Global Burden of Skin Disease: Inequities and Innovations.

PubMed

Seth, Divya; Cheldize, Khatiya; Brown, Danielle; Freeman, Esther F

2017-09-01

We review the current understanding of the burden of dermatological disease through the lens of the Global Burden of Disease project, evaluate the impact of skin disease on quality of life in a global context, explore socioeconomic implications, and finally summarize interventions towards improving quality of dermatologic care in resource-poor settings. The Global Burden of Disease project has shown that skin diseases continue to be the 4 th leading cause of nonfatal disease burden world-wide. However, research efforts and funding do not match with the relative disability of skin diseases. International and national efforts, such as the WHO List of Essential Medicines, are critical towards reducing the socioeconomic burden of skin diseases and increasing access to care. Recent innovations such as teledermatology, point-of-care diagnostic tools, and task-shifting help to provide dermatological care to underserved regions in a cost-effective manner. Skin diseases cause significant non-fatal disability worldwide, especially in resource-poor regions. Greater impetus to study the burden of skin disease in low resource settings and policy efforts towards delivering high quality care are essential in improving the burden of skin diseases.

The role of neighborhood economic context on physical activity among children: Evidence from the Geographic Research on Wellbeing (GROW) study.

PubMed

Kim, Yeonwoo; Cubbin, Catherine

2017-08-01

Less than half of young children in the U.S. meet physical activity recommendations. While neighborhood economic context has been shown to be associated with physical activity, it is unknown whether this association varies according to family economic context. This study thus investigates whether neighborhood economic context, measured by poverty concentration and income inequality, are associated with physical activity among poor and non-poor children using data from the Geographic Research on Wellbeing study, California, 2012-2013 (N=2670). Poor children who resided in (a) poor and equal neighborhoods or (b) non-poor and equal neighborhoods were more likely to engage in sufficient physical activity than were children residing in non-poor and unequal neighborhoods. Poor children in (a) non-poor and equal neighborhoods, (b) poor and equal neighborhoods, or (c) poor and unequal neighborhoods were less likely to report insufficient physical activity than those in non-poor and unequal neighborhoods. Neighborhood economic context was not associated with physical activity among non-poor children. Findings suggest that neighborhood economic context presents a social barrier to physical activity among poor children. Increasing physical activity among poor children in non-poor and unequal neighborhoods should be a high policy priority. Perceived social cohesion, perceived neighborhood safety, and park and walkability indicators did not mediate the associations between neighborhood economic context and physical activity. Further research needs to explore the mechanisms by which neighborhood economic context affects physical activity among children. Copyright © 2017 Elsevier Inc. All rights reserved.

Collective arrangements and social networks: Coping strategies for the poor households in the Great Ruaha Catchment in Tanzania

NASA Astrophysics Data System (ADS)

Kadigi, Reuben M. J.; Mdoe, N. S. Y.; Ashimogo, G. C.

Access to water and land resources underpins the socio-economic fabric of many societies in the Southern Africa region, which is characterized broadly as underdeveloped with widespread food insecurity, exacerbated by persistent droughts, erratic rainfalls and increasing human populations. The availability of land and water resources is increasingly diminishing and becoming a stumbling block to the development of the agrarian societies in the region. The poor households have in turn adopted new livelihood coping mechanisms but little research has been done to assess the effectiveness of these ‘instruments’. Consequently, the concepts of sustainable water resources management and agricultural development have remained elusive and poorly understood by policy makers as well as by water resources planners and managers. Recognizing this, a study was conducted between 2002 and 2005 under the RIPARWIN (Raising Irrigation Productivity and Releasing Water for Intersectoral Needs) project to assess the spatial dynamics of livelihood capital, vulnerability and coping strategies for the poor agrarian households in the Upper Great Ruaha River Catchment (GRRC) in Tanzania. The results of analysis showed an array of livelihood platforms and institutional contexts that act to shape the existing livelihood typologies in the GRRC. In addition, the results showed a gradual increase in household vulnerability from upstream to downstream, particularly in terms of access to physical and natural assets. Vulnerability was found to be directly associated with the number of dependants. The female-headed households were relatively more likely to be vulnerable than the male-headed households (cf. probabilities of 27% and 21%, respectively). The value of collective arrangements and drawing on social networks crosscut all social strata and ranked as the most common livelihood strategy. This suggests that the scope for reducing vulnerability among the poor households in the GRRC critically depends on the existing institutional arrangements and mechanisms. Of paramount importance is perhaps the need to facilitate the establishment and empowerment of water use associations and apex bodies. In the study area, this appears to be promising enough to build ‘strong’ institutional platforms through which water and land resources would be managed sustainably.

The gendered health workforce: mixed methods analysis from four fragile and post-conflict contexts.

PubMed

Witter, Sophie; Namakula, Justine; Wurie, Haja; Chirwa, Yotamu; So, Sovanarith; Vong, Sreytouch; Ros, Bandeth; Buzuzi, Stephen; Theobald, Sally

2017-12-01

It is well known that the health workforce composition is influenced by gender relations. However, little research has been done which examines the experiences of health workers through a gender lens, especially in fragile and post-conflict states. In these contexts, there may not only be opportunities to (re)shape occupational norms and responsibilities in the light of challenges in the health workforce, but also threats that put pressure on resources and undermine gender balance, diversity and gender responsive human resources for health (HRH). We present mixed method research on HRH in four fragile and post-conflict contexts (Sierra Leone, Zimbabwe, northern Uganda and Cambodia) with different histories to understand how gender influences the health workforce. We apply a gender analysis framework to explore access to resources, occupations, values, decision-making and power. We draw largely on life histories with male and female health workers to explore their lived experiences, but complement the analysis with evidence from surveys, document reviews, key informant interviews, human resource data and stakeholder mapping. Our findings shed light on patterns of employment: in all contexts women predominate in nursing and midwifery cadres, are under-represented in management positions and are clustered in lower paying positions. Gendered power relations shaped by caring responsibilities at the household level, affect attitudes to rural deployment and women in all contexts face challenges in accessing both pre- and in-service training. Coping strategies within conflict emerged as a key theme, with experiences here shaped by gender, poverty and household structure. Most HRH regulatory frameworks did not sufficiently address gender concerns. Unless these are proactively addressed post-crisis, health workforces will remain too few, poorly distributed and unable to meet the health needs of vulnerable populations. Practical steps need to be taken to identify gender barriers proactively and engage staff and communities on best approaches for change. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The gendered health workforce: mixed methods analysis from four fragile and post-conflict contexts

PubMed Central

Witter, Sophie; Namakula, Justine; Wurie, Haja; Chirwa, Yotamu; So, Sovanarith; Vong, Sreytouch; Ros, Bandeth; Buzuzi, Stephen; Theobald, Sally

2017-01-01

Abstract It is well known that the health workforce composition is influenced by gender relations. However, little research has been done which examines the experiences of health workers through a gender lens, especially in fragile and post-conflict states. In these contexts, there may not only be opportunities to (re)shape occupational norms and responsibilities in the light of challenges in the health workforce, but also threats that put pressure on resources and undermine gender balance, diversity and gender responsive human resources for health (HRH). We present mixed method research on HRH in four fragile and post-conflict contexts (Sierra Leone, Zimbabwe, northern Uganda and Cambodia) with different histories to understand how gender influences the health workforce. We apply a gender analysis framework to explore access to resources, occupations, values, decision-making and power. We draw largely on life histories with male and female health workers to explore their lived experiences, but complement the analysis with evidence from surveys, document reviews, key informant interviews, human resource data and stakeholder mapping. Our findings shed light on patterns of employment: in all contexts women predominate in nursing and midwifery cadres, are under-represented in management positions and are clustered in lower paying positions. Gendered power relations shaped by caring responsibilities at the household level, affect attitudes to rural deployment and women in all contexts face challenges in accessing both pre- and in-service training. Coping strategies within conflict emerged as a key theme, with experiences here shaped by gender, poverty and household structure. Most HRH regulatory frameworks did not sufficiently address gender concerns. Unless these are proactively addressed post-crisis, health workforces will remain too few, poorly distributed and unable to meet the health needs of vulnerable populations. Practical steps need to be taken to identify gender barriers proactively and engage staff and communities on best approaches for change. PMID:29244105

A responsive evaluation of mental health treatment in Cambodia: Intentionally addressing poverty to increase cultural responsiveness in therapy.

PubMed

Seponski, Desiree M; Lewis, Denise C; Megginson, Maegan C

2014-01-01

Mental health issues are significant contributors to the global burden of disease with the highest incidence in resource poor countries; 90% of those in need of mental health treatment reside in low resource countries but receive only 10% of the world's resources. Cambodia, the eighth least developed country in the world, serves as one example of the need to address mental health concerns in low-income, resource poor countries. The current study utilises responsive evaluation methodology to explore how poverty-stricken Cambodian clients, therapists and supervisors experience Western models of therapy as culturally responsive to their unique needs. Quantitative and qualitative data were triangulated across multiple stakeholders using numerous methods including a focus group, interviews, surveys, case illustrations and live supervision observation and analysed using constant comparative analysis. Emerging findings suggest that poverty, material needs, therapy location and financial situations greatly impact the daily lives and mental health conditions of Cambodians and hinder clients' therapeutic progress. The local community needs and context of poverty greatly hinder clients' therapeutic progress in therapy treatment and when therapy does not directly address the culture of poverty, clients did not experience therapy as valuable despite some temporary decreases in mental health symptoms.

Linking community resources in diabetes care: a role for technology?

PubMed

Tung, Elizabeth L; Peek, Monica E

2015-07-01

Designing and implementing effective lifestyle modification strategies remains one of the great challenges in diabetes care. Historically, programs have focused on individual behavior change with little or no attempt to integrate change within the broader social framework or community context. However, these contextual factors have been shown to be associated with poor diabetes outcomes, particularly in low-income minority populations. Recent evidence suggests that one way to address these disparities is to match patient needs to existing community resources. Not only does this position patients to more quickly adapt behavior in a practical way, but this also refers patients back to their local communities where a support mechanism is in place to sustain healthy behavior. Technology offers a new and promising platform for connecting patients to meaningful resources (also referred to as "assets"). This paper summarizes several noteworthy innovations that use technology as a practical bridge between healthcare and community-based resources that promote diabetes self-care.

Perceived social justice, long-term unemployment and health. A survey among marginalised groups in Austria.

PubMed

Freidl, Wolfgang; Fazekas, Christian; Raml, Reinhard; Pretis, Manfred; Feistritzer, Gert

2007-07-01

Although socially disadvantaged groups are known to have a high risk of poor health the involved mechanisms and psychosocial dynamics are not fully understood. Long-term unemployment and the perception of social justice may both additionally endanger health. We therefore set out to explore the specific impact of these two context variables on self-reported health, health behaviour, and resources in marginalised groups. A structured interview survey was conducted in three federal provinces in Austria, which targeted a quota sample of 486 subjects in long-term unemployment. Both, duration of long-term unemployment and low perceived social justice, are strongly associated with self-reported poor health and low personal (internal) and social (external) health resources. The best differentiation of dependent variables concerning the univariate analyses was found with respect to social health resources, as all variables on this level significantly correlated with perceived social justice but not with duration of long-term unemployment. While this study does not allow to establish causal relationships, the associations we found suggest that also perceived social justice needs to be taken into account in interventions that are intended to foster equity in health among socially disadvantaged groups.

What shapes research impact on policy? Understanding research uptake in sexual and reproductive health policy processes in resource poor contexts

PubMed Central

2011-01-01

Assessing the impact that research evidence has on policy is complex. It involves consideration of conceptual issues of what determines research impact and policy change. There are also a range of methodological issues relating to the question of attribution and the counter-factual. The dynamics of SRH, HIV and AIDS, like many policy arenas, are partly generic and partly issue- and context-specific. Against this background, this article reviews some of the main conceptualisations of research impact on policy, including generic determinants of research impact identified across a range of settings, as well as the specificities of SRH in particular. We find that there is scope for greater cross-fertilisation of concepts, models and experiences between public health researchers and political scientists working in international development and research impact evaluation. We identify aspects of the policy landscape and drivers of policy change commonly occurring across multiple sectors and studies to create a framework that researchers can use to examine the influences on research uptake in specific settings, in order to guide attempts to ensure uptake of their findings. This framework has the advantage that distinguishes between pre-existing factors influencing uptake and the ways in which researchers can actively influence the policy landscape and promote research uptake through their policy engagement actions and strategies. We apply this framework to examples from the case study papers in this supplement, with specific discussion about the dynamics of SRH policy processes in resource poor contexts. We conclude by highlighting the need for continued multi-sectoral work on understanding and measuring research uptake and for prospective approaches to receive greater attention from policy analysts. PMID:21679384

Helping Young People Stay Afloat: A Qualitative Study of Community Resources and Supports for LGBTQ Adolescents in the United States and Canada.

PubMed

Eisenberg, Marla E; Mehus, Christopher J; Saewyc, Elizabeth M; Corliss, Heather L; Gower, Amy L; Sullivan, Richard; Porta, Carolyn M

2018-01-01

LGBTQ youth are at increased risk of poor health outcomes. This qualitative study gathered data from LGBTQ adolescents regarding their communities and describes the resources they draw on for support. We conducted 66 go-along interviews with diverse LGBTQ adolescents (mean age = 16.6) in Minnesota, Massachusetts, and British Columbia in 2014-2015, in which interviewers accompanied participants in their communities to better understand those contexts. Their responses were systematically organized and coded for common themes, reflecting levels of the social ecological model. Participants described resources at each level, emphasizing organizational, community, and social factors such as LGBTQ youth organizations and events, media presence, and visibility of LGBTQ adults. Numerous resources were identified, and representative themes were highly consistent across locations, genders, orientations, racial/ethnic groups, and city size. Findings suggest new avenues for research with LGBTQ youth and many opportunities for communities to create and expand resources and supports for this population.

Getting support in polarized societies: income, social networks, and socioeconomic context.

PubMed

Letki, Natalia; Mieriņa, Inta

2015-01-01

This paper explores how unequal resources and social and economic polarization affects the size of social networks and their use to access resources. We argue that individual resource position generates divergent expectations with regard to the impact of polarization on the size of networks on one hand, and their usefulness for accessing resources on the other. Social and economic polarization encourages reliance on informal networks, but those at the bottom of the social structure are forced to rely on more extensive networks than the wealthy to compensate for their isolated and underprivileged position. At the same time, social and economic polarization limits the resources the poor can access through their networks. We provide evidence consistent with these propositions, based on data derived from the International Social Survey Programme 2001 "Social Networks" dataset combined with contextual information on the levels of economic inequality in particular countries along with whether they experienced postcommunism. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Building capacity for cognitive behavioral therapy delivery for depression in disaster-impacted contexts.

PubMed

Ngo, Victoria K; Centanni, Angela; Wong, Eunice; Wennerstrom, Ashley; Miranda, Jeanne

2011-01-01

Numerous challenges exist in implementing evidence-based practices, such as cognitive behavioral therapy, in resource poor, ethnic minority, and/or disaster-affected communities with disparities in mental health. Community-academic participatory partnerships are a promising approach to addressing disparities by implementing community-appropriate, evidence-based depression care. A community-academic collaborative was formed in New Orleans after Hurricane Katrina to expand resources for effective depression care, including cognitive behavioral therapy. In this article, we: 1) describe our model of building capacity to deliver cognitive behavioral therapy for depression in post-disaster community-based settings; 2) discuss the impact of this training program on therapist reported practice; and 3) share lessons learned regarding disseminating and sustaining evidence-based interventions in the context of a disaster impacted community. Using a mixed methods approach, we found that this model was feasible, acceptable, and disseminated knowledge about cognitive behavioral therapy in community settings. Over the course of two years, community providers demonstrated the feasibility of implementing evidence-based practice and potential for local community leadership. The lessons learned from this model of implementation may help address barriers to disseminating evidence-based interventions in other low-resource, disaster-impacted community settings.

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

PubMed Central

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Objectives Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. Methods This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. Results The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Conclusions Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services. PMID:26405800

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services.

Different Orthographies Different Context Effects: The Effects of Arabic Sentence Context in Skilled and Poor Readers.

ERIC Educational Resources Information Center

Rabia, Salim Abu; Siegel, Linda S.

1995-01-01

Investigates whether Arabic orthography differs from an alphabetic orthography regarding context effects among poor and skilled readers. Finds that skilled as well as poor readers significantly improved their reading accuracy when they read voweled and unvoweled words in context and that skilled readers significantly improved their reading voweled…

Economic development, income inequality and environmental degradation of fisheries resources in Mauritius.

PubMed

Sobhee, Sanjeev K

2004-07-01

This article examines how environmental degradation of fisheries resources in the context of Mauritius is linked up with human investment in education, economic growth, and income inequality. Empirical evidence shows that public-sector investment in education promotes economic growth, but at the expense of greater inequality of income. Among the vulnerable groups affected by this type of development process lies the fisherman community. In fact, children of poor families in coastal Mauritius have constrained access to complete school education because of the persistently high opportunity cost involved. Hence, this community is caught up in a vicious circle, as its children or grandchildren would barely be redeployed elsewhere other than in the fisheries sector itself. Such exclusion might account for the overexploitation of marine resources of the island and the accompanying reduction in fish catch over recent years.

The control of malaria vectors in the context of the Health for All by the Year 2000 Global Strategy.

PubMed

Slooff, R

1987-12-01

The changing picture of malaria worldwide needs to be viewed in the context of other developments before we can determine the directions to take to be able to provide the thrusts required in malaria vector control. As a result of population growth, increasing urbanization and continuing pressure on scarce natural resources, the epidemiology of malaria and its manifestation as a public health problem are undergoing profound modifications, indeed in several parts of the world. This picture is further complicated by the spread of resistance to pesticides in the vector and to drugs in Plasmodium falciparum. In the immediate future, these trends will continue. In addition, the appearance of suitable vaccines is a highly probable event to be taken into consideration. The WHO Global Strategy of Health For All by the Year 2000 aims at the improvement of levels of health through primary health care. Among other things, this implies a greater reliance on community involvement and on intersectoral collaboration for health. In this light, the major malaria problems in the year 2000 will be: (1) "hard core" endemic areas with inadequate infrastructure and poor socio-economic development; (2) resource development areas, in particular those under illegal or poor controlled exploitation; (3) expanding urban areas and (4) increased mobility of non-immunes, particularly if uncontrolled. In order to cope with these problems, thrusts are required towards the development of vector control strategies, covering the following fields: (1) tools for vector control integrated in primary health care, (2) new chemicals, (3) improved and new biologicals, (4) environmental management and the adoption of health safeguards in resource development projects and (5) manpower development.

Effects of resource variation during early life and adult social environment on contest outcomes in burying beetles: a context-dependent silver spoon strategy?

PubMed

Hopwood, Paul E; Moore, Allen J; Royle, Nick J

2014-06-22

Good early nutritional conditions may confer a lasting fitness advantage over individuals suffering poor early conditions (a 'silver spoon' effect). Alternatively, if early conditions predict the likely adult environment, adaptive plastic responses might maximize individual performance when developmental and adult conditions match (environmental-matching effect). Here, we test for silver spoon and environmental-matching effects by manipulating the early nutritional environment of Nicrophorus vespilloides burying beetles. We manipulated nutrition during two specific early developmental windows: the larval environment and the post-eclosion environment. We then tested contest success in relation to variation in adult social environmental quality experienced (defined according to whether contest opponents were smaller (good environment) or larger (poor environment) than the focal individual). Variation in the larval environment influenced adult body size but not contest success per se for a given adult social environment experienced (an 'indirect' silver spoon effect). Variation in post-eclosion environment affected contest success dependent on the quality of the adult environment experienced (a context-dependent 'direct' silver spoon effect). By contrast, there was no evidence for environmental-matching. The results demonstrate the importance of social environmental context in determining how variation in nutrition in early life affects success as an adult.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders.

PubMed

Horseman, Susan V; Buller, Henry; Mullan, Siobhan; Whay, Helen R

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders

PubMed Central

Horseman, Susan V.; Buller, Henry

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively. PMID:27501387

Social-ecological resilience and social conflict: institutions and strategic adaptation in Swedish water management.

PubMed

Galaz, Victor

2005-11-01

Dealing with uncertainty and complexity in social-ecological systems is profoundly dependent on the ability of natural resource users to learn and adapt from ecological surprises and crises. This paper analyzes why and how learning processes are affected by strategic behavior among natural resource users and how social conflict is affected by social and ecological uncertainty. The claim is that social conflict among natural resource users seriously inhibits the possibilities of learning and adaptation in social-ecological systems. This is done combining insights from political science, experimental economics, and social-psychology and an analytical case study elaborating social conflict and institutional change in Swedish water management institutions. This paper also discusses the crucial role the institutional context plays in defining the outcome of learning processes in Swedish water management institutions and hence highlights previously poorly elaborated political aspects of learning processes and institutional change in social-ecological systems.

Neonatal hypothermia in low-resource settings.

PubMed

Mullany, Luke C

2010-12-01

Hypothermia among newborns is considered an important contributor to neonatal morbidity and mortality in low-resource settings. However, in these settings only limited progress has been made towards understanding the risk of mortality after hypothermia, describing how this relationship is dependent on both the degree or severity of exposure and the gestational age and weight status of the baby, and implementing interventions to mitigate both exposure and the associated risk of poor outcomes. Given the centrality of averting neonatal mortality to achieving global milestones towards reductions in child mortality by 2015, recent years have seen substantial resources and efforts implemented to improve understanding of global epidemiology of neonatal health. In this article, a summary of the burden, consequences, and risk factors of neonatal hypothermia in low-resources settings is presented, with a particular focus on community-based data. Context-appropriate interventions for reducing hypothermia exposure and the role of these interventions in reducing global neonatal mortality burden are explored. Copyright © 2010 Elsevier Inc. All rights reserved.

Public engagement in Malawi through a health-talk radio programme ' Umoyo nkukambirana': A mixed-methods evaluation.

PubMed

Nyirenda, Deborah; Makawa, Tamara Chipasula; Chapita, Greyson; Mdalla, Chisomo; Nkolokosa, Mzati; O'byrne, Thomasena; Heyderman, Robert; Desmond, Nicola

2018-02-01

Radio is an effective source of health information in many resource poor countries. In Malawi, 53% of households own radios however few radio programmes in Malawi focus on health issues in the context of medical research. An interactive health-talk radio programme ' Umoyo nkukambirana' was introduced by Malawi-Liverpool-Wellcome Trust Clinical Research Programme on a national radio station. The aim was to increase awareness of health and medical research, and improve engagement between researchers, healthcare workers and the public. The content and presentation were developed through participatory community consultations. Focus Group Discussions were conducted with established Radio Listening Clubs whilst quantitative data was collected using toll free FrontlineSMS to explore national response. A total of 277 to 695 SMS (Median: 477) were received per theme. The majority of SMS were received from men (64%) and mainly from rural areas (54%). The programme improved knowledge of medical research, health and dispelled misconceptions. This study suggests that the radio may be an effective means of increasing the exposure of men to health information in resource poor settings.

Public engagement in Malawi through a health-talk radio programme ‘Umoyo nkukambirana’: A mixed-methods evaluation

PubMed Central

Nyirenda, Deborah; Makawa, Tamara Chipasula; Chapita, Greyson; Mdalla, Chisomo; Nkolokosa, Mzati; O’byrne, Thomasena; Heyderman, Robert; Desmond, Nicola

2016-01-01

Radio is an effective source of health information in many resource poor countries. In Malawi, 53% of households own radios however few radio programmes in Malawi focus on health issues in the context of medical research. An interactive health-talk radio programme ‘Umoyo nkukambirana’ was introduced by Malawi-Liverpool-Wellcome Trust Clinical Research Programme on a national radio station. The aim was to increase awareness of health and medical research, and improve engagement between researchers, healthcare workers and the public. The content and presentation were developed through participatory community consultations. Focus Group Discussions were conducted with established Radio Listening Clubs whilst quantitative data was collected using toll free FrontlineSMS to explore national response. A total of 277 to 695 SMS (Median: 477) were received per theme. The majority of SMS were received from men (64%) and mainly from rural areas (54%). The programme improved knowledge of medical research, health and dispelled misconceptions. This study suggests that the radio may be an effective means of increasing the exposure of men to health information in resource poor settings. PMID:27365364

The Chinese perspective on pastoral resource economics: a vision of the future in a context of socio-ecological vulnerability.

PubMed

Yu, L; Farrell, K N

2016-11-01

This paper reviews institutional changes in pastureland use in China over the last 30 years and discusses their impacts on pastoral communities, drawing evidence from case studies of two agro-pastoralist and two pastoralist communities. Those who rely directly on pastureland for their livelihood are vulnerable to the joint effects of pastureland degradation and climate change. The authors argue that a 'top-down' governance structure with no participation from local communities and a 'one size fits all' institutional solution are a poor fit for pastoralism management. The authors conclude that the current institutional environment in China may be leading to decreasing populations, reduced livestock rearing, impoverishment and increasing inequality within pastoral communities. Bearing in mind that pastoral systems have characteristics that are specific to their areas and tailored to their local context, the authors recommend paying greater attention to 'bottom-up', locally specified strategies which can be combined with long-term institutional arrangements that have historically provided pastoralists and agro-pastoralists with the resources to adapt to change.

The Social Context of Managing Diabetes across the Life Span

PubMed Central

Wiebe, Deborah J.; Helgeson, Vicki; Berg, Cynthia A.

2016-01-01

Diabetes self-management is crucial to maintaining quality of life and preventing long-term complications, and occurs daily in the context of close interpersonal relationships. This article examines how social relationships are central to meeting the complex demands of managing type 1 and type 2 diabetes across the life span. The social context of diabetes management includes multiple resources, including family (parents, spouses), peers, romantic partners, and health care providers. We discuss how these social resources change across the life span, focusing on childhood and adolescence, emerging adulthood, and adulthood and aging. We review how diabetes both affects and is affected by key social relationships at each developmental period. Despite high variability in how the social context is conceptualized and measured across studies, findings converge on the characteristics of social relationships that facilitate or undermine diabetes management across the life span. These characteristics are consistent with both Interpersonal Theory and Self-Determination Theory, two organizing frameworks that we utilize to explore social behaviors that are related to diabetes management. Involvement and support from one’s social partners, particularly family members, is consistently associated with good diabetes outcomes when characterized by warmth, collaboration and acceptance. Under-involvement and interactions characterized by conflict and criticism are consistently associated with poor diabetes outcomes. Intrusive involvement that contains elements of social control may undermine diabetes management, particularly when it impinges on self-efficacy. Implications for future research directions and for interventions that promote the effective use of the social context to improve diabetes self-management are discussed. PMID:27690482

Deep groundwater quantity and quality in the southwestern US

NASA Astrophysics Data System (ADS)

Kang, M.; Ayars, J. E.; Jackson, R. B.

2017-12-01

Groundwater demands are growing in many arid regions and adaptation through the use of non-traditional resources during extreme droughts is increasingly common. One such resource is deep groundwater, which we define as deeper than 300 m and up to several kilometer-depths. Although deep groundwater has been studied in the context of oil and gas, geothermal, waste disposal, and other uses, it remains poorly characterized, especially for the purposes of human consumption and irrigation uses. Therefore, we evaluate deep groundwater quantity and quality within these contexts. We compile and analyze data from water management agencies and oil and gas-based sources for the southwestern US, with a detailed look at California's Central Valley. We also use crop tolerance thresholds to evaluate deep groundwater quality for irrigation purposes. We find fresh and usable groundwater volume estimates in California's Central Valley to increase by three- and four-fold respectively when depths of up to 3 km are considered. Of the ten basins in the southwestern US with the most data, we find that the Great Basin has the greatest proportions of fresh and usable deep groundwater. Given the potentially large deep groundwater volumes, it is important to characterize the resource, guard against subsidence where extracted, and protect it for use in decades and centuries to come.

Power, politics and rehabilitation in sub-Saharan Africa: from the personal to the political.

PubMed

Campbell, Catherine

2011-01-01

This article discusses the complexities of facilitating community-based rehabilitation in resource-poor contexts in Sub-Saharan Africa. It does so through a reflection on the book Able-Bodied: Scenes from a Curious Life, written by Leslie Swartz, a South African expert on disability in the context of international development. Swartz uses his own personal experiences as son of a disabled father as a springboard for reflections on his long involvement in the often-fraught areas of disability research and activism. He pays particular attention to the way in which emotions shape the struggles around expertise and power that bedevil disability identity politics. In particular, his work highlights how the complex dynamics of race, class and disability undermine the effectiveness of the movement.

Learning from diverse contexts: equity and inclusion in the responses to AIDS.

PubMed

Loewenson, R

2007-01-01

This paper situates the findings of the diverse studies reported in this journal supplement in a global context that both fuels the epidemic through inequality and poverty and also provides new opportunities for global commitments, solidarity and resources. The studies in this issue signal that, while information and awareness about HIV and AIDS is now high, there is still poor access to services for people to know their own risk and a deeper need to address the asymmetries of power and access to resources that influence the control people have over their sexual relationships and lives. The studies in this supplement describe, in very different contexts, responses to the impact of AIDS that are grounded within the actions of individuals, households and extended families, against a background of existing disadvantage in assets, endowment and access to state and private sector resources. Community networks reduce social isolation and provide solidarity to households struggling to respond to AIDS. The extra work involved is often done by women, particularly where the weakening of the state has left communities disadvantaged. The paper argues that connections across communities to support survival need vertical links to national and global resources, services and markets to support, sustain and transform lives. The studies demonstrate the positive effect of this through primary healthcare systems, non-government organisation support and the social movements of people living with HIV and AIDS. If the first wave of the global response to AIDS built awareness and an emergency response to prevention, treatment and care, there is now need for a 'second wave' that provides strong measures to connect communities to social, national and global resources. Elements of this 'second wave' include people's--especially women and young people's--access to services to know their individual risk, measures that enhance their autonomy and the need for a massive increase in investment in and access to decent work.

Study on the potential for delay tolerant networks by health workers in low resource settings.

PubMed

Syed-Abdul, Shabbir; Scholl, Jeremiah; Lee, Peisan; Jian, Wen-Shan; Liou, Der-Ming; Li, Yu-Chuan

2012-09-01

Medical Informatics Systems (MIS) have been suggested as having great potential to improve health care delivery in low resource settings. One of the major barriers for adopting MIS in this context is a lack of adequate network/communication infrastructure. Delay Tolerant Networking (DTN) is an approach for establishing network connectivity in situations where it is possible to support physical transport of the digital information. To date most DTN research has been technically oriented, and very few services have been implemented to support healthcare systems using the technology. It is thus unclear about the potential that DTN may have for supporting MIS systems in low resource settings. The goals of the paper are twofold, first, to gain an initial estimate of interest in different services that can be supported by DTN. Second, to find out the necessary frequency associated with each service for supporting health work in low resource settings. Fifty questionnaires were distributed to attendants at the International Conference on Global Health that had acknowledged having health work experience in a poor connectivity context. The respondents were using a 5-point Likert scale regarding if 9 different potential DTN services "would be useful". They also were asked how often data delivery would be necessary for these services to be useful. The Chi square was calculated to measure acceptance. 37 responses were received, aggregating the response rate of 74%. The respondents represented having work experience from 8 months to 15 years from 35 resource poor countries. The Chi square test showed very high statistical significance for "strongly agree and agree" for the potential usefulness of the proposed DTN services, with a p-value less than 0.001. The frequency of data delivery that would be necessary for services to be useful varied considerably. This study provides evidence of potential for DTN to support useful services that support health work in low resource settings, and that services like access to email, notification of lab results, backup of EHR and teleconsultation are seem to be most important services that can be supported by DTN. The necessary frequency of data delivery for each service, will be highly dependent on context. In a low resource setting with limited mobility, the physical transport of digital data at a frequency of less than once per week should still be sufficient for useful services like notification of lab results and ordering of medical supplies. Research comparing different methods for delivery of DTN data should thus be useful. Further research and collaboration between MIS and Computer Science research communities is recommended in order to help develop DTN services that can be evaluated. Efforts to enhance awareness among stakeholders about how DTN can be used to support health services should be worthwhile. Copyright © 2011. Published by Elsevier Ireland Ltd.

