of the law's application.

Investigating the "inverse care law" in dental care: A comparative analysis of Canadian jurisdictions.

PubMed

Dehmoobadsharifabadi, Armita; Singhal, Sonica; Quiñonez, Carlos

2017-03-01

To compare physician and dentist visits nationally and at the provincial/territorial level and to assess the extent of the "inverse care law" in dental care among different age groups in the same way. Publicly available data from the 2007 to 2008 Canadian Community Health Survey were utilized to investigate physician and dentist visits in the past 12 months in relation to self-perceived general and oral health by performing descriptive statistics and binary logistic regression, controlling for age, sex, education, income, and physician/dentist population ratios. Analysis was conducted for all participants and stratified by age groups - children (12-17 years), adults (18-64 years) and seniors (65 years and over). Nationally and provincially/territorially, it appears that the "inverse care law" persists for dental care but is not present for physician care. Specifically, when comparing to those with excellent general/oral health, individuals with poor general health were 2.71 (95% confidence interval [CI]: 2.70-2.72) times more likely to visit physicians, and individuals with poor oral health were 2.16 (95% CI: 2.16-2.17) times less likely to visit dentists. Stratified analyses by age showed more variability in the extent of the "inverse care law" in children and seniors compared to adults. The "inverse care law" in dental care exists both nationally and provincially/territorially among different age groups. Given this, it is important to assess the government's role in improving access to, and utilization of, dental care in Canada.

A perturbation method to the tent map based on Lyapunov exponent and its application

NASA Astrophysics Data System (ADS)

Cao, Lv-Chen; Luo, Yu-Ling; Qiu, Sen-Hui; Liu, Jun-Xiu

2015-10-01

Perturbation imposed on a chaos system is an effective way to maintain its chaotic features. A novel parameter perturbation method for the tent map based on the Lyapunov exponent is proposed in this paper. The pseudo-random sequence generated by the tent map is sent to another chaos function — the Chebyshev map for the post processing. If the output value of the Chebyshev map falls into a certain range, it will be sent back to replace the parameter of the tent map. As a result, the parameter of the tent map keeps changing dynamically. The statistical analysis and experimental results prove that the disturbed tent map has a highly random distribution and achieves good cryptographic properties of a pseudo-random sequence. As a result, it weakens the phenomenon of strong correlation caused by the finite precision and effectively compensates for the digital chaos system dynamics degradation. Project supported by the Guangxi Provincial Natural Science Foundation, China (Grant No. 2014GXNSFBA118271), the Research Project of Guangxi University, China (Grant No. ZD2014022), the Fund from Guangxi Provincial Key Laboratory of Multi-source Information Mining & Security, China (Grant No. MIMS14-04), the Fund from the Guangxi Provincial Key Laboratory of Wireless Wideband Communication & Signal Processing, China (Grant No. GXKL0614205), the Education Development Foundation and the Doctoral Research Foundation of Guangxi Normal University, the State Scholarship Fund of China Scholarship Council (Grant No. [2014]3012), and the Innovation Project of Guangxi Graduate Education, China (Grant No. YCSZ2015102).

Differences in antiretroviral scale up in three South African provinces: the role of implementation management

PubMed Central

2010-01-01

Background South Africa’s antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country’s quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. Methods The paper is a comparative case study of the early management of ART scale up in three South African provincial governments – Western Cape, Gauteng and Free State – focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high) achieved in the three provinces. Results While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. Conclusions This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up. PMID:20594370

Insights from the evaluation of a provincial healthy eating strategy in Nova Scotia, Canada.

PubMed

Sim, S Meaghan; Kirk, Sara F L

2013-10-01

Healthy Eating Nova Scotia represents the first provincial comprehensive healthy eating strategy in Canada and a strategy that is framed within a population-health model. Five years after strategy launch, our objective was to evaluate Healthy Eating Nova Scotia to determine perceptions of strategy implementation and strategy outputs. The focus of the current paper is on the findings of this evaluation. We conducted an evaluation of the strategy through three activities that included a document review, survey of key stakeholders and in-depth interviews with key strategy informants. The findings from each of the activities were integrated to determine what has worked well with strategy implementation, what could be improved and what outputs have resulted. The evaluation was conducted in the Canadian province of Nova Scotia. Participants for this evaluation included survey respondents (n 120) and key informants (n 16). A total of 156 documents were also reviewed. Significant investments have been made towards inter-sectoral partnerships and resourcing that has provided the necessary leadership and momentum for the strategy. Policy development has been leveraged through the strategy primarily in the health and education sectors and is perceived as a visible success. Clarity of human resource roles and funding within the context of a provincial strategy may be beneficial for continued strategy implementation, as is expansion of policy development. Known to be the first evaluation of its kind, these findings and related considerations will be of interest to policy makers developing and implementing similar strategies in their own jurisdictions.

Medical cannabis: considerations for the anesthesiologist and pain physician.

PubMed

Beaulieu, Pierre; Boulanger, Aline; Desroches, Julie; Clark, Alexander J

2016-05-01

New regulations are in place at the federal and provincial levels in Canada regarding the way medical cannabis is to be controlled. We present them together with guidance for the safe use of medical cannabis and recent clinical trials on cannabis and pain. The new Canadian regulations on the use of medical cannabis, the provincial regulations, and the various cannabis products available from the Canadian Licensed Producers were reviewed from Health Canada, provincial licensing authorities, and the licensed producers website, respectively. Recent clinical trials on cannabis and pain were reviewed from the existing literature. Health Canada has approved a new regulation on medical marijuana/cannabis, the Marihuana for Medical Purposes Regulations: The production of medical cannabis by individuals is illegal. Health Canada, however, has licensed authorized producers across the country, limiting the production to specific licenses of certain cannabis products. There are currently 26 authorized licensed producers from seven Canadian provinces offering more than 200 strains of marijuana. We provide guidance for the safe use of medical cannabis. The recent literature indicates that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain. The science of medical cannabis and the need for education of healthcare professionals and patients require continued effort. Although cannabinoids work to decrease pain, there is still a need to confirm these beneficial effects clinically and to exploit them with acceptable benefit-to-risk ratios.

Cancer mortality in Yukon 1999–2013: elevated mortality rates and a unique cancer profile

PubMed Central

Simkin, Jonathan; Woods, Ryan; Elliott, Catherine

2017-01-01

ABSTRACT Background: Although cancer is the leading cause of death in Canada, cancer in the North has been incompletely described. Objective: To determine cancer mortality rates in the Yukon Territory, compare them with Canadian rates, and identify major causes of cancer mortality. Design: The Yukon Vital Statistics Registry provided all cancer deaths for Yukon residents between 1999-2013. Age-standardised mortality rates (ASMRs) were calculated using direct standardisation and compared with Canadian rates. Standardised mortality ratios (SMRs) were calculated using indirect standardisation relative to age-specific rates from Canada, British Columbia (BC), and three sub-provincial BC administrative health regions : Interior Health (IH), Northern Health (NH) and Vancouver Coastal Health (VCH). Trends in smoothed ASMRs were examined with graphical methods. Results: Yukon’s all-cancer ASMRs were elevated compared with national and provincial rates for the entire period. Disparities were greatest compared with the urban VCH: prostate (SMRVCH=246.3, 95% CI 140.9–351.6), female lung (SMRVCH=221.2, 95% CI 154.3–288.1), female breast (SMRVCH=169.0 95% CI, 101.4–236.7), and total colorectal (SMRVCH=149.3, 95% CI 101.8–196.8) cancers were significantly elevated. Total stomach cancer mortality was significantly elevated compared with all comparators. Conclusions: Yukon cancer mortality rates were elevated compared with national, provincial, urban, and southern-rural jurisdictions. More research is required to elucidate these differences. PMID:28598269

[Study on the immunization status and its influencing factors among workers from the polio network laboratories in China].

PubMed

Guo, Y S; Wang, J Q; Xu, C; Liu, Y N; He, X H; Wei, Q

2017-06-10

Objective: To Investigate the immune status and influencing factors of provincial polio network laboratory (PNL) workers in China so as to provide evidence for the development of related strategies to protect personnel working at the PNLs. Methods: All the practitioners from the PNLs at the provincial centers for disease control, were selected as objects for this study, from October to December, 2016, under a questionnaire survey. Information on status of immunity and influencing factors was collected, with SAS software, trend chi-square used for statistics analysis. Results: A total of 77 workers were involved in this survey, with 60 (78 % ) of them completed the polio-based immune program but the rest 17 (22 % ) remained records unclear. 66 people (about 86 % ) remembered clearly that they had received vaccination when engaging in the polio-lab work, but the rest 11 (14 % ) with only partial vaccination records. We also noticed that the Influencing factors realted to vaccination status were: age ( χ (2)=2.48, P <0.05), title ( χ (2)=2.51, P <0.05), years of employment ( P <0.000 1), education ( χ (2)=0.74, P =0.46) and gender ( χ (2)=0.46, P =0.50). Conclusion: Immune status of the Chinese provincial PNL practitioners appeared fairly good as 86 % of all the workers had received polio-related vaccination, with 41 % of them completed a 3-time inoculation program, when started working in this field.