A plasmid library of full-length zebrafish rab proteins for in vivo cell biology.

PubMed

Hall, Thomas E; Martel, Nick; Lo, Harriet P; Xiong, Zherui; Parton, Robert G

2017-01-01

The zebrafish is an emerging model for highly sophisticated medium-throughput experiments such as genetic and chemical screens. However, studies of entire protein families within this context are often hampered by poor genetic resources such as clone libraries. Here we describe a complete collection of 76 full-length open reading frame clones for the zebrafish rab protein family. While the mouse genome contains 60 rab genes and the human genome 63, we find that 18 zebrafish rab genes have 2, and in the case of rab38, 3 paralogues. In contrast, we were unable to identify zebrafish orthologues of the mammalian Rab2b, Rab17 or Rab29. We make this resource available through the Addgene repository to facilitate cell biologic approaches using this model.

The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia.

PubMed

Galderisi, Silvana; Rossi, Alessandro; Rocca, Paola; Bertolino, Alessandro; Mucci, Armida; Bucci, Paola; Rucci, Paola; Gibertoni, Dino; Aguglia, Eugenio; Amore, Mario; Bellomo, Antonello; Biondi, Massimo; Brugnoli, Roberto; Dell'Osso, Liliana; De Ronchi, Diana; Di Emidio, Gabriella; Di Giannantonio, Massimo; Fagiolini, Andrea; Marchesi, Carlo; Monteleone, Palmiero; Oldani, Lucio; Pinna, Federica; Roncone, Rita; Sacchetti, Emilio; Santonastaso, Paolo; Siracusano, Alberto; Vita, Antonio; Zeppegno, Patrizia; Maj, Mario

2014-10-01

In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictors of real-life functioning in people with schizophrenia, and to assess their relative contribution. Based on previous literature and clinical experience, several factors were selected and grouped into three categories: illness-related variables, personal resources and context-related factors. Some of these variables were never investigated before in relationship with real-life functioning. In 921 patients with schizophrenia living in the community, we found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a structural equation model. Neurocognition exhibited the strongest, though indirect, association with real-life functioning. Positive symptoms and disorganization, as well as avolition, proved to have significant direct and indirect effects, while depression had no significant association and poor emotional expression was only indirectly and weakly related to real-life functioning. Availability of a disability pension and access to social and family incentives also showed a significant direct association with functioning. Social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services served as mediators. The observed complex associations among investigated predictors, mediators and real-life functioning strongly suggest that integrated and personalized programs should be provided as standard treatment to people with schizophrenia. Copyright © 2014 World Psychiatric Association.

A Dynamic Ubiquitous Learning Resource Model with Context and Its Effects on Ubiquitous Learning

ERIC Educational Resources Information Center

Chen, Min; Yu, Sheng Quan; Chiang, Feng Kuang

2017-01-01

Most ubiquitous learning researchers use resource recommendation and retrieving based on context to provide contextualized learning resources, but it is the kind of one-way context matching. Learners always obtain fixed digital learning resources, which present all learning contents in any context. This study proposed a dynamic ubiquitous learning…

Multidimensional poverty in rural Mozambique: a new metric for evaluating public health interventions.

PubMed

Victor, Bart; Blevins, Meridith; Green, Ann F; Ndatimana, Elisée; González-Calvo, Lázaro; Fischer, Edward F; Vergara, Alfredo E; Vermund, Sten H; Olupona, Omo; Moon, Troy D

2014-01-01

Poverty is a multidimensional phenomenon and unidimensional measurements have proven inadequate to the challenge of assessing its dynamics. Dynamics between poverty and public health intervention is among the most difficult yet important problems faced in development. We sought to demonstrate how multidimensional poverty measures can be utilized in the evaluation of public health interventions; and to create geospatial maps of poverty deprivation to aid implementers in prioritizing program planning. Survey teams interviewed a representative sample of 3,749 female heads of household in 259 enumeration areas across Zambézia in August-September 2010. We estimated a multidimensional poverty index, which can be disaggregated into context-specific indicators. We produced an MPI comprised of 3 dimensions and 11 weighted indicators selected from the survey. Households were identified as "poor" if were deprived in >33% of indicators. Our MPI is an adjusted headcount, calculated by multiplying the proportion identified as poor (headcount) and the poverty gap (average deprivation). Geospatial visualizations of poverty deprivation were created as a contextual baseline for future evaluation. In our rural (96%) and urban (4%) interviewees, the 33% deprivation cut-off suggested 58.2% of households were poor (29.3% of urban vs. 59.5% of rural). Among the poor, households experienced an average deprivation of 46%; thus the MPI/adjusted headcount is 0.27 ( = 0.58×0.46). Of households where a local language was the primary language, 58.6% were considered poor versus Portuguese-speaking households where 73.5% were considered non-poor. Living standard is the dominant deprivation, followed by health, and then education. Multidimensional poverty measurement can be integrated into program design for public health interventions, and geospatial visualization helps examine the impact of intervention deployment within the context of distinct poverty conditions. Both permit program implementers to focus resources and critically explore linkages between poverty and its social determinants, thus deriving useful findings for evidence-based planning.

Differences in Poor Readers' Abilities to Identify High-Frequency Words in Isolation and Context.

ERIC Educational Resources Information Center

Krieger, Veronica K.

1981-01-01

Reports that fourth-grade poor readers were able to identify more high-frequency words in context than in isolation. Discusses the findings in terms of a context-oriented approach of word identification instruction and assessment. (FL)

Evaluating a Pivot-Based Approach for Bilingual Lexicon Extraction

PubMed Central

Kim, Jae-Hoon; Kwon, Hong-Seok; Seo, Hyeong-Won

2015-01-01

A pivot-based approach for bilingual lexicon extraction is based on the similarity of context vectors represented by words in a pivot language like English. In this paper, in order to show validity and usability of the pivot-based approach, we evaluate the approach in company with two different methods for estimating context vectors: one estimates them from two parallel corpora based on word association between source words (resp., target words) and pivot words and the other estimates them from two parallel corpora based on word alignment tools for statistical machine translation. Empirical results on two language pairs (e.g., Korean-Spanish and Korean-French) have shown that the pivot-based approach is very promising for resource-poor languages and this approach observes its validity and usability. Furthermore, for words with low frequency, our method is also well performed. PMID:25983745

[Organizational capacity for continuous improvement of health services].

PubMed

Saturno-Hernández, Pedro J; Hernández-Avila, Mauricio; Magaña-Valladares, Laura; Garcia-Saisó, Sebastián; Vertiz-Ramírez, José de Jesús

2015-01-01

While the Mexican health system has achieved significant progress, as reflected in the growing improvement in population health, heterogeneity in the quality of services and its impact on health in different population groups is still a challenge. The costs or poor quality represent about 20 to 40% of the health system's expenditure. We need to develop organizational capacity to implement quality management systems in order to identify, evaluate, prevent and eventually overcome the health system's challenges. A competency-based comprehensive strategy for training human resources is proposed including undergraduate and graduate education as well as continuing education, which will contribute to improve the quality function at the various levels of responsibility in the health system. The proposed strategy responds to the context of the Mexican health system, but it could be adapted to other systems and contexts.

Towards a sustainable framework for computer based health information systems (CHIS) for least developed countries (LDCs).

PubMed

Gordon, Abekah Nkrumah; Hinson, Robert Ebo

2007-01-01

The purpose of this paper is to argue for a theoretical framework by which development of computer based health information systems (CHIS) can be made sustainable. Health Management and promotion thrive on well-articulated CHIS. There are high levels of risk associated with the development of CHIS in the context of least developed countries (LDC), thereby making them unsustainable. This paper is based largely on literature survey on health promotion and information systems. The main factors accounting for the sustainability problem in less developed countries include poor infrastructure, inappropriate donor policies and strategies, poor infrastructure and inadequate human resource capacity. To counter these challenges and to ensure that CHIS deployment in LDCs is sustainable, it is proposed that the activities involved in the implementation of these systems be incorporated into organizational routines. This will ensure and secure the needed resources as well as the relevant support from all stakeholders of the system; on a continuous basis. This paper sets out to look at the issue of CHIS sustainability in LDCs, theoretically explains the factors that account for the sustainability problem and develops a conceptual model based on theoretical literature and existing empirical findings.

Role of nutrition, infection, and the microbiota in the efficacy of oral vaccines.

PubMed

Bhattacharjee, Amrita; Hand, Timothy W

2018-06-15

Oral vaccines (OVs), provide protection against pathogens that infect mucosal surfaces and their potency relies on their capacity to elicit T- and B-cell responses directed to these surfaces. Oral vaccination efficacy has been found to vary considerably with differences in geographical locations and socioeconomic status. Specifically, in children living in resource-poor countries, undernourishment and chronic gastrointestinal (GI) infection are associated with the failure of OVs, which is a tragic outcome for the children who would benefit most from mucosal-based protection from infection. Both undernutrition and GI infection have been shown to profoundly affect the microbiota, inducing 'dysbiosis' characterized by narrowed bacterial diversity and increased frequency of bacterial clades associated with the induction of inflammation. Recent studies have demonstrated that the microbiota exerts a profound effect on the development of mucosal immune responses. Therefore, it seems likely that OV failure in resource-poor regions is affected by alterations to the immune response driven by dysbiotic changes to the microbiota. Here, we review the contribution of the microbiota to OV efficacy in the context of diet and GI infection. © 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

Human resources for health: global crisis and international cooperation.

PubMed

Portela, Gustavo Zoio; Fehn, Amanda Cavada; Ungerer, Regina Lucia Sarmento; Poz, Mario Roberto Dal

2017-07-01

From the 1990s onwards, national economies became connected and globalized. Changes in the demographic and epidemiological profile of the population highlighted the need for further discussions and strategies on Human Resources for Health (HRH). The health workforce crisis is a worldwide phenomenon. It includes: difficulties in attracting and retaining health professionals to work in rural and remote areas, poor distribution and high turnover of health staff particularly physicians, poor training of health workforces in new sanitation and demographic conditions and the production of scientific evidence to support HRH decision making, policy management, programs and interventions. In this scenario, technical cooperation activities may contribute to the development of the countries involved, strengthening relationships and expanding exchanges as well as contributing to the production, dissemination and use of technical scientific knowledge and evidence and the training of workers and institutional strengthening. This article aims to explore this context highlighting the participation of Brazil in the international cooperation arena on HRH and emphasizing the role of the World Health Organization in confronting this crisis that limits the ability of countries and their health systems to improve the health and lives of their populations.

Where technology does not go: specialised neonatal care in resource-poor and conflict-affected contexts

PubMed Central

van den Boogaard, W.; Van den Bergh, R.; Takarinda, K. C.; Martinez, P.; Bekouanebandi, J. G.; Javed, I.; Ndelema, B.; Lefèvre, A.; Khalid, G. G.; Zuniga, I.

2017-01-01

Setting: Although neonatal mortality is gradually decreasing worldwide, 98% of neonatal deaths occur in low- and middle-income countries, where hospital care for sick and premature neonates is often unavailable. Médecins Sans Frontières Operational Centre Brussels (MSF-OCB) managed eight specialised neonatal care units (SNCUs) at district level in low-resource and conflict-affected settings in seven countries. Objective: To assess the performance of the MSF SNCU model across different settings in Africa and Southern Asia, and to describe the set-up of eight SNCUs, neonate characteristics and clinical outcomes among neonates from 2012 to 2015. Design: Multicentric descriptive study. Results: The MSF SNCU model was characterised by an absence of high-tech equipment and an emphasis on dedicated nursing and medical care. Focus was on the management of hypothermia, hypoglycaemia, feeding support and early identification/treatment of infection. Overall, 11 970 neonates were admitted, 41% of whom had low birthweight (<2500 g). The main diagnoses were low birthweight, asphyxia and neonatal infections. Overall mortality was 17%, with consistency across the sites. Chances of survival increased with higher birthweight. Conclusion: The standardised SNCU model was implemented across different contexts and showed in-patient outcomes within acceptable limits. Low-tech medical care for sick and premature neonates can and should be implemented at district hospital level in low-resource settings. PMID:28695092

Priorities for Action in a Rural Older Adults Study

PubMed Central

Averill, Jennifer B.

2013-01-01

This article reports the findings from a recent study of older adults in the rural southwestern United States and discusses practice and research implications. The aim of the study was to analyze health disparities and strengths in the contexts of rurality, aging, a depressed economy, and limited health resources. Identified themes needing action included sustained access to prescriptions, transportation solutions for older adults in isolated communities, inadequate access to care, poor infrastructure and coordination of services, scarce assisted living and in-home care for frail older adults, and barriers related to culture, language, and economics. PMID:22929381

A Determination of Eligibility to the National Register of Historic Places for Select Historic Properties Along the Souris River in North Dakota

DTIC Science & Technology

1989-08-01

Company Historic District," 1985. "Historic Resources of Hardin, Montana," :984. "Silver Bow Brewery Malt House," 1982. "Silver Bow County Poor Farm...34i QQL-- Q ..i FEATURE TYPE CULTURAL MATERIAL ’iii Site Type -0,- Cm Scatter , , Bone 0 Chimney %.Z Ceramics tA Context .Q, Depression 1 Charcoal i...Sec , QQQ i, QQ . Q, ,LTL, L- Twp R ,.. , Sec ,., QQO 1- QQ’ L- Q’ ’ FEATURE TYPE CULTURAL MATERIAL &. Site Type m, Cm Scatter ,.Z, Bone Chimney

Measurements of Sexuality-Based Stigma among Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM) in Resource-Poor Settings: A Review.

PubMed

Freeland, Ryan; Rogers, Erin; van Rooyen, Heidi; Darbes, Lynae; Saylor, Kate; Stephenson, Rob

2018-05-01

Gay, bisexual, and other men who have sex with men (GBMSM) in resource-poor settings are disproportionately affected by the HIV/AIDS epidemic. GBMSM living in these settings may face unique barriers to HIV prevention, including legal barriers and increased sexuality-based stigma. It is therefore imperative to tailor HIV prevention and care resources to recognize the lived realities of GBMSM in these settings. Central to this is the accurate measurement of sexuality-based stigma. However, there is wide inconsistency in how sexuality-based stigma is measured among GBMSM in resource-poor settings. This paper reviews recent studies of sexuality-based stigma among GBMSM in resource-poor settings, finding great variability in measurements. The results of the review call for greater attention to the development of contextually and culturally specific measures of sexuality-based stigma for GBMSM living in resource-poor settings.

Physiotherapy beyond Our Borders: Investigating Ideal Competencies for Canadian Physiotherapists Working in Resource-Poor Countries

PubMed Central

Cassady, Christina; Meru, Rehana; Chan, Nga Man Carmen; Engelhardt, Julie; Fraser, Michelle

2014-01-01

ABSTRACT Purpose: To explore the perspectives of Canadian physiotherapists with global health experience on the ideal competencies for Canadian physiotherapists working in resource-poor countries. Method: A qualitative interpretive methodology was used, and the Essential Competency Profile for Physiotherapists in Canada, 2009 (ECP), was employed as a starting point for investigation and analysis. Semi-structured one-on-one interviews (60–90 minutes) were conducted with 17 Canadian physiotherapists who have worked in resource-poor countries. Descriptive and thematic analyses were conducted collaboratively. Results: The seven ECP roles—Expert, Communicator, Collaborator, Manager, Advocate, Scholarly Practitioner, and Professional—were all viewed as important for Canadian physiotherapists working in resource-poor countries. Two roles, Communicator and Manager, have additional competencies that participants felt were important. Three novel roles—Global Health Learner, Critical Thinker, and Respectful Guest—were created to describe other competencies related to global health deemed crucial by participants. Conclusions: This is the first study to examine competencies required by Canadian physiotherapists working in resource-poor countries. In addition to the ECP roles, supplementary competencies are recommended for engagement in resource-poor countries. These findings align with ideas in current global health and international development literature. Future research should examine the relevance of these findings to resource-poor settings within Canada. PMID:24719503

Quality: what do poor women want?

PubMed

Verma, A

1994-01-01

Although all individuals and couples want high quality services, many dimensions of such services are impractical or even unfeasible in poor settings. The author considers the situation in the majority of South Asian countries where 75-80% of the population lives in rural areas or urban slums on the periphery of large metropolitan cities. Typically poorly trained community health workers live and work in cramped, unhygienic, poorly equipped service delivery centers often with neither electricity nor safe drinking water. Supplies of essential drugs, contraceptives, and equipment are extremely limited. When the workers do not live in the small facilities, they often commute by bus from a neighboring village or walk 5-6 kilometers to work. The number of males or females available and willing to be trained for services is often insufficient. The author explains that good quality is all relative. Such impoverished contexts demand that standards be situation-specific, dependent upon resource availability, and fitted to local circumstances and the social milieu. Moreover, efforts must be made to focus upon the needs of women and undertake low-cost improvements where possible. The Mini Welfare Center Scheme of the Indian Ministry of Health and Family Welfare to help voluntary organizations promote health and family welfare activities is described.

Insights into the management of chronic myeloid leukemia in resource-poor settings: a Mexican perspective.

PubMed

Gomez-de-León, Andrés; Gómez-Almaguer, David; Ruiz-Delgado, Guillermo J; Ruiz-Arguelles, Guillermo J

2017-09-01

The arrival of targeted therapy for chronic myeloid leukemia (CML) was revolutionary. However, due to the high cost of tyrosine kinase inhibitors, access to this highly effective therapy with strict monitoring strategies is limited in low to middle-income countries. In this context, following standard recommendations proposed by experts in developed countries is difficult. Areas covered: This review aims to provide an insight into the management of patients with CML living in a resource-limited setting. It addresses several issues: diagnosis, initial treatment, disease monitoring, and additional treatment alternatives including allogeneic hematopoietic stem cell transplantation. Expert commentary: Imatinib is probably the most cost-effective TKI for initial treatment in developing and underdeveloped countries. Generic imatinib preparations should be evaluated before considering their widespread use. Adherence to treatment should be emphasized. Adequate monitoring can be performed through several methods successfully and is important for predicting outcomes, particularly early in the first year, and if treatment suspension is being considered. Access to further therapeutic alternatives should define our actions after failure or intolerance to imatinib, preferring additional TKIs if possible. Allogeneic transplantation in chronic phase is a viable option in this context.

How can managers in the hospital in the home units help to balance technology and physician-patient knowledge?

PubMed

Cepeda-Carrión, Gabriel; Cegarra-Navarro, Juan Gabriel; Martínez-Caro, Eva; Eldridge, Stephen

2011-10-01

With the passing of time, knowledge like other resources can become obsolete. Thus, people in a healthcare system need to update their knowledge in order to keep pace with the ongoing changes in their operational environment. Information technology continually provides a great amount of new knowledge which can lead to healthcare professionals becoming overloaded with knowledge. This overloading can be alleviated by a process of unlearning which enables the professional to retain just the relevant and critical knowledge required to improve the quality of service provided by them. This paper shows some of the tools and methods that Hospital-in-the-Home Units (HHUs) have used to update the physician-patient knowledge and the technology knowledge of the HHUs' personnel. A survey study was carried out in the HHU in Spanish health system in 2010. Fifty-five doctors and 62 nurses belonging to 44 HHUs. None. Three hypotheses are presented and supported, which suggest that technology and physician-patient knowledge is related to the unlearning context and the unlearning context impacts positively on the quality of health services provided. The key benefits of the unlearning context for the quality of service provided in HHUs are clear: it enables them to identify and replace poor practices and also avoids the reinvention of the wheel (e.g.: by minimizing unnecessary work caused by the use of poor methods) and it reduces costs through better productivity and efficiency (improving services to patients).

Social Context and Problem Factors among Youth with Juvenile Justice Involvement Histories.

PubMed

Voisin, Dexter R; Sales, Jessica M; Hong, Jun Sung; Jackson, Jerrold M; Rose, Eve S; DiClemente, Ralph J

2017-01-01

Youth with juvenile justice histories often reside in poorly resourced communities and report high rates of depression, gang involved networks, and STI-sexual related risk behaviors, compared to their counterparts. The primary aim of this study was to examine the relationship between social context (ie, a combined index score comprised of living in public housing, being a recipient of free school lunch, and witnessing community violence) and risk factors that are disproportionately worse for juvenile justice youth such as depression, gang involved networks and STI sexual risk behaviors. Data were collected from a sample of detained youth ages 14 to 16 (N = 489). Questions assessed demographics, social context, depression, gang-involved networks, and STI risk behaviors. Multiple logistic regression models, controlling for age, gender, race, school enrollment, and family social support, indicated that participants who reported poorer social context had double the odds of reporting being depressed; three times higher odds of being in a gang; three times higher odds of personally knowing a gang member; and double the odds of having engaged in STI-risk behaviors. These results provide significant information that can help service providers target certain profiles of youth with juvenile justice histories for early intervention initiatives.

Role of innovative institutional structures in integrated governance. A case study of integrating health and nutrition programs in Chhattisgarh, India.

PubMed

Kalita, Anuska; Mondal, Shinjini

2012-01-01

The aim of this paper is to highlight the significance of integrated governance in bringing about community participation, improved service delivery, accountability of public systems and human resource rationalisation. It discusses the strategies of innovative institutional structures in translating such integration in the areas of public health and nutrition for poor communities. The paper draws on experience of initiating integrated governance through innovations in health and nutrition programming in the resource-poor state of Chhattisgarh, India, at different levels of governance structures--hamlets, villages, clusters, blocks, districts and at the state. The study uses mixed methods--i.e. document analysis, interviews, discussions and quantitative data from facilities surveys--to present a case study analyzing the process and outcome of integration. The data indicate that integrated governance initiatives improved convergence between health and nutrition departments of the state at all levels. Also, innovative structures are important to implement the idea of integration, especially in contexts that do not have historical experience of such partnerships. Integration also contributed towards improved participation of communities in self-governance, community monitoring of government programs, and therefore, better services. As governments across the world, especially in developing countries, struggle towards achieving better governance, integration can serve as a desirable process to address this. Integration can affect the decentralisation of power, inclusion, efficiency, accountability and improved service quality in government programs. The institutional structures detailed in this paper can provide models for replication in other similar contexts for translating and sustaining the idea of integrated governance. This paper is one of the few to investigate innovative public institutions of a and community mobilisation to explore this important, and under-researched, topic.

Socioeconomic differential in self-assessment of health and happiness in 5 African countries: Finding from World Value Survey.

PubMed

Adesanya A, Oluwafunmilade; Rojas, Bomar Mendez; Darboe, Amadou; Beogo, Idrissa

2017-01-01

Factors that contribute to wealth related inequalities in self-rated health (SRH) and happiness remains unclear most especially in sub-Saharan countries (SSA). This study aims to explore and compare socioeconomic differentials in SRH and happiness in five SSA countries. Using the 2010/2014 World Values Survey (WVS), we obtained a sample of 9,869 participants of age 16 and above from five SSA countries (Nigeria, Ghana, South Africa, Rwanda and Zimbabwe). Socioeconomic inequalities were quantified using the concentration index. The contribution of each predictor to concentration index's magnitude was obtained by means of regression based decomposition analysis. Poor SRH ranges from approximately 9% in Nigeria to 20% in Zimbabwe, whereas unhappiness was lower in Rwanda (9.5%) and higher in South Africa (23.3%). Concentration index was negative for both outcomes in all countries, which implies that poor SRH and unhappiness are excessively concentrated among the poorest socioeconomic strata. Although magnitudes differ across countries, however, the major contributor to wealth-related inequality in poor SRH is satisfaction with financial situation whereas for unhappiness the major contributors are level of income and satisfaction with financial situation. This study underscores an association between wealth related inequalities and poor SRH and unhappiness in the context of SSA. Improving equity in health, as suggested by the commission of social determinants of health may be useful in fighting against the unfair distribution of resources. Thus, knowledge about the self-rating of health and happiness can serve as proxy estimates for understanding the distribution of health care access and economic resources needed for well-being in resident countries.

Multidimensional Poverty in Rural Mozambique: A New Metric for Evaluating Public Health Interventions

PubMed Central

Victor, Bart; Blevins, Meridith; Green, Ann F.; Ndatimana, Elisée; González-Calvo, Lázaro; Fischer, Edward F.; Vergara, Alfredo E.; Vermund, Sten H.; Olupona, Omo; Moon, Troy D.

2014-01-01

Background Poverty is a multidimensional phenomenon and unidimensional measurements have proven inadequate to the challenge of assessing its dynamics. Dynamics between poverty and public health intervention is among the most difficult yet important problems faced in development. We sought to demonstrate how multidimensional poverty measures can be utilized in the evaluation of public health interventions; and to create geospatial maps of poverty deprivation to aid implementers in prioritizing program planning. Methods Survey teams interviewed a representative sample of 3,749 female heads of household in 259 enumeration areas across Zambézia in August-September 2010. We estimated a multidimensional poverty index, which can be disaggregated into context-specific indicators. We produced an MPI comprised of 3 dimensions and 11 weighted indicators selected from the survey. Households were identified as “poor” if were deprived in >33% of indicators. Our MPI is an adjusted headcount, calculated by multiplying the proportion identified as poor (headcount) and the poverty gap (average deprivation). Geospatial visualizations of poverty deprivation were created as a contextual baseline for future evaluation. Results In our rural (96%) and urban (4%) interviewees, the 33% deprivation cut-off suggested 58.2% of households were poor (29.3% of urban vs. 59.5% of rural). Among the poor, households experienced an average deprivation of 46%; thus the MPI/adjusted headcount is 0.27 ( = 0.58×0.46). Of households where a local language was the primary language, 58.6% were considered poor versus Portuguese-speaking households where 73.5% were considered non-poor. Living standard is the dominant deprivation, followed by health, and then education. Conclusions Multidimensional poverty measurement can be integrated into program design for public health interventions, and geospatial visualization helps examine the impact of intervention deployment within the context of distinct poverty conditions. Both permit program implementers to focus resources and critically explore linkages between poverty and its social determinants, thus deriving useful findings for evidence-based planning. PMID:25268951

Employee subjective well-being and physiological functioning: An integrative model

PubMed Central

Tay, Louis

2015-01-01

Research shows that worker subjective well-being influences physiological functioning—an early signal of poor health outcomes. While several theoretical perspectives provide insights on this relationship, the literature lacks an integrative framework explaining the relationship. We develop a conceptual model explaining the link between subjective well-being and physiological functioning in the context of work. Integrating positive psychology and occupational stress perspectives, our model explains the relationship between subjective well-being and physiological functioning as a result of the direct influence of subjective well-being on physiological functioning and of their common relationships with work stress and personal resources, both of which are influenced by job conditions. PMID:28070359

Employee subjective well-being and physiological functioning: An integrative model.

PubMed

Kuykendall, Lauren; Tay, Louis

2015-01-01

Research shows that worker subjective well-being influences physiological functioning-an early signal of poor health outcomes. While several theoretical perspectives provide insights on this relationship, the literature lacks an integrative framework explaining the relationship. We develop a conceptual model explaining the link between subjective well-being and physiological functioning in the context of work. Integrating positive psychology and occupational stress perspectives, our model explains the relationship between subjective well-being and physiological functioning as a result of the direct influence of subjective well-being on physiological functioning and of their common relationships with work stress and personal resources, both of which are influenced by job conditions.

[Is survival enough? Challenges of the integration of health and well-being in the third world].

PubMed

Brachet-Márquez, V

1992-01-01

In this paper the paths taken by developing countries to improve the health and well-being of their populations in a context of diminishing resources is discussed. Emphasis is placed on Latin American countries and the objective is to clarify the changing nature of the relationship between health and social well-being in the 1970s and 1980s. In the second part of the paper three viable and different political scenarios to confront this problem are presented: 1) survival without well-being; 2) survival and eradication of extreme poverty, and 3) survival, eradication of extreme poverty, and selective reconversion of the poor.

Ethics in practice: the state of the debate on promoting the social value of global health research in resource poor settings particularly Africa.

PubMed

Lairumbi, Geoffrey M; Michael, Parker; Fitzpatrick, Raymond; English, Michael C

2011-11-15

Promoting the social value of global health research undertaken in resource poor settings has become a key concern in global research ethics. The consideration for benefit sharing, which concerns the elucidation of what if anything, is owed to participants, their communities and host nations that take part in such research, and the obligations of researchers involved, is one of the main strategies used for promoting social value of research. In the last decade however, there has been intense debate within academic bioethics literature seeking to define the benefits, the beneficiaries, and the scope of obligations for providing these benefits. Although this debate may be indicative of willingness at the international level to engage with the responsibilities of researchers involved in global health research, it remains unclear which forms of benefits or beneficiaries should be considered. International and local research ethics guidelines are reviewed here to delineate the guidance they provide. We reviewed documents selected from the international compilation of research ethics guidelines by the Office for Human Research Protections under the US Department of Health and Human Services. Access to interventions being researched, the provision of unavailable health care, capacity building for individuals and institutions, support to health care systems and access to medical and public health interventions proven effective, are the commonly recommended forms of benefits. The beneficiaries are volunteers, disease or illness affected communities and the population in general. Interestingly however, there is a divide between "global opinion" and the views of particular countries within resource poor settings as made explicit by differences in emphasis regarding the potential benefits and the beneficiaries. Although in theory benefit sharing is widely accepted as one of the means for promoting the social value of international collaborative health research, there is less agreement amongst major guidelines on the specific responsibilities of researchers over what is ethical in promoting the social value of research. Lack of consensus might have practical implications for efforts aimed at enhancing the social value of global health research undertaken in resource poor settings. Further developments in global research ethics require more reflection, paying attention to the practical realities of implementing the ethical principles in real world context. © 2011 Lairumbi et al; licensee BioMed Central Ltd.

Social capital and health in the least developed countries: A critical review of the literature and implications for a future research agenda

PubMed Central

Story, William T.

2015-01-01

Research on the linkage between social capital and health has grown in recent years; however, there is a dearth of evidence from resource-poor countries. This review examines the association between social capital and physical health (including health behaviours) in the least developed countries (LDCs). Citations were searched using three databases from 1990 to 2011 using the keyword ‘social capital’ combined with the name of each of the 48 LDCs. Of the 14 studies reviewed, 12 took place in Africa and two in South Asia. All used cross-sectional study designs, including five qualitative and nine quantitative studies. The literature reviewed suggests that social capital is an important factor for improving health in resource-poor settings; however, more research is needed in order to determine the best measures for social capital and elucidate the mechanisms through which social capital affects health in the developing world. Future research on social capital and health in the developing world should focus on applying appropriate theoretical conceptualizations of social capital to the developing country context, adapting and validating instruments for measuring social capital, and examining multilevel models of social capital and health in developing countries. PMID:24172027

Optimizing lay counsellor services for chronic care in South Africa: a qualitative systematic review.

PubMed

Petersen, Inge; Fairall, Lara; Egbe, Catherine O; Bhana, Arvin

2014-05-01

To conduct a qualitative systematic review on the use of lay counsellors in South Africa to provide lessons on optimizing their use for psychological and behavioural change counselling for chronic long-term care in scare-resource contexts. A qualitative systematic review of the literature on lay counsellor services in South Africa. Twenty-nine studies met the inclusion criteria. Five randomized control trials and two cohort studies reported that lay counsellors can provide behaviour change counselling with good outcomes. One multi-centre cohort study provided promising evidence of improved anti-retroviral treatment adherence and one non-randomized controlled study provided promising results for counselling for depression. Six studies found low fidelity of lay counsellor-delivered interventions in routine care. Reasons for low fidelity include poor role definition, inconsistent remuneration, lack of standardized training, and poor supervision and logistical support. Within resource-constrained settings, adjunct behaviour change and psychological services provided by lay counsellors can be harnessed to promote chronic care at primary health care level. Optimizing lay counsellor services requires interventions at an organizational level that provide a clear role definition and scope of practice; in-service training and formal supervision; and sensitization of health managers to the importance and logistical requirements of counselling. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

EPIC Studies: Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010-11.

PubMed

Brenzel, Logan; Schütte, Carl; Goguadze, Keti; Valdez, Werner; Le Gargasson, Jean-Bernard; Guthrie, Teresa

2016-02-01

Governments in resource-poor settings have traditionally relied on external donor support for immunization. Under the Global Vaccine Action Plan, adopted in 2014, countries have committed to mobilizing additional domestic resources for immunization. Data gaps make it difficult to map how well countries have done in spending government resources on immunization to demonstrate greater ownership of programs. This article presents findings of an innovative approach for financial mapping of routine immunization applied in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. This approach uses modified System of Health Accounts coding to evaluate data collected from national and subnational levels and from donor agencies. We found that government sources accounted for 27-95 percent of routine immunization financing in 2011, with countries that have higher gross national product per capita better able to finance requirements. Most financing is channeled through government agencies and used at the primary care level. Sustainable immunization programs will depend upon whether governments have the fiscal space to allocate additional resources. Ongoing robust analysis of routine immunization should be instituted within the context of total health expenditure tracking. Project HOPE—The People-to-People Health Foundation, Inc.

Designing a theory-informed, contextually appropriate intervention strategy to improve delivery of paediatric services in Kenyan hospitals.

PubMed

English, Mike

2013-03-28

District hospital services in Kenya and many low-income countries should deliver proven, effective interventions that could substantially reduce child and newborn mortality. However such services are often of poor quality. Researchers have therefore been challenged to identify intervention strategies that go beyond addressing knowledge, skill, or resource inadequacies to support health systems to deliver better services at scale. An effort to develop a system-oriented intervention tailored to local needs and context and drawing on theory is described. An intervention was designed to improve district hospital services for children based on four main strategies: a reflective process to distill root causes for the observed problems with service delivery; developing a set of possible intervention approaches to address these problems; a search of literature for theory that provided the most appropriate basis for intervention design; and repeatedly moving backwards and forwards between identified causes, proposed interventions, identified theory, and knowledge of the existing context to develop an overarching intervention that seemed feasible and likely to be acceptable and potentially sustainable. In addition to human and resource constraints key problems included failures of relevant professionals to take responsibility for or ownership of the challenge of pediatric service delivery; inadequately prepared, poorly supported leaders of service units (mid-level managers) who are often professionally and geographically isolated and an almost complete lack of useful information for routinely monitoring or understanding service delivery practice or outcomes. A system-oriented intervention recognizing the pivotal role of leaders of service units but addressing the outer and inner setting of hospitals was designed to help shape and support an appropriate role for these professionals. It aims to foster a sense of ownership while providing the necessary understanding, knowledge, and skills for mid-level managers to work effectively with senior managers and frontline staff to improve services. The intervention will include development of an information system, feedback mechanisms, and discussion fora that promote positive change. The vehicle for such an intervention is a collaborative network partnering government and national professional associations. This case is presented to promote discussion on approaches to developing context appropriate interventions particularly in international health.

School Burnout and Engagement in the Context of Demands-Resources Model

ERIC Educational Resources Information Center

Salmela-Aro, Katariina; Upadyaya, Katja

2014-01-01

Background: A four-wave longitudinal study tested the demands-resources model in the school context. Aim: To examine the applicability of the demands-resources to the school context. Method: Data of 1,709 adolescents were gathered, once during the transition from comprehensive to post-comprehensive education, twice during post-comprehensive…

Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist?

PubMed

Thiam, Sylla; Delamou, Alexandre; Camara, Soriba; Carter, Jane; Lama, Eugene Kaman; Ndiaye, Bara; Nyagero, Josephat; Nduba, John; Ngom, Mor

2015-01-01

The Ebola outbreak emerged in a remote corner of Guinea in December 2013, and spread into Liberia and Sierra Leone in the context of weak health systems. In this paper, we report on the main challenges faced by frontline health services and by communities including their perceptions and views on the current Ebola response in the Prefectures of Coyah and Forecariah in Guinea. A cross-sectional study was conducted in December 2014 using mixed approaches: (i) Desk review; (ii) Interviews; and (iii) Direct observation. Almost one year after the beginning of the Ebola virus disease outbreak in West Africa, the perceptions of stakeholders and the observed reality were that the level of preparedness in the two health districts was low. The study identified poor coordination mechanisms, inadequate training of human resources and lack of equipment and supplies to field teams and health facilities as key elements that affected the response. The situation was worsened by the inadequate communication strategy, misconceptions around the disease, ignorance of local culture and customs and lack of involvement of local communities in the control strategies, within the context of poor socioeconomic development. As a result distrust developed between communities and those seeking to control the epidemic and largely contributed to the reluctance of the communities to participate and contribute to the effort. There is a need to rethink the way disease control interventions in the context of an emergency such as Ebola virus disease are designed, planned and implemented in low income countries.

Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist?

PubMed Central

Thiam, Sylla; Delamou, Alexandre; Camara, Soriba; Carter, Jane; Lama, Eugene Kaman; Ndiaye, Bara; Nyagero, Josephat; Nduba, John; Ngom, Mor

2015-01-01

Introduction The Ebola outbreak emerged in a remote corner of Guinea in December 2013, and spread into Liberia and Sierra Leone in the context of weak health systems. In this paper, we report on the main challenges faced by frontline health services and by communities including their perceptions and views on the current Ebola response in the Prefectures of Coyah and Forecariah in Guinea. Methods A cross-sectional study was conducted in December 2014 using mixed approaches: (i) Desk review; (ii) Interviews; and (iii) Direct observation. Results Almost one year after the beginning of the Ebola virus disease outbreak in West Africa, the perceptions of stakeholders and the observed reality were that the level of preparedness in the two health districts was low. The study identified poor coordination mechanisms, inadequate training of human resources and lack of equipment and supplies to field teams and health facilities as key elements that affected the response. The situation was worsened by the inadequate communication strategy, misconceptions around the disease, ignorance of local culture and customs and lack of involvement of local communities in the control strategies, within the context of poor socioeconomic development. As a result distrust developed between communities and those seeking to control the epidemic and largely contributed to the reluctance of the communities to participate and contribute to the effort. Conclusion There is a need to rethink the way disease control interventions in the context of an emergency such as Ebola virus disease are designed, planned and implemented in low income countries. PMID:26740850

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study

PubMed Central

Khabbache, Hicham; Jebbar, Abdelhak; Rania, Nadia; Doucet, Marie-Chantal; Watfa, Ali Assad; Candau, Joël; Martini, Mariano; Siri, Anna; Brigo, Francesco; Bragazzi, Nicola Luigi

2017-01-01

Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014–2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one’s own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources. PMID:28435341

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study.

PubMed

Khabbache, Hicham; Jebbar, Abdelhak; Rania, Nadia; Doucet, Marie-Chantal; Watfa, Ali Assad; Candau, Joël; Martini, Mariano; Siri, Anna; Brigo, Francesco; Bragazzi, Nicola Luigi

2017-01-01

Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014-2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one's own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.

Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority.

PubMed

Hall, Brian J; Murray, Sarah M; Galea, Sandro; Canetti, Daphna; Hobfoll, Stevan E

2015-04-01

Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder. A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews. The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD. A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.

Access to potable water and sanitation in Cameroon within the context of Millennium Development Goals (MDGS).

PubMed

Ako, Andrew Ako; Shimada, Jun; Eyong, Gloria Eneke Takem; Fantong, Wilson Yetoh

2010-01-01

Cameroon has been fully engaged with the Millennium Development Goals (MDGs) since their inception in 2000. This paper examines the situation of access to potable water and sanitation in Cameroon within the context of the Millennium Development Goals (MDGs), establishes whether Cameroon is on the track of meeting the MDGs in these domains and proposes actions to be taken to bring it closer to these objectives. Based on analyzed data obtained from national surveys, government ministries, national statistical offices, bibliographic research, reports and interviews, it argues that Cameroon will not reach the water and sanitation MGDs. While Cameroon is not yet on track to meet the targets of the MDGs for water and sanitation, it has made notable progress since 1990, much more needs to be done to improve the situation, especially in rural areas. In 2006, 70% of the population had access to safe drinking water and the coverage in urban centres is 88%, significantly better than the 47% in rural areas. However, rapid urbanization has rendered existing infrastructure inadequate with periurban dwellers also lacking access to safe drinking water. Sanitation coverage is also poor. In urban areas only 58% of the population has access to improved sanitation facilities, and the rate in rural areas is 42%. Women and girls shoulder the largest burden in collecting water, 15% of urban and 18% rural populations use improved drinking water sources over 30 minutes away. Cameroon faces the following challenges in reaching the water and sanitation MDGs: poor management and development of the resources, coupled with inadequate political will and commitment for the long term; rapid urbanization; urban and rural poverty and regulation and legislative lapses. The authors propose that: bridging the gap between national water policies and water services; recognizing the role played by Civil Society Organizations (CSOs) in the attainment of MDGs; developing a Council Water Resource Management Policy and Strategy (CWARMPS); organizing an institutional framework for the water and sanitation sector as well as completion and implementation of an Integrated Water Resources Management (IWRM) plan, would bring Cameroon closer to the water and sanitation MDGs.

Catastrophic healthcare payments and impoverishment in the occupied Palestinian territory.

PubMed

Mataria, Awad; Raad, Firas; Abu-Zaineh, Mohammad; Donaldson, Cam

2010-01-01

Financial protection from the risks of ill health has globally recognized importance as a principal performance goal of any health system. This type of financial protection involves minimizing catastrophic payments for healthcare and their associated impoverishing effects. Realization of this performance goal is heavily influenced by factors related to the overall policy environment and sociopolitical context in each country. To examine the incidence and intensity of catastrophic and impoverishing healthcare payments borne by Palestinian households between 1998 and 2007. The incidence and intensity of these effects are examined within the historically unique policy and socioeconomic context of the occupied Palestinian territory. A healthcare payment was considered catastrophic if it exceeded 10% of household resources, or 40% of resources net of food expenditures. The impoverishing effect of healthcare was examined by comparing poverty incidence and intensity before and after healthcare payments. The data source was a series of annual expenditure and consumption surveys covering 1998 and 2004-7, and including representative samples of Palestinian households (n = 1231-3098, per year). Total household expenditure was used as a proxy for household level of resources; and the sum of household expenses on a comprehensive list of medical goods and services was used to estimate healthcare payments. While only around 1% of the surveyed households spent ≥40% of their total household expenditures (net of food expenses) on healthcare in 1998, the percentage was almost doubled in 2007. In terms of impoverishing effect, while 11.8% of surveyed households fell into deep poverty in 1998 due to healthcare payments, 12.5% of households entered deep poverty for the same reason in 2006. Over the same period, the monthly amount by which poor households failed to reach the deep poverty line due to healthcare payments increased from $US9.4 to $US12.9. The inability of the Palestinian healthcare system to protect against the financial risks of ill health could be attributed to the prevailing sociopolitical conditions of the occupied Palestinian territory, and to some intrinsic system characteristics. It is recommended that pro-poor financing schemes be pursued to mitigate the negative impact of the recurrent health shocks affecting Palestinian households.

Optimizing Search and Ranking in Folksonomy Systems by Exploiting Context Information

NASA Astrophysics Data System (ADS)

Abel, Fabian; Henze, Nicola; Krause, Daniel

Tagging systems enable users to annotate resources with freely chosen keywords. The evolving bunch of tag assignments is called folksonomy and there exist already some approaches that exploit folksonomies to improve resource retrieval. In this paper, we analyze and compare graph-based ranking algorithms: FolkRank and SocialPageRank. We enhance these algorithms by exploiting the context of tags, and evaluate the results on the GroupMe! dataset. In GroupMe!, users can organize and maintain arbitrary Web resources in self-defined groups. When users annotate resources in GroupMe!, this can be interpreted in context of a certain group. The grouping activity itself is easy for users to perform. However, it delivers valuable semantic information about resources and their context. We present GRank that uses the context information to improve and optimize the detection of relevant search results, and compare different strategies for ranking result lists in folksonomy systems.

"Wealth Makes Many Friends": Children Expect More Giving From Resource-Rich Than Resource-Poor Individuals.

PubMed

Ahl, Richard E; Dunham, Yarrow

2017-08-21

Young children show social preferences for resource-rich individuals, although few studies have explored the causes underlying such preferences. We evaluate the viability of one candidate cause: Children believe that resource wealth relates to behavior, such that they expect the resource rich to be more likely to materially benefit others (including themselves) than the resource poor. In Studies 1 and 2 (ages 4-10), American children from predominantly middle-income families (n = 94) and Indian children from lower income families (n = 30) predicted that the resource rich would be likelier to share with others than the resource poor. In Study 3, American children (n = 66) made similar predictions in an incentivized decision-making task. The possibility that children's expectations regarding giving contribute to prowealth preferences is discussed. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Generating global political priority for urban health: the role of the urban health epistemic community

PubMed Central

Shawar, Yusra Ribhi; Crane, Lani G

2017-01-01

Abstract Over the past decade there has been much discussion of the challenges posed by rapid urbanization in the developing world; yet the health of the urban poor, and especially those residing in low- and middle-income countries, continues to receive little political priority in most developing countries and at the global level. This research applies social science scholarship and a public policy analytical framework to assess the factors that have challenged efforts to make health in urban poor settings a priority. We conducted 19 semi-structured phone interviews with key urban health proponents and experts representing agencies that shape opinions and manage resources in global health. We also conducted a literature review, which included published scholarly literature and reports from organizations involved in urban health provision and advocacy. Utilizing a process-tracing method, we triangulated among these sources of data to create a historical narrative and analyse the factors that shape the global level of attention to and resources for urban health. The urban health agenda continues to be challenged by six factors, three of which concern the political context or characteristics of the issue: long-standing competition with the dominant development agenda that is rural health oriented; limited data and measurement tools that can effectively gauge the extent of the problem; and lack of evidence on how to best to address the issue. The other three factors are directly under the control of the urban health community: the community’s ineffective governance; little common understanding among its members of the problem and how to address it; and an unconvincing framing of the issue to the public. The study offers suggestions as to what advocates can do to secure greater attention and resources in order to help address the health needs of the urban poor. PMID:28582532

Generating global political priority for urban health: the role of the urban health epistemic community.

PubMed

Shawar, Yusra Ribhi; Crane, Lani G

2017-10-01

Over the past decade there has been much discussion of the challenges posed by rapid urbanization in the developing world; yet the health of the urban poor, and especially those residing in low- and middle-income countries, continues to receive little political priority in most developing countries and at the global level. This research applies social science scholarship and a public policy analytical framework to assess the factors that have challenged efforts to make health in urban poor settings a priority. We conducted 19 semi-structured phone interviews with key urban health proponents and experts representing agencies that shape opinions and manage resources in global health. We also conducted a literature review, which included published scholarly literature and reports from organizations involved in urban health provision and advocacy. Utilizing a process-tracing method, we triangulated among these sources of data to create a historical narrative and analyse the factors that shape the global level of attention to and resources for urban health. The urban health agenda continues to be challenged by six factors, three of which concern the political context or characteristics of the issue: long-standing competition with the dominant development agenda that is rural health oriented; limited data and measurement tools that can effectively gauge the extent of the problem; and lack of evidence on how to best to address the issue. The other three factors are directly under the control of the urban health community: the community's ineffective governance; little common understanding among its members of the problem and how to address it; and an unconvincing framing of the issue to the public. The study offers suggestions as to what advocates can do to secure greater attention and resources in order to help address the health needs of the urban poor. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Community health workers, recipients' experiences and constraints to care in South Africa - a pathway to trust.

PubMed

Nxumalo, Nonhlanhla; Goudge, Jane; Manderson, Lenore

2016-01-01

Community health workers (CHWs) affiliated with community-based organisations are central to the implementation of primary health care in district health services in South Africa. Here, we explore factors that affect the provision of and access to care in two provinces - Gauteng and Eastern Cape. Drawing on narratives of care recipients and the CHWs who support them, we illustrate the complex issues surrounding health maintenance and primary care outreach in poor communities, and describe how the intimate interactions between providers and recipients work to build trust. In the study we report here, householders in Gauteng Province had poor access to health care and other services, complicating the impoverished circumstances of their everyday lives. The limited resources available to CHWs hindered their ability to meet householders' needs and for householders to benefit from existing services. CHWs in the Eastern Cape were better able to address the needs of poor householders because of the organisational support available to them. Based on an ethos of integrated and holistic care, this enabled the CHWs to address the recipients' context-related needs, and health and medical needs, while building greater levels of trust with their clients.

Children’s experiences of corporal punishment: A qualitative study in an urban township of South Africa

PubMed Central

Breen, Alison; Daniels, Karen; Tomlinson, Mark

2015-01-01

Exposure to violence is a serious mental and public health issue. In particular, children exposed to violence are at risk for poor developmental outcomes and physical and mental health problems. One area that has been shown to increase the risk for poor outcomes is the use of corporal punishment as a discipline method. While researchers are starting to ask children directly abouttheir experiences of violence, there is limited research with children about their perspectives on physical punishment, particularly in low-and middle-income countries (LMIC). This paper begins to address this gap by reporting on the spontaneous data that emerged during 24 qualitative interviews that were conducted with children, aged 8–12 in South Africa. The themes that emerged indicated that corporal punishment is an everyday experience, that it has negative emotional and behavioral consequences, and that it plays a role in how children resolve interpersonal conflicts. The study highlights the challenges for violence prevention interventions in under-resourced contexts. PMID:26094159

Identifying synergies between water resource protection and farm business objectives: the role of soil management

NASA Astrophysics Data System (ADS)

Stoate, Chris

2017-04-01

We use a 3,000 ha BACI experiment on clay soils in central England as a focus for exploring synergies between Water Framework Directive targets for water quality (sediment, nutrients and pesticides) and crop production objectives of farm businesses. Based on base of catchment annual sediment loads, we estimate annual soil loss from farmland to be in the order of 0.3 - 0.6 tonnes per hectare. This has impacts on aquatic ecology, reservoir storage capacity and downstream flood risk through sedimentation of drainage channels. Soil loss is relatively low in a European context but reflects poorly functioning soils with high runoff risk, and poor crop performance due to compaction, low organic matter, waterlogging, and competition from the grass weed, blackgrass (Alopecuris alopoides). We use a range of mechanisms to increase farmers' awareness, understanding and motivation for improving soil management to meet multiple public and private benefits of soil function and present results for soil organic matter testing, earthworm surveying, and horizontal and vertical soil compaction mapping.

Support Groups, Marriage, and the Management of Ambiguity among HIV-Positive Women in Northern Nigeria

PubMed Central

Rhine, Kathryn A.

2013-01-01

In the context of the African HIV epidemic, support groups are not simply spaces for discussions of social and health well-being; neither are they institutions functioning solely to cultivate self-responsible and economically empowered patients. HIV-positive women in northern Nigeria have appropriated a support group to facilitate their marriage arrangements. In this group, women negotiate the threats of stigma and the promises of respectable marriage through what I call the management of ambiguity surrounding their HIV status. I further argue that the practice of support group matchmaking reveals the local political economic dynamics that shape social and illness trajectories in resource-poor settings. PMID:23946544

Health related social exclusion in Europe: a multilevel study of the role of welfare generosity

PubMed Central

2013-01-01

Introduction The aim of this paper was to investigate the association between health, social position, social participation and the welfare state. Extending recent research on the social consequences of poor health, we asked whether and how welfare generosity is related to the risk of social exclusion associated with combinations of poor health, low education and economic inactivity. Methods Our analyses are based on data from the European Social Survey, round 3 (2006/7), comprising between 21,205 and 21,397 individuals, aged 25–59 years, within 21 European welfare states. The analyses were conducted by means of multilevel logistic regression analysis in STATA 12. Results The results demonstrated that the risk of non-participation in social networks decreased as welfare generosity increased. The risk of social exclusion, i.e. non-participation in social networks among disadvantaged groups, seldom differed from the overall association, and in absolute terms it was invariably smaller in more generous welfare state contexts. Conclusions The results showed that there were no indications of higher levels of non-participation among disadvantaged groups in more generous welfare states. On the contrary, resources made available by the welfare state seemed to matter to all individuals in terms of overall lower levels of non-participation. As such, these results demonstrate the importance of linking health related social exclusion to the social policy context. PMID:24073744

Health related social exclusion in Europe: a multilevel study of the role of welfare generosity.

PubMed

Saltkjel, Therese; Dahl, Espen; van der Wel, Kjetil A

2013-09-28

The aim of this paper was to investigate the association between health, social position, social participation and the welfare state. Extending recent research on the social consequences of poor health, we asked whether and how welfare generosity is related to the risk of social exclusion associated with combinations of poor health, low education and economic inactivity. Our analyses are based on data from the European Social Survey, round 3 (2006/7), comprising between 21,205 and 21,397 individuals, aged 25-59 years, within 21 European welfare states. The analyses were conducted by means of multilevel logistic regression analysis in STATA 12. The results demonstrated that the risk of non-participation in social networks decreased as welfare generosity increased. The risk of social exclusion, i.e. non-participation in social networks among disadvantaged groups, seldom differed from the overall association, and in absolute terms it was invariably smaller in more generous welfare state contexts. The results showed that there were no indications of higher levels of non-participation among disadvantaged groups in more generous welfare states. On the contrary, resources made available by the welfare state seemed to matter to all individuals in terms of overall lower levels of non-participation. As such, these results demonstrate the importance of linking health related social exclusion to the social policy context.

The Presence of Organizational Resources in Poor Urban Neighborhoods: An Analysis of Average and Contextual Effects

ERIC Educational Resources Information Center

Small, Mario Luis; McDermott, Monica

2006-01-01

Wilson (1987) and others argue that poor neighborhoods lack important organizational resources the middle class takes for granted, such as childcare centers, grocery stores and pharmacies. However, this approach does not distinguish poor neighborhoods from segregated neighborhoods, ignores immigration and neglects city differences. Using…

Tanzanian midwives' perception of their professional role and implications for continuing professional development education.

PubMed

Jones, Brooke; Michael, Rene; Butt, Janice; Hauck, Yvonne

2016-03-01

This study explored Tanzanian midwives' perceptions of their professional role within their local context. Findings were to inform recommendations for continuing professional development education programs by Western midwifery educators. Using focus group interviews with sixteen Tanzanian midwives, the findings revealed that the midwives' overwhelming focus was on saving lives of women and newborns. The fundamental elements of saving lives involved prioritising care through receiving handover and undertaking physical assessment. Midwives were challenged by the poor working conditions, perceived lack of knowledge and associated low status within the local community. Based upon these findings, recommendations for continuing professional development education for Tanzanian midwives must ensure that saving lives is a major focus and that strategies taught must be relevant to the low-resource context of this developing country. In recognition of the high-risk women being cared for, there needs to be a focus on the prevention and management of maternity emergencies, in collaboration with medical practitioners. Copyright © 2015 Elsevier Ltd. All rights reserved.

HIV vaccines: current challenges and future directions.

PubMed

Avrett, Sam; Collins, Chris

2002-07-01

Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network with a series of articles that describe past developments and future directions in several areas of policy and law related to HIV/AIDS. The following article is the first of these, discussing current challenges and future directions in the development of and access to HIV vaccines. It argues that governments are under public health, ethical, and legal obligations to develop and provide access to HIV vaccines. It further explains what is required for governments to fulfill their obligations: additional commitment and resources for HIV vaccine development in the context of increased global research and development regarding diseases of the poor; increased support and advocacy for partnerships to develop HIV vaccines; enhanced regulatory capacity in every country to review, approve, and monitor HIV vaccines; and assurance of global supply of, procurement of, delivery of, and access to vaccines in the context of efforts to increase global access to public health measures and technologies.

Implementing “insider” ethnography: lessons from the Public Conversations about HIV/AIDS project in rural South Africa

PubMed Central

Angotti, Nicole; Sennott, Christie

2015-01-01

We describe the conceptualization and implementation of a research methodology in which “insider” community members work with “outsider” investigators as participant observers to document everyday conversations taking place in public settings in their communities. Our study took place in a resource-poor area of rural South Africa and focused on HIV/AIDS, yet we aim here to provide a road map for those interested in implementing this approach in other contexts for various empirical ends. Because this approach is unusual, we highlight considerations in selecting a team of ethnographers, describe the training process, and offer ways to ensure the data collected are trustworthy and confidential. We describe the advantages and limitations of utilizing “insider ethnography” in contexts where being indigenous to the study site provides access to perspectives that cannot be obtained through other methods. Finally, we examine how mutuality and the positionality of the research team affect data collection and quality. PMID:26451131

Complex interplay between health and successful aging: Role of perceived stress, resilience, and social support

PubMed Central

Moore, Raeanne C.; Eyler, Lisa T.; Mausbach, Brent T.; Zlatar, Zvinka Z.; Thompson, Wesley K.; Peavy, Guerry; Fazeli, Pariya L.; Jeste, Dilip V.

2014-01-01

Psychological and psychosocial resources, including resilience and social support, have traditionally been studied in the context of the stress paradigm and, more recently, in the context of successful aging. This study used moderated mediation analyses to examine the role of perceived stress in the relationships between physical and mental health functioning and self-rated successful aging (SRSA), and whether differences between people in level of resilience and social support changes the role of perceived stress in these relationships. A cross-sectional study of 1,006 older adults (Mean=77 years) completed scales addressing SRSA, physical and mental health functioning, perceived stress, resilience, and social support. Results indicated that the strength of relationships between both physical and mental health functioning and SRSA were reduced after accounting for variation in level of perceived stress. The role of perceived stress in the association between mental health functioning and SRSA was found to be stronger among participants with the highest levels of resilience, and the influence of perceived stress on the degree of relationship between physical health functioning and SRSA was stronger among those with greatest social support. These findings suggest that interventions to reduce perceived stress may help break the link between disability and poor well-being in older adults. The findings further suggest that the impact of such interventions might differ depending on psychological resources (i.e., resilience) for mental health disabilities and external resources (i.e., social support) for those with physical health problems. The complex interplay of these factors should be taken into account in clinical settings. PMID:25217186

The research, policy and practice interface: reflections on using applied social research to promote equity in health in Malawi.

PubMed

Theobald, Sally; Nhlema-Simwaka, Bertha

2008-09-01

The case for research to promote equity in health in resource poor contexts such as Malawi is compelling. In Malawi, nearly half of all the people with tuberculosis cannot afford to access free tuberculosis services. In this scenario, there is a clear need to understand the multiple barriers poor women and men face in accessing services and pilot interventions to address these in a way that engages policy makers, practitioners and communities. This paper provides a critical reflection on our experience as applied social researchers working at the REACH (Research for Equity and Community Health) Trust in Malawi. Our work largely uses qualitative research methodologies as a tool for applied social research to explore the equity dimensions of health services in the country. We argue that a key strength of qualitative research methods and analysis is the ability to bring the perceptions and experiences of marginalised groups to policy makers and practitioners. The focus of this paper is two-fold. The first focus lies in synthesising the opportunities and challenges we have encountered in promoting the use of applied social research, and in particular qualitative research methods, on TB and HIV in Malawi. The second focus is on documenting and reflecting on our experiences of using applied social research to promote gender equity in TB/HIV policy and practice in Malawi. In this paper, we reflect on the strategic frameworks we have used in the Malawian context to try and bring the voices of poor women and men to policy makers and practitioners and hence intensify the research to policy and practice interface.

Open Educational Resources (OER): Opportunities and Challenges for Indian Higher Education

ERIC Educational Resources Information Center

Dutta, Indrajeet

2016-01-01

Creation of knowledge workers holds key for success of a country. Unfortunately, many of the countries though having chain of human resources yet are unable to transform human resources to their advantage as they face multiple challenges like poverty, poor economy, poor infrastructure, limited access to education and inadequate technological…

Rethinking the cost of healthcare in low-resource settings: the value of time-driven activity-based costing

PubMed Central

McBain, Ryan K; Jerome, Gregory; Warsh, Jonathan; Browning, Micaela; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Rhatigan, Joseph; Leandre, Fernet; Kaplan, Robert

2016-01-01

Low-income and middle-income countries account for over 80% of the world's infectious disease burden, but <20% of global expenditures on health. In this context, judicious resource allocation can mean the difference between life and death, not just for individual patients, but entire patient populations. Understanding the cost of healthcare delivery is a prerequisite for allocating health resources, such as staff and medicines, in a way that is effective, efficient, just and fair. Nevertheless, health costs are often poorly understood, undermining effectiveness and efficiency of service delivery. We outline shortcomings, and consequences, of common approaches to estimating the cost of healthcare in low-resource settings, as well as advantages of a newly introduced approach in healthcare known as time-driven activity-based costing (TDABC). TDABC is a patient-centred approach to cost analysis, meaning that it begins by studying the flow of individual patients through the health system, and measuring the human, equipment and facility resources used to treat the patients. The benefits of this approach are numerous: fewer assumptions need to be made, heterogeneity in expenditures can be studied, service delivery can be modelled and streamlined and stronger linkages can be established between resource allocation and health outcomes. TDABC has demonstrated significant benefits for improving health service delivery in high-income countries but has yet to be adopted in resource-limited settings. We provide an illustrative case study of its application throughout a network of hospitals in Haiti, as well as a simplified framework for policymakers to apply this approach in low-resource settings around the world. PMID:28588971

Rethinking the cost of healthcare in low-resource settings: the value of time-driven activity-based costing.

PubMed

McBain, Ryan K; Jerome, Gregory; Warsh, Jonathan; Browning, Micaela; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Rhatigan, Joseph; Leandre, Fernet; Kaplan, Robert

2016-01-01

Low-income and middle-income countries account for over 80% of the world's infectious disease burden, but <20% of global expenditures on health. In this context, judicious resource allocation can mean the difference between life and death, not just for individual patients, but entire patient populations. Understanding the cost of healthcare delivery is a prerequisite for allocating health resources, such as staff and medicines, in a way that is effective, efficient, just and fair. Nevertheless, health costs are often poorly understood, undermining effectiveness and efficiency of service delivery. We outline shortcomings, and consequences, of common approaches to estimating the cost of healthcare in low-resource settings, as well as advantages of a newly introduced approach in healthcare known as time-driven activity-based costing (TDABC). TDABC is a patient-centred approach to cost analysis, meaning that it begins by studying the flow of individual patients through the health system, and measuring the human, equipment and facility resources used to treat the patients. The benefits of this approach are numerous: fewer assumptions need to be made, heterogeneity in expenditures can be studied, service delivery can be modelled and streamlined and stronger linkages can be established between resource allocation and health outcomes. TDABC has demonstrated significant benefits for improving health service delivery in high-income countries but has yet to be adopted in resource-limited settings. We provide an illustrative case study of its application throughout a network of hospitals in Haiti, as well as a simplified framework for policymakers to apply this approach in low-resource settings around the world.