"If I ever did have a daughter, I wouldn't raise her in New Brunswick:" exploring women's experiences obtaining abortion care before and after policy reform.

PubMed

Foster, Angel M; LaRoche, Kathryn J; El-Haddad, Julie; DeGroot, Lauren; El-Mowafi, Ieman M

2017-05-01

New Brunswick (NB)'s Regulation 84-20 has historically restricted funded abortion care to procedures deemed medically necessary by two physicians and performed in a hospital by an obstetrician-gynecologist. However, on January 1, 2015, the provincial government amended the regulation and abolished the "two physician rule." We aimed to document women's experiences obtaining abortion care in NB before and after the Regulation 84-20 amendment; identify the economic and personal costs associated with obtaining abortion care; and examine the ways in which geography, age and language-minority status condition access to care. We conducted 33 semistructured telephone interviews with NB residents who had abortions between 2009 and 2014 (n=27) and after January 1, 2015 (n=6), in English and French. We audiorecorded and transcribed all interviews and conducted content and thematic analyses using ATLAS.ti software to manage our data. The cost of travel is significant for NB residents trying to access abortion services. Women reported significant wait times which impacted the disclosure of their pregnancy and the gestational age at the time of the abortion. Further, many women reported that physicians refused to provide referrals for abortion care. Even after the amendment to 84-20, all participants reported that they were required to have two physicians approve their procedure. The funding restrictions for abortion care in NB represent a profound inequity. Amending Regulation 84-20 was an important step but failed to address the fundamental issue that clinic-based abortion care is not funded and significant barriers to access persist. NB's policies create unnecessary barriers to accessing timely and affordable abortion care and produce a significant health inequity for women in the province. Further policy reforms are required to ensure that women are able to get the abortion care to which they are entitled. Copyright © 2017 Elsevier Inc. All rights reserved.

Precepting at the time of a natural disaster.

PubMed

Myhre, Douglas; Bajaj, Sameer; Fehr, Lana; Kapusta, Mike; Woodley, Kristine; Nagji, Alim

2017-04-01

Natural disasters strike communities that have varied degrees of preparedness, both physical and psychological. Rural communities may be particularly vulnerable as they often do not have the infrastructure or resources to prepare in advance. The psychological impact of a natural disaster is amplified in learners who may be temporary members of the community and therefore cannot draw on personal support during the crisis. They may turn to their clinical preceptors for guidance. The Slave Lake fire (population 6782) in May 2011 and the High River flood (population 12 920) in June 2013 are examples of natural disasters that have occurred in rural Alberta, Canada. At the time of these critical incidents, three medical students and one family medicine resident from the two provincial medical schools were participating in rotations in these communities. Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective. Accordingly, using a modified Delphi approach, we captured the experiences of learners that were then refined into two themes, each containing three recommendations: considerations for action during a natural disaster and considerations for action after the acute crisis has passed. Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective IMPLICATIONS: Our recommendations provide suggestions for practical solutions that build on the usual expectations of mentors and may benefit the student-teacher relationship at the time of a disaster and beyond. They are meant to initiate discussion regarding further study aimed towards creating recommendations for preceptor response that may cross disciplines. © 2016 John Wiley & Sons Ltd.

75 FR 13252 - Deschutes Provincial Advisory Committee (DPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... National Forest Supervisor's office (1001 SW. Emkay Drive, Bend, Oregon) from 9 a.m. until 1 p.m. All..., 97759, Phone (541) 549-7735. John Allen, Deschutes National Forest Supervisor. [FR Doc. 2010-6031 Filed...

Youth retail tobacco access in Canada: regional variation, perceptions, and predictors from YSS 2010/2011.

PubMed

Minaker, Leia M; Soni, Shilpa; Nguyen, Nghia; Manske, Steve

2015-12-01

Retail tobacco access is an important determinant of youth smoking prevalence. This study examines perceptions of ease in obtaining cigarettes and how prevalence of self-reported retail tobacco access among youth smokers varies by province in Canada. Additionally, relevant retail experiences, such as being asked for identification by a store clerk, are described. Data from grades 9-12 students who participated in the 2010/2011 Youth Smoking Survey, a nationally generalizable sample of Canadian students (n=31396) were used to examine retail tobacco access and related experiences. Logistic regression models were used to examine differences in retail tobacco access and retail tobacco experiences by sociodemographic and regional characteristics. 79% of students who never smoked thought it would be easy to get cigarettes. About one-quarter of smokers reported usually buying cigarettes from stores, and the percent of student smokers usually buying cigarettes in stores ranged from 16% in British Columbia to 36% in Quebec. Compared to grade 9 students, grade 12 students had higher odds of report being asked for identification (OR=6.3, 95% CI 1.9-21.5). Retail tobacco access appears to be a significant source of cigarette access among Canadian youth. Retail tobacco access varies significantly by province, which suggests provincial policies should be strengthened. Copyright © 2015. Published by Elsevier Ltd.

Mobile phone-based syndromic surveillance system, Papua New Guinea.

PubMed

Rosewell, Alexander; Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B; Ray, Pradeep; MacIntyre, C Raina

2013-11-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone-based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance.

Mobile Phone–based Syndromic Surveillance System, Papua New Guinea

PubMed Central

Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B.; Ray, Pradeep; MacIntyre, C. Raina

2013-01-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone–based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance. PMID:24188144

[Nutritional therapy of duodenocutaneous fistula].

PubMed

Sun, Yuan-shui; Shao, Qin-shu; Xu, Xiao-dong; Hu, Jun-feng; Xu, Ji; Shi, Dun; Ye, Zai-yuan

2010-09-01

To summarize the experience in nutritional support for the management of duodenocutaneous fistula. Data of 32 patients with duodenocutaneous fistula in Zhejiang provincial people's hospital from January 1999 to December 2009 were analyzed retrospectively. The mean duration of nutritional support was 35.6 days (range, 8-82 days). Eight received total parenteral nutrition, 2 total enteral nutrition, and 22 parenteral nutrition combined with enteral nutrition respectively. Succus entericus reinfusion with enteral nutrition was used in 11 cases, glutamine-enriched nutritional support in 28 cases, somatostatin in 12 cases. In these patients, the healing rate was 75.0% after conservative treatment. In the 8 patients who underwent surgery, 6 were cured and 2 died (due to severe abdominal infection and multiple organ failure). A total of 30 patients had the fistulas cured and discharged. Parenteral nutrition combined with enteral nutrition, succus entericus reinfusion combined with enteral nutrition, glutamine-enriched nutritional support and somatostatin are important factors for the healing of duodenocutaneous fistulas.

Does rural generalist focused medical school and family medicine training make a difference? Memorial University of Newfoundland outcomes.

PubMed

Rourke, James; Asghari, Shabnam; Hurley, Oliver; Ravalia, Mohamed; Jong, Michael; Graham, Wendy; Parsons, Wanda; Duggan, Norah; O'Keefe, Danielle; Moffatt, Scott; Stringer, Katherine; Sturge Sparkes, Carolyn; Hippe, Janelle; Harris Walsh, Kristin; McKay, Donald; Samarasena, Asoka