Marginal Returns: Re-Thinking Mobility and Educational Benefit in Contexts of Chronic Poverty

ERIC Educational Resources Information Center

Maddox, Bryan

2010-01-01

As a result of chronic poverty many people in South Asia experience poor quality schooling, interrupted schooling, or no schooling at all. People affected by poverty face multiple constraints on wellbeing, which typically include informal employment, low wages and poor health. In such contexts the benefits and, more specifically, the…

An ethnographic study of Latino preschool children's oral health in rural California: Intersections among family, community, provider and regulatory sectors

PubMed Central

Barker, Judith C; Horton, Sarah B

2008-01-01

Background Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California. Methods Findings are reported from an ethnographic investigation, conducted in 2005–2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents) and 47 primary caregivers (mothers) of children at least one of whom was under 6 years of age. Results Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural low-income populations. Stringent state fiscal reimbursement policies further complicated the situation. Conclusion Several societal sectors or contexts of care significantly intersected to produce or sustain poor oral health care for children. Parental beliefs and practices, leading for example to delay in seeking care, were compounded by lack of key community or economic resources, and the organization and delivery of professional dental services. In the context of state-mandated policies and procedures, these all worked to militate against children receiving timely care that would considerably reduce oral health disparities among this highly disadvantaged population. PMID:18377660

A genome-wide resource for the analysis of protein localisation in Drosophila

PubMed Central

Sarov, Mihail; Barz, Christiane; Jambor, Helena; Hein, Marco Y; Schmied, Christopher; Suchold, Dana; Stender, Bettina; Janosch, Stephan; KJ, Vinay Vikas; Krishnan, RT; Krishnamoorthy, Aishwarya; Ferreira, Irene RS; Ejsmont, Radoslaw K; Finkl, Katja; Hasse, Susanne; Kämpfer, Philipp; Plewka, Nicole; Vinis, Elisabeth; Schloissnig, Siegfried; Knust, Elisabeth; Hartenstein, Volker; Mann, Matthias; Ramaswami, Mani; VijayRaghavan, K; Tomancak, Pavel; Schnorrer, Frank

2016-01-01

The Drosophila genome contains >13000 protein-coding genes, the majority of which remain poorly investigated. Important reasons include the lack of antibodies or reporter constructs to visualise these proteins. Here, we present a genome-wide fosmid library of 10000 GFP-tagged clones, comprising tagged genes and most of their regulatory information. For 880 tagged proteins, we created transgenic lines, and for a total of 207 lines, we assessed protein expression and localisation in ovaries, embryos, pupae or adults by stainings and live imaging approaches. Importantly, we visualised many proteins at endogenous expression levels and found a large fraction of them localising to subcellular compartments. By applying genetic complementation tests, we estimate that about two-thirds of the tagged proteins are functional. Moreover, these tagged proteins enable interaction proteomics from developing pupae and adult flies. Taken together, this resource will boost systematic analysis of protein expression and localisation in various cellular and developmental contexts. DOI: http://dx.doi.org/10.7554/eLife.12068.001 PMID:26896675

Global cancer research initiative

PubMed Central

Love, Richard R

2010-01-01

Cancer is an increasing problem for low- and middle-income countries undergoing an epidemiologic transition from dominantly acute communicable disease to more frequent chronic disease with increased public health successes in the former domain. Progress against cancer in high-income countries has been modest and has come at enormous expense. There are several well-conceived global policy and planning initiatives which, with adequate political will, can favorably impact the growing global cancer challenges. Most financial resources for cancer, however, are spent on diagnosis and management of patients with disease in circumstances where specific knowledge about effective approaches is significantly limited, and the majority of interventions, other than surgery, are not cost-effective in resource-limited countries by global standards. In summary, how to intervene effectively on a global scale for the majority of citizens who develop cancer is poorly defined. In contrast to technology-transfer approaches, markedly increased clinical research activities are more likely to benefit cancer sufferers. In these contexts, a global cancer research initiative is proposed, and mechanisms for realizing such an effort are suggested. PMID:21188101

Informal m-health: How are young people using mobile phones to bridge healthcare gaps in Sub-Saharan Africa?

PubMed

Hampshire, Kate; Porter, Gina; Owusu, Samuel Asiedu; Mariwah, Simon; Abane, Albert; Robson, Elsbeth; Munthali, Alister; DeLannoy, Ariane; Bango, Andisiwe; Gunguluza, Nwabisa; Milner, James

2015-10-01

The African communications 'revolution' has generated optimism that mobile phones might help overcome infrastructural barriers to healthcare provision in resource-poor contexts. However, while formal m-health programmes remain limited in coverage and scope, young people are using mobile phones creatively and strategically in an attempt to secure effective healthcare. Drawing on qualitative and quantitative data collected in 2012-2014 from over 4500 young people (aged 8-25 y) in Ghana, Malawi and South Africa, this paper documents these practices and the new therapeutic opportunities they create, alongside the constraints, contingencies and risks. We argue that young people are endeavouring to lay claim to a digitally-mediated form of therapeutic citizenship, but that a lack of appropriate resources, social networks and skills ('digital capital'), combined with ongoing shortcomings in healthcare delivery, can compromise their ability to do this effectively. The paper concludes by offering tentative suggestions for remedying this situation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Adapting biomodulatory strategies for treatment in new contexts: pancreatic and oral cancers (Conference Presentation)

NASA Astrophysics Data System (ADS)

Anbil, Sriram R.; Rizvi, Imran; Khan, Amjad P.; Celli, Jonathan P.; Maytin, Edward V.; Hasan, Tayyaba

2016-03-01

Biomodulation of cancer cell metabolism represents a promising approach to overcome tumor heterogeneity and poor selectivity, which contribute significantly to treatment resistance. To date, several studies have demonstrated that modulation of cell metabolism including the heme synthesis pathway serves as an elegant approach to improve the efficacy of aminolevulinic acid (ALA) based photodynamic therapy (PDT). However, the ability of biomodulation-enhanced PDT to improve outcomes in low resource settings and to address challenges in treating lethal tumors with exogenous photosensitizers remains underexplored. The ability of vitamin D or methotrexate to enhance PDT efficacy in a carcinogen-induced hamster cheek pouch model of oral squamous cell carcinoma and in 3D cell-based models for pancreatic ductal adenocarcinoma is evaluated. Challenges associated with adapting PDT regimens to low resource settings, understanding the effects of biomodulatory agents on the metabolism of cancer cells, and the differential effects of biomodulatory agents on tumor and stromal cells will be discussed.

Impact of scabies in resource-poor communities.

PubMed

Heukelbach, Jorg; Mazigo, Humphrey D; Ugbomoiko, Uade S

2013-04-01

Features of endemic scabies are specific in resource-poor and underprivileged communities, with implications for control measures on the community level. In this review, these special aspects are addressed. Scabies is endemic in many resource-poor communities, with a prevalence of 20% and higher. Transmission is influenced by social attitudes, migration, access to healthcare services, housing conditions, hygiene conditions, and crowding. Endemic scabies occurs with severe infestations, complications, and sequels, mainly in children. Sleep loss as a result of scabies-related itching is common. Complications include secondary infections by group A streptococci and acute poststreptococcal glomerulonephritis. Shame, restriction of leisure activities, and stigmatization are common. Treatment of scabies includes a variety of topical compounds, but control on the community level is not an easy task. As ivermectin kills a variety of other parasites, this oral drug is increasingly used for mass treatment. Intervention should address socioemotional aspects using an integrated approach with professionals from different areas, and the community. Scabies is a neglected disease and needs to be perceived as an important public health problem causing morbidity in many resource-poor communities. Future work on epidemiology, clinical aspects, transmission dynamics, socioeconomic aspects, and sustainable control in resource-poor communities is needed.

New technology and illness self-management: Potential relevance for resource-poor populations in Asia.

PubMed

Lucas, Henry

2015-11-01

Advances in technology have made it possible for many standard diagnostic and health monitoring procedures, traditionally carried out by qualified personnel within medical facilities, to be reliably undertaken by patients or carers in their own homes with a minimum of basic training. There has also been a dramatic increase in the number and diversity of both sources of information on health issues and the possibilities for sharing information and experiences over ICT-based social networks. It has been suggested that these developments have the potential to 'empower' patients, reducing their dependence on providers and possibly improving their quality of care by increasing the volume and timeliness of diagnostic data and encouraging active self-management of their condition, for example through lifestyle changes. Perhaps more significantly, it is also seen by many economies with ageing populations as a way to contain high and ever rising healthcare costs. It has also been suggested that a move to greater self-management supported by expert networks and smart phone technology could improve the treatment of many millions of patients with chronic diseases in low and middle income economies that are also confronting the potential cost implications of epidemiological and demographic transitions, combined with the higher expectations of a more educated and knowledgeable population. There is now limited evidence that some fairly basic e- and mHealth interventions, for example in the areas of MNCH, malaria and HIV/AIDS can have a positive impact, even in resource-poor contexts. The aim here is to explore the extent to which further investment in technology could play a role in the development of an effective and affordable health sector strategy for at least some developing economies. It is suggested that the effectiveness of the approach may be highly dependent on the specific health conditions addressed, the nature of existing health systems and the overall socio-economic and cultural context. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

Resource-poor settings: infrastructure and capacity building: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Geiling, James; Burkle, Frederick M; Amundson, Dennis; Dominguez-Cherit, Guillermo; Gomersall, Charles D; Lim, Matthew L; Luyckx, Valerie; Sarani, Babak; Uyeki, Timothy M; West, T Eoin; Christian, Michael D; Devereaux, Asha V; Dichter, Jeffrey R; Kissoon, Niranjan

2014-10-01

Planning for mass critical care (MCC) in resource-poor or constrained settings has been largely ignored, despite their large populations that are prone to suffer disproportionately from natural disasters. Addressing MCC in these settings has the potential to help vast numbers of people and also to inform planning for better-resourced areas. The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of disaster (mitigation/preparedness/response/recovery), literature searches were conducted to identify evidence on which to answer the key questions in these areas. Given a lack of data upon which to develop evidence-based recommendations, expert-opinion suggestions were developed, and consensus was achieved using a modified Delphi process. The five key questions were then separated as follows: definition, infrastructure and capacity building, resources, response, and reconstitution/recovery of host nation critical care capabilities and research. Addressing these questions led the panel to offer 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part 1, Infrastructure/Capacity in this article, and part 2, Response/Recovery/Research in the accompanying article. Lack of, or presence of, rudimentary ICU resources and limited capacity to enhance services further challenge resource-poor and constrained settings. Hence, capacity building entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is needed to mount a surge response. Moreover, planning should include when to disengage and how the host nation can provide capacity beyond the mass casualty care event.

Resource specialists lead local insect community turnover associated with temperature - analysis of an 18-year full-seasonal record of moths and beetles.

PubMed

Thomsen, Philip Francis; Jørgensen, Peter Søgaard; Bruun, Hans Henrik; Pedersen, Jan; Riis-Nielsen, Torben; Jonko, Krzysztof; Słowińska, Iwona; Rahbek, Carsten; Karsholt, Ole

2016-01-01

Insect responses to recent climate change are well documented, but the role of resource specialization in determining species vulnerability remains poorly understood. Uncovering local ecological effects of temperature change with high-quality, standardized data provides an important first opportunity for predictions about responses of resource specialists, and long-term time series are essential in revealing these responses. Here, we investigate temperature-related changes in local insect communities, using a sampling site with more than a quarter-million records from two decades (1992-2009) of full-season, quantitative light trapping of 1543 species of moths and beetles. We investigated annual as well as long-term changes in fauna composition, abundance and phenology in a climate-related context using species temperature affinities and local temperature data. Finally, we explored these local changes in the context of dietary specialization. Across both moths and beetles, temperature affinity of specialists increased through net gain of hot-dwelling species and net loss of cold-dwelling species. The climate-related composition of generalists remained constant over time. We observed an increase in species richness of both groups. Furthermore, we observed divergent phenological responses between cold- and hot-dwelling species, advancing and delaying their relative abundance, respectively. Phenological advances were particularly pronounced in cold-adapted specialists. Our results suggest an important role of resource specialization in explaining the compositional and phenological responses of insect communities to local temperature increases. We propose that resource specialists in particular are affected by local temperature increase, leading to the distinct temperature-mediated turnover seen for this group. We suggest that the observed increase in species number could have been facilitated by dissimilar utilization of an expanded growing season by cold- and hot-adapted species, as indicated by their oppositely directed phenological responses. An especially pronounced advancement of cold-adapted specialists suggests that such phenological advances might help minimize further temperature-induced loss of resource specialists. Although limited to a single study site, our results suggest several local changes in the insect fauna in concordance with expected change of larger-scale temperature increases. © 2015 The Authors. Journal of Animal Ecology © 2015 British Ecological Society.

Can context justify an ethical double standard for clinical research in developing countries?

PubMed Central

Landes, Megan

2005-01-01

Background The design of clinical research deserves special caution so as to safeguard the rights of participating individuals. While the international community has agreed on ethical standards for the design of research, these frameworks still remain open to interpretation, revision and debate. Recently a breach in the consensus of how to apply these ethical standards to research in developing countries has occurred, notably beginning with the 1994 placebo-controlled trials to reduce maternal to child transmission of HIV-1 in Africa, Asia and the Caribbean. The design of these trials sparked intense debate with the inclusion of a placebo-control group despite the existence of a 'gold standard' and trial supporters grounded their justifications of the trial design on the context of scarcity in resource-poor settings. Discussion These 'contextual' apologetics are arguably an ethical loophole inherent in current bioethical methodology. However, this convenient appropriation of 'contextual' analysis simply fails to acknowledge the underpinnings of feminist ethical analysis upon which it must stand. A more rigorous analysis of the political, social, and economic structures pertaining to the global context of developing countries reveals that the bioethical principles of beneficence and justice fail to be met in this trial design. Conclusion Within this broader, and theoretically necessary, understanding of context, it becomes impossible to justify an ethical double standard for research in developing countries. PMID:16045801

The intricate relationship between a medical school and a teaching hospital: A case study in Uganda.

PubMed

Mubuuke, Aloysius Gonzaga; Businge, Francis; Mukule, Emmanuel

2014-01-01

The relationship between medical schools and teaching hospitals is full of opportunities but also challenges even though they have complementary goals that could enhance each other. Although medical schools and teaching hospitals may face some similar challenges around the world, there could be context-specific observations that differ in resource-rich versus resource-limited settings. The purpose of this study was to investigate factors that are perceived to have influenced the relationship between a medical school and a teaching hospital in Uganda, a resource-limited setting. This was a cross-sectional, descriptive study in which key informant individual interviews were conducted with senior administrators and senior staff members of the Mulago Hospital and Makerere University Medical School. The interviews explored factors perceived to have favoured the working relationship between the two institutions, challenges faced and likely future opportunities. Both quantitative and qualitative data were generated. Thematic analysis was used with the qualitative data. Respondents reported a strained relationship between the two institutions, with unfavourable factors far outweighing the favourable factors influencing the relationship. Key negative reported factors included having different administrative set-ups, limited opportunities to share funds and to forge research collaborations, unexploited potential of sharing human resources to address staff shortages, as well as a lack of a memorandum of understanding between the two institutions. This study identifies barriers in the existing relationship between a teaching hospital and medical college in a resource-poor country. It proposes a collaborative model, rather than competitive model, for the two institutions that may work in both resource-limited and resource-rich settings.

Language Policy in Multilingual Contexts: Revisiting Ruiz's "Language-as-Resource" Orientation

ERIC Educational Resources Information Center

de Jong, Ester J.; Li, Zhuo; Zafar, Aliya M.; Wu, Chiu-Hui

2016-01-01

In this article, we apply Ruiz's language-as-resource orientation to three international settings: Taiwan, Pakistan, and mainland China. Our guiding question was how different languages (indigenous languages, Chinese, and English) were positioned differently as resources in these contexts. For our analysis, we used Lo Bianco's (2001) elaboration…

Context aware adaptive security service model

NASA Astrophysics Data System (ADS)

Tunia, Marcin A.

2015-09-01

Present systems and devices are usually protected against different threats concerning digital data processing. The protection mechanisms consume resources, which are either highly limited or intensively utilized by many entities. The optimization of these resources usage is advantageous. The resources that are saved performing optimization may be utilized by other mechanisms or may be sufficient for longer time. It is usually assumed that protection has to provide specific quality and attack resistance. By interpreting context situation of business services - users and services themselves, it is possible to adapt security services parameters to countermeasure threats associated with current situation. This approach leads to optimization of used resources and maintains sufficient security level. This paper presents architecture of adaptive security service, which is context-aware and exploits quality of context data issue.

Designing a theory-informed, contextually appropriate intervention strategy to improve delivery of paediatric services in Kenyan hospitals

PubMed Central

2013-01-01

Background District hospital services in Kenya and many low-income countries should deliver proven, effective interventions that could substantially reduce child and newborn mortality. However such services are often of poor quality. Researchers have therefore been challenged to identify intervention strategies that go beyond addressing knowledge, skill, or resource inadequacies to support health systems to deliver better services at scale. An effort to develop a system-oriented intervention tailored to local needs and context and drawing on theory is described. Methods An intervention was designed to improve district hospital services for children based on four main strategies: a reflective process to distill root causes for the observed problems with service delivery; developing a set of possible intervention approaches to address these problems; a search of literature for theory that provided the most appropriate basis for intervention design; and repeatedly moving backwards and forwards between identified causes, proposed interventions, identified theory, and knowledge of the existing context to develop an overarching intervention that seemed feasible and likely to be acceptable and potentially sustainable. Results and discussion In addition to human and resource constraints key problems included failures of relevant professionals to take responsibility for or ownership of the challenge of pediatric service delivery; inadequately prepared, poorly supported leaders of service units (mid-level managers) who are often professionally and geographically isolated and an almost complete lack of useful information for routinely monitoring or understanding service delivery practice or outcomes. A system-oriented intervention recognizing the pivotal role of leaders of service units but addressing the outer and inner setting of hospitals was designed to help shape and support an appropriate role for these professionals. It aims to foster a sense of ownership while providing the necessary understanding, knowledge, and skills for mid-level managers to work effectively with senior managers and frontline staff to improve services. The intervention will include development of an information system, feedback mechanisms, and discussion fora that promote positive change. The vehicle for such an intervention is a collaborative network partnering government and national professional associations. This case is presented to promote discussion on approaches to developing context appropriate interventions particularly in international health. PMID:23537192

Use of mobile technology-based participatory mapping approaches to geolocate health facility attendees for disease surveillance in low resource settings.

PubMed

Fornace, Kimberly M; Surendra, Henry; Abidin, Tommy Rowel; Reyes, Ralph; Macalinao, Maria L M; Stresman, Gillian; Luchavez, Jennifer; Ahmad, Riris A; Supargiyono, Supargiyono; Espino, Fe; Drakeley, Chris J; Cook, Jackie

2018-06-18

Identifying fine-scale spatial patterns of disease is essential for effective disease control and elimination programmes. In low resource areas without formal addresses, novel strategies are needed to locate residences of individuals attending health facilities in order to efficiently map disease patterns. We aimed to assess the use of Android tablet-based applications containing high resolution maps to geolocate individual residences, whilst comparing the functionality, usability and cost of three software packages designed to collect spatial information. Using Open Data Kit GeoODK, we designed and piloted an electronic questionnaire for rolling cross sectional surveys of health facility attendees as part of a malaria elimination campaign in two predominantly rural sites in the Rizal, Palawan, the Philippines and Kulon Progo Regency, Yogyakarta, Indonesia. The majority of health workers were able to use the tablets effectively, including locating participant households on electronic maps. For all households sampled (n = 603), health facility workers were able to retrospectively find the participant household using the Global Positioning System (GPS) coordinates and data collected by tablet computers. Median distance between actual house locations and points collected on the tablet was 116 m (IQR 42-368) in Rizal and 493 m (IQR 258-886) in Kulon Progo Regency. Accuracy varied between health facilities and decreased in less populated areas with fewer prominent landmarks. Results demonstrate the utility of this approach to develop real-time high-resolution maps of disease in resource-poor environments. This method provides an attractive approach for quickly obtaining spatial information on individuals presenting at health facilities in resource poor areas where formal addresses are unavailable and internet connectivity is limited. Further research is needed on how to integrate these with other health data management systems and implement in a wider operational context.

Assessing dementia in resource-poor regions.

PubMed

Maestre, Gladys E

2012-10-01

The numbers and proportions of elderly are increasing rapidly in developing countries, where prevalence of dementia is often high. Providing cost-effective services for dementia sufferers and their caregivers in these resource-poor regions poses numerous challenges; developing resources for diagnosis must be the first step. Capacity building for diagnosis involves training and education of healthcare providers, as well as the general public, development of infrastructure, and resolution of economic and ethical issues. Recent progress in some low-to-middle-income countries (LMICs) provides evidence that partnerships between wealthy and resource-poor countries, and between developing countries, can improve diagnostic capabilities. Without the involvement of the mental health community of developed countries in such capacity-building programs, dementia in the developing world is a disaster waiting to happen.

Educational Equity in Poor Urban Contexts--Exploring Issues of Place/Space and Young People's Identity and Agency

ERIC Educational Resources Information Center

Raffo, Carlo

2011-01-01

An enduring concern for educational policy in many affluent countries is the endemic nature of educational inequalities that are predominately located in poor urban contexts. Given the inabilities of school reform "per se" to deal with these inequalities, the paper focuses on issues of scarcity and spatial processes that are implicated…

Promoting food security and well-being among poor and HIV/AIDS affected households: lessons from an interactive and integrated approach.

PubMed

Swaans, Kees; Broerse, Jacqueline; Meincke, Maylin; Mudhara, Maxwell; Bunders, Joske

2009-02-01

Participatory and interdisciplinary approaches have been suggested to develop appropriate agricultural innovations as an alternative strategy to improve food security and well-being among HIV/AIDS affected households. However, sustainable implementation of such interactive approaches is far from easy and straight forward. This study reports of the Interactive Learning and Action (ILA) approach, a methodology for agricultural innovation which has been adapted to the context of HIV/AIDS. Role players in agriculture and health were brought together to stimulate and sustain innovation among three support groups for poor and affected households in a rural high HIV/AIDS prevalence area in South Africa. The effectiveness of the approach was evaluated using both outcome and process criteria. The results indicate that an interactive approach in which service providers/researchers engage themselves as actors to explore the livelihood system and develop appropriate solutions in joint collaboration with resource users has potential. However, it also revealed that cooperation among participants and stakeholders at the interface of agriculture and HIV/AIDS is complicated and sensitive to erosion. Of particular concern was the difficulty of mobilizing members from poor and affected households to participate and to overcome stigma and discrimination. Lessons and potential applications for the further development of interactive approaches are discussed.

The economic rationale of public and private sector roles in the provision of animal health services.

PubMed

Ahuja, V

2004-04-01

In the changing market environment of livestock products, the delivery of animal health services is emerging as an important priority area for enhancing the competitiveness of poor livestock producers. At the same time, governments are continuing to face serious budgetary difficulties and are finding it difficult to expand the reach of these services or improve service quality. In this context of a changing environment and dwindling public resources, this paper revisits the economic framework that has thus far guided thinking about public and private sector roles in the provision of animal health services and examines the ongoing debate on livestock service delivery for the poor. The paper highlights the importance of strong institutions and appropriate legislation for regulating behaviour and enforcing contracts and re-emphasises the idea, which is supported by economic theory, that there is a need for task sharing between the public and private sectors. The paper further emphasizes the need for: a) integrating the debate on livestock service delivery with the larger debate on political economy and institutional development, and b) ensuring service access in poor marginal areas by working through membership organisations, self-help groups and civil society organisations, and by promoting the use of para-professionals and community-based animal health delivery systems.

Density-mediated, context-dependent consumer-resource interactions between ants and extrafloral nectar plants.

PubMed

Chamberlain, Scott A; Holland, J Nathaniel

2008-05-01

Interspecific interactions are often mediated by the interplay between resource supply and consumer density. The supply of a resource and a consumer's density response to it may in turn yield context-dependent use of other resources. Such consumer-resource interactions occur not only for predator-prey and competitive interactions, but for mutualistic ones as well. For example, consumer-resource interactions between ants and extrafloral nectar (EFN) plants are often mutualistic, as EFN resources attract and reward ants which protect plants from herbivory. Yet, ants also commonly exploit floral resources, leading to antagonistic consumer-resource interactions by disrupting pollination and plant reproduction. EFN resources associated with mutualistic ant-plant interactions may also mediate antagonistic ant-flower interactions through the aggregative density response of ants on plants, which could either exacerbate ant-flower interactions or alternatively satiate and distract ants from floral resources. In this study, we examined how EFN resources mediate the density response of ants on senita cacti in the Sonoran Desert and their context-dependent use of floral resources. Removal of EFN resources reduced the aggregative density of ants on plants, both on hourly and daily time scales. Yet, the increased aggregative ant density on plants with EFN resources decreased rather than increased ant use of floral resources, including contacts with and time spent in flowers. Behavioral assays showed no confounding effect of floral deterrents on ant-flower interactions. Thus, ant use of floral resources depends on the supply of EFN resources, which mediates the potential for both mutualistic and antagonistic interactions by increasing the aggregative density of ants protecting plants, while concurrently distracting ants from floral resources. Nevertheless, only certain years and populations of study showed an increase in plant reproduction through herbivore protection or ant distraction from floral resources. Despite pronounced effects of EFN resources mediating the aggregative density of ants on plants and their context-dependent use of floral resources, consumer-resource interactions remained largely commensalistic.

Complex interplay between health and successful aging: role of perceived stress, resilience, and social support.

PubMed

Moore, Raeanne C; Eyler, Lisa T; Mausbach, Brent T; Zlatar, Zvinka Z; Thompson, Wesley K; Peavy, Guerry; Fazeli, Pariya L; Jeste, Dilip V

2015-06-01

Psychological and psychosocial resources, including resilience and social support, have traditionally been studied in the context of the stress paradigm and, more recently, in the context of successful aging. This study used moderated mediation analyses to examine the role of perceived stress in the relationships between physical and mental health functioning and self-rated successful aging (SRSA) and whether differences between people in level of resilience and social support changes the role of perceived stress in these relationships. A cross-sectional study of 1,006 older adults (mean age: 77 years) completed scales addressing SRSA, physical and mental health functioning, perceived stress, resilience, and social support. Results indicated that the strength of relationships between both physical and mental health functioning and SRSA were reduced after accounting for variation in level of perceived stress. The role of perceived stress in the association between mental health functioning and SRSA was found to be stronger among participants with the highest levels of resilience, and the influence of perceived stress on the degree of relationship between physical health functioning and SRSA was stronger among those with greatest social support. These findings suggest that interventions to reduce perceived stress may help break the link between disability and poor well-being in older adults. The findings further suggest that the impact of such interventions might differ depending on psychological resources (i.e., resilience) for mental health disabilities and external resources (i.e., social support) for those with physical health problems. The complex interplay of these factors should be taken into account in clinical settings. Copyright © 2015 American Association for Geriatric Psychiatry. All rights reserved.

How do you get the Rose Bengal Test at the point-of-care to diagnose brucellosis in Africa? The importance of a systems approach.

PubMed

Ducrotoy, Marie J; Bardosh, Kevin L

2017-01-01

Brucellosis is a major neglected zoonotic disease, whose burden both in animals and humans is severely under-reported. Diagnosis in humans identifies cases in order to treat the disease at the individual level. In animals diagnosis is implemented at the population level in the context of appropriate control or eradication strategies. Molecular and bacteriological diagnosis are rarely undertaken in sub-Saharan Africa, at least outside research projects, due to cost, skills and laboratory infrastructure issues. The brucellosis toolbox contains a wide range of serological tests, but the perfect test for use in animals and humans respectively does not exist. Drug and diagnostic discovery for the neglected zoonoses are notoriously poor, and there is limited investment interest in developing new tools for brucellosis diagnosis. But are current tools being used to their full capacity? The rose Bengal test (RBT) stands out as an efficient, practical and very cheap test adapted for use in the resource-poor context. In this paper, we argue that a social science or system's approach to explore the practicality of improving diagnostic capacity at the point-of care in high-risk brucellosis areas of rural Africa may be a step towards solving the issue of under-diagnosis, but this must go hand-in-hand with implementation of control measures at source in the animal reservoir and capacity to treat human cases. Copyright © 2016 Elsevier B.V. All rights reserved.

Costing the scaling-up of human resources for health: lessons from Mozambique and Guinea Bissau

PubMed Central

2010-01-01

Introduction In the context of the current human resources for health (HRH) crisis, the need for comprehensive Human Resources Development Plans (HRDP) is acute, especially in resource-scarce sub-Saharan African countries. However, the financial implications of such plans rarely receive due consideration, despite the availability of much advice and examples in the literature on how to conduct HRDP costing. Global initiatives have also been launched recently to standardise costing methodologies and respective tools. Methods This paper reports on two separate experiences of HRDP costing in Mozambique and Guinea Bissau, with the objective to provide an insight into the practice of costing exercises in information-poor settings, as well as to contribute to the existing debate on HRH costing methodologies. The study adopts a case-study approach to analyse the methodologies developed in the two countries, their contexts, policy processes and actors involved. Results From the analysis of the two cases, it emerged that the costing exercises represented an important driver of the HRDP elaboration, which lent credibility to the process, and provided a financial framework within which HRH policies could be discussed. In both cases, bottom-up and country-specific methods were designed to overcome the countries' lack of cost and financing data, as well as to interpret their financial systems. Such an approach also allowed the costing exercises to feed directly into the national planning and budgeting process. Conclusions The authors conclude that bottom-up and country-specific costing methodologies have the potential to serve adequately the multi-faceted purpose of the exercise. It is recognised that standardised tools and methodologies may help reduce local governments' dependency on foreign expertise to conduct the HRDP costing and facilitate regional and international comparisons. However, adopting pre-defined and insufficiently flexible tools may undermine the credibility of the costing exercise, and reduce the space for policy negotiation opportunities within the HRDP elaboration process. PMID:20579341

Costing the scaling-up of human resources for health: lessons from Mozambique and Guinea Bissau.

PubMed

Tyrrell, Amanda K; Russo, Giuliano; Dussault, Gilles; Ferrinho, Paulo

2010-06-25

In the context of the current human resources for health (HRH) crisis, the need for comprehensive Human Resources Development Plans (HRDP) is acute, especially in resource-scarce sub-Saharan African countries. However, the financial implications of such plans rarely receive due consideration, despite the availability of much advice and examples in the literature on how to conduct HRDP costing. Global initiatives have also been launched recently to standardise costing methodologies and respective tools. This paper reports on two separate experiences of HRDP costing in Mozambique and Guinea Bissau, with the objective to provide an insight into the practice of costing exercises in information-poor settings, as well as to contribute to the existing debate on HRH costing methodologies. The study adopts a case-study approach to analyse the methodologies developed in the two countries, their contexts, policy processes and actors involved. From the analysis of the two cases, it emerged that the costing exercises represented an important driver of the HRDP elaboration, which lent credibility to the process, and provided a financial framework within which HRH policies could be discussed. In both cases, bottom-up and country-specific methods were designed to overcome the countries' lack of cost and financing data, as well as to interpret their financial systems. Such an approach also allowed the costing exercises to feed directly into the national planning and budgeting process. The authors conclude that bottom-up and country-specific costing methodologies have the potential to serve adequately the multi-faceted purpose of the exercise. It is recognised that standardised tools and methodologies may help reduce local governments' dependency on foreign expertise to conduct the HRDP costing and facilitate regional and international comparisons. However, adopting pre-defined and insufficiently flexible tools may undermine the credibility of the costing exercise, and reduce the space for policy negotiation opportunities within the HRDP elaboration process.

Conservation of resources theory and research use in health systems.

PubMed

Alvaro, Celeste; Lyons, Renée F; Warner, Grace; Hobfoll, Stevan E; Martens, Patricia J; Labonté, Ronald; Brown, Richard E

2010-10-20

Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use?In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. COR theory contributes to understanding the role of resources in research use, resistance to research use, and potential strategies to enhance research use. Resources (and a lack of them) may account for the observed disparities in research uptake across health systems. This paper offers a theoretical foundation to guide further examination of the COR-KT ideas and necessary supports for research use in resource-challenged environments.

Conservation of resources theory and research use in health systems

PubMed Central

2010-01-01

Background Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use? In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. Methods A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. Results The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. Conclusions COR theory contributes to understanding the role of resources in research use, resistance to research use, and potential strategies to enhance research use. Resources (and a lack of them) may account for the observed disparities in research uptake across health systems. This paper offers a theoretical foundation to guide further examination of the COR-KT ideas and necessary supports for research use in resource-challenged environments. PMID:20961445

Stratified reproduction, family planning care and the double edge of history.

PubMed

Harris, Lisa H; Wolfe, Taida

2014-12-01

There is a growing clinical consensus that Medicaid sterilization consent protections should be revisited because they impede desired care for many women. Here, we consider the broad social and ideological contexts for past sterilization abuses, beyond informed consent. Throughout the US history, the fertility and childbearing of poor women and women of color were not valued equally to those of affluent white women. This is evident in a range of practices and policies, including black women's treatment during slavery, removal of Native children to off-reservation boarding schools and coercive sterilizations of poor white women and women of color. Thus, reproductive experiences throughout the US history were stratified. This ideology of stratified reproduction persists today in social welfare programs, drug policy and programs promoting long-acting reversible contraception. At their core, sterilization abuses reflected an ideology of stratified reproduction, in which some women's fertility was devalued compared to other women's fertility. Revisiting Medicaid sterilization regulations must therefore put issues of race, ethnicity, class, power and resources - not just informed consent - at the center of analyses.

Children's experiences of corporal punishment: A qualitative study in an urban township of South Africa.

PubMed

Breen, Alison; Daniels, Karen; Tomlinson, Mark

2015-10-01

Exposure to violence is a serious mental and public health issue. In particular, children exposed to violence are at risk for poor developmental outcomes and physical and mental health problems. One area that has been shown to increase the risk for poor outcomes is the use of corporal punishment as a discipline method. While researchers are starting to ask children directly about their experiences of violence, there is limited research with children about their perspectives on physical punishment, particularly in low-and middle-income countries (LMIC). This paper begins to address this gap by reporting on the spontaneous data that emerged during 24 qualitative interviews that were conducted with children, aged 8-12 in South Africa. The themes that emerged indicated that corporal punishment is an everyday experience, that it has negative emotional and behavioral consequences, and that it plays a role in how children resolve interpersonal conflicts. The study highlights the challenges for violence prevention interventions in under-resourced contexts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Communicating vaccine safety in the context of immunization programs in low resource settings.

PubMed

Arwanire, Edison M; Mbabazi, William; Mugyenyi, Possy

2015-01-01

Vaccines are effective in preventing infectious diseases and their complications, hence reducing morbidity and infectious disease mortaity. Successful immunization programs, however, depend on high vaccine acceptance and coverage rates. In recent years there has been an increased level of public concern towards real or perceived adverse events associated with immunizations, leading to many people in high- as well as low-resource settings to refuse vaccines. Health care workers therefore must be able to provide parents and guardians of children with the most current and accurate information about the benefits and risks of vaccination. Communicating vaccine safety using appropriate channels plays a crucial role in maintaining public trust and confidence in vaccination programs. Several factors render this endeavor especially challenging in low-resource settings where literacy rates are low and access to information is often limited. Many languages are spoken in most countries in low-resource settings, making the provision of appropriate information difficult. Poor infrastructure often results in inadequate logistics. Recently, some concerned consumer groups have been able to propagate misinformation and rumors. To successfully communicate vaccine safety in a resource limited setting it is crucial to use a mix of communication channels that are both culturally acceptable and effective. Social mobilization through cultural, administrative and political leaders, the media or text messages (SMS) as well as the adoption of the Village Health Team (VHT) strategy whereby trained community members (Community Health Workers (CHWs)) are providing primary healthcare, can all be effective in increasing the demand for immunization.

Social determinants of health--a comparative study of Bosnian adolescents in different cultural contexts.

PubMed

Sujoldzić, Anita; Peternel, Lana; Kulenović, Tarik; Terzić, Rifet

2006-12-01

This study investigated the effects of sociocultural contexts on health and the psychological well-being of immigrant adolescents, aged 15 to 18 years, originally from Bosnia and Herzegovina and now living as displaced persons either in Bosnia, or immigrants in Croatia and Austria. The study addresses the social determinants of health with a specific focus on five factors in the social environment that might have an influence on health status: gender, socio-economic status (SES), perceived discrimination and exposure to violence, social support and religious commitment. Dependent variables included self-rated health, a count of self-reported objective health problems and a range of indices of psychological well-being (somatic stress, anxiety, depression and self-esteem). The purpose of the study was to examine whether social risk factors have an effect on health, which factors mediate these effects on self-rated health and to assess whether these effects differ by gender Results indicate that perceived discrimination and violence are related to poor health through psychological stress as a major mechanism with stronger effects for girls in the study. Differences across the three socio-cultural contexts reveal the complexity and specificity of the relationships between analyzed factors as the association between discrimination and health was attenuated for some groups due to the protective resources of immigrants.

Socio-economic factors associated with maternal health-seeking behaviours among women from poor households in rural Egypt.

PubMed

Benova, Lenka; Campbell, Oona M R; Sholkamy, Hania; Ploubidis, George B

2014-11-25

Socio-economic inequalities in basic maternal health interventions exist in Egypt, yet little is known about health-seeking of poor households. This paper assesses levels of maternal health-seeking behaviours in women living in poor households in rural Upper Egypt, and compares these to national averages. Secondly, we construct innovative measures of socio-economic resourcefulness among the rural poor in order to examine the association between the resulting variables and the four dimensions of maternal health-seeking behaviour. We analysed a cross-sectional survey conducted in Assiut and Sohag governorates in 2010-2011 of 2,242 women in households below the poverty line in 65 poorest villages in Egypt. The associations between four latent socio-economic constructs (socio-cultural resourcefulness, economic resourcefulness, dwelling quality and woman's status) and receipt of any antenatal care (ANC), regular ANC (four or more visits), facility delivery and private sector delivery for women's most recent pregnancy in five years preceding survey were assessed using multivariate logistic regression. In the sample, 58.5% of women reported using any ANC and 51.1% facility delivery, lower than national coverage (74.2% and 72.4%, respectively). The proportion of ANC users receiving regular ANC was lower (67%) than nationally (91%). Among women delivering in facilities, 18% of women in the poor Upper Egypt sample used private providers (63% nationally). In multivariate analysis, higher economic resourcefulness was associated with higher odds of receiving ANC but with lower odds of facility delivery. Socio-cultural resourcefulness was positively associated with receiving any ANC, regular ANC and facility delivery, whereas it was not associated with private delivery care. Dwelling quality was positively associated with private delivery facility use. Woman's status was not independently associated with any of the four behaviours. Coverage of basic maternal health interventions and utilisation of private providers are lower among rural poor women in Upper Egypt than nationally. Variables capturing socio-cultural resourcefulness and economic resourcefulness were useful predictors of ANC and facility delivery. Further understanding of issues surrounding availability, affordability and quality of maternal health services among the poor is crucial to eliminating inequalities in maternal health coverage in Egypt.

Women in water management: the need for local planning.

PubMed

Bhatt, M R

1995-08-01

This article on women's role in water resource management is based on a paper delivered at a seminar organized at the Water and Land Management Institute in Anand, India, in 1994. The article reflects Family Planning International's (FPI) experience in community-based water resource development. Most analyses of village and household water management data exclude women's role. The reasons are identified as the lack of inclusion of women's thinking in land-development research and planning, the dominance of males in planning and consequent male assumptions made about women's work and use of water, the lack of valuation of the nonmonetary nature of women's relationship to water, and the ease of ignoring women. Women's roles that are obstacles to inclusion in research and planning are identified as the lack of effective women's lobbies, the undervaluation by women of their work, and the lack of professional recognition of women as potential users of water or spokespersons for more than their own self-interests as women. National water policies are shifting to community-based management because local authorities are in daily contact with users, of whom about 50% are women. Historically national policy shifted from attention to distribution of investments in the water sector to reorganization of water agencies and to building up the capacity of private or voluntary agencies. The local context allows for more efficient and effective responses to local conditions. Local institutions and groups are better equipped to solicit local participation. One primary lesson learned by FPI is that local water resource planning is very important in strengthening the economic and individual capacity of poor people in underdeveloped areas. FPI's experience in Mahesana, Banaskantha, and Sabarkantha in Gujarat state supports this lesson learned. Water resource development policies resulted in mixed outcomes, and national control has been inefficient and disrespectful to local authorities. Another obstacle in Gujarat to water resource development is identified as increased demand for public water services and inadequate provision of services due to remoteness of the area and financial limitations of central agencies. Infrastructure is poorly maintained.

Water resources assessment in a poorly gauged mountainous catchment using a geographical information system and remote sensing

NASA Astrophysics Data System (ADS)

Shrestha, Roshan; Takara, Kaoru; Tachikawa, Yasuto; Jha, Raghu N.

2004-11-01

Water resources assessment, which is an essential task in making development plans managing water resources, is considerably difficult to do in a data-poor region. In this study, we attempted to conduct a quantitative water resources assessment in a poorly gauged mountainous catchment, i.e. the River Indrawati catchment (1233 km2) in Nepal. This catchment is facing problems such as dry-season water scarcity and water use conflicts. However, the region lacks the basic data that this study needs. The data needed are supplemented from field surveys and global data (e.g. GTOPO30 DEM data, LandsatTM data and MODIS NDVI data). The global data have significantly helped us to draw out the information needed for a number of water-use scenarios. These data helped us determine that the available water quantity is enough at present to address the dry-season problems. The situation is not much worse for the immediate future; however, the threat of drought is noticed in a future scenario in which resources are consumed extensively. The study uses a geographical information system and remotely sensed data analysis tools extensively. Utilization of modern tools and global data is found effective for investigating practical problems and for detecting important features of water resources, even though the catchment is poorly gauged.

Forms of benefit sharing in global health research undertaken in resource poor settings: a qualitative study of stakeholders' views in Kenya.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; English, Michael C

2012-01-17

Increase in global health research undertaken in resource poor settings in the last decade though a positive development has raised ethical concerns relating to potential for exploitation. Some of the suggested strategies to address these concerns include calls for providing universal standards of care, reasonable availability of proven interventions and more recently, promoting the overall social value of research especially in clinical research. Promoting the social value of research has been closely associated with providing fair benefits to various stakeholders involved in research. The debate over what constitutes fair benefits; whether those that addresses micro level issues of justice or those focusing on the key determinants of health at the macro level has continued. This debate has however not benefited from empirical work on what stakeholders consider fair benefits. This study explores practical experiences of stakeholders involved in global health research in Kenya, over what benefits are fair within a developing world context. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.The range of benefits articulated by stakeholders addresses both micro and macro level concerns for justice by for instance, seeking to engage with interests of those facilitating research, and the broader systemic issues that make resource poor settings vulnerable to exploitation. We interpret these views to suggest a need for global health research to engage with current crises that face people in these settings as well as the broader systemic issues that produce them. Global health research should provide benefits that address both the micro and macro level issues of justice in order to forestall exploitation. Embracing the two is however challenging in terms of how the various competing interests/needs should be balanced ethically, especially in the absence of structures to guide the process. This challenge should point to the need for greater dialogue to facilitate value clarification among stakeholders.

'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

PubMed

Mwacalimba, Kennedy Kapala; Green, Judith

2015-03-01

'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of trade and development issues remain relatively unexamined, and few studies to date have explored the implications of global disease governance for resource-constrained countries outside the main centres of zoonotic outbreaks. This article draws on a policy study of national level avian and pandemic influenza preparedness between 2005 and 2009 across the sectors of trade, health and agriculture in Zambia. We highlight the challenges of integrating disease control interventions amidst trade and developmental realities in resource-poor environments. One Health prioritizes disease risk mitigation, sidelining those trade and development narratives which speak to broader public health concerns. We show how locally important trade and development imperatives were marginalized in Zambia, limiting the effectiveness of pandemic preparedness. Our findings are likely to be generalizable to other resource-constrained countries, and suggest that effective disease governance requires alignment with trade and development sectors, as well as integration of veterinary and public health sectors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Human–nature interactions and the consequences and drivers of provisioning wildlife

PubMed Central

Gaston, Kevin J.

2018-01-01

Many human populations are undergoing an extinction of experience, with a progressive decline in interactions with nature. This is a consequence both of a loss of opportunity for, and orientation towards, such experiences. The trend is of concern in part because interactions with nature can be good for human health and wellbeing. One potential means of redressing these losses is through the intentional provision of resources to increase wildlife populations in close proximity to people, thereby increasing the potential for positive human–nature experiences, and thence the array of benefits that can result. In this paper, we review the evidence that these resource subsidies have such a cascade of effects. In some Westernized countries, the scale of provision is extraordinarily high, and doubtless leads to both positive and negative impacts for wildlife. In turn, these impacts often lead to more frequent, reliable and closer human–nature interactions, with a greater variety of species. The consequences for human wellbeing remain poorly understood, although benefits documented in the context of human–nature interactions more broadly seem likely to apply. There are also some important feedback loops that need to be better characterized if resource provisioning is to contribute effectively towards averting the extinction of experience. This article is part of the theme issue ‘Anthropogenic resource subsidies and host–parasite dynamics in wildlife’. PMID:29531147

Translating evidence into practice in low resource settings: cervical cancer screening tests are only part of the solution in rural India.

PubMed

Isaac, Rita; Finkel, Madelon; Olver, Ian; Annie, I K; Prashanth, H R; Subhashini, J; Viswanathan, P N; Trevena, Lyndal J

2012-01-01

The majority of women in rural India have poor or no access to cervical cancer screening services, although one-quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

Resilience through participation and coping-enabling social environments: the case of HIV-affected children in sub-Saharan Africa

PubMed Central

Skovdal, Morten; Daniel, Marguerite

2012-01-01

Many children and youths living in low-resource and high-HIV-prevalence communities in sub-Saharan Africa are presented with daily hardships that few of us can even imagine. It is therefore no surprise that most research reporting on the experiences of HIV-affected children in resource-poor settings focuses on their poor health and development outcomes, casting them as victims. However, there is a growing trend to draw on more strengths-based conceptualisations in the study and support of HIV-affected children and youths. In this introduction to a special issue of The African Journal of AIDS Research, we cement this trend by providing a theoretical exposition and critique of the ‘coping’ and ‘resilience’ concepts and draw on the 11 empirical studies that make up this special issue to develop a framework that appropriates the concepts for a particular context and area of study: HIV-affected children in sub-Saharan Africa. The articles included here show, albeit in different ways and to different degrees, that the resilience of HIV-affected children in the region is an outcome of their agency and interactions with their social environment. Policy actors and practitioners working to support HIV-affected children in Africa should take heed of the proposed framework and draw on the research presented here to build coping-enabling social environments—presenting children and youths in Africa with greater opportunity to actively deal with hardship and work towards a more promising future. PMID:24482634

The effect of food quality during growth on spatial memory consolidation in adult pigeons.

PubMed

Scriba, M F; Gasparini, J; Jacquin, L; Mettke-Hofmann, C; Rattenborg, N C; Roulin, A

2017-02-15

Poor environmental conditions experienced during early development can have negative long-term consequences on fitness. Animals can compensate for negative developmental effects through phenotypic plasticity by diverting resources from non-vital to vital traits such as spatial memory to enhance foraging efficiency. We tested in young feral pigeons ( Columba livia ) how diets of different nutritional value during development affect the capacity to retrieve food hidden in a spatially complex environment, a process we refer to as 'spatial memory'. Parents were fed with either high- or low-quality food from egg laying until young fledged, after which all young pigeons received the same high-quality diet until memory performance was tested at 6 months of age. The pigeons were trained to learn a food location out of 18 possible locations in one session, and then their memory of this location was tested 24 h later. Birds reared with the low-quality diet made fewer errors in the memory test. These results demonstrate that food quality during development has long-lasting effects on memory, with a moderate nutritional deficit improving spatial memory performance in a foraging context. It might be that under poor feeding conditions resources are redirected from non-vital to vital traits, or pigeons raised with low-quality food might be better in using environmental cues such as the position of the sun to find where food was hidden. © 2017. Published by The Company of Biologists Ltd.

Resource-poor settings: response, recovery, and research: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Geiling, James; Burkle, Frederick M; West, T Eoin; Uyeki, Timothy M; Amundson, Dennis; Dominguez-Cherit, Guillermo; Gomersall, Charles D; Lim, Matthew L; Luyckx, Valerie; Sarani, Babak; Christian, Michael D; Devereaux, Asha V; Dichter, Jeffrey R; Kissoon, Niranjan

2014-10-01

Planning for mass critical care in resource-poor and constrained settings has been largely ignored, despite large, densely crowded populations who are prone to suffer disproportionately from natural disasters. As a result, disaster response has been suboptimal and in many instances hampered by lack of planning, education and training, information, and communication. The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of the disaster cycle (mitigation/preparedness/response/recovery). Literature searches were conducted to identify evidence to answer the key questions in these areas. Given a lack of data on which to develop evidence-based recommendations, expert-opinion suggestions were developed, and consensus was achieved using a modified Delphi process. The five key questions were as follows: definition, capacity building and mitigation, what resources can we bring to bear to assist/surge, response, and reconstitution and recovery of host nation critical care capabilities. Addressing these led the panel to offer 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part I, Infrastructure/Capacity in the accompanying article, and part II, Response/Recovery/Research in this article. A lack of rudimentary ICU resources and capacity to enhance services plagues resource-poor or constrained settings. Capacity building therefore entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is often needed to mount a surge response. Moreover, the disengagement of these responding groups and host country recovery require active planning. Future improvements in all phases require active research activities.

Perceptions about Probiotic Yogurt for Health and Nutrition in the Context of HIV/AIDS in Mwanza, Tanzania

PubMed Central

Whaling, Melissa A.; Reid, Gregor; Hekmat, Sharereh; Thind, Amardeep; Mwanga, Joseph; Changalucha, John

2012-01-01

Recently, the food and malnutrition issues have taken centre stage within the arena of HIV/AIDS epidemic, with several calls being made for context-specific health and nutrition interventions to deal with the emerging food insecurity and malnutrition issues in settings with high burdens of HIV/AIDS. The use of probiotics as nutritional supplements in HIV/AIDS-affected and resource-poor settings has also been advocated. This paper presents the results of a qualitative study on community knowledge and perceptions about probiotics and their potential impact on people's everyday life in the context of the HIV/AIDS epidemic. In-depth interviews (n=26) were conducted with residents in Mwanza, Tanzania. The results showed that people living with HIV/AIDS, who were using probiotic yogurt produced through a joint partnership of Western Heads East, Tanzania Medical Research Institute and the Tukwamune Women's Group, reported perceived beneficial effects, such as gain in weight and improved health and well-being. Yet, these beneficial effects might be resulting in growing misconceptions about probiotic yogurt being ‘medicine’ for the treatment of HIV/AIDS; this is leading some people living with HIV/AIDS to abandon taking their antiretroviral medications based on the view that the probiotic yogurt is making them feel much better. The findings illustrate the potential challenges with regard to the introduction of nutritional food supplements into new contexts plagued by malnutrition and infectious diseases. Public-health education and awareness programmes are needed when introducing novel foods into such contexts. PMID:22524117

Task set induces dynamic reallocation of resources in visual short-term memory.

PubMed

Sheremata, Summer L; Shomstein, Sarah

2017-08-01

Successful interaction with the environment requires the ability to flexibly allocate resources to different locations in the visual field. Recent evidence suggests that visual short-term memory (VSTM) resources are distributed asymmetrically across the visual field based upon task demands. Here, we propose that context, rather than the stimulus itself, determines asymmetrical distribution of VSTM resources. To test whether context modulates the reallocation of resources to the right visual field, task set, defined by memory-load, was manipulated to influence visual short-term memory performance. Performance was measured for single-feature objects embedded within predominantly single- or two-feature memory blocks. Therefore, context was varied to determine whether task set directly predicts changes in visual field biases. In accord with the dynamic reallocation of resources hypothesis, task set, rather than aspects of the physical stimulus, drove improvements in performance in the right- visual field. Our results show, for the first time, that preparation for upcoming memory demands directly determines how resources are allocated across the visual field.

Executive Resources and Item-Context Binding: Exploring the Influence of Concurrent Inhibition, Updating, and Shifting Tasks on Context Memory

PubMed Central

Nieznański, Marek; Obidziński, Michał; Zyskowska, Emilia; Niedziałkowska, Daria

2015-01-01

Previous research has demonstrated that context memory performance decreases as a result of cognitive load. However, the role of specific executive resources availability has not been specified yet. In a dual-task experiment, participants performed three kinds of concurrent task engaging: inhibition, updating, or shifting operations. In comparison with a no-load single-task condition, a significant decrease in item and context memory was observed, regardless of the kind of executive task. When executive load conditions were compared with non-specific cognitive load conditions, a significant interference effect was observed in the case of the inhibition task. The inhibition process appears to be an aspect of executive control, which relies on the same resource as item-context binding does, especially when binding refers to associations retrieved from long-term memory. PMID:26435761

Reframing implementation as an organisational behaviour problem.

PubMed

Clay-Williams, Robyn; Braithwaite, Jeffrey

2015-01-01

The purpose of this paper is to report on a process evaluation of a randomised controlled trial (RCT) intervention study that tested the effectiveness of classroom- and simulation-based crew resource management courses, alone and in combination, and identifies organisational barriers and facilitators to implementation of team training programmes in healthcare. The RCT design consisted of a before and after study with a team training intervention. Quantitative data were gathered on utility and affective reactions to training, and on teamwork knowledge, attitudes, and behaviours of the learners. A sample of participants was interviewed at the conclusion of the study. Interview responses were analysed, alongside qualitative elements of the classroom course critique, to search for evidence, context, and facilitation clues to the implementation process. The RCT method provided scientifically robust data that supported the benefits of classroom training. Qualitative data identified a number of facilitators to implementation of team training, and shed light on some of the ways that learning was diffused throughout the organisation. Barriers to successful implementation were also identified, including hospital time and resource constraints and poor organisational communication. Quantitative randomised methods have intermittently been used to evaluate team training interventions in healthcare. Despite two decades of team training trials, however, the authors do not know as well as the authors would like what goes on inside the "black box" of such RCTs. While results are usually centred on outcomes, this study also provides insight into the context and mechanisms associated with those outcomes and identifies barriers and facilitators to successful intervention implementation.

A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings

PubMed Central

Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H.Y.; Cole, Donald

2013-01-01

Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were ‘HIV’ or ‘AIDS’ and ‘community-based care’ or ‘CBC’. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages. PMID:23594416

A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings.

PubMed

Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H Y; Cole, Donald

2013-04-16

Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were 'HIV' or 'AIDS' and 'community-based care' or 'CBC'. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.

Palliative care, public health and justice: setting priorities in resource poor countries.

PubMed

Blinderman, Craig

2009-12-01

Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. For patients requiring terminal care, we are guided less by principles of justice and more by the duty to relieve suffering and society's commitment to protecting the professional's obligation to uphold principles of beneficence, compassion and non-abandonment. A fair deliberation process is necessary to allow these strong moral commitments to serve as reasons when setting priorities in resource poor countries.

Political Impetus: Towards a Successful Agenda-Setting for Inclusive Health Policies in Low- and Middle-Income Countries Comment on "Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam".

PubMed

Yang, Xiaoguang; Qian, Xu

2016-02-04

Agenda-setting is a crucial step for inclusive health policies in the low- and middle-income countries (LMICs). Enlightened by Ha et al manuscript, this commentary paper argues that 'political impetus' is the key to the successful agenda-setting of health policies in LMICs, though other determinants may also play the role during the process. This Vietnamese case study presents a good example for policy-makers of other LMICs; it offers insights for contexts where there are limited health resources and poor health performance. Further research which compares various stages of the health policy process across countries, is much needed. © 2016 by Kerman University of Medical Sciences.

Challenges in managing postpartum hemorrhage in resource-poor countries.

PubMed

Karoshi, Mahantesh; Keith, Louis

2009-06-01

Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.

Resource Security Impacts Men’s Female Breast Size Preferences

PubMed Central

Swami, Viren; Tovée, Martin J.

2013-01-01

It has been suggested human female breast size may act as signal of fat reserves, which in turn indicates access to resources. Based on this perspective, two studies were conducted to test the hypothesis that men experiencing relative resource insecurity should perceive larger breast size as more physically attractive than men experiencing resource security. In Study 1, 266 men from three sites in Malaysia varying in relative socioeconomic status (high to low) rated a series of animated figures varying in breast size for physical attractiveness. Results showed that men from the low socioeconomic context rated larger breasts as more attractive than did men from the medium socioeconomic context, who in turn perceived larger breasts as attractive than men from a high socioeconomic context. Study 2 compared the breast size judgements of 66 hungry versus 58 satiated men within the same environmental context in Britain. Results showed that hungry men rated larger breasts as significantly more attractive than satiated men. Taken together, these studies provide evidence that resource security impacts upon men’s attractiveness ratings based on women’s breast size. PMID:23483919

Relative importance of competition and plant-soil feedback, their synergy, context dependency and implications for coexistence.

PubMed

Lekberg, Ylva; Bever, James D; Bunn, Rebecca A; Callaway, Ragan M; Hart, Miranda M; Kivlin, Stephanie N; Klironomos, John; Larkin, Beau G; Maron, John L; Reinhart, Kurt O; Remke, Michael; van der Putten, Wim H

2018-06-12

Plants interact simultaneously with each other and with soil biota, yet the relative importance of competition vs. plant-soil feedback (PSF) on plant performance is poorly understood. Using a meta-analysis of 38 published studies and 150 plant species, we show that effects of interspecific competition (either growing plants with a competitor or singly, or comparing inter- vs. intraspecific competition) and PSF (comparing home vs. away soil, live vs. sterile soil, or control vs. fungicide-treated soil) depended on treatments but were predominantly negative, broadly comparable in magnitude, and additive or synergistic. Stronger competitors experienced more negative PSF than weaker competitors when controlling for density (inter- to intraspecific competition), suggesting that PSF could prevent competitive dominance and promote coexistence. When competition was measured against plants growing singly, the strength of competition overwhelmed PSF, indicating that the relative importance of PSF may depend not only on neighbour identity but also density. We evaluate how competition and PSFs might interact across resource gradients; PSF will likely strengthen competitive interactions in high resource environments and enhance facilitative interactions in low-resource environments. Finally, we provide a framework for filling key knowledge gaps and advancing our understanding of how these biotic interactions influence community structure. © 2018 John Wiley & Sons Ltd/CNRS.

Innovative newborn health technology for resource-limited environments.

PubMed

Thairu, L; Wirth, M; Lunze, K

2013-01-01

To review medical devices addressing newborn health in resource-poor settings, and to identify existing and potential barriers to their actual and efficient use in these settings. We searched Pubmed as our principal electronic reference library and dedicated databases such as Maternova and the Maternal and Neonatal Directed Assessment of Technology. We also researched standard public search engines. Studies and grey literature reports describing devices for use in a low- or middle-income country context were eligible for inclusion. Few devices are currently described in the peer-reviewed medical or public health literature. The majority of newborn-specific devices were found in the grey literature. Most sources described infant warmers, neonatal resuscitators, and phototherapy devices. Other devices address the diagnosis of infectious diseases, monitoring of oxygen saturation, assisted ventilation, prevention of mother-to-child transmission of HIV, assisted childbirth, weight or temperature assessment, and others. Many medical devices designed for newborns in the developing world are under development or in the early stages of production, but the vast majority of them are not available when and where they are needed. Making them available to mothers, newborns, and birth attendants in resource-limited countries at the time and place of birth will require innovative and creative production, distribution, and implementation approaches. © 2012 Blackwell Publishing Ltd.

Hunting behaviour and breeding performance of northern goshawks Accipiter gentilis, in relation to resource availability, sex, age and morphology

NASA Astrophysics Data System (ADS)

Penteriani, Vincenzo; Rutz, Christian; Kenward, Robert

2013-10-01

Animal territories that differ in the availability of food resources will require (all other things being equal) different levels of effort for successful reproduction. As a consequence, breeding performance may become most strongly dependent on factors that affect individual foraging where resources are poor. We investigated potential links between foraging behaviour, reproductive performance and morphology in a goshawk Accipiter gentilis population, which experienced markedly different resource levels in two different parts of the study area (rabbit-rich vs. rabbit-poor areas). Our analyses revealed (1) that rabbit abundance positively affected male reproductive output; (2) that age, size and rabbit abundance (during winter) positively affected different components of female reproductive output; (3) that foraging movements were inversely affected by rabbit abundance for both sexes (for females, this may mainly have reflected poor provisioning by males in the rabbit-poor area); (4) that younger breeders (both in males and females) tended to move over larger distances than older individuals (which may have reflected both a lack of hunting experience and mate searching); and (5) that male body size (wing length) showed some covariation with resource conditions (suggesting possible adaptations to hunting agile avian prey in the rabbit-poor area). Although we are unable to establish firm causal relationships with our observational data set, our results provide an example of how territory quality (here, food abundance) and individual features (here, age and morphology) may combine to shape a predator's foraging behaviour and, ultimately, its breeding performance.

Profiles of Kindergarten Classroom and Elementary School Contexts: Associations with the First-Grade Outcomes of Children Transitioning from Head Start

PubMed Central

Lee, Phyllis; Bierman, Karen L.

2018-01-01

Poor quality classroom and school contexts may impede the academic and behavioral adjustment of low-income students when they transition into kindergarten. Several studies have examined the impact of teacher-student interactions on student progress, whereas others have explored the impact of school-level adversity (e.g., student poverty, school achievement levels). Expanding on prior findings, this study used latent profile analysis to characterize kindergarten contexts in terms of both classroom teacher-student interaction quality and school-level adversity. Following 164 children longitudinally and accounting for functioning in Head Start prior to kindergarten entry, associations between kindergarten context profiles and first grade outcomes revealed that children who experienced dual-risk contexts in kindergarten (classrooms with poor quality teacher-student interactions in schools with high levels of adversity) demonstrated the greatest aggression and social difficulties in first grade. Associations between kindergarten context profiles and first grade academic outcomes were less clear. PMID:29731516

Laboratory challenges in the scaling up of HIV, TB, and malaria programs: The interaction of health and laboratory systems, clinical research, and service delivery.