2018-03-01

Rural recruitment and retention of physicians is a global issue. The Faculty of Medicine at Memorial University of Newfoundland, Canada, was established as a rural-focused medical school with a social accountability mandate that aimed to meet the healthcare needs of a sparse population distributed over a large landmass as well as the needs of other rural and remote areas of Canada. This study aimed to assess whether Memorial medical degree (MD) and postgraduate (PG) programs were effective at producing physicians for their province and rural physicians for Canada compared with other Canadian medical schools. This retrospective cohort study included medical school graduates who completed their PG training between 2004 and 2013 in Canada. Practice locations of study subjects were georeferenced and assigned to three geographic classes: Large Urban; Small City/Town; and Rural. Analyses were performed at two levels. (1) Provincial level analysis compared Memorial PG graduates practicing where they received their MD and/or PG training with other medical schools who are the only medical school in their province (n=4). (2) National-level analysis compared Memorial PG graduates practicing in rural Canada with all other Canadian medical schools (n=16). Descriptive and bivariate analyses were performed. Overall, 18 766 physicians practicing in Canada completed Canadian PG training (2004-2013), and of those, 8091 (43%) completed Family Medicine (FM) training. Of all physicians completing Canadian PG training, 1254 (7%) physicians were practicing rurally and of those, 1076 were family physicians. There were 379 Memorial PG graduates and of those, 208 (55%) completed FM training and 72 (19%) were practicing rurally, and of those practicing rurally, 56 were family physicians. At the national level, the percentage of all Memorial PG graduates (19.0%) and FM PG graduates (26.9%) practicing rurally was significantly better than the national average for PG (6.4%, p<0.000) and FM (12.9%, p<0.000). Among 391 physicians practicing in Newfoundland and Labrador (NL), 257 (65.7%) were Memorial PG graduates and 247 (63.2%) were Memorial MD graduates. Of the 163 FM graduates, 148 (90.8%) were Memorial FM graduates and 118 (72.4%) were Memorial MD graduates. Of the 68 in rural practice, 51 (75.0%) were Memorial PG graduates and 31 (45.6%) were Memorial MD graduates. Of the 41 FM graduates in rural practice, 39 (95.1%) were Memorial FM graduates and 22 (53.7%) were Memorial MD graduates. Two-sample proportion tests demonstrated Memorial University provided a larger proportion of its provincial physician resource supply than the other four single provincial medical schools, by medical school MD for FM (72.4% vs 44.3%, p<0.000) and for overall (63.2% vs 43.5% p<0.000), and by medical school PG for FM (90.8 % vs 72.0%, p<0.000). This study found Memorial University graduates were more likely to establish practice in rural areas compared with the national average for most program types as well as more likely to establish practice in NL compared with other single medical schools' graduates in their provinces. This study highlights the impact a comprehensive rural-focused social accountability approach can have at supplying the needs of a population both at the regional and rural national levels.

Log export and import restrictions of the U.S. Pacific Northwest and British Columbia: past and present.

Treesearch

Christine L. Lane

1998-01-01

Export constraints affecting North American west coast logs have existed intermittently since 1831. Recent developments have tended toward tighter restrictions. National, Provincial, and State rules are described.

Simultaneous estimation of aerosol optical constants and size distribution from angular light-scattering measurement signals

NASA Astrophysics Data System (ADS)

He, Zhen-Zong; Liang, Dong; Mao, Jun-Kui; Han, Xing-Si

2018-05-01

Not Available Project supported by the Jiangsu Provincial Natural Science Foundation, China (Grant Nos. BK20170800 and BK20160794) and the National Natural Science Foundation of China (Grant No. 51606095).

A Survey of the Island Province.

ERIC Educational Resources Information Center

McDowell, Stirling

1985-01-01

Briefly reviews some of the findings of the 1984 survey of public attitudes toward the provincial education system conducted by Prince Edward Island's School System Review Commission and discusses some of the commission's resulting 94 recommendations for improvement. (PGD)

Teaching Reform and Practice of the Provincial-Level Quality Course: Quantum Mechanics

ERIC Educational Resources Information Center

Wang, Hongmei

2010-01-01

According to the actuality of Dezhou University, some useful reforms in teaching content, teaching method, and teaching measure are introduced, combining with the characteristics of the course of quantum mechanism in this article.

The Canadian kidney paired donation program: a national program to increase living donor transplantation.

PubMed

Cole, Edward H; Nickerson, Peter; Campbell, Patricia; Yetzer, Kathy; Lahaie, Nick; Zaltzman, Jeffery; Gill, John S

2015-05-01

Establishment of a national kidney paired donation (KPD) program represents a unique achievement in Canada's provincially organized health care system. Key factors enabling program implementation included consultation with international experts, formation of a unique organization with a mandate to facilitate interprovincial collaboration, and the volunteer efforts of members of the Canadian transplant community to overcome a variety of logistical barriers. As of December 2013, the program had facilitated 240 transplantations including 10% with Calculated panel reactive antibody (cPRA) ≥97%. Unique features of the Canadian KPD program include participation of n = 55 nondirected donors, performance of only donor specific antibody negative transplants, the requirement for donor travel, and nonuse of bridge donors. The national KPD program has helped maintain the volume of living kidney donor transplants in Canada over the past 5 years and serves as a model of inter-provincial collaboration to improve the delivery of health care to Canadians.

Forecasting residential electricity demand in provincial China.

PubMed

Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan

2017-03-01

In China, more than 80% electricity comes from coal which dominates the CO2 emissions. Residential electricity demand forecasting plays a significant role in electricity infrastructure planning and energy policy designing, but it is challenging to make an accurate forecast for developing countries. This paper forecasts the provincial residential electricity consumption of China in the 13th Five-Year-Plan (2016-2020) period using panel data. To overcome the limitations of widely used predication models with unreliably prior knowledge on function forms, a robust piecewise linear model in reduced form is utilized to capture the non-deterministic relationship between income and residential electricity consumption. The forecast results suggest that the growth rates of developed provinces will slow down, while the less developed will be still in fast growing. The national residential electricity demand will increase at 6.6% annually during 2016-2020, and populous provinces such as Guangdong will be the main contributors to the increments.

The academic, personality, and physical outcomes of only children in China.

PubMed

Falbo, T; Poston, D L

1993-02-01

Representative samples of 1,000 schoolchildren from 4 Chinese provinces were surveyed to compare the outcomes of only children to those of firstborn and later-born children. The children's ages ranged from 8 to 17 years, with half of the sample in the third grade and the other half in the sixth grade. 3 types of outcomes were considered. In terms of academics, differences between only children and others were found in 3 of the 4 provincial samples, with onlies being most likely to outscore others in verbal tests. In terms of personality evaluations, very few only-child effects were found. In 2 of the 4 provincial samples, only children were found to be taller or to weigh more than others. Taken together, these results suggest that the one-child policy in China is not producing a generation of "little emperors."

Identification of Potential Sources of Mercury (Hg) in Farmland Soil Using a Decision Tree Method in China.

PubMed

Zhong, Taiyang; Chen, Dongmei; Zhang, Xiuying

2016-11-09

Identification of the sources of soil mercury (Hg) on the provincial scale is helpful for enacting effective policies to prevent further contamination and take reclamation measurements. The natural and anthropogenic sources and their contributions of Hg in Chinese farmland soil were identified based on a decision tree method. The results showed that the concentrations of Hg in parent materials were most strongly associated with the general spatial distribution pattern of Hg concentration on a provincial scale. The decision tree analysis gained an 89.70% total accuracy in simulating the influence of human activities on the additions of Hg in farmland soil. Human activities-for example, the production of coke, application of fertilizers, discharge of wastewater, discharge of solid waste, and the production of non-ferrous metals-were the main external sources of a large amount of Hg in the farmland soil.

New distribution records for Canadian Aleocharinae (Coleoptera, Staphylinidae), and new synonymies for Trichiusa

PubMed Central

Klimaszewski, Jan; Godin, Benoit; Langor, David; Bourdon, Caroline; Lee, Seung-Il; Horwood, Denise

2015-01-01

Abstract Fifty-four new Canadian provincial records of aleocharine beetles (Staphylinidae), including three new Canadian records and one new North American record, are presented. Of these, 33 are new provincial records for Saskatchewan, 14 for Alberta, two for British Columbia, three for Manitoba, two for the Northwest Territories and one for the Yukon Territory. The following are new Canadian records: Trichiusa pilosa Casey [formerly reported from Nova Scotia and Ontario as Trichiusa postica Casey], Acrotona recondita (Erichson) and the adventive Palaearctic Atheta nigra (Kraatz), which is also a new North American record. Bionomics information and new locality records are provided. The following new synonyms of Trichiusa pilosa Casey are established: Trichiusa atra Casey, Trichiusa monticola Casey, Trichiusa parviceps Casey, and Trichiusa postica Casey. The numbers of Aleocharinae remaining to be discovered in Canadian provinces and territories are discussed. PMID:25931964

An exploration of China's mortality decline under Mao: A provincial analysis, 1950–80

PubMed Central

Babiarz, Kimberly Singer; Eggleston, Karen; Miller, Grant; Zhang, Qiong

2014-01-01

China's growth in life expectancy between 1950 and 1980 ranks as among the most rapid sustained increases in documented global history. However, no study of which we are aware has quantitatively assessed the relative importance of various explanations proposed for these gains. We create and analyse a new province-level panel data set spanning 1950-80 using historical information from Chinese public health archives, official provincial yearbooks, and infant and child mortality records contained in the 1988 National Survey of Fertility and Contraception. Although exploratory, our results suggest that increases in educational attainment and public health campaigns jointly explain 50-70 per cent of the dramatic reductions in infant and under-five mortality during our study period. These results are consistent with the importance of non-medical determinants of population health improvement – and under some circumstances, how general education may amplify the effectiveness of public health interventions. PMID:25495509

Composition of the council of representatives: Report on the apportionment ballot for representation year 2011.