PubMed

Birx, Deborah; de Souza, Mark; Nkengasong, John N

2009-06-01

Strengthening national health laboratory systems in resource-poor countries is critical to meeting the United Nations Millennium Development Goals. Despite strong commitment from the international community to fight major infectious diseases, weak laboratory infrastructure remains a huge rate-limiting step. Some major challenges facing laboratory systems in resource-poor settings include dilapidated infrastructure; lack of human capacity, laboratory policies, and strategic plans; and limited synergies between clinical and research laboratories. Together, these factors compromise the quality of test results and impact patient management. With increased funding, the target of laboratory strengthening efforts in resource-poor countries should be the integrating of laboratory services across major diseases to leverage resources with respect to physical infrastructure; types of assays; supply chain management of reagents and equipment; and maintenance of equipment.

Reports of self-rated health by citizenship and homeownership, United States 2000-2010.

PubMed

Miranda, Patricia Y; Reyes, Adriana; Hudson, Darrell; Yao, Nengliang; Bleser, William K; Amy Snipes, S; BeLue, Rhonda

2017-07-01

Citizenship facilitates home ownership, which promotes access to additional resources and structures social context, factors that improve the health of individuals and communities. The objective of this study was to examine whether citizenship moderated the association between homeownership and self-rated health. We used multivariate logistic regression models and propensity score matching techniques to examine this association using pooled years 2000-2010 of the Medical Expenditure Panel Survey data linked with the National Health Interview Survey to examine U.S. adults aged 18 and older (N=170,429). Rates of fair/poor health among homeowners vs. non-homeowners were comparable for foreign-born non-citizens. However, native- and foreign-born citizen non-homeowners showed significantly higher rates of reporting fair/poor health, with native-born citizens having the highest rates of poor health. While homeownership is protective for self-rated health, not meeting the "American Dream" of home ownership may be embodied more in the health of native-born citizens as "failure" and translate into poorer self-rated health. However, the economic privileges of homeownership and its association with better self-rated health are limited to citizens. Non-citizens may be disadvantaged despite socioeconomic position, particularly wealth as considered by homeownership, placing citizenship at the forefront as the most proximate and important burden besides socioeconomic status that needs further investigation as a fundamental health determinant. Copyright © 2017 Elsevier Inc. All rights reserved.

A cognitive framework for analyzing and describing introductory students' use and understanding of mathematics in physics

NASA Astrophysics Data System (ADS)

Tuminaro, Jonathan

Many introductory, algebra-based physics students perform poorly on mathematical problem solving tasks in physics. There are at least two possible, distinct reasons for this poor performance: (1) students simply lack the mathematical skills needed to solve problems in physics, or (2) students do not know how to apply the mathematical skills they have to particular problem situations in physics. While many students do lack the requisite mathematical skills, a major finding from this work is that the majority of students possess the requisite mathematical skills, yet fail to use or interpret them in the context of physics. In this thesis I propose a theoretical framework to analyze and describe students' mathematical thinking in physics. In particular, I attempt to answer two questions. What are the cognitive tools involved in formal mathematical thinking in physics? And, why do students make the kinds of mistakes they do when using mathematics in physics? According to the proposed theoretical framework there are three major theoretical constructs: mathematical resources, which are the knowledge elements that are activated in mathematical thinking and problem solving; epistemic games, which are patterns of activities that use particular kinds of knowledge to create new knowledge or solve a problem; and frames, which are structures of expectations that determine how individuals interpret situations or events. The empirical basis for this study comes from videotaped sessions of college students solving homework problems. The students are enrolled in an algebra-based introductory physics course. The videotapes were transcribed and analyzed using the aforementioned theoretical framework. Two important results from this work are: (1) the construction of a theoretical framework that offers researchers a vocabulary (ontological classification of cognitive structures) and grammar (relationship between the cognitive structures) for understanding the nature and origin of mathematical use in the context physics, and (2) a detailed understanding, in terms of the proposed theoretical framework, of the errors that students make when using mathematics in the context of physics.

Hippocampal Contribution to Context Encoding across Development Is Disrupted following Early-Life Adversity.

PubMed

Lambert, Hilary K; Sheridan, Margaret A; Sambrook, Kelly A; Rosen, Maya L; Askren, Mary K; McLaughlin, Katie A

2017-02-15

Context can drastically influence responses to environmental stimuli. For example, a gunshot should provoke a different response at a public park than a shooting range. Little is known about how contextual processing and neural correlates change across human development or about individual differences related to early environmental experiences. Children ( N = 60; 8-19 years, 24 exposed to interpersonal violence) completed a context encoding task during fMRI scanning using a delayed match-to-sample design with neutral, happy, and angry facial cues embedded in realistic background scenes. Outside the scanner, participants completed a memory test for context-face pairings. Context memory and neural correlates of context encoding did not vary with age. Larger hippocampal volume was associated with better context memory. Posterior hippocampus was recruited during context encoding, and greater activation in this region predicted better memory for contexts paired with angry faces. Children exposed to violence had poor memory of contexts paired with angry faces, reduced hippocampal volume, and atypical neural recruitment on encoding trials with angry faces, including reduced hippocampal activation and greater functional connectivity between hippocampus and ventrolateral prefrontal cortex (vlPFC). Greater hippocampus-vlPFC connectivity was associated with worse memory for contexts paired with angry faces. Posterior hippocampus appears to support context encoding, a process that does not exhibit age-related variation from middle childhood to late adolescence. Exposure to dangerous environments in childhood is associated with poor context encoding in the presence of threat, likely due to greater vlPFC-dependent attentional narrowing on threat cues at the expense of hippocampus-dependent processing of the broader context. SIGNIFICANCE STATEMENT The ability to use context to guide reactions to environmental stimuli promotes flexible behavior. Remarkably little research has examined how contextual processing changes across development or about influences of the early environment. We provide evidence for posterior hippocampus involvement in context encoding in youth and lack of age-related variation from middle childhood to late adolescence. Children exposed to interpersonal violence exhibited poor memory of contexts paired with angry faces and atypical neural recruitment during context encoding in the presence of threatening facial cues. Heightened attention to threat following violence exposure may come at the expense of encoding contextual information, which may ultimately contribute to pathological fear expressed in safe contexts. Copyright © 2017 the authors 0270-6474/17/371925-10$15.00/0.

The relation between children's reading comprehension level and their comprehension of idioms.

PubMed

Cain, Kate; Oakhill, Jane; Lemmon, Kate

2005-01-01

We report an investigation of 9-year-olds' ability to interpret idioms in relation to their reading comprehension level. We manipulated whether the idioms were transparent or opaque, whether they were real or novel, whether they were presented in isolation or in a supportive narrative context. As predicted, children were better able to explain the meanings of idioms in context than in isolation. The good and poor comprehenders did not differ in their abilities to interpret transparent idioms in context, but the poor comprehenders were significantly worse at using context to work out the meanings of opaque idioms. The explanation task revealed the source of information used by the children to derive nontarget interpretations. We discuss these findings in relation to idiom processing strategies and Levorato and Cacciari's global elaboration model.

Editorial comment on Malkin and Keane (2010).

PubMed

Voigt, Herbert F; Krishnan, Shankar M

2010-07-01

Malkin and Keane (Med Biol Eng Comput, 2010) take an innovative approach to determine if unused, broken medical and laboratory equipment could be repaired by volunteers with limited resources. Their positive results led them to suggest that resource-poor countries might benefit from an on-the-job educational program for local high school graduates. The program would train biomedical technician assistants (BTAs) who would repair medical devices and instrumentation and return them to service. This is a program worth pursuing in resource-poor countries.

Development and deforestation: Indian forestry in perspective.

PubMed

Haeuber, R

1993-07-01

Discussion focused primarily on the industrial demand for forest resources, which were affected by India's policies and contributed to deforestation. Forest policy failed due to inadequate understanding and knowledge of the social, political, and economic complexities of consuming forest resources. Policy can be beneficial when it fulfills national goals and satisfies the needs of competing interests. Future efforts must take into account that economic development will be constrained by ecological systems and must serve to improve the quality of life, rather than improve the quantity of goods and services produced. Development must also be concerned with stabilizing population growth. Approaches must not focus exclusively on population pressure or commercialization. The task of reformulating concepts of development is one that India and all countries face. According to the National Remote Sensing Agency, forests covered 14.1% of India's territory in 1980-82; this forest area has decreased by 22.4% in 10 years. Over 40 years, the development strategy and political context has been to increase agricultural productivity through land clearing rather than land reform, and industrial demand was given priority. This postindependence strategy followed in the footsteps of British colonial policy, and the dominant theoretical and practical knowledge of development at the time. The assumptions were based on an infinite supply of natural resources and perfect substitutability of resources. Progress in economic development was based on measures such as the gross national product or the national income accounts. The consequence was a neglect of the needs of poor rural populations, and increasing pressure on forest resources. India's development strategy is traced from 1947 when it had vast undeveloped resources and a large work force capability through the various 5-year plans directed to expanding agricultural production and to achieving rapid industrialization.

Patient, practice and organisational influences on asthma control: observational data from a national study on primary care in the United Kingdom.

PubMed

Hoskins, Gaylor; Williams, Brian; Jackson, Cathy; Norman, Paul; Donnan, Peter

2012-05-01

Achieving asthma control is central to optimising patient quality of life and clinical outcome. Contemporary models of chronic disease management across a variety of countries point to the importance of micro, meso and macro level influences on patient care and outcome. However, asthma outcomes research has almost invariably concentrated on identifying and addressing patient predictors. Little is known about higher level organisational influences. This paper explores the contribution of organisational factors on poor asthma control, allowing for patient factors, at three organisational levels: the individual patient, local service deliverers, and strategic regional providers. Prospective cross-sectional observational cohort study of 64,929 people with asthma from 1205 primary care practices spread throughout the United Kingdom (UK). Patient clinical data were recorded during a routine asthma review. Data were analysed using simple descriptive, multiple regression and complex multi-level modelling techniques, accounting for practice clustering of patients. Poor asthma control was associated with areas of higher deprivation [regression coefficient 0.026 (95% confidence intervals 0.006; 0.046)] and urban practice [-0.155 (-0.275; -0.035)] but not all local and regional variation was explained by the data. In contrast, patient level predictors of poor control were: short acting bronchodilator overuse [2.129 (2.091; 2.164)], days-off due to asthma [1.203 (1.148; 1.258)], PEFR<80 [0.76 (0.666; 0.854)], non-use of a self-management plan (SMP) [0.554 (0.515; 0.593)], poor inhaler technique [0.53 (0.475; 0.585)], poor medication compliance [0.385 (-0.007; 0.777)], and gender [0.314 (0.281; 0.347)]. Pattern of medication use, smoking history, age, body mass index (BMI), and health service resource use were also significant factors for predicting control. Targeting of health service resource requires knowledge of the factors associated with poor control of asthma symptoms. In the UK the contribution of local and regional structures appears minimal in explaining variation in asthma outcomes. However, unexplained variation in the data suggests other unrecorded factors may play a part. While patient personal characteristics (including self-management plan use, inhaler technique, medication compliance) appear to be the predominant influence the complex nature of the disease means that some, perhaps more subtle, influences are affecting the variability at all levels and this variance needs to be explored. Further research in other international contexts is required to identify the likely applicability of these findings to other health care systems. Copyright © 2011 Elsevier Ltd. All rights reserved.

Five Resources on Teaching Methods

ERIC Educational Resources Information Center

Simmons, Linda Wright

2009-01-01

This article offers five resources on teaching approaches that enhance learner participation and can be adapted inmost congregational learning contexts. These models emerge from diverse religious and secular perspectives; some are tailored for adult learners and some are ideal for learning in multicultural contexts. In alphabetical order, they are…

Do adjunct tuberculosis tests, when combined with Xpert MTB/RIF, improve accuracy and the cost of diagnosis in a resource-poor setting?

PubMed Central

Theron, Grant; Pooran, Anil; Peter, Jonny; van Zyl-Smit, Richard; Mishra, Hridesh Kumar; Meldau, Richard; Calligaro, Greg; Allwood, Brian; Sharma, Surendra Kumar; Dawson, Rod; Dheda, Keertan

2017-01-01

Information regarding the utility of adjunct diagnostic tests in combination with Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) is limited. We hypothesised adjunct tests could enhance accuracy and/or reduce the cost of tuberculosis (TB) diagnosis prior to MTB/RIF testing, and rule-in or rule-out TB in MTB/RIF-negative individuals. We assessed the accuracy and/or laboratory-associated cost of diagnosis of smear microscopy, chest radiography (CXR) and interferon-γ release assays (IGRAs; T-SPOT-TB (Oxford Immunotec, Oxford, UK) and QuantiFERON-TB Gold In-Tube (Cellestis, Chadstone, Australia)) combined with MTB/RIF for TB in 480 patients in South Africa. When conducted prior to MTB/RIF: 1) smear microscopy followed by MTB/RIF (if smear negative) had the lowest cost of diagnosis of any strategy investigated; 2) a combination of smear microscopy, CXR (if smear negative) and MTB/RIF (if imaging compatible with active TB) did not further reduce the cost per TB case diagnosed; and 3) a normal CXR ruled out TB in 18% of patients (57 out of 324; negative predictive value (NPV) 100%). When downstream adjunct tests were applied to MTB/RIF-negative individuals, radiology ruled out TB in 24% (56 out of 234; NPV 100%), smear microscopy ruled in TB in 21% (seven out of 24) of culture-positive individuals and IGRAs were not useful in either context. In resource-poor settings, smear microscopy combined with MTB/RIF had the highest accuracy and lowest cost of diagnosis compared to either technique alone. In MTB/RIF-negative individuals, CXR has poor rule-in value but can reliably rule out TB in approximately one in four cases. These data inform upon the programmatic utility of MTB/RIF in high-burden settings. PMID:22075479

A Range-Normalization Model of Context-Dependent Choice: A New Model and Evidence

PubMed Central

Camerer, Colin

2012-01-01

Most utility theories of choice assume that the introduction of an irrelevant option (called the decoy) to a choice set does not change the preference between existing options. On the contrary, a wealth of behavioral data demonstrates the dependence of preference on the decoy and on the context in which the options are presented. Nevertheless, neural mechanisms underlying context-dependent preference are poorly understood. In order to shed light on these mechanisms, we design and perform a novel experiment to measure within-subject decoy effects. We find within-subject decoy effects similar to what have been shown previously with between-subject designs. More importantly, we find that not only are the decoy effects correlated, pointing to similar underlying mechanisms, but also these effects increase with the distance of the decoy from the original options. To explain these observations, we construct a plausible neuronal model that can account for decoy effects based on the trial-by-trial adjustment of neural representations to the set of available options. This adjustment mechanism, which we call range normalization, occurs when the nervous system is required to represent different stimuli distinguishably, while being limited to using bounded neural activity. The proposed model captures our experimental observations and makes new predictions about the influence of the choice set size on the decoy effects, which are in contrast to previous models of context-dependent choice preference. Critically, unlike previous psychological models, the computational resource required by our range-normalization model does not increase exponentially as the set size increases. Our results show that context-dependent choice behavior, which is commonly perceived as an irrational response to the presence of irrelevant options, could be a natural consequence of the biophysical limits of neural representation in the brain. PMID:22829761

The role of gender in housing for individuals with severe mental illness: a qualitative study of the Canadian service context

PubMed Central

Kidd, Sean A; Virdee, Gursharan; Krupa, Terry; Burnham, Darrell; Hemingway, Dawn; Margolin, Indrani; Patterson, Michelle; Zabkiewicz, Denise

2013-01-01

Objective This study was undertaken to examine the role of gender as it relates to access to housing among individuals with severe mental illness (SMI) in Canada. Design An exploratory, qualitative approach was used to assess the perspectives of Canadian housing experts. The focus of inquiry was on the role of gender and associated intersections (eg, ethnicity) in pathways to housing access and housing needs for individuals with SMI. Setting A purposeful sampling strategy was undertaken to access respondents across all Canadian geographic regions, with diversity across settings (urban and rural) and service sectors (hospital based and community based). Participants –29 individuals (6 men and 23 women) considered to be experts in a housing service context as it pertains to SMI were recruited. On average, participants had worked for 15 years in services that specialised in the support and delivery of housing services to people with SMI. Measures Semistructured interviews with participants focused on the role gender plays in access to housing in their specific context. Barriers and facilitators were examined as were intersections with other relevant factors, such as ethnicity, poverty and parenthood. Quantitative ratings of housing accessibility as a function of gender were also collected. Results Participants across geographic contexts described a lack of shelter facilities for women, leading to a reliance on exploitative circumstances. Other findings included a compounding of discrimination for ethnic minority women, the unique resource problems faced in rural contexts, and the difficulties that attend access to shelter and housing for parents with SMI. Conclusions These findings suggest that, along with a generally poor availability of housing stock for individuals with SMI, access problems are compounded by a lack of attention to the unique needs and illness trajectories that attend gender. PMID:23794544

Hunter-gatherer residential mobility and the marginal value of rainforest patches.

PubMed

Venkataraman, Vivek V; Kraft, Thomas S; Dominy, Nathaniel J; Endicott, Kirk M

2017-03-21

The residential mobility patterns of modern hunter-gatherers broadly reflect local resource availability, but the proximate ecological and social forces that determine the timing of camp movements are poorly known. We tested the hypothesis that the timing of such moves maximizes foraging efficiency as hunter-gatherers move across the landscape. The marginal value theorem predicts when a group should depart a camp and its associated foraging area and move to another based on declining marginal return rates. This influential model has yet to be directly applied in a population of hunter-gatherers, primarily because the shape of gain curves (cumulative resource acquisition through time) and travel times between patches have been difficult to estimate in ethnographic settings. We tested the predictions of the marginal value theorem in the context of hunter-gatherer residential mobility using historical foraging data from nomadic, socially egalitarian Batek hunter-gatherers ( n  = 93 d across 11 residential camps) living in the tropical rainforests of Peninsular Malaysia. We characterized the gain functions for all resources acquired by the Batek at daily timescales and examined how patterns of individual foraging related to the emergent property of residential movements. Patterns of camp residence times conformed well with the predictions of the marginal value theorem, indicating that communal perceptions of resource depletion are closely linked to collective movement decisions. Despite (and perhaps because of) a protracted process of deliberation and argument about when to depart camps, Batek residential mobility seems to maximize group-level foraging efficiency.

Hunter-gatherer residential mobility and the marginal value of rainforest patches

PubMed Central

Venkataraman, Vivek V.; Kraft, Thomas S.; Endicott, Kirk M.

2017-01-01

The residential mobility patterns of modern hunter-gatherers broadly reflect local resource availability, but the proximate ecological and social forces that determine the timing of camp movements are poorly known. We tested the hypothesis that the timing of such moves maximizes foraging efficiency as hunter-gatherers move across the landscape. The marginal value theorem predicts when a group should depart a camp and its associated foraging area and move to another based on declining marginal return rates. This influential model has yet to be directly applied in a population of hunter-gatherers, primarily because the shape of gain curves (cumulative resource acquisition through time) and travel times between patches have been difficult to estimate in ethnographic settings. We tested the predictions of the marginal value theorem in the context of hunter-gatherer residential mobility using historical foraging data from nomadic, socially egalitarian Batek hunter-gatherers (n = 93 d across 11 residential camps) living in the tropical rainforests of Peninsular Malaysia. We characterized the gain functions for all resources acquired by the Batek at daily timescales and examined how patterns of individual foraging related to the emergent property of residential movements. Patterns of camp residence times conformed well with the predictions of the marginal value theorem, indicating that communal perceptions of resource depletion are closely linked to collective movement decisions. Despite (and perhaps because of) a protracted process of deliberation and argument about when to depart camps, Batek residential mobility seems to maximize group-level foraging efficiency. PMID:28265058

Resilience offers escape from trapped thinking on poverty alleviation

PubMed Central

Lade, Steven J.; Haider, L. Jamila; Engström, Gustav; Schlüter, Maja

2017-01-01

The poverty trap concept strongly influences current research and policy on poverty alleviation. Financial or technological inputs intended to “push” the rural poor out of a poverty trap have had many successes but have also failed unexpectedly with serious ecological and social consequences that can reinforce poverty. Resilience thinking can help to (i) understand how these failures emerge from the complex relationships between humans and the ecosystems on which they depend and (ii) navigate diverse poverty alleviation strategies, such as transformative change, that may instead be required. First, we review commonly observed or assumed social-ecological relationships in rural development contexts, focusing on economic, biophysical, and cultural aspects of poverty. Second, we develop a classification of poverty alleviation strategies using insights from resilience research on social-ecological change. Last, we use these advances to develop stylized, multidimensional poverty trap models. The models show that (i) interventions that ignore nature and culture can reinforce poverty (particularly in agrobiodiverse landscapes), (ii) transformative change can instead open new pathways for poverty alleviation, and (iii) asset inputs may be effective in other contexts (for example, where resource degradation and poverty are tightly interlinked). Our model-based approach and insights offer a systematic way to review the consequences of the causal mechanisms that characterize poverty traps in different agricultural contexts and identify appropriate strategies for rural development challenges. PMID:28508077

Resilience offers escape from trapped thinking on poverty alleviation.

PubMed

Lade, Steven J; Haider, L Jamila; Engström, Gustav; Schlüter, Maja

2017-05-01

The poverty trap concept strongly influences current research and policy on poverty alleviation. Financial or technological inputs intended to "push" the rural poor out of a poverty trap have had many successes but have also failed unexpectedly with serious ecological and social consequences that can reinforce poverty. Resilience thinking can help to (i) understand how these failures emerge from the complex relationships between humans and the ecosystems on which they depend and (ii) navigate diverse poverty alleviation strategies, such as transformative change, that may instead be required. First, we review commonly observed or assumed social-ecological relationships in rural development contexts, focusing on economic, biophysical, and cultural aspects of poverty. Second, we develop a classification of poverty alleviation strategies using insights from resilience research on social-ecological change. Last, we use these advances to develop stylized, multidimensional poverty trap models. The models show that (i) interventions that ignore nature and culture can reinforce poverty (particularly in agrobiodiverse landscapes), (ii) transformative change can instead open new pathways for poverty alleviation, and (iii) asset inputs may be effective in other contexts (for example, where resource degradation and poverty are tightly interlinked). Our model-based approach and insights offer a systematic way to review the consequences of the causal mechanisms that characterize poverty traps in different agricultural contexts and identify appropriate strategies for rural development challenges.

Exploring precarious employment and women's health within the context of U.S. microenterprise using focus groups.

PubMed

Salt, Rebekah; Lee, Jongwon

2014-01-01

Nursing has been a leader in exploring social determinants of health within the context of U.S. microenterprise and women's health. The purpose of this study was to explore precarious employment within the context of microenterprise and women's health using focus groups with clientele from New Mexico (NM). The specific aims were to identify (1) the health concerns of low-income women who utilized resources from Women's Economic Self-Sufficiency Team (WESST), and (2) the meaning of precarious employment in low-income women's lives. Fourteen women, ranging in age from 21-65 years, who were affiliated with regional WESST sites around NM participated in focus groups and completed a demographic questionnaire. Focus group data were analyzed using content analysis. The degree of interrater agreement was determined by calculating the Cohen's kappa, percentage agreement, and prevalence-adjusted and bias-adjusted kappa (PABAK). Two broad themes emerged from these data: (1) Working for Yourself and (2) Strategies. Although the women identified concerns about participation in microenterprise, flexibility, freedom, and feeling purposeful were motivators to pursue a small business. The kappa statistics on the five transcripts revealed poor inter-rater agreement, yet PABAK, which is a more sophisticated inter-rater reliability index, indicated that inter-rater agreement between the two raters was satisfactory. Despite the challenges associated with microenterprise in the US, women found value in working for themselves. © 2014 Wiley Periodicals, Inc.

Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015.

PubMed

Florian, Jana; Roy, Nicole M St Omer; Quintiliani, Lisa M; Truong, Ve; Feng, Yi; Bloch, Philippe P; Russinova, Zlatka L; Lasser, Karen E

2016-08-11

Diabetes self-management takes place within a complex social and environmental context.  This study's objective was to examine the perceived and actual presence of community assets that may aid in diabetes control. We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts.  Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes "hot spots").  We coded the discussions and identified relevant themes.  We further explored themes related to the built environment through community asset mapping.  Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores. Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church.  Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities.  Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables.  Only 1 of the exercise facilities had signage regarding hours or services.  Memberships ranged from free to $9.95 per month.  Overall, these findings were inconsistent with participants' reports in the photovoice group. We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes.

Poverty and violence, frustration and inventiveness: hospital ward life in Bangladesh.

PubMed

Zaman, Shahaduz

2004-11-01

An ethnographic exploration was done in an orthopaedic ward of a government teaching hospital in Bangladesh to understand the nature of hospital culture in the context of Bangladeshi society at large. Life and work in the ward result in a culture that is simultaneously created by its inhabitants and the conditions in which they are situated. The study shows that biomedicine is a product of particular social conditions and that the hospital reflects features of its society. Behind the injuries and broken limbs in the ward are stories of violence, crime, and intolerance occurring in a society where masses of people fight over limited resources. In the ward people interact in an extremely hierarchical manner. The patients, who are mainly from poor economic backgrounds, remain at the bottom of the hierarchy. Doctors and other staff members are often professionally frustrated. Strikes related to hospital staff's various professional demands hamper the regular flow of work in the ward. Family members are engaged in nursing and provide various kinds of support to their hospitalized relatives. Patients give small bribes to ward boys and cleaners to obtain their day-to-day necessities. Patients joke with each other and mock senior doctors. Thus, they neutralize their powerlessness and drive away the monotony of their stay. Doctors develop 'indigenous' solutions to orthopaedic problems. Instead of using high-tech devices, they employ instruments made of bamboo, bricks, and razor blades. This study shows how medical practice takes shape in an understaffed, under-resourced and poorly financed hospital operating in a low-income country.

African Swine Fever in Uganda: Qualitative Evaluation of Three Surveillance Methods with Implications for Other Resource-Poor Settings.

PubMed

Chenais, Erika; Sternberg-Lewerin, Susanna; Boqvist, Sofia; Emanuelson, Ulf; Aliro, Tonny; Tejler, Emma; Cocca, Giampaolo; Masembe, Charles; Ståhl, Karl

2015-01-01

Animal diseases impact negatively on households and on national economies. In low-income countries, this pertains especially to socio-economic effects on household level. To control animal diseases and mitigate their impact, it is necessary to understand the epidemiology of the disease in its local context. Such understanding, gained through disease surveillance, is often lacking in resource-poor settings. Alternative surveillance methods have been developed to overcome some of the hurdles obstructing surveillance. The objective of this study was to evaluate and qualitatively compare three methods for surveillance of acute infectious diseases using African swine fever in northern Uganda as an example. Report-driven outbreak investigations, participatory rural appraisals (PRAs), and a household survey using a smartphone application were evaluated. All three methods had good disease-detecting capacity, and each of them detected many more outbreaks compared to those reported to the World Organization for Animal Health during the same time period. Apparent mortality rates were similar for the three methods although highest for the report-driven outbreak investigations, followed by the PRAs, and then the household survey. The three methods have different characteristics and the method of choice will depend on the surveillance objective. The optimal situation might be achieved by a combination of the methods: outbreak detection via smartphone-based real-time surveillance, outbreak investigation for collection of biological samples, and a PRA for a better understanding of the epidemiology of the specific outbreak. All three methods require initial investments and continuous efforts. The sustainability of the surveillance system should, therefore, be carefully evaluated before making such investments.

Poor health and loneliness in later life: the role of depressive symptoms, social resources, and rural environments.

PubMed

Burholt, Vanessa; Scharf, Thomas

2014-03-01

We draw on cognitive discrepancy theory to hypothesize and test a pathway from poor health to loneliness in later life. We hypothesize that poor health will have a negative influence on social participation and social resources, and these factors will mediate between health and loneliness. We hypothesize that rural environments will amplify any difficulties associated with social participation or accessing social resources and that depression will moderate how intensely people react to levels of social contact and support. We conceptualize a mediation model and a moderated-mediation model. Nationally representative data on older people living in the Republic of Ireland are used to validate the hypothesized pathways. In the mediation model, health has a significant indirect effect on loneliness through the mediating variables social resources and social participation. In the moderated-mediation model, rurality moderates the pathway between health and social resources but not social participation. Depressive symptoms moderate the effect of social resources on loneliness but not social participation. The results provide further credence to cognitive discrepancy theory, suggesting that depressive symptoms influence cognitive processes, interfering with judgments about the adequacy of social interaction. The theory is extended by demonstrating the impact of the environment on loneliness.

Psychological interventions for post-traumatic stress disorder in people living with HIV in Resource poor settings: a systematic review.

PubMed

Verhey, Ruth; Chibanda, Dixon; Brakarsh, Jonathan; Seedat, Soraya

2016-10-01

Post-traumatic stress disorder is pervasive in low- and middle-income countries. There is evidence to suggest that post-traumatic stress disorder is more common among people living with HIV than non-infected matched controls. We carried out a systematic review of interventions for adult post-traumatic stress disorder from resource poor settings with a focus on people living with HIV. We included all studies that investigated interventions for adult post-traumatic stress disorder from resource poor settings with a focus on interventions that were either randomised controlled trials or observational cohort studies carried out from 1980 to May 2015. Of the 25 articles that were identified for full review, two independent reviewers identified seven studies that met our study inclusion criteria. All randomised controlled trials (RCT) (n = 6) used cognitive behavioural therapy-based interventions and focused on people living with HIV in resource poor settings. There was only one study focusing on the use of lay counsellors to address post-traumatic stress disorder but core competencies were not described. There were no intervention studies from Africa, only an observational cohort study from Rwanda. Rigorously evaluated interventions for adult post-traumatic stress disorder in people living with HIV are rare. Most were undertaken in resource poor settings located in high-income countries. There is a need for research on the development and implementation of appropriate interventions for post-traumatic stress disorder in people living with HIV in low- and middle-income countries. © 2016 John Wiley & Sons Ltd.

Landscape Context and Regional Patterns in Arkansas' Forests

Treesearch

Victor A. Rudis

2001-01-01

Abstract - Recent results from Forest Inventory and Analysis (FIA) surveys provided an opportunity to explore the spatial and temporal context for Arkansas’ forests, including associated range, recreation, water, and wildlife habitat resources. Noted were damage agents and multipurpose resource indicators: evidence of human-associated activities (...

Fuelwood, agro-forestry, and natural resource management: the development significance of land tenure and other resource management/utilization systems

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

Brokensha, D.; Castro, A.P.; Kundu, M.

1984-04-01

Using a systems approach and focusing on the social context, the study examines natural resource management in relation to fuelwood production and agroforestry. An initial section describing the use and interlinkage of the concepts of ecozone and ecosystem is followed by a discussion of problem ecozones, human use of ecozones, agricultural ecosystems, resource competition, uses of trees and forest products, and tree planting. Rural resource management strategies at the household, community, local, and state levels are discussed in the context of political economy, land tenure and rights, tenancy and sharecropping, group or public landholding, and acquisition and transfer of land.

Specialized Knowledge Representation and the Parameterization of Context.

PubMed

Faber, Pamela; León-Araúz, Pilar

2016-01-01

Though instrumental in numerous disciplines, context has no universally accepted definition. In specialized knowledge resources it is timely and necessary to parameterize context with a view to more effectively facilitating knowledge representation, understanding, and acquisition, the main aims of terminological knowledge bases. This entails distinguishing different types of context as well as how they interact with each other. This is not a simple objective to achieve despite the fact that specialized discourse does not have as many contextual variables as those in general language (i.e., figurative meaning, irony, etc.). Even in specialized text, context is an extremely complex concept. In fact, contextual information can be specified in terms of scope or according to the type of information conveyed. It can be a textual excerpt or a whole document; a pragmatic convention or a whole culture; a concrete situation or a prototypical scenario. Although these versions of context are useful for the users of terminological resources, such resources rarely support context modeling. In this paper, we propose a taxonomy of context primarily based on scope (local and global) and further divided into syntactic, semantic, and pragmatic facets. These facets cover the specification of different types of terminological information, such as predicate-argument structure, collocations, semantic relations, term variants, grammatical and lexical cohesion, communicative situations, subject fields, and cultures.

Specialized Knowledge Representation and the Parameterization of Context

PubMed Central

Faber, Pamela

2016-01-01

Though instrumental in numerous disciplines, context has no universally accepted definition. In specialized knowledge resources it is timely and necessary to parameterize context with a view to more effectively facilitating knowledge representation, understanding, and acquisition, the main aims of terminological knowledge bases. This entails distinguishing different types of context as well as how they interact with each other. This is not a simple objective to achieve despite the fact that specialized discourse does not have as many contextual variables as those in general language (i.e., figurative meaning, irony, etc.). Even in specialized text, context is an extremely complex concept. In fact, contextual information can be specified in terms of scope or according to the type of information conveyed. It can be a textual excerpt or a whole document; a pragmatic convention or a whole culture; a concrete situation or a prototypical scenario. Although these versions of context are useful for the users of terminological resources, such resources rarely support context modeling. In this paper, we propose a taxonomy of context primarily based on scope (local and global) and further divided into syntactic, semantic, and pragmatic facets. These facets cover the specification of different types of terminological information, such as predicate-argument structure, collocations, semantic relations, term variants, grammatical and lexical cohesion, communicative situations, subject fields, and cultures. PMID:26941674

Qualitative study of perceived causes of tuberculosis treatment default among health care workers in Morocco.

PubMed

Kizub, D; Ghali, I; Sabouni, R; Bourkadi, J E; Bennani, K; El Aouad, R; Dooley, K E

2012-09-01

In Morocco, tuberculosis (TB) treatment default is increasing in some urban areas. To provide a detailed description of factors that contribute to patient default and solutions from the point of view of health care professionals who participate in TB care. In-depth interviews were conducted with 62 physicians and nurses at nine regional public pulmonary clinics and local health clinics. Participants had a median of 24 years of experience in health care. Treatment default was seen as a result of multilevel factors related to the patient (lack of means, being a migrant worker, distance to treatment site, poor understanding of treatment, drug use, mental illness), medical team (high patient load, low motivation, lack of resources for tracking defaulters), treatment organization (poor communication between treatment sites, no systematic strategy for patient education or tracking, incomplete record keeping), and health care system and society. Tailored recommendations for low- and higher-cost interventions are provided. Interventions to enhance TB treatment completion should take into account the local context and multilevel factors that contribute to default. Qualitative studies involving health care workers directly involved in TB care can be powerful tools to identify contributing factors and define strategies to help reduce treatment default.

Structural barriers to ART adherence in Southern Africa: challenges and potential ways forward

PubMed Central

KAGEE, A.; REMIEN, R.H.; BERKMAN, A.; HOFFMAN, S.; CAMPOS, L.; SWARTZ, L.

2010-01-01

Structural barriers to antiretroviral treatment (ART) adherence are economic, institutional, political and cultural factors, that collectively influence the extent to which persons living with HIV follow their medication regimens. We identify three sets of structural barriers to ART adherence that are salient in Southern Africa: poverty-related, institutional, and political and cultural. Examples of poverty-related barriers are competing demands in the context of resource-constrained settings, the lack of transport infrastructure, food insecurity, the role of disability grants and poor social support. Examples of institutional factors are logistical barriers, overburdened health care facilities, limited access to mental health services and difficulties in ensuring adequate counseling. Examples of political and cultural barriers are controversies in the provision of treatment for AIDS, migration, traditional beliefs about HIV and AIDS, poor health literacy and gender inequalities. In forging a way forward, we identify ways in which individuals, communities and health care systems may overcome some of these structural barriers. Finally, we make recommendations for further research on structural barriers to ART adherence. In all likelihood, enhancing adherence to ART requires the efforts of a variety of disciplines, including public health, psychology, anthropology, sociology and medicine. PMID:20509066

Microfluidic point-of-care diagnostics for resource-poor environments

NASA Astrophysics Data System (ADS)

Laksanasopin, Tassaneewan; Chin, Curtis D.; Moore, Hannah; Wang, Jennifer; Cheung, Yuk Kee; Sia, Samuel K.

2009-05-01

Point-of-care (POC) diagnostics have tremendous potential to improve human health in remote and resource-poor settings. However, the design criteria for diagnostic tests appropriate in settings with limited infrastructure are unique and challenging. Here we present a custom optical reader which quantifies silver absorbance from heterogeneous immunoassays. The reader is simple and low-cost and suited for POC diagnostics.

Improving the Instructional Leadership of Heads of Department in Under-Resourced Schools: A Collaborative Action-Learning Approach

ERIC Educational Resources Information Center

Seobi, Boitshepo Audrey; Wood, Lesley

2016-01-01

An unacceptable number of learners in under-resourced schools in South Africa are failing to perform adequately in national and international benchmark tests. Poor learner performance has been linked to poor-quality teaching, which, in turn, can be attributed in part to a lack of instructional leadership at schools. According to policy, heads of…

Paediatric Palliative Care in Resource-Poor Countries

PubMed Central

Boucher, Sue; Daniels, Alex; Nkosi, Busi

2018-01-01

There is a great need for paediatric palliative care (PPC) services globally, but access to services is lacking in many parts of the world, particularly in resource-poor settings. Globally it is estimated that 21.6 million children need access to palliative care, with 8.2 needing specialist services. PC has been identified as important within the global health agenda e.g., within universal health coverage, and a recent Lancet commission report recognised the need for PPC. However, a variety of challenges have been identified to PPC development globally such as: access to treatment, access to medications such as oral morphine, opiophobia, a lack of trained health and social care professionals, a lack of PPC policies and a lack of awareness about PPC. These challenges can be overcome utilising a variety of strategies including advocacy and public awareness, education, access to medications, implementation and research. Examples will be discussed impacting on the provision of PPC in resource-poor settings. High-quality PPC service provision can be provided with resource-poor settings, and there is an urgent need to scale up affordable, accessible, and quality PPC services globally to ensure that all children needing palliative care can access it. PMID:29463065

Parity and parents' health in later life: the gendered case of Ismailia, Egypt.

PubMed

Engelman, Michal; Agree, Emily M; Yount, Kathryn M; Bishai, David

2010-07-01

We investigate the relationship between reproduction and functional health in later life among women and men in the resource-poor and gender-stratified setting of Ismailia governorate, Egypt. Analyses of survey data collected in 2003 show a statistically significant positive association between parity and difficulty with activities of daily living (ADLs), controlling for demographic and socio-economic factors and other co-morbid conditions. We also find that the number of daughters (but not sons) is associated with worse physical functioning, and this association is more pronounced for older fathers than for older mothers. Our results indicate that both biological and social pathways link fertility and later-life health in this context, and that prescribed familial roles may underlie the differential impact of sons and daughters on the health of mothers and fathers in later life.

Impact of Teachers' Practices on Students' Reading Comprehension Growth in Guatemala.

PubMed

Rubio, Fernando; de Véliz, Leslie Rosales; Mosquera, María Cristina Perdomo; López, Ventura Salanic

2017-03-01

This article discusses an educational intervention, with a strong emphasis on reading development in a bilingual context, in the Western Highlands of Guatemala (WH), a highly disadvantaged region, where the majority of the population is of Mayan origin and primary education is poor. The majority of the students in the Western Highlands speak a Mayan language as their mother tongue, yet they are generally taught in Spanish. We assisted in the development and implementation of a bilingual/intercultural education model including teacher training at the university level and bilingual materials development. Implementation included education for administrators and teacher coaching. For this intervention, aimed at improving reading outcomes, we report data for the first 3 years of implementation, and offer insights for system-wide interventions in low-resource areas. © 2017 Wiley Periodicals, Inc.

Understanding the school outcomes of juvenile offenders: an exploration of neighborhood influences and motivational resources.

PubMed

Chung, He Len; Mulvey, Edward P; Steinberg, Laurence

2011-08-01

As a group, delinquent youth complete less education and show poor academic outcomes compared to their non-delinquent peers. To better understand pathways to school success, this study integrated individual- and neighborhood-level data to examine academic functioning among 833 White, Black, and Hispanic male juvenile offenders (age 14-17) living in two urban communities. A multilevel path analysis confirmed that youth in relatively more affluent communities report greater access to opportunities in the areas of education and employment, and that these opportunities are associated with higher expectations to succeed and better grades. Findings highlight the importance of taking an ecological approach for understanding processes that shape school effort and achievement. Implications are discussed in the context of promoting academic success among juvenile offenders, specifically, and for understanding pathways to healthy adjustment, more generally.

Neurobehavioural methods, effects and prevention: workers' human rights are why the field matters for developing countries.

PubMed

London, L

2009-11-01

Little research into neurobehavioural methods and effects occurs in developing countries, where established neurotoxic chemicals continue to pose significant occupational and environmental burdens, and where agents newly identified as neurotoxic are also widespread. Much of the morbidity and mortality associated with neurotoxic agents remains hidden in developing countries as a result of poor case detection, lack of skilled personnel, facilities and equipment for diagnosis, inadequate information systems, limited resources for research and significant competing causes of ill-health, such as HIV/AIDS and malaria. Placing the problem in a human rights context enables researchers and scientists in developing countries to make a strong case for why the field of neurobehavioural methods and effects matters because there are numerous international human rights commitments that make occupational and environmental health and safety a human rights obligation.

Marketing the municipal model: the London County Council Nursing Service recruitment strategies 1930-45.

PubMed

Kirby, S

1998-01-01

Municipally administered, with its origins in the Poor Laws, the LCC Nursing Service could be said to have been a Cinderella Service in comparison with the prestigious London voluntary hospitals. This paper analyses the recruitment strategies of the London County Council Nursing Service within the context of the overall national situation during the 1930s and the Second World War. These can be categorised as cosmetic, reactive, innovative and pragmatic. An astute nursing leadership could use the resources of a large municipal authority to challenge the voluntary hospitals in the nursing labour market in the area of acute hospital care. The image of the acute hospitals could be favourably projected; however, local as well as national difficulty persisted in the recruitment of candidates to Cinderella services such as tuberculosis sanatoria.

Using a community-based definition of poverty for targeting poor households for premium subsidies in the context of a community health insurance in Burkina Faso.

PubMed

Savadogo, Germain; Souarès, Aurelia; Sié, Ali; Parmar, Divya; Bibeau, Gilles; Sauerborn, Rainer

2015-02-06

One of the biggest challenges in subsidizing premiums of poor households for community health insurance is the identification and selection of these households. Generally, poverty assessments in developing countries are based on monetary terms. The household is regarded as poor if its income or consumption is lower than a predefined poverty cut-off. These measures fail to recognize the multi-dimensional character of poverty, ignoring community members' perception and understanding of poverty, leaving them voiceless and powerless in the identification process. Realizing this, the steering committee of Nouna's health insurance devised a method to involve community members to better define 'perceived' poverty, using this as a key element for the poor selection. The community-identified poor were then used to effectively target premium subsidies for the insurance scheme. The study was conducted in the Nouna's Health District located in northwest Burkina Faso. Participants in each village were selected to take part in focus-group discussions (FGD) organized in 41 villages and 7 sectors of Nouna's town to discuss criteria and perceptions of poverty. The discussions were audio recorded, transcribed and analyzed in French using the software NVivo 9. From the FGD on poverty and the subjective definitions and perceptions of the community members, we found that poverty was mainly seen as scarcity of basic needs, vulnerability, deprivation of capacities, powerlessness, voicelessness, indecent living conditions, and absence of social capital and community networks for support in times of need. Criteria and poverty groups as described by community members can be used to identify poor who can then be targeted for subsidies. Policies targeting the poorest require the establishment of effective selection strategies. These policies are well-conditioned by proper identification of the poor people. Community perceptions and criteria of poverty are grounded in reality, to better appreciate the issue. It is crucial to take these perceptions into account in undertaking community development actions which target the poor. For most community-based health insurance schemes with limited financial resources, using a community-based definition of poverty in the targeting of the poorest might be a less costly alternative.

Type 1 Diabetes in a Resource-Poor Setting: Malnutrition Related, Malnutrition Modified, or Just Diabetes?

PubMed

Balcha, Shitaye Alemu; Phillips, David I W; Trimble, Elisabeth R

2018-06-14

Very little is known about the occurrence of type 1 diabetes (T1DM) in resource-poor countries and particularly in their rural hinterlands. Studies of the epidemiology of T1DM in Ethiopia and similar countries in sub-Saharan Africa show that the pattern of presenting disease differs substantially from that in the West. Typically, the peak age of onset of the disease is more than a decade later with a male excess and a low prevalence of indicators of islet-cell autoimmunity. It is also associated with markers of undernutrition. These findings raise the question as to whether the principal form of T1DM seen in these resource-poor communities has a different pathogenesis. Whether the disease is a direct result of malnutrition or whether malnutrition may modify the expression of islet-cell autoimmunity is unclear. However, the poor prognosis in these settings underlines the urgent need for detailed clinical and epidemiological studies.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods.

PubMed

Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J

2016-01-01

Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

PubMed Central

Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

2016-01-01

Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival. PMID:27225791

Human Resource Development and New Technology in the Automobile Industry: A Case Study of Ford Motor Company's Dearborn Engine Plant. The Development and Utilization of Human Resources in the Context of Technological Change and Industrial Restructuring.

ERIC Educational Resources Information Center

Chen, Kan; And Others

This report centers around a plant-level study of the development and utilization of human resources in the context of technological change and industrial restructuring in the crankshaft production area of Ford Motor Company's Dearborn Engine Plant (DEP). The introductory chapter describes how the study was conducted, provides an introduction to…

Cyber Foraging for Improving Survivability of Mobile Systems

DTIC Science & Technology

2016-02-10

environments—such as dynamic context, limited computing resources, disconnected- intermittent - limited (DIL) network connectivity, and high levels of stress...environments, such as dynamic context, limited computing resources, disconnected- intermittent -limited (DIL) network connectivity, and high levels of...Table 1: Mapping of Cloudlet Features to Survivability Requirements Threats Intermittent Cloudlet- Enterprise Connectivity Mobility Limited

Core Skills for Effective Science Communication: A Teaching Resource for Undergraduate Science Education

ERIC Educational Resources Information Center

Mercer-Mapstone, Lucy; Kuchel, Louise

2017-01-01

Science communication is a diverse and transdisciplinary field and is taught most effectively when the skills involved are tailored to specific educational contexts. Few academic resources exist to guide the teaching of communication with non-scientific audiences for an undergraduate science context. This mixed methods study aimed to explore what…

Theory of Mind Is Related to Children's Resource Allocations in Gender Stereotypic Contexts

ERIC Educational Resources Information Center

Rizzo, Michael T.; Killen, Melanie

2018-01-01

The present study investigated the relations between 4- to 6-year-old children's (N = 67) gender stereotypes, resource allocations, and mental state knowledge in gender-stereotypic contexts. Participants were told vignettes about female and male characters completing gender-stereotyped activities (making dolls or trucks). Children held stereotypic…

Standard & Poor's "Return on Resources" Measure of School Performance. Issue Brief. Volume 1, Issue 1

ERIC Educational Resources Information Center

Reeder, Brian

2004-01-01

Standard & Poors (S&P) uses a measure they call a Performance Cost Index (PCI) as their measure of a school or district?s ?Return on Resources?. The Performance Cost Index is defined as the average cost per measured ?unit? of student performance. In its simplest form, the Performance Cost Index is calculated as per student expenditures divided by…

Negation in context: Evidence from the visual world paradigm.

PubMed

Orenes, Isabel; Moxey, Linda; Scheepers, Christoph; Santamaría, Carlos

2016-01-01

Literature assumes that negation is more difficult to understand than affirmation, but this might depend on the pragmatic context. The goal of this paper is to show that pragmatic knowledge modulates the unfolding processing of negation due to the previous activation of the negated situation. To test this, we used the visual world paradigm. In this task, we presented affirmative (e.g., her dad was rich) and negative sentences (e.g., her dad was not poor) while viewing two images of the affirmed and denied entities. The critical sentence in each item was preceded by one of three types of contexts: an inconsistent context (e.g., She supposed that her dad had little savings) that activates the negated situation (a poor man), a consistent context (e.g., She supposed that her dad had enough savings) that activates the actual situation (a rich man), or a neutral context (e.g., her dad lived on the other side of town) that activates neither of the two models previously suggested. The results corroborated our hypothesis. Pragmatics is implicated in the unfolding processing of negation. We found an increase in fixations on the target compared to the baseline for negative sentences at 800 ms in the neutral context, 600 ms in the inconsistent context, and 1450 ms in the consistent context. Thus, when the negated situation has been previously introduced via an inconsistent context, negation is facilitated.

Assessing the Impact of Energy Access on Households in Kyrgyzstan: Government Rhetoric Versus Daily Realities

NASA Astrophysics Data System (ADS)

Meyer, Alyssa

While significant literature enumerates the impacts of electrification on development, the impact of energy insecurity on daily life and governance is comparatively poorly understood. In post-Soviet Kyrgyzstan, I will argue that this question is of critical importance for two reasons. First, if one were to only study state rhetoric on the subject, one might believe it to be self-evident that Kyrgyzstan is energy secure and even exporting excess hydroelectric production to its neighbors. In actuality, as I will illustrate by comparing household accounts of the impact of energy supply intermittencies on daily life to government rhetoric on energy, the sector's exports are only indicative of the government's lack of concern for domestic demand and desperate need for revenue. Yet, given that a similar mismatch in the resource allocation priorities of Kyrgyzstani citizens and those of their government created context for revolution in 2010, this finding has serious implications for the political stability of the country. Second, with the progression of global climate change, the population's struggle to access already restricted resource bases will only be further complicated by climate-induced vulnerabilities and resource degradation. Particularly in the short-term, while such a mismatch persists, consumer-driven, community-level interventions must play a key role in improving the energy access, capacity to adapt to climate change, and economic well-being of Kyrgyzstani citizens.

The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals.

PubMed

Fisher, Jane Rw; de Mello, Meena Cabral; Izutsu, Takashi; Tran, Tuan

2011-01-07

Mental health problems in women during pregnancy and after childbirth and their adverse consequences for child health and development have received sustained detailed attention in high-income countries. In contrast, evidence has only been generated more recently in resource-constrained settings.In June 2007 the United Nations Population Fund, the World Health Organization, the Key Centre for Women's Health in Society, a WHO Collaborating Centre for Women's Health and the Research and Training Centre for Community Development in Vietnam convened the first international expert meeting on maternal mental health and child health and development in resource-constrained settings. It aimed to appraise the evidence about the nature, prevalence and risks for common perinatal mental disorders in women; the consequences of these for child health and development and ameliorative strategies in these contexts.The substantial disparity in rates of perinatal mental disorders between women living in high- and low-income settings, suggests social rather than biological determinants. Risks in resource-constrained contexts include: poverty; crowded living situations; limited reproductive autonomy; unintended pregnancy; lack of empathy from the intimate partner; rigid gender stereotypes about responsibility for household work and infant care; family violence; poor physical health and discrimination. Development is adversely affected if infants lack day-to-day interactions with a caregiver who can interpret their cues, and respond effectively. Women with compromised mental health are less able to provide sensitive, responsive infant care. In resource-constrained settings infants whose mothers are depressed are less likely to thrive and to receive optimal care than those whose mothers are well.The meeting outcome is the Hanoi Expert Statement (Additional file 1). It argues that the Millennium Development Goals to improve maternal health, reduce child mortality, promote gender equality and empower women, achieve universal primary education and eradicate extreme poverty and hunger cannot be attained without a specific focus on women's mental health. It was co-signed by the international expert group; relevant WHO and UNFPA departmental representatives and international authorities. They concur that social rather than medical responses are required. Improvements in maternal mental health require a cross-sectoral response addressing poverty reduction, women's rights, social protection, violence prevention, education and gender in addition to health.

Diffusion of novel healthcare technologies to resource poor settings.

PubMed

Malkin, Robert; von Oldenburg Beer, Kim

2013-09-01

A new product has completed clinical trials in a distant, resource poor hospital using a few dozen prototypes. The data looks great. The novel medical device solves a widely felt problem. The next goal is to integrate the device into the country's healthcare system and spread the device to other countries. But how? In order to be widely used, the device must be manufactured and distributed. One option is to license the intellectual property (IP) to an interested third party, if one can be found. However, it is possible to manage the manufacturing and distribution without licensing. There are at least two common means for manufacturing a novel medical device targeted to resource poor settings: (a) formal (contract) manufacturing and (b) informal (local) manufacturing. There are three primary routes to diffusion of novel medical devices in the developing world: (1) local distributors (2) direct international sales and (3) international donations. Perhaps surprisingly, the least effective mechanism is direct importation through donation. The most successful mechanism, the method used by nearly all working medical devices in resource-poor settings, is the use of contract manufacturing and a local distributor. This article is written for the biomedical innovator and entrepreneur who wishes to make a novel healthcare technology or product available and accessible to healthcare providers and patients in the developing world. There are very few documented cases and little formal research in this area. To this end, this article describes and explores the manufacturing and distribution options in order to provide insights into when and how each can be applied to scale up a novel technology to make a difference in a resource poor setting.

Poor Health and Loneliness in Later Life: The Role of Depressive Symptoms, Social Resources, and Rural Environments

PubMed Central

2014-01-01

Objectives. We draw on cognitive discrepancy theory to hypothesize and test a pathway from poor health to loneliness in later life. We hypothesize that poor health will have a negative influence on social participation and social resources, and these factors will mediate between health and loneliness. We hypothesize that rural environments will amplify any difficulties associated with social participation or accessing social resources and that depression will moderate how intensely people react to levels of social contact and support. Methods. We conceptualize a mediation model and a moderated-mediation model. Nationally representative data on older people living in the Republic of Ireland are used to validate the hypothesized pathways. Results. In the mediation model, health has a significant indirect effect on loneliness through the mediating variables social resources and social participation. In the moderated-mediation model, rurality moderates the pathway between health and social resources but not social participation. Depressive symptoms moderate the effect of social resources on loneliness but not social participation. Discussion. The results provide further credence to cognitive discrepancy theory, suggesting that depressive symptoms influence cognitive processes, interfering with judgments about the adequacy of social interaction. The theory is extended by demonstrating the impact of the environment on loneliness. PMID:24326076

Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

PubMed

Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

2015-06-01

Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. Copyright © 2015. Published by Elsevier Ireland Ltd.

Community managed services for persons with intellectual disability: Andhra Pradesh experience.

PubMed

Narayan, Jayanthi; Pratapkumar, Raja; Reddy, Sudhakara P

2017-09-01

In resource poor settings innovative and bottom-up approaches are required to provide services to people with with disabilities. In this context, the present paper explains a community-based model of manpower development and coordination of services for people with intellectual disabilities in unified state of Andhra Pradesh in India. Women with disabilities from the village were identified, and those willing to be trained to work as community resource persons (CRPs) were selected and given hands-on training in a phased manner. A total of 130 women were trained in five groups of 25-30 per group and were deployed in the community to screen, identify and refer children with intellectual disabilities. The training content included basic stimulation and interface with functionaries of other government departments of health, education and welfare to ensure comprehensive service delivery. Neighbourhood centres (NHCs) were established where the CRPs could meet with families collectively. The results indicated that the CRPs were welcomed by the families. The NHCs established primarily as recreation centres, promoted inclusion and functioned as information dissemination centre. The services provided by the CRPs were owned and monitored by the Women's self-help group and the disability groups thus ensuring sustainability of the model.

Regional action plan handling of social welfare problem in nganjuk regency

NASA Astrophysics Data System (ADS)

Zain, IM; Utami, WS; Setyawan, KG

2018-01-01

Local action plans are expected to ensure a social protection for vulnerable and disadvantaged groups or PMKS. The method used in this research is by primary survey and secondary survey. The condition of the people who still belong to PMKS requires the state to come to the community to solve the problems faced. Stakeholders should be involved to handle PMKS. The activities presented should also receive periodic monitoring and evaluation so that there is progress reporting at any time. Implementable poverty reduction strategies and policies are social protection strategies, opportunity expansion strategies, resource capacity building strategies, community empowerment strategies and partnership strategies. The flow of PMKS is the validation and updating of data, the fulfillment of the basic needs of the PMKS family, the development of PMKS human resources, the improvement of the quality of life for poor families, the institutions of poverty alleviation stakeholders and the unemployed at the base level. The Regional Action Plan (RAP) is prepared as a reference in the context of carrying out PMKS mitigation which is expected to serve as a guide for managers and program implementers with relevant agencies that are conducted jointly and continuously for the period of time specified.

Management of an Obstructed Tracheostomy in a Limited-Resource Setting

PubMed Central

Chiaravalli, Julie; Lufesi, Norman; Shawa, Elwin; Nkhoma, Vitumbiko; Sigalet, Elaine

2017-01-01

Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi. The novel aspect of this report is that it depicts the integration of low-tech simulation with a deteriorating patient scenario educational methodology. This integration enables the use of affordable and sustainable simulation materials in Malawi context to deliver learning objectives that are otherwise not achievable. It was designed to train nurses, clinical officers, and nursing students from the ICU and male/female surgical wards. It can be utilized to train similar learners in other resource-poor regions of the world, as well as remote areas of the more developed countries. PMID:28616369

[Avoidable perinatal deaths and the environment outside the health care system: a case study in a city in Greater Metropolitan Rio de Janeiro].

PubMed

Rosa, Maria L G; Hortale, Virginia Alonso

2002-01-01

This paper focuses on the role of environmental factors external to the health care system in the occurrence of perinatal deaths in maternity hospitals belonging to the local health system in a city in Greater Metropolitan Rio de Janeiro in 1994. Elements from the political and administrative context that contribute to an understanding of the relationship between failures in health care and structural deficiencies in these maternity hospitals were divided into four groups of variables: distribution of resources, spatial and temporal factors, organizational and managerial features, and action by interest groups. Semi-structured interviews were conducted. The study concluded that poor performance in four groups of variables may have contributed to perinatal mortality: distribution of resources was insufficient to provide quality in health care, especially in private maternity hospitals; there was no formal or informal regional or hierarchical organization of obstetric care in the city; Ministry of Health guidelines were ignored in all four maternity hospitals, while in three of the hospitals there were no admissions procedures and delivery and fetal follow-up listed in their own rules; and the level of actual participation was low.

Successful healthcare programs and projects: organization portfolio management essentials.

PubMed

Pickens, Scott; Solak, Jamie

2005-01-01

Many healthcare organization projects take more time and resources than planned and fail to deliver desired business outcomes. Healthcare IT is a major component of many projects and often undeservedly receives the blame for failure. Poor results are often not a result of faulty healthcare IT or poor project management or poor project execution alone. Many projects fail because of poor portfolio management--poor planning and management of the portfolio of initiatives designed to meet an organization's strategic goals. Because resources are limited, portfolio management enables organizations to more strategically allocate and manage their resources so care delivery, service delivery, and initiatives that advance organizations toward their strategic goals, including healthcare IT initiatives, can be accomplished at the levels of quality and service desired by an organization. Proper portfolio management is the essential foundation for program and project success and supports overall organization success. Without portfolio management, even programs and projects that execute flawlessly may not meet desired objectives. This article discusses the essential requirements for porfolio management. These include opportunity identification, return on investment (ROI) forecast, project prioritization, capacity planning (inclusive of human, financial, capital, and facilities resources), work scheduling, program and project management and execution, and project performance and value assessment. Portfolio management is essential to successful healthcare project execution. Theories are drawn from the Organizational Project Management Maturity Model (OPM3) work of the Project Management Institute and other leading strategy, planning, and organization change management research institutes.

The girl-child: problems and survival in the Nigerian context.

PubMed

Anyanwu, S O

1995-01-01

This article examines the living conditions and survival of girl children in Nigeria and the preferential treatment of boy children. Girls are discriminated against in Nigeria in access to educational opportunity, food, and nutrition. Girls carry a heavy burden of farm work and house work. Girls are married off at early ages, which interferes with their education or acquisition of skills needed for survival. Beliefs must be changed about the value of girl children. Rapid economic development is dependent upon elimination of gender bias. Female education serves as an investment that will help facilitate the achievement of family planning objectives and the production of healthier children. Poor female nutrition contributes to greater vulnerability to disease and to poor physical and mental development. It is recommended that nutrition be improved for females and that illegal child labor be abolished. Early marriage should be outlawed, and parents should be educated about the benefits of later marriage. A National Children's Commission should be set up for defending the rights of the girl child in an educational, social, cultural, political, and economic context. The Commission should maintain statistics on child survival and other socioeconomic factors. Parents have an important role to fulfill in helping female children achieve the basic necessities of survival and development and in learning about the fundamentals of child development and care. Teachers have an important role to play in teaching about sex education, drug education, family planning, and AIDS. Women's groups have an important role to play in focusing attention on various problems confronting girl children. Government must focus more resources on reducing the inequalities between boys and girls, change discriminatory laws, and establish political stability. International aid should increase and be directed to female child survival.

Key species and impact of fishery through food web analysis: A case study from Baja California Sur, Mexico

NASA Astrophysics Data System (ADS)

Rocchi, Marta; Scotti, Marco; Micheli, Fiorenza; Bodini, Antonio

2017-01-01

Ecosystem-Based Management (EBM) aims to support the protection of natural ecosystems and to improve economic activities. It requires considering all of the actors interacting in social-ecological systems (e.g., fish and fishers) in the understanding that their interplay determines the dynamic behavior of the single actors as well as that of the system as a whole. Connections are thus central to EBM. Within the ecological dimension of socio-ecological systems, interactions between species define such connections. Understanding how connections affect ecosystem and species dynamics is often impaired by a lack of data. We propose food web network analysis as a tool to help bridge the gap between EBM theory and practice in data-poor contexts, and illustrate this approach through its application to a coastal marine ecosystem in Baja California Sur, Mexico. First, we calculated centrality indices to identify which key (i.e., most central) species must be considered when designing strategies for sustainable resource management. Second, we analyzed the resilience of the system by measuring changes in food web structure due to the local extinction of vulnerable species (i.e., by mimicking the possible effect of excessive fishing pressure). The consequences of species removals were quantified in terms of impacts on global structural indices and species' centrality indices. Overall, we found that this coastal ecosystem shows high resilience to species loss. We identified species (e.g., Octopus sp. and the kelp bass, Paralabrax clathratus) whose protection could further decrease the risk of potential negative impacts of fishing activities on the Baja California Sur food web. This work introduces an approach that can be applied to other ecosystems to aid the implementation of EBM in data-poor contexts.