PubMed

2010-01-01

Each year, the apportionment ballot is used to determine how many representatives each division and state, provincial, and territorial association will have on the Council of Representatives. The system is described in Article V, Sections 6 and 7, of the American Psychological Association (APA) Bylaws. Briefly, all APA fellows, members, and voting associates are sent an apportionment ballot on or before November 1. Voting members indicate the division( s) and/or state, provincial, or territorial association(s) through which they desire to have their interests represented on Council in the following year by allocating a total of 10 votes to one or more of these groups. Beginning with the 2003 legislative year the total number of representatives (seats) on Council was set at 162. This article reports the apportionment ballot for representation year 2001. 2010 APA, all rights reserved.

Identification of Potential Sources of Mercury (Hg) in Farmland Soil Using a Decision Tree Method in China

PubMed Central

Zhong, Taiyang; Chen, Dongmei; Zhang, Xiuying

2016-01-01

Identification of the sources of soil mercury (Hg) on the provincial scale is helpful for enacting effective policies to prevent further contamination and take reclamation measurements. The natural and anthropogenic sources and their contributions of Hg in Chinese farmland soil were identified based on a decision tree method. The results showed that the concentrations of Hg in parent materials were most strongly associated with the general spatial distribution pattern of Hg concentration on a provincial scale. The decision tree analysis gained an 89.70% total accuracy in simulating the influence of human activities on the additions of Hg in farmland soil. Human activities—for example, the production of coke, application of fertilizers, discharge of wastewater, discharge of solid waste, and the production of non-ferrous metals—were the main external sources of a large amount of Hg in the farmland soil. PMID:27834884

The primacy of politics: charting the governance of the Papua New Guinea health system since independence.

PubMed

Day, Benjamin

2009-01-01

To chart the course of health governance in Papua New Guinea (PNG) since Independence, this article identifies two arks of public sector administration in PNG. Each was instigated by the passing of an Organic Law. The reform periods presaged by the Organic Law on Provincial Government 1976 (OLPG) and the Organic Law on Provincial Governments and Local-level Governments 1995 (OLPGLLG) have fundamentally transformed the political and administrative structures governing the country, and in particularly those relating to health. Comparing the organization of the government-operated health system during each of these reform periods not only reveals why PNG's health services have struggled to improve since Independence, but also casts light on the key drivers of fundamental reforms in PNG. Ultimately, the exercise illustrates the 'primacy of politics', and why political concerns invariably trump service delivery concerns.

A broadband high-efficiency Doherty power amplifier using symmetrical devices

NASA Astrophysics Data System (ADS)

Cheng, Zhiqun; Zhang, Ming; Li, Jiangzhou; Liu, Guohua

2018-04-01

This paper proposes a method for broadband and high-efficiency amplification of Doherty power amplifier (DPA) using symmetric devices. In order to achieve the perfect load modulation, the carrier amplifier output circuit total power length is designed to odd multiple of 90°, and the peak amplifier output total power length is designed to even multiple of 180°. The proposed method is demonstrated by designing a broadband high-efficiency DPA using identical 10-W packaged GaN HEMT devices. Measurement results show that over 51% drain efficiency is achieved at 6-dB back-off power, over the frequency band of 1.9–2.4 GHz. Project supported by the National Natural Science Foundation of China (No. 60123456), the Zhejiang Provincial Natural Science Foundation of China (No. LZ16F010001), and the Zhejiang Provincial Public Technology Research Project (No. 2016C31070).

Magnetic and mechanical properties of Ni-Mn-Ga/Fe-Ga ferromagnetic shape memory composite

NASA Astrophysics Data System (ADS)

Tan, Chang-Long; Zhang, Kun; Tian, Xiao-Hua; Cai, Wei

2015-05-01

A ferromagnetic shape memory composite of Ni-Mn-Ga and Fe-Ga was fabricated by using spark plasma sintering method. The magnetic and mechanical properties of the composite were investigated. Compared to the Ni-Mn-Ga alloy, the threshold field for magnetic-field-induced strain in the composite is clearly reduced owing to the assistance of internal stress generated from Fe-Ga. Meanwhile, the ductility has been significantly improved in the composite. A fracture strain of 26% and a compressive strength of 1600 MPa were achieved. Projects supported by the National Natural Science Foundation of China (Grant Nos. 51271065 and 51301054), the Program for New Century Excellent Talents in Heilongjiang Provincial Education Department, China (Grant No. 1253-NCET-009), the Youth Academic Backbone in Heilongjiang Provincial Education Department, China (Grant No. 1251G022), the Projects of Heilongjiang, China, and China Postdoctoral Science Foundation.

[Current status on management and needs related to education and training programs set for new employees at the provincial Centers for Disease Control and Prevention, in China].

PubMed

Ma, J; Meng, X D; Luo, H M; Zhou, H C; Qu, S L; Liu, X T; Dai, Z

2016-06-01

In order to understand the current management status on education/training and needs for training among new employees working at the provincial CDC in China during 2012-2014, so as to provide basis for setting up related programs at the CDC levels. Based on data gathered through questionnaire surveys run by CDCs from 32 provincial and 5 specifically-designated cities, microsoft excel was used to analyze the current status on management of education and training, for new employees. There were 156 management staff members working on education and training programs in 36 CDCs, with 70% of them having received intermediate or higher levels of education. Large differences were seen on equipment of training hardware in different regions. There were 1 214 teaching staff with 66 percent in the fields or related professional areas on public health, in 2014. 5084 new employees conducted pre/post training programs, from 2012 to 2014 with funding as 750 thousand RMB Yuan. 99.5% of the new employees expressed the needs for further training while. 74% of the new staff members expecting a 2-5 day training program to be implemented. 79% of the new staff members claimed that practice as the most appropriate method for training. Institutional programs set for education and training at the CDCs need to be clarified, with management team organized. It is important to provide more financial support on both hardware, software and human resources related to training programs which are set for new stuff members at all levels of CDCs.

[Descriptive Study of the Activities Performed By the Provincial Medical Deontology Commissions].

PubMed

García-Guerrero, Julio; Tarazona López, Ernesto; Martínez Calduch, Blanca; Vera-Remartínez, Enrique Jesús; Jiménez de Aldasoro, María Antonia; Boix Rajadell, Vicente; Ventura López, Mario

2016-01-01

to describe the expedient's features those settle the medical ethics commissions of the provincial colleges (PMEC). descriptive study, retrospective from the typology of the received claims to the PMEC between 01-06-2013 and 31-05-2014. The colleges were selected by simple stratified random sample. Variables related with the origin of the claim, chapter of the Medical Ethics Code affected, resolution timescales, judgement and others; were gathered. Descriptive analysis of the variables, expressing with medians the quantitative variables and their corresponding interquartile ranges; and with absolute and relative frequencies the qualitative ones. A bivariate analysis, through Kruskal-Wallis and Chi-square tests. 10 provincial colleges participated (47.652 members, 20.2% from the Spanish total) that communicated 120 claims. Overall impact: 2.5 claims %0 members/year. The denouncers are mainly patients (80%). The family medicine is the most affected specialty (19.2% of the claims), the quality of the medical attention the most affected chapter of the CD (60% of the claims). The global resolution timescale was 115.5 days (55-187). The PMEC judged ethical failure in 17 cases (14.2), 10 of them within the private sector. 8 (6.7%) were pending on the date 01-03-2015. 8 cases (6.7%) ended in disciplinary file by the management board, one in verbal amonestation and one was pendent of resolution. the incidence of the medical ethics claims is low, as well as the proportion of disciplinary files. Too many discrepancies exist between the judgements of the PMEC and the college's management boards.

Pollution Emissions, Environmental Policy, and Marginal Abatement Costs

PubMed Central

He, Ling-Yun; Ou, Jia-Jia

2017-01-01

Pollution emissions impose serious social negative externalities, especially in terms of public health. To reduce pollution emissions cost-effectively, the marginal abatement costs (MACs) of pollution emissions must be determined. Since the industrial sectors are the essential pillars of China’s economic growth, as well as leading energy consumers and sulfur dioxide (SO2) emitters, estimating MACs of SO2 emissions at the industrial level can provide valuable information for all abatement efforts. This paper tries to address the critical and essential issue in pollution abatement: How do we determine the MACs of pollution emissions in China? This paper first quantifies the SO2 emission contribution of different industrial sectors in the Chinese economy by an Input-Output method and then estimates MACs of SO2 for industrial sectors at the national level, provincial level, and sectoral level by the shadow price theory. Our results show that six sectors (e.g., the Mining and Washing of Coal sector) should be covered in the Chinese pollution emission trading system. We have also found that the lowest SO2 shadow price is 2000 Yuan/ton at the national level, and that shadow prices should be set differently at the provincial level. Our empirical study has several important policy implications, e.g., the estimated MACs may be used as a pricing benchmark through emission allowance allocation. In this paper, the MACs of industrial sectors are calculated from the national, provincial and sectoral levels; therefore, we provide an efficient framework to track the complex relationship between sectors and provinces. PMID:29206170

Use of modern contraceptives among married women in Vietnam: a multilevel analysis using the Multiple Indicator Cluster Survey (2011) and the Vietnam Population and Housing Census (2009).

PubMed

Vu, Lan Thi Hoang; Oh, Juhwan; Bui, Quyen Thi-Tu; Le, Anh Thi-Kim

2016-01-01

The prevalence of modern contraceptive use is an important indicator that reflects accessibility to reproductive health services. Satisfying unmet needs for family planning alone could reduce the number of maternal deaths by almost a third. This study uses multiple data sources to examine multilevel factors associated with the use of modern contraceptives among married women in Vietnam aged 15-49 years. Data from different national surveys (Vietnam Population and Housing Census, Vietnam Living Standard Survey, and Multiple Indicator Cluster Survey) were linked to create a dataset including individual and contextual (provincial) variables (N=8,341). Multilevel modeling was undertaken to examine the impact of both individual and provincial characteristics on modern contraceptive use. Odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Individual factors significantly associated with the use of modern contraceptives were age 30-34 years (reference 15-19 years) (OR=1.63); high socioeconomic status (SES) (OR=0.8); having two living children (OR=2.4); and having a son (OR=1.4). The provincial poverty rate mediated the association between the individual's SES and the likelihood of using modern contraceptives. The proportion of women in Vietnam using modern contraceptive methods has remained relatively high in recent years with significant variation across Vietnam's 63 provinces. Women of lower SES are more likely to use modern contraceptive methods, especially in the poorer provinces. Achieving access to universal reproductive health is one of the Millennium Development Goals. Vietnam must continue to make progress in this area.

The health management information system of Pakistan under devolution: health managers' perceptions.

PubMed

Qazi, Muhammad Suleman; Ali, Moazzam; Kuroiwa, Chushi

2008-04-01

Devolution implies that use of data for decision making starts at the level of data generation. However under a newly decentralized system, managers may face different hurdles in utilizing the preexisting Health Management Information System (HMIS). This qualitative research explores the perceptions of health managers regarding HMIS under the devolution reforms enacted in 2001 in Pakistan. The study was carried out by interviewing 26 managers at various levels in seven selected districts in all provinces. There was general dissatisfaction and confusion over roles and responsibility: respondents reported that the overall atmosphere was characterized by the reluctance of provincial managers to release data under their authority, the absence of prerequisite human resources, and conflicts of interests between political and administrative leadership. The devolution didn't bring immediate good effects for the HMIS. Treated as a least priority area, staff was distributed from provincial HMIS cells, causing overburdening of remaining staff and jeopardizing data analysis. Reporting regularity from the districts was also compromised secondary to political interference and loss of provincial control. The present HMIS is in need of redesigning so that it may keep pace with the devolved system. The HMIS reforms are needed to improve information systems at the district level, capacity building of district managers, political commitment, and administrative ownership of the system and to earmark and make available resource and promote evidence-based decision making. Change in the public administration culture towards encouraging initiative taking at lower levels, introduction of performance incentives, inculcating work ethics, encouraging local accountability, and good governance are all essential.

Trends of selected cattle diseases in eastern Zambia between 1988 and 2008.

PubMed

Mubamba, Chrisborn; Sitali, Joseph; Gummow, Bruce

2011-09-01

Livestock diseases have long been a challenge to livestock production and public health in sub-Saharan Africa and Zambia in particular. The Eastern Province of Zambia is one area in Zambia that is not spared by this challenge. Among various livestock diseases affecting cattle in this region, the most prominent are East Coast Fever (ECF) and African Animal Trypanasomiasis (AAT). Since little has been published on the epidemiological trends of these diseases in eastern Zambia, a retrospective epidemiological study was carried out using reports that were submitted to the provincial veterinary office over the past 20 years. This paper assists in evaluating the impact of some of these aid programmes. Data was analysed using Excel(©), SPSS(®), Epi Info(©), and Epi Map(©) software. Apparent prevalence of AAT in cattle had decreased in the study period from estimates as high as 50% in Katete and Petauke district in 1990 and 1992 respectively to just below 3% (Petauke and Katete) in 2008, thereby, reducing the provincial apparent prevalence from 20% in 1992 to just below 3% in 2008. AAT apparent prevalence dropped from estimates as high as 17% in Chadiza district and 6% in Chipata district in 1990 to just below 1% in 2008 thereby reducing the provincial mean prevalence of East Coast Fever from 6% (1990) to 1% (2008). The inclusion of donor assistance in disease control programmes for both AAT and ECF appeared to have a significant impact on the prevalence of both diseases. Copyright © 2011 Elsevier B.V. All rights reserved.

Diabetes Care Program of Nova Scotia: Celebrating 25 Years of Improving Diabetes Care in Nova Scotia.

PubMed

Payne, Jennifer I; Dunbar, Margaret J; Talbot, Pamela; Tan, Meng H

2018-06-01

The Diabetes Care Program of Nova Scotia (DCPNS)'s mission is "to improve, through leadership and partnerships, the health of Nova Scotians living with, affected by, or at risk of developing diabetes." Working together with local, provincial and national partners, the DCPNS has improved and standardized diabetes care in Nova Scotia over the past 25 years by developing and deploying a resourceful and collaborative program model. This article describes the model and highlights its key achievements. With balanced representation from frontline providers through to senior decision makers in health care, the DCPNS works across the age continuum, supporting the implementation of national clinical practice guidelines and, when necessary, developing provincial guidelines to meet local needs. The development and implementation of standardized documentation and data collection tools in all diabetes centres created a robust opportunity for the development and expansion of the DCPNS registry. This registry provides useful clinical and statistical information to staff, providers within the circle of care, management and senior leadership. Data are used to support individual care, program planning, quality improvement and business planning at both the local and the provincial levels. The DCPNS supports the sharing of new knowledge and advances through continuous education for providers. The DCPNS's ability to engage diabetes educators and key physician champions has ensured balanced perspectives in the creation of tools and resources that can be effective in real-world practice. The DCPNS has evolved to become an illustrative example of the chronic care model in action. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Planktonic marine diatom record of the past 18 m.y.: Appearances and extinctions in the Pacific and Southern Oceans

USGS Publications Warehouse

Barron, J.A.

2003-01-01

Recently published diatom biochronologies provide accurate (to 0.1 m.y.) determination of the ages of appearances and disappearances of planktonic diatoms during the past 18 m.y. in the equatorial Pacific, North Pacific, and Southern Ocean. Comparisons of these records reveal the age of evolutionary appearance and extinction of species and their region of origin. Extinct planktonic diatom species have a mean longevity of 3.4 ?? 2.8 m.y. (SD, n = 53) in the equatorial Pacific, 2.5 ?? 2.1 m.y. (n = 52) in the North Pacific, and 2.9 ?? 2.3 m.y. (n = 38) in the Southern Ocean. The relatively large standard deviations are likely due to the inclusion of taxa that probably could be subdivided into two or more species. In the equatorial Pacific, evolutionary turnover of diatom species was relatively high between 18.0 and 6.0 Ma compared with the period after 6.0 Ma, presumably reflecting changing oceanic circulation and evolving water masses. In the North Pacific, evolutionary turnover peaked between 10.0 and 4.5 Ma, with increasing high-latitude cooling and enhanced provincialism. In the Southern Ocean, evolutionary turnover of endemic diatoms was greatest between 5.0 and 1.6 Ma, which provides evidence for the strong provincial character of Pliocene diatom assemblages. Taken as a whole, oceanic diatom assemblages became increasingly provincial in character during the late Miocene and Pliocene, as pole-to-equator thermal gradients increased and oceanic frontal systems were strengthened.

Genome-Wide Diversity and Phylogeography of Mycobacterium avium subsp. paratuberculosis in Canadian Dairy Cattle

PubMed Central

Ahlstrom, Christina; Barkema, Herman W.; Stevenson, Karen; Zadoks, Ruth N.; Biek, Roman; Kao, Rowland; Trewby, Hannah; Haupstein, Deb; Kelton, David F.; Fecteau, Gilles; Labrecque, Olivia; Keefe, Greg P.; McKenna, Shawn L. B.; Tahlan, Kapil; De Buck, Jeroen

2016-01-01

Mycobacterium avium subsp. paratuberculosis (MAP) is the causative bacterium of Johne’s disease (JD) in ruminants. The control of JD in the dairy industry is challenging, but can be improved with a better understanding of the diversity and distribution of MAP subtypes. Previously established molecular typing techniques used to differentiate MAP have not been sufficiently discriminatory and/or reliable to accurately assess the population structure. In this study, the genetic diversity of 182 MAP isolates representing all Canadian provinces was compared to the known global diversity, using single nucleotide polymorphisms identified through whole genome sequencing. MAP isolates from Canada represented a subset of the known global diversity, as there were global isolates intermingled with Canadian isolates, as well as multiple global subtypes that were not found in Canada. One Type III and six “Bison type” isolates were found in Canada as well as one Type II subtype that represented 86% of all Canadian isolates. Rarefaction estimated larger subtype richness in Québec than in other Canadian provinces using a strict definition of MAP subtypes and lower subtype richness in the Atlantic region using a relaxed definition. Significant phylogeographic clustering was observed at the inter-provincial but not at the intra-provincial level, although most major clades were found in all provinces. The large number of shared subtypes among provinces suggests that cattle movement is a major driver of MAP transmission at the herd level, which is further supported by the lack of spatial clustering on an intra-provincial scale. PMID:26871723

Comparison of oncology drug approval between Health Canada and the US Food and Drug Administration.

PubMed

Ezeife, Doreen A; Truong, Tony H; Heng, Daniel Y C; Bourque, Sylvie; Welch, Stephen A; Tang, Patricia A

2015-05-15

The drug approval timeline is a lengthy process that often varies between countries. The objective of this study was to delineate the Canadian drug approval timeline for oncology drugs and to compare the time to drug approval between Health Canada (HC) and the US Food and Drug Administration (FDA). In total, 54 antineoplastic drugs that were approved by the FDA between 1989 and 2012 were reviewed. For each drug, the following milestones were determined: the dates of submission and approval for both the FDA and HC and the dates of availability on provincial drug formularies in Canadian provinces and territories. The time intervals between the aforementioned milestones were calculated. Of 54 FDA-approved drugs, 49 drugs were approved by HC at the time of the current study. The median time from submission to approval was 9 months (interquartile range [IQR], 6-14.5 months) for the FDA and 12 months (IQR, 10-21.1 months) for HC (P < .0006). The time from HC approval to the placement of a drug on a provincial drug formulary was a median of 16.7 months (IQR, 5.9-27.2 months), and there was no interprovincial variability among the 5 Canadian provinces that were analyzed (P = .5). The time from HC submission to HC approval takes 3 months longer than the same time interval for the FDA. To the authors' knowledge, this is the first documentation of the time required to bring an oncology drug from HC submission to placement on a provincial drug formulary. © 2015 American Cancer Society.

Indoor household residual spraying program performance in Matabeleland South province, Zimbabwe: 2011 to 2012; a descriptive cross-sectional study.

PubMed

Chimberengwa, Pugie Tawanda; Masuka, Nyasha; Gombe, Notion Tafara; Tshimanga, Mufuta; Takundwa, Lucia; Bangure, Donewell

2015-01-01

Matabeleland South launched the malaria pre-elimination campaign in 2012 but provincial spraying coverage has failed to attain 95% target, with some districts still encountering malaria outbreaks. A study was conducted to evaluate program performance against achieving malaria pre-elimination. A descriptive cross sectional study was done in 5 districts carrying out IRS using the logical framework involving inputs, process, outputs and outcome evaluation. Health workers recruited into the study included direct program implementers, district and provincial program managers. An interviewer administered questionnaire, checklists, key informant interviewer guide and desk review of records were used to collect data. We enrolled 37 primary respondents and 5 key informants. Pre-elimination, Epidemic Preparedness and Response plans were absent in all districts. Shortages of inputs were reported by 97% of respondents, with districts receiving 80% of requested budget. Insecticides were procured centrally at national level. Spraying started late and districts failed to spray all targeted households by end of December. The province is using makeshift camps with inappropriate evaporation ponds where liquid DDT waste is not safely accounted for. The provincial IHRS coverage for 2011 was 84%. Challenges cited included; food shortages for spraymen, late delivery of inputs and poor state of IHRS equipment. The province has failed to achieve Malaria pre-elimination IRS coverage targets for 2011/12 season. Financial and logistical challenges led to delays in supply of program inputs, recruitment and training of sprayers. The Province should establish camping infrastructure with standard evaporation ponds to minimise contamination of the environment.

Compassionate use programs in Italy: ethical guidelines.

PubMed

De Panfilis, Ludovica; Satolli, Roberto; Costantini, Massimo

2018-03-09

This article proposes a retrospective analysis of a compassionate use (CU), using a case study of request for Avelumab for a patient suffering from Merkel Cell Carcinoma. The study is the result of a discussion within a Provincial Ethics Committee (EC) following the finding of a high number of requests for CU program. The primary objective of the study is to illustrate the specific ethical and clinical profiles that emerge from the compassionate use program (CUP) issue. The secondary goals are: a) to promote a moral reflection among physicians who require approval for the CUP and b) provide the basis for recommendations on how to request CUP. The instruments for carrying out the analysis of the case study and the discussion are as follows: Analysis of the audio-recording of the EC meeting regarding the selected Case study. In-depth discussion of topics that emerged during the meeting by means of administration of 5 semi-structured interviews with 2 doctors involved in the case (proposing physician and palliative physician) and with 3 components of the EC who played a major role in the EC internal discussion. In an exploration of emerging clinical and ethical issues, four primary themes arise: 1. efficacy, safety of the treatment and patient's quality of life; 2. clear, realistic, adequate communication; 3. right to hope; 4. simultaneous Palliative Care approach. The results of ethical analysis carried out concern two areas: 1) ethical profiles relating to the use of CUP; 2) the role of the EC concerning the compassionate use of drugs and the need to provide recommendations on how to request CUP. With the aim of implementing these conclusions, the provincial EC of Reggio Emilia chose to steer the request for drugs for compassionate use through recommendations for good clinical and ethical practice based on the following assumptions: 1) the "simultaneous care" approach must be preferred. Secondly, 2) the EC's assessment must be part of the decision-making process that the care team conducts before proposing compassionate use to the patient.

High-resolution satellite remote sensing of provincial PM2.5 trends in China from 2001 to 2015

NASA Astrophysics Data System (ADS)

Lin, C. Q.; Liu, G.; Lau, A. K. H.; Li, Y.; Li, C. C.; Fung, J. C. H.; Lao, X. Q.

2018-05-01

Given the vast territory of China, the long-term PM2.5 trends may substantially differ among the provinces. In this study, we aim to assess the provincial PM2.5 trends in China during the past few Five-Year Plan (FYP) periods. The lack of long-term PM2.5 measurements, however, makes such assessment difficult. Satellite remote sensing of PM2.5 concentration is an important step toward filling this data gap. In this study, a PM2.5 data set was built over China at a resolution of 1 km from 2001 to 2015 using satellite remote sensing. Analyses show that the national average of PM2.5 concentration increased by 0.04 μg·m-3·yr-1 during the 10th FYP period (2001-2005) and started to decline by -0.65 μg·m-3·yr-1 and -2.33 μg·m-3·yr-1 during the 11th (2006-2010) and the 12th (2011-2015) FYP period, respectively. In addition, substantial differences in the PM2.5 trends were observed among the provinces. Provinces in the Beijing-Tianjin-Hebei (BTH) region had the largest reduction of PM2.5 concentrations during the 10th and 12th FYP period. The greatest reduction rate of PM2.5 concentration during the 10th and 12th FYP period was observed in Beijing (-3.68 μg·m-3·yr-1) and Tianjin (-6.62 μg·m-3·yr-1), respectively. In contrast, PM2.5 concentrations remained steady for provinces in eastern and southeastern China (e.g., Shanghai) during the 12th FYP period. In overall, great efforts are still required to effectively reduce the PM2.5 concentrations in future.

Causes of low vision and blindness in rural Indonesia

PubMed Central

Saw, S-M; Husain, R; Gazzard, G M; Koh, D; Widjaja, D; Tan, D T H

2003-01-01

Aim: To determine the prevalence rates and major contributing causes of low vision and blindness in adults in a rural setting in Indonesia Methods: A population based prevalence survey of adults 21 years or older (n=989) was conducted in five rural villages and one provincial town in Sumatra, Indonesia. One stage household cluster sampling procedure was employed where 100 households were randomly selected from each village or town. Bilateral low vision was defined as habitual VA (measured using tumbling “E” logMAR charts) in the better eye worse than 6/18 and 3/60 or better, based on the WHO criteria. Bilateral blindness was defined as habitual VA worse than 3/60 in the better eye. The anterior segment and lens of subjects with low vision or blindness (both unilateral and bilateral) (n=66) were examined using a portable slit lamp and fundus examination was performed using indirect ophthalmoscopy. Results: The overall age adjusted (adjusted to the 1990 Indonesia census population) prevalence rate of bilateral low vision was 5.8% (95% confidence interval (CI) 4.2 to 7.4) and bilateral blindness was 2.2% (95% CI 1.1 to 3.2). The rates of low vision and blindness increased with age. The major contributing causes for bilateral low vision were cataract (61.3%), uncorrected refractive error (12.9%), and amblyopia (12.9%), and the major cause of bilateral blindness was cataract (62.5%). The major causes of unilateral low vision were cataract (48.0%) and uncorrected refractive error (12.0%), and major causes of unilateral blindness were amblyopia (50.0%) and trauma (50.0%). Conclusions: The rates of habitual low vision and blindness in provincial Sumatra, Indonesia, are similar to other developing rural countries in Asia. Blindness is largely preventable, as the major contributing causes (cataract and uncorrected refractive error) are amenable to treatment. PMID:12928268

Economic Burden in Chinese Patients with Diabetes Mellitus Using Electronic Insurance Claims Data

PubMed Central

Vemer, Pepijn; Zhu, Jingjing; Postma, Maarten J.; Chen, Wen

2016-01-01

Background There is a paucity of studies that focus on the economic burden in daily care in China using electronic health data. The aim of this study is to describe the development of the economic burden of diabetic patients in a sample city in China from 2009 to 2011 using electronic data of patients’ claims records. Methods This study is a retrospective, longitudinal study in an open cohort of Chinese patients with diabetes. The patient population consisted of people living in a provincial capital city in east China, covered by the provincial urban employee basic medical insurance (UEBMI). We included any patient who had at least one explicit diabetes diagnosis or received blood glucose lowering medication in at least one registered outpatient visit or hospitalization during a calendar year in the years 2009–2011. Cross-sectional descriptions of different types of costs, prevalence of diabetic complications and related diseases, medication use were performed for each year separately and differences between three years were compared using a chi-square test or the non-parametric Kruskal-Wallis H test. Results Our results showed an increasing trend in total medical cost (from 2,383 to 2,780 USD, p = 0.032) and diabetes related cost (from 1,655 to 1,857 USD) for those diabetic patients during the study period. The diabetes related economic burden was significantly related to the prevalence of complications and related diseases (p<0.001). The overall medication cost during diabetes related visits also increased (from 1,335 to 1,383 USD, p = 0.021). But the use pattern and cost of diabetes-related medication did not show significant changes during the study period. Conclusion The economic burden of diabetes increased significantly in urban China. It is important to improve the prevention and treatment of diabetes to contribute to the sustainability of the Chinese health-care system. PMID:27570976

Effects of the performance level and the FIFA "11" injury prevention program on the injury rate in Italian male amateur soccer players.

PubMed

Gatterer, H; Ruedl, G; Faulhaber, M; Regele, M; Burtscher, M

2012-02-01

Soccer is characterized by high injury rates that necessitate interventions for its reduction. The "11" is a multi-modal preventive program that was developed to reduce injury rate. However, outcomes on the effectiveness of the program are not unambiguous and data for the largest group at risk (i.e., male adult amateur players) are missing. The study aims to assess the injury rate in male adult amateur soccer players of different levels and to evaluate the effectiveness of the prevention program the "11". Three amateur soccer teams participated in the study during the first round of a competition season. Two teams played at a regional level (6th Italian league) and one team at a provincial level (7th Italian league). The regional league is of a higher skill level compared to the provincial league. Duration and frequency of training and match sessions and the occurrence of time-loss injuries were recorded. One team of the 6th league performed an injury prevention program. The total injury rate for the intervention and the control team in the 6th league was 3.3 (CI 0.7-5.9) and 4.3 (CI 1.3-7.3) injuries/1000 h, respectively (P=0.841). The 6th league control team tended to have a lesser injury rate compared to the 7th league team (P=0.081). The relative risk was 2 fold higher in the 7th compared to the 6th league team (P=0.0285 one tailed). Present results show that injury rate in amateur soccer depended rather on the skill level than the prevention program. In this study the prevention program the "11" was not shown to be highly effective in soccer player of intermediate level (i.e., 6th Italian league).

Facilitating Community-Based Exercise for People With Stroke: Cross-Sectional e-Survey of Physical Therapist Practice and Perceived Needs

PubMed Central

Lau, Carrie; Chitussi, Danielle; Elliot, Sarah; Giannone, Jennifer; McMahon, Mary-Katherine; Sibley, Kathryn M.; Tee, Alda; Matthews, Julie

2016-01-01

Background Educating people with stroke about community-based exercise programs (CBEPs) is a recommended practice that physical therapists are well positioned to implement. Objective The aim of this study was to evaluate the provision of education about CBEPs to people with stroke, barriers to providing education, and preferences for resources to facilitate education among physical therapists in neurological practice. Design A cross-sectional e-survey of physical therapists treating adults with stroke in Ontario, Canada, was conducted. Methods A link to the questionnaire was emailed to physical therapists in a provincial stroke network, a provincial physical therapy association, and on hospital and previous research lists. Results Responses from 186 physical therapists were analyzed. The percentage of respondents who reported providing CBEP education was 84.4%. Only 36.6% reported typically providing education to ≥7 out of 10 patients with stroke. Physical (90.5%) and preventative (84.6%) health benefits of exercise were most frequently discussed. Therapists reported most commonly delivering education at discharge (73.7%). Most frequently cited barriers to educating patients were a perceived lack of suitable programs (53.2%) and a lack of awareness of local CBEPs (23.8%). Lists of CBEPs (94.1%) or brochures (94.1%) were considered to be facilitators. The percentage of physical therapists providing CBEP education varied across acute, rehabilitation, and public outpatient settings. Limitations The percentage of physical therapists providing education may have been overestimated if respondents who deliver CBEP education were more likely to participate and if participants answered in a socially desirable way. Conclusions Even though a high proportion of physical therapists provide CBEP education, education is not consistently delivered to the majority of patients poststroke. Although a CBEP list or brochure would facilitate education regarding existing CBEPs, efforts to implement CBEPs are needed to help overcome the lack of suitable programs. PMID:26294684

Diversity and distribution of parasitic angiosperms in China.

PubMed

Zhang, Guangfu; Li, Qian; Sun, Shucun

2018-05-01

Parasitic plants are an important component of vegetation worldwide, but their diversity and distribution in China have not been systematically reported. This study aimed to (1) explore floral characteristics of China's parasitic plants, (2) map spatial distribution of diversity of these species, and (3) explore factors influencing the distribution pattern. We compiled a nationwide species list of parasitic plants in China, and for each species, we recorded its phylogeny, endemism, and life form (e.g., herb vs. shrub; hemiparasite vs. holoparasite). Species richness and area-corrected species richness were calculated for 28 provinces, covering 98.89% of China's terrestrial area. Regression analyses were performed to determine relationships between provincial area-corrected species richness of parasitic plants and provincial total species richness (including nonparasitic plants) and physical settings (altitude, midlongitude, and midlatitude). A total of 678 species of parasitic angiosperms are recorded in China, 63.13% of which are endemic. Of the total, 59.73% (405 species) are perennials, followed by shrubs/subshrubs (14.75%) and vines (1.47%). About 76.11% (516 species) are of root hemiparasites, higher than that of stem parasites (100, 14.75%), root holoparasites (9.00%), and endophytic parasites (0.15%). A significant positive relationship is found between the area-corrected species richness and the total species richness, which has been previously demonstrated to increase with decreasing longitude and latitude. Moreover, more parasitic species are found in the southwest high-altitude areas than low areas. Consistently, the area-corrected species richness increases with increasing altitude, decreasing latitude, and decreasing longitude, as indicated by regression analyses. China is rich in parasitic flora with a high proportion of endemic species. Perennials and root hemiparasites are the dominant types. The spatial distribution of parasitic plants is largely heterogeneous, with more species living in southwest China, similar to the distribution pattern of Chinese angiosperms. The positive relationship between parasitic and nonparasitic plant species richness should be addressed in the future.

Examining the social determinants of children's developmental health: protocol for building a pan-Canadian population-based monitoring system for early childhood development

PubMed Central

Guhn, Martin; Janus, Magdalena; Enns, Jennifer; Brownell, Marni; Forer, Barry; Duku, Eric; Muhajarine, Nazeem; Raos, Rob

2016-01-01

Introduction Early childhood is a key period to establish policies and practices that optimise children's health and development, but Canada lacks nationally representative data on social indicators of children's well-being. To address this gap, the Early Development Instrument (EDI), a teacher-administered questionnaire completed for kindergarten-age children, has been implemented across most Canadian provinces over the past 10 years. The purpose of this protocol is to describe the Canadian Neighbourhoods and Early Child Development (CanNECD) Study, the aims of which are to create a pan-Canadian EDI database to monitor trends over time in children's developmental health and to advance research examining the social determinants of health. Methods and analysis Canada-wide EDI records from 2004 to 2014 (representing over 700 000 children) will be linked to Canada Census and Income Taxfiler data. Variables of socioeconomic status derived from these databases will be used to predict neighbourhood-level EDI vulnerability rates by conducting a series of regression analyses and latent variable models at provincial/territorial and national levels. Where data are available, we will measure the neighbourhood-level change in developmental vulnerability rates over time and model the socioeconomic factors associated with those trends. Ethics and dissemination Ethics approval for this study was granted by the Behavioural Research Ethics Board at the University of British Columbia. Study findings will be disseminated to key partners, including provincial and federal ministries, schools and school districts, collaborative community groups and the early childhood development research community. The database created as part of this longitudinal population-level monitoring system will allow researchers to associate practices, programmes and policies at school and community levels with trends in developmental health outcomes. The CanNECD Study will guide future early childhood development action and policies, using the database as a tool for formative programme and policy evaluation. PMID:27130168

Facilitating Community-Based Exercise for People With Stroke: Cross-Sectional e-Survey of Physical Therapist Practice and Perceived Needs.

PubMed

Lau, Carrie; Chitussi, Danielle; Elliot, Sarah; Giannone, Jennifer; McMahon, Mary-Katherine; Sibley, Kathryn M; Tee, Alda; Matthews, Julie; Salbach, Nancy M

2016-04-01

Educating people with stroke about community-based exercise programs (CBEPs) is a recommended practice that physical therapists are well positioned to implement. The aim of this study was to evaluate the provision of education about CBEPs to people with stroke, barriers to providing education, and preferences for resources to facilitate education among physical therapists in neurological practice. A cross-sectional e-survey of physical therapists treating adults with stroke in Ontario, Canada, was conducted. A link to the questionnaire was emailed to physical therapists in a provincial stroke network, a provincial physical therapy association, and on hospital and previous research lists. Responses from 186 physical therapists were analyzed. The percentage of respondents who reported providing CBEP education was 84.4%. Only 36.6% reported typically providing education to ≥7 out of 10 patients with stroke. Physical (90.5%) and preventative (84.6%) health benefits of exercise were most frequently discussed. Therapists reported most commonly delivering education at discharge (73.7%). Most frequently cited barriers to educating patients were a perceived lack of suitable programs (53.2%) and a lack of awareness of local CBEPs (23.8%). Lists of CBEPs (94.1%) or brochures (94.1%) were considered to be facilitators. The percentage of physical therapists providing CBEP education varied across acute, rehabilitation, and public outpatient settings. The percentage of physical therapists providing education may have been overestimated if respondents who deliver CBEP education were more likely to participate and if participants answered in a socially desirable way. Even though a high proportion of physical therapists provide CBEP education, education is not consistently delivered to the majority of patients poststroke. Although a CBEP list or brochure would facilitate education regarding existing CBEPs, efforts to implement CBEPs are needed to help overcome the lack of suitable programs. © 2016 American Physical Therapy Association.

The rapid moving Capriglio earth flow (Parma Province, North Italy): multi-temporal mapping and GB-InSAR monitoring

NASA Astrophysics Data System (ADS)

Bardi, Federica; Raspini, Federico; Frodella, William; Lombardi, Luca; Nocentini, Massimiliano; Gigli, Giovanni; Morelli, Stefano; Corsini, Alessandro; Casagli, Nicola

2017-04-01

This research presents the main findings of the multi-temporal mapping and of the long-term, real-time monitoring of the Capriglio landslide in the Emilian Apennines (Northern Italy). The landslide, triggered by prolonged rainfall and rapid snowmelt, activated of April 6th 2013. It is constituted by two main adjacent enlarging bodies with a roto-translational kinematics. They activated in sequence and subsequently joined into a large fast moving earth flow, channelizing downstream the Bardea Creek, for a total length of about 3600 meters. The landslide completely destroyed a 450 m sector of the provincial roadway S.P. 101, and its retrogression tendency put at high risk the Capriglio and Pianestolla villages, located in the upper watershed area of the Bardea River. Furthermore, the advancing toe seriously threatened the Antria bridge, representing the "Massese" provincial roadway S.P. 665R transect over the Bardea Creek, the only strategic roadway left able to connect the above-mentioned villages. With the final aim of supporting local authorities in the hazard assessment and risk management during the emergency phase, on May 5th 2013 aerial optical surveys were conducted to accurately map the landslide extension and evolution. Moreover, a GB-InSAR monitoring campaign was started in order to assess displacements of the whole landslide area. The versatility and flexibility of the GB-InSAR sensors allowed acquiring data with two different configurations, designed and set up to continuously retrieve information on the landslide movements rates (both in its upper slow-moving sectors and in its fast-moving toe). The first acquisition mode revealed that the Capriglio and Pianestolla villages were affected by minor displacements (order of magnitude of few millimetres per month). The second acquisition mode allowed to acquire data every 28'', reaching very high temporal resolution values by applying GB-InSAR technique (Monserrat et al., 2014; Caduff et al., 2015).

Tetanus toxoid immunization campaign in West Nusa Tenggara, Indonesia.

PubMed

1985-01-01

A tetanus toxoid (TT) immunization campaign was carried out in Central Lombok district of Indonesia in the province of West Nusa Tenggara (NTB) from January to April 1985. A coverage rate of 93% for 2 doses was obtained among women of childbearing age. This paper summarizes the major components of the activity, discussing some of the strengths and weaknesses of the campaign. The major objective of this crash campaign was to raise the tetanus immunity level throughout the fertile age group and thus to achieve a marked reduction in the incidence of neonatal tetanus. A draft protocol for the campaign was developed by national and provincial health staff. The governor of NTB pledged the full support of the provincial administrative apparatus, and funds, equipment, and vaccine were guaranteed at the national level. Commitments of support were received from all relevant sectoral departments at provincial and district levels. About 2 weeks before the vaccination activities began, PKK cadres -- about 6000 women in Central Lombok district -- were provided with forms to take a census of all fertile women in their respective areas. This information was consolidated at the village level, where a serial number was assigned to each name. The enumeration forms were later used as vaccination registers. The number of women identified in each village was reported to the appropriate health center for use in planning vaccine requirements and the deployment of manpower. 2 or 3 days prior to the scheduled vaccination session, PKK cadres again visited all women on their census list to inform them of the place and time of the vaccinator's visit and to distribute appointment cards which carried serial numbers matching those on the census list. The 31 vaccinators were newly qualified nursing school graduates awaiting their 1st government postings. They were given a 2-day orientation course on campaign strategy and methods, and their work schedule was explained. First-line technical supervision was the responsibility of the rural health center doctor in each subdistrict, supported by the district chief of health services and his staff. The campaign was officially opened on January 7, 1986. Each of the 9 subdistricts was completely covered before vaccinators moved on to the next one. A total of 1086 vaccination posts were required. Vaccine was shipped from Jakarta in 3 batches during the course of the campaign to avoid overloading storage facilities in the province. It then was transferred to the district as required. The campaign achieved remarkably good results. It is important to monitor the extent to which the TT campaign experience contributes to improved performance of the routine immunization delivery system in NTB.

Libya: Background and U.S. Relations

DTIC Science & Technology

2006-06-13

for nuclear weapons designs or enrichment equipment disclosed by Libya. Leslie Lopez, “Libyans Got Nuclear Training at Malaysian Company, Police Say...characterized by continuous bargaining and rivalry among the provincial governments over taxation , development, and constitutional issues. In 1963, King