Closing the poor-rich gap in contraceptive use in urban Kenya: are family planning programs increasingly reaching the urban poor?

PubMed

Fotso, Jean Christophe; Speizer, Ilene S; Mukiira, Carol; Kizito, Paul; Lumumba, Vane

2013-08-27

Kenya is characterized by high unmet need for family planning (FP) and high unplanned pregnancy, in a context of urban population explosion and increased urban poverty. It witnessed an improvement of its FP and reproductive health (RH) indicators in the recent past, after a period of stalled progress. The objectives of the paper are to: a) describe inequities in modern contraceptive use, types of methods used, and the main sources of contraceptives in urban Kenya; b) examine the extent to which differences in contraceptive use between the poor and the rich widened or shrank over time; and c) attempt to relate these findings to the FP programming context, with a focus on whether the services are increasingly reaching the urban poor. We use data from the 1993, 1998, 2003 and 2008/09 Kenya demographic and health survey. Bivariate analyses describe the patterns of modern contraceptive use and the types and sources of methods used, while multivariate logistic regression models assess how the gap between the poor and the rich varied over time. The quantitative analysis is complemented by a review on the major FP/RH programs carried out in Kenya. There was a dramatic change in contraceptive use between 2003 and 2008/09 that resulted in virtually no gap between the poor and the rich in 2008/09, by contrast to the period 1993-1998 during which the improvement in contraceptive use did not significantly benefit the urban poor. Indeed, the late 1990s marked the realization by the Government of Kenya and its development partners, of the need to deliberately target the poor with family planning services. Most urban women use short-term and less effective methods, with the proportion of long-acting method users dropping by half during the review period. The proportion of private sector users also declined between 2003 and 2008/09. The narrowing gap in the recent past between the urban poor and the urban rich in the use of modern contraception is undoubtedly good news, which, coupled with the review of the family program context, suggests that family planning programs may be increasingly reaching the urban poor.

The How Project: understanding contextual challenges to global surgical care provision in low-resource settings

PubMed Central

Raykar, Nakul P; Yorlets, Rachel R; Liu, Charles; Goldman, Roberta; Greenberg, Sarah L M; Kotagal, Meera; Farmer, Paul E; Meara, John G; Roy, Nobhojit; Gillies, Rowan D

2016-01-01

Introduction 5 billion people around the world do not have access to safe, affordable, timely surgical care. This series of qualitative interviews was launched by The Lancet Commission on Global Surgery (LCoGS) with the aim of understanding the contextual challenges—the specific circumstances—faced by surgical care providers in low-resource settings who care for impoverished patients, and how those providers overcome these challenges. Methods From January 2014 to February 2015, 20 LCoGS collaborators conducted semistructured interviews with 148 surgical providers in low-resource settings in 21 countries. Stratified purposive sampling was used to include both rural and urban providers, and reputational case selection identified individuals. Interviewers were trained with an implementation manual. Following immersion into de-identified texts from completed interviews, topical coding and further analysis of coded texts was completed by an independent analyst with periodic validation from a second analyst. Results Providers described substantial financial, geographic and cultural barriers to patient access. Rural surgical teams reported a lack of a trained workforce and insufficient infrastructure, equipment, supplies and banked blood. Urban providers face overcrowding, exacerbated by minimal clinical and administrative support, and limited interhospital care coordination. Many providers across contexts identified national health policies that do not reflect the realities of resource-poor settings. Some findings were region-specific, such as weak patient–provider relationships and unreliable supply chains. In all settings, surgical teams have created workarounds to deliver care despite the challenges. Discussion While some differences exist between countries, the barriers to safe surgery and anaesthesia are overall consistent and resource-dependent. Efforts to advance and expand global surgery must address these commonalities, while local policymakers can tailor responses to key contextual differences. PMID:28588976

The How Project: understanding contextual challenges to global surgical care provision in low-resource settings.

PubMed

Raykar, Nakul P; Yorlets, Rachel R; Liu, Charles; Goldman, Roberta; Greenberg, Sarah L M; Kotagal, Meera; Farmer, Paul E; Meara, John G; Roy, Nobhojit; Gillies, Rowan D

2016-01-01

5 billion people around the world do not have access to safe, affordable, timely surgical care. This series of qualitative interviews was launched by The Lancet Commission on Global Surgery (LCoGS) with the aim of understanding the contextual challenges-the specific circumstances-faced by surgical care providers in low-resource settings who care for impoverished patients, and how those providers overcome these challenges. From January 2014 to February 2015, 20 LCoGS collaborators conducted semistructured interviews with 148 surgical providers in low-resource settings in 21 countries. Stratified purposive sampling was used to include both rural and urban providers, and reputational case selection identified individuals. Interviewers were trained with an implementation manual. Following immersion into de-identified texts from completed interviews, topical coding and further analysis of coded texts was completed by an independent analyst with periodic validation from a second analyst. Providers described substantial financial, geographic and cultural barriers to patient access. Rural surgical teams reported a lack of a trained workforce and insufficient infrastructure, equipment, supplies and banked blood. Urban providers face overcrowding, exacerbated by minimal clinical and administrative support, and limited interhospital care coordination. Many providers across contexts identified national health policies that do not reflect the realities of resource-poor settings. Some findings were region-specific, such as weak patient-provider relationships and unreliable supply chains. In all settings, surgical teams have created workarounds to deliver care despite the challenges. While some differences exist between countries, the barriers to safe surgery and anaesthesia are overall consistent and resource-dependent. Efforts to advance and expand global surgery must address these commonalities, while local policymakers can tailor responses to key contextual differences.

Improvement of Human Resources Quality through Vocational Training in Tourism in Karimunjawa Islands (Central Java, Indonesia): A Pro-Economical Tourism Approach

ERIC Educational Resources Information Center

Putro, S. Eko; Sukirno; Budi, S.; Didik, W.

2016-01-01

The effort to improve human resource quality is not easy to be implemented. This effort becomes more complicated to do when implemented to the group of poor community, especially in this case marginal community of small island. This research analyzes the characteristic of poor household in small island as well as the strategy of poverty…

Developing child mental health services in resource-poor countries.

PubMed

Omigbodun, Olayinka

2008-06-01

Despite significant gains in tackling the major causes of child mortality and evidence of an urgent need for child mental health services, resource-poor countries continue to lag behind in child and adolescent mental health service development. This paper analyses possible barriers to the development of child mental health services in resource-poor countries and attempts to proffer solutions. Obstacles identified are the magnitude of child mental health problems that remain invisible to policy makers, an absence of child mental policies to guide the process of service development, and overburdened child mental health professionals. The belief systems about mental illness also prompt help seeking in alternative health systems, thereby reducing the evidence for the burden associated with health seeking. Solutions that may support child mental health service development are the provision of adequate advocacy tools to reveal the burden, poverty alleviation, health awareness programmes, enforcing legislation, training centred within the region, and partnerships with professionals in developed countries. These solutions require simultaneous approaches to encourage service development and utilization. Reductions in child mortality in resource-poor countries will be even more dramatic in the years to come and preparations need to be made to take care of the mental health needs of the children who will survive.

Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru.

PubMed

Carnero, Andres M; Mayta-Tristan, Percy; Konda, Kelika A; Mezones-Holguin, Edward; Bernabe-Ortiz, Antonio; Alvarado, German F; Canelo-Aybar, Carlos; Maguiña, Jorge L; Segura, Eddy R; Quispe, Antonio M; Smith, Edward S; Bayer, Angela M; Lescano, Andres G

2017-08-01

Plagiarism is a serious, yet widespread type of research misconduct, and is often neglected in developing countries. Despite its far-reaching implications, plagiarism is poorly acknowledged and discussed in the academic setting, and insufficient evidence exists in Latin America and developing countries to inform the development of preventive strategies. In this context, we present a longitudinal case study of seven instances of plagiarism and cheating arising in four consecutive classes (2011-2014) of an Epidemiology Masters program in Lima, Peru, and describes the implementation and outcomes of a multifaceted, "zero-tolerance" policy aimed at introducing research integrity. Two cases involved cheating in graded assignments, and five cases correspond to plagiarism in the thesis protocol. Cases revealed poor awareness of high tolerance to plagiarism, poor academic performance, and widespread writing deficiencies, compensated with patchwriting and copy-pasting. Depending on the events' severity, penalties included course failure (6/7) and separation from the program (3/7). Students at fault did not engage in further plagiarism. Between 2011 and 2013, the Masters program sequentially introduced a preventive policy consisting of: (i) intensified research integrity and scientific writing education, (ii) a stepwise, cumulative writing process; (iii) honor codes; (iv) active search for plagiarism in all academic products; and (v) a "zero-tolerance" policy in response to documented cases. No cases were detected in 2014. In conclusion, plagiarism seems to be widespread in resource-limited settings and a greater response with educational and zero-tolerance components is needed to prevent it.

The Math You Need, When You Need It: Student-Centered Web Resources Designed to Decrease Math Review and Increase Quantitative Geology in the Classroom

NASA Astrophysics Data System (ADS)

Wenner, J. M.; Baer, E. M.

2007-12-01

Introductory geoscience courses are rife with quantitative concepts from graphing to rates to unit conversions. Recent research suggests that supplementary mathematical instruction increases post-secondary students' retention and performance in science courses. Nonetheless, many geoscience faculty feel that they do not have enough time to cover all the geoscience content, let alone covering the math they often feel students should have learned before reaching their classes. We present our NSF-funded effort to create web modules for students that address these concerns. Our web resources focus on both student performance and faculty time issues by building students' quantitative skills through web-based, self-paced modular tutorials. Each module can be assigned to individual students who have demonstrated on a pre-test that they are in need of supplemental instruction. The pre-test involves problems that place mathematical concepts in a geoscience context and determines the students who need the most support with these skills. Students needing support are asked to complete a three-pronged web-based module just before the concept is needed in class. The three parts of each tutorial include: an explanation of the mathematics, a page of practice problems and an on-line quiz that is graded and sent to the instructor. Each of the modules is steeped in best practices in mathematics and geoscience education, drawing on multiple contexts and utilizing technology. The tutorials also provide students with further resources so that they can explore the mathematics in more depth. To assess the rigor of this program, students are given the pre-test again at the end of the course. The uniqueness of this program lies in a rich combination of mathematical concepts placed in multiple geoscience contexts, giving students the opportunity to explore the way that math relates to the physical world. We present several preliminary modules dealing with topics common in introductory geoscience courses. We seek feedback from faculty teaching all levels of geoscience addressing several questions: In what math/geoscience topics do you feel students need supplemental instruction? Where do students come up against quantitative topics that make them drop the class or perform poorly? Would you be willing to review or help us to test these modules in your class?

Groundwater: the processes and global significance of aquifer degradation.

PubMed Central

Foster, S S D; Chilton, P J

2003-01-01

The exploitation of groundwater resources for human use dates from the earliest civilizations, but massive resource development has been largely restricted to the past 50 years. Although global in scope, the emphasis of this paper is on groundwater-based economies in a developing nation context, where accelerated resource development has brought major social and economic benefits over the past 20 years. This results from groundwater's significant role in urban water supply and in rural livelihoods, including irrigated agriculture. However, little of the economic benefit of resource development has been reinvested in groundwater management, and concerns about aquifer degradation and resource sustainability began to arise. A general review, for a broad-based audience, is given of the mechanisms and significance of three semi-independent facets of aquifer degradation. These are (i) depletion of aquifer storage and its effects on groundwater availability, terrestrial and aquatic ecosystems; (ii) groundwater salinization arising from various different processes of induced hydraulic disturbance and soil fractionation; and (iii) vulnerability of aquifers to pollution from land-use and effluent discharge practices related to both urban development and agricultural intensification. Globally, data with which to assess the status of aquifer degradation are of questionable reliability, inadequate coverage and poor compilation. Recourse has to be made to 'type examples' and assumptions about the extension of similar hydrogeological settings likely to be experiencing similar conditions of groundwater demand and subsurface contaminant load. It is concluded that (i) aquifer degradation is much more than a localized problem because the sustainability of the resource base for much of the rapid socio-economic development of the second half of the twentieth century is threatened on quite a widespread geographical basis; and (ii) major (and long overdue) investments in groundwater resource and quality protection are urgently needed. These investments include appropriate institutional provisions, demand-side management, supply-side enhancement and pollution control. PMID:14728791

Linking urban families to community resources in the context of pediatric primary care.

PubMed

Garg, Arvin; Sarkar, Sonia; Marino, Mark; Onie, Rebecca; Solomon, Barry S

2010-05-01

Pediatric guidelines emphasize the importance for healthcare providers to view children in the context of family and community, and promote community resources at visits. In 2006, a Family Help Desk (FHD) was established in an urban academic-based clinic in Baltimore, MD to assist healthcare providers in educating families about available community-based resources. A longitudinal cohort pilot study was conducted during a 6-week period in 2007 to evaluate the impact of the FHD in connecting at-risk families to community resources. Overall, 6% of parents (n=59) who brought their child for a scheduled clinic visit accessed the FHD. Parents had a mean of 1.7 social needs, including after-school programs and childcare (29%), employment (13%), housing (12%), and food (11%). Most parents who utilized the FHD (64%) contacted a community resource or service within 6 months of their clinic visit. Nineteen parents (32%) who utilized the FHD enrolled in community programs. A clinic-based multi-disciplinary model can empower families to connect with community-based resources for basic social needs. The Family Help Desk model has great potential for addressing family psychosocial needs, and educating families about community resources within the context of pediatric primary care. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Online Mental Health Resources in Rural Australia: Clinician Perceptions of Acceptability

PubMed Central

Holloway, Kristi; Riley, Geoffrey; Auret, Kirsten

2013-01-01

Background Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients. Objective To understand rural clinicians’ attitudes towards the acceptability of online mental health resources as a treatment option in the rural context. Methods In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method. Results Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources. Conclusions Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing services, and provide opportunities for renegotiating the socially defined role of the clinician in the eHealth era. PMID:24007949

Online mental health resources in rural Australia: clinician perceptions of acceptability.

PubMed

Sinclair, Craig; Holloway, Kristi; Riley, Geoffrey; Auret, Kirsten

2013-09-05

Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients. To understand rural clinicians' attitudes towards the acceptability of online mental health resources as a treatment option in the rural context. In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method. Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources. Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing services, and provide opportunities for renegotiating the socially defined role of the clinician in the eHealth era.

Social Networks and the Poor: Toward Effective Policy and Practice.

ERIC Educational Resources Information Center

Auslander, Gail K.; Litwin, Howard

1988-01-01

Study of adults (N=3,025) revealed significantly fewer network resources among the poor than among higher income groups. Asserts social workers must avoid addressing the problems of the poor solely through informal networks and target network interventions carefully to achieve maximum effectiveness. (Author)

Extreme ecosystem instability suppressed tropical dinosaur dominance for 30 million years.

PubMed

Whiteside, Jessica H; Lindström, Sofie; Irmis, Randall B; Glasspool, Ian J; Schaller, Morgan F; Dunlavey, Maria; Nesbitt, Sterling J; Smith, Nathan D; Turner, Alan H

2015-06-30

A major unresolved aspect of the rise of dinosaurs is why early dinosaurs and their relatives were rare and species-poor at low paleolatitudes throughout the Late Triassic Period, a pattern persisting 30 million years after their origin and 10-15 million years after they became abundant and speciose at higher latitudes. New palynological, wildfire, organic carbon isotope, and atmospheric pCO2 data from early dinosaur-bearing strata of low paleolatitudes in western North America show that large, high-frequency, tightly correlated variations in δ(13)Corg and palynomorph ecotypes occurred within a context of elevated and increasing pCO2 and pervasive wildfires. Whereas pseudosuchian archosaur-dominated communities were able to persist in these same regions under rapidly fluctuating extreme climatic conditions until the end-Triassic, large-bodied, fast-growing tachymetabolic dinosaurian herbivores requiring greater resources were unable to adapt to unstable high CO2 environmental conditions of the Late Triassic.

Climate-smart agriculture for food security

NASA Astrophysics Data System (ADS)

Lipper, Leslie; Thornton, Philip; Campbell, Bruce M.; Baedeker, Tobias; Braimoh, Ademola; Bwalya, Martin; Caron, Patrick; Cattaneo, Andrea; Garrity, Dennis; Henry, Kevin; Hottle, Ryan; Jackson, Louise; Jarvis, Andrew; Kossam, Fred; Mann, Wendy; McCarthy, Nancy; Meybeck, Alexandre; Neufeldt, Henry; Remington, Tom; Sen, Pham Thi; Sessa, Reuben; Shula, Reynolds; Tibu, Austin; Torquebiau, Emmanuel F.

2014-12-01

Climate-smart agriculture (CSA) is an approach for transforming and reorienting agricultural systems to support food security under the new realities of climate change. Widespread changes in rainfall and temperature patterns threaten agricultural production and increase the vulnerability of people dependent on agriculture for their livelihoods, which includes most of the world's poor. Climate change disrupts food markets, posing population-wide risks to food supply. Threats can be reduced by increasing the adaptive capacity of farmers as well as increasing resilience and resource use efficiency in agricultural production systems. CSA promotes coordinated actions by farmers, researchers, private sector, civil society and policymakers towards climate-resilient pathways through four main action areas: (1) building evidence; (2) increasing local institutional effectiveness; (3) fostering coherence between climate and agricultural policies; and (4) linking climate and agricultural financing. CSA differs from 'business-as-usual' approaches by emphasizing the capacity to implement flexible, context-specific solutions, supported by innovative policy and financing actions.

Extreme ecosystem instability suppressed tropical dinosaur dominance for 30 million years

NASA Astrophysics Data System (ADS)

Whiteside, Jessica H.; Lindström, Sofie; Irmis, Randall B.; Glasspool, Ian J.; Schaller, Morgan F.; Dunlavey, Maria; Nesbitt, Sterling J.; Smith, Nathan D.; Turner, Alan H.

2015-06-01

A major unresolved aspect of the rise of dinosaurs is why early dinosaurs and their relatives were rare and species-poor at low paleolatitudes throughout the Late Triassic Period, a pattern persisting 30 million years after their origin and 10-15 million years after they became abundant and speciose at higher latitudes. New palynological, wildfire, organic carbon isotope, and atmospheric pCO2 data from early dinosaur-bearing strata of low paleolatitudes in western North America show that large, high-frequency, tightly correlated variations in δ13Corg and palynomorph ecotypes occurred within a context of elevated and increasing pCO2 and pervasive wildfires. Whereas pseudosuchian archosaur-dominated communities were able to persist in these same regions under rapidly fluctuating extreme climatic conditions until the end-Triassic, large-bodied, fast-growing tachymetabolic dinosaurian herbivores requiring greater resources were unable to adapt to unstable high CO2 environmental conditions of the Late Triassic.

Gender, sexual health and reproductive health promotion.

PubMed

Moeti, M R

1995-01-01

The underlying factors of poverty, migration, marginalization, lack of information and skills, disempowerment, and poor access to services which affect HIV/STD risk are also closely related to those which affect sexual and reproductive health. Reproductive health problems include unplanned and unwanted pregnancies, unsafe abortions, pregnancy-related illness and death, and STDs including HIV/AIDS. This interrelationship between factors is leading increasingly to the integration of HIV/STD education and prevention within the broader framework of sexual and reproductive health promotion. Such intervention allows the possible reinforcement of the impact of interventions upon important underlying factors and behaviors linked to individual, family, and community vulnerability to HIV/STDs as well as other reproductive health problems. Integration will also optimize the use of increasingly scarce resources and increase the likelihood of responses, interventions, and programs being sustainable. Sexual and reproductive health, placing HIV/STD prevention into context, and focus upon men are discussed.

NEIGHBORHOOD EFFECT HETEROGENEITY BY FAMILY INCOME AND DEVELOPMENTAL PERIOD: EVIDENCE FROM A COUNTERFACTUAL MODEL OF HIGH SCHOOL GRADUATION

PubMed Central

Wodtke, Geoffrey T.; Elwert, Felix; Harding, David J.

2016-01-01

Effects of disadvantaged neighborhoods on child educational outcomes likely depend on a family's economic resources and the timing of neighborhood exposures during the course of child development. This study investigates how timing of exposure to disadvantaged neighborhoods during childhood versus adolescence affects high school graduation and whether these effects vary across families with different income levels. It follows 6,137 children in the PSID from childhood through adolescence and overcomes methodological problems associated with the joint endogeneity of neighborhood context and family income by adapting novel counterfactual methods—a structural nested mean model estimated via two-stage regression-with-residuals—for time-varying treatments and time-varying effect moderators. Results indicate that exposure to disadvantaged neighborhoods, particularly during adolescence, has a strong negative effect on high school graduation, and that this negative effect is more severe for children from poor families. PMID:27017709

Child health in Peru: importance of regional variation and community effects on children's height and weight.

PubMed

Shin, Heeju

2007-12-01

In developing countries, height and weight are good indicators of children's health and nutritional status. Maternal education has been accepted as one of the most important influences on child health. Using the 2000 Demographic and Health Survey of Peru, however, I find that the effect of maternal education varies as a function of region. In the most prosperous urban region, maternal education is less important for child health than in poor rural areas, and a higher level of education has a greater effect in rural areas. Multilevel analysis shows that a significant part of the observed correlation between maternal education and child health is moderated by regional differences and community characteristics. The finding suggests that Peruvian public policy should emphasize resource redistribution as well as women's education, and that investment in maternal education should be considered within regional contexts to enhance child health in rural areas.

Revealing sparks: John Wesley and the religious utility of electrical healing.

PubMed

Bertucci, Paola

2006-09-01

In the eighteenth century, dramatic electrical performances were favourite entertainments for the upper classes, yet the therapeutic uses of electricity also reached the lower strata of society. This change in the social composition of electrical audiences attracted the attention of John Wesley, who became interested in the subject in the late 1740s. The paper analyses Wesley's involvement in the medical applications of electricity by taking into account his theological views and his proselytizing strategies. It sets his advocacy of medical electricity in the context of his philanthropic endeavours aimed at the sick poor, connecting them to his attempts to spread Methodism especially among the lower classes. It is argued that the healing virtues of electricity entailed a revision of the morality of electrical experiment which made electric sparks powerful resources for the popularization of the Methodist way of life, based on discipline, obedience to established authorities and love and fear of God.

Brief Report: Decentralizing ART Supply for Stable HIV Patients to Community-Based Distribution Centers: Program Outcomes From an Urban Context in Kinshasa, DRC.

PubMed

Vogt, Florian; Kalenga, Lucien; Lukela, Jean; Salumu, Freddy; Diallo, Ibrahim; Nico, Elena; Lampart, Emmanuel; Van den Bergh, Rafael; Shah, Safieh; Ogundahunsi, Olumide; Zachariah, Rony; Van Griensven, Johan

2017-03-01

Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centers among 2603 patients with HIV in Kinshasa, Democratic Republic of Congo, using a multilevel Poisson regression model. Death, loss to follow-up, and transfer out were 0.3%, 9.0%, and 0.7%, respectively, at 24 months. Overall attrition was 5.66/100 person-years. Patients with >3 years on ART, >500 cluster of differentiation type-4 count, body mass index >18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centers are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage.

Extreme ecosystem instability suppressed tropical dinosaur dominance for 30 million years

PubMed Central

Whiteside, Jessica H.; Lindström, Sofie; Irmis, Randall B.; Glasspool, Ian J.; Schaller, Morgan F.; Dunlavey, Maria; Nesbitt, Sterling J.; Smith, Nathan D.; Turner, Alan H.

2015-01-01

A major unresolved aspect of the rise of dinosaurs is why early dinosaurs and their relatives were rare and species-poor at low paleolatitudes throughout the Late Triassic Period, a pattern persisting 30 million years after their origin and 10–15 million years after they became abundant and speciose at higher latitudes. New palynological, wildfire, organic carbon isotope, and atmospheric pCO2 data from early dinosaur-bearing strata of low paleolatitudes in western North America show that large, high-frequency, tightly correlated variations in δ13Corg and palynomorph ecotypes occurred within a context of elevated and increasing pCO2 and pervasive wildfires. Whereas pseudosuchian archosaur-dominated communities were able to persist in these same regions under rapidly fluctuating extreme climatic conditions until the end-Triassic, large-bodied, fast-growing tachymetabolic dinosaurian herbivores requiring greater resources were unable to adapt to unstable high CO2 environmental conditions of the Late Triassic. PMID:26080428

HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.

PubMed

Tamba, B I; Azoicăi, Doina; Druguş, Daniela

2016-01-01

Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony.

Readability Assessment of Online Patient Abdominoplasty Resources.

PubMed

Phillips, Nicole A; Vargas, Christina R; Chuang, Danielle J; Lee, Bernard T

2015-02-01

Limited functional health literacy is recognized as an important contributor to health disparities in the United States. As internet access becomes more universal, there is increasing concern about whether patients with poor or marginal literacy can access understandable healthcare information. As such, the National Institutes of Health and American Medical Association recommend that patient information be written at a sixth grade level. This study identifies the most popular online resources for patient information about abdominoplasty and evaluates their readability in the context of average American literacy. The two largest internet search engines were queried for "tummy tuck surgery" to simulate a patient search in lay terms. The ten most popular sites common to both search engines were identified, and all relevant articles from the main sites were downloaded. Sponsored results were excluded. Readability analysis of the articles was performed using ten established tests. Online information about abdominoplasty from the ten most popular publically available websites had an overall average readability of 12th grade. Mean reading grade level scores among tests were: Coleman-Liau 11.9, Flesch-Kincaid 11.4, FORCAST 11.1, Fry 13, Gunning Fog 13.5, New Dale-Chall 11.8, New Fog Count 9.9, Raygor Estimate 12, and SMOG 13.4; Flesch Reading Ease index score was 46. Online patient resources about abdominoplasty are uniformly above the recommended target readability level and are likely too difficult for many patients to understand. A range of readability identified among websites could allow surgeons to guide patients to more appropriate resources for their literacy skills.

Improving resident well-being and clinical learning environment through academic initiatives.

PubMed

Lee, Nathaniel; Appelbaum, Nital; Amendola, Michael; Dodson, Kelley; Kaplan, Brian

2017-07-01

Organizational effects on job satisfaction, burnout, work-life balance, and perceived support have not been studied in the context of the clinical learning environment. We evaluated the relationship between academic resources and resident well-being, the clinical learning environment, and in-service examination performance of surgical residents. Residents of general surgery and surgical specialty programs were recruited from March 2016 through June 2016 across the Southeast, Mid-Atlantic, and Northeast regions. Program directors were asked to allow distribution of a paper survey or to forward an electronic survey link onto residents. Five dichotomous questions were asked regarding access to academic resources. Validated measures were obtained assessing resident well-being and perceived clinical learning environment. Data were analyzed through t-tests and chi-squared test of independence. We received 276 respondents across 50 programs. Residents perceiving adequate support to succeed had less burnout (P = 0.008), better resilience (P = 0.009), better job satisfaction (P < 0.001), less work/life strain (P = 0.001), better workplace climate (P < 0.001), better organizational support (P < 0.001), and were more likely to have high performance on the in-service examination (P = 0.001). Specific resources including educational stipends, review questions, in-service board prep, and support for poor performers correlated with improved well-being and perceived clinical learning environment. Provision of academic resources has implications beyond in-service examination performance, correlating with improved resident well-being and perceptions of the clinical learning environment. Copyright © 2017 Elsevier Inc. All rights reserved.

The problem of institutional fit in integrated water resources management: A case of Zimbabwe’s Mazowe catchment

NASA Astrophysics Data System (ADS)

Chereni, A.

Integrated Water Resources Management (IWRM) concepts have now been accepted in various contexts and efforts are now being made to implement these concepts. Zimbabwe adopted and indigenized IWRM within the 1990s Water Reforms and stakeholder institutions designed to engender cross-sectoral efforts are now in place. Using evidence from Mazowe Catchment, this paper observes that far from fostering integration, institutions involved in water resources management are multiple, disparate and discordant. In practice, associational relationships - specifications of mandate based roles, lines and direction of accountability and evaluation criteria - of institutions intended to foster sectoral integration in natural resources management are not defined. These poorly defined associational relationships coupled with a dearth of a catchment management and development outline plan have translated into a lack of compulsion of duty among institutions. The study derives its evidence from a blend of qualitative unstructured interviews, participant observation and secondary sources. Although the weaknesses of IWRM are more contextual, it is argued, there are certain weaknesses that are also conceptual. IWRM, it is argued, has to contend with a growing plethora of methodological and motivational questions. Whilst it is agreeable within IWRM discourse that institutions need to be integrated, in practice, the approach falls short of a methodological approach that addresses ways in which the various aspects of these disparate institutions could be harmonized. The paper suggests that associational relationships or modes of interaction among institutions need to be defined. This definition should be based on a catchment development master plan.

A comparison of techniques for generating forest ownership spatial products

Treesearch

Brett J. Butler; Jaketon H. Hewes; Greg C. Liknes; Mark D. Nelson; Stephanie A. Snyder

2014-01-01

To fully understand forest resources, it is imperative to understand the social context in which the forests exist. A pivotal part of that context is the forest ownership. It is the owners, operating within biophysical and social constraints, who ultimately decide if the land will remain forested, how the resources will be used, and by whom. Forest ownership patterns...

Under-Resourced, Undervalued, and Underutilized: Making the Case for Teachers in Refugee and Emergency Contexts

ERIC Educational Resources Information Center

West, Amy R.; Ring, Hannah Reeves

2015-01-01

Teachers are a critical resource for children in refugee and emergency settings. Yet few studies have examined what motivates or demotivates teachers, especially in refugee and emergency contexts. In this article we explore the key findings from field research conducted in Algeria and Ethiopia by the American Institutes for Research (AIR) as part…

A Deeper Understanding of Reuse: Learning Designs, Activities, Resources and Their Contexts

ERIC Educational Resources Information Center

Wills, Sandra; Pegler, Chris

2016-01-01

This paper positions discussion of learning designs in the broad context of reuse and repurpose. It proposes that not enough attention has been given to the "purpose" of reuse and the motivation of those who choose to share or use reusable learning resources. There is a need for both a broad and deep understanding of what occurs when…

NATO Phase Zero Contracting - A Proposed Strategic and Operational Planning Construct Within the NATO Framework for Defense Planning and Standardization

DTIC Science & Technology

2015-02-12

become better stewards of scarce resources, to eliminate potential waste, and to reduce abuse of taxpayer money due to poor management, operational...stewards of scarce resources, to eliminate potential waste, and to reduce abuse of taxpayer money due to poor management, operational redundancy and...Conference—Best Practices and Lessons Learned and Training and Educating for Acquisition, Procurement and Contracting in Defense Institutions

One World-One Health and neglected zoonotic disease: elimination, emergence and emergency in Uganda.

PubMed

Smith, James; Taylor, Emma Michelle; Kingsley, Pete

2015-03-01

This paper traces the emergence and tensions of an internationally constructed and framed One World-One Health (OWOH) approach to control and attempt to eliminate African Trypanosomiasis in Uganda. In many respects Trypanosomiasis is a disease that an OWOH approach is perfectly designed to treat, requiring an integrated approach built on effective surveillance in animals and humans, quick diagnosis and targeting of the vector. The reality appears to be that the translation of global notions of OWOH down to national and district levels generates problems, primarily due to interactions between: a) international, external actors not engaging with the Ugandan state; b) actors setting up structures and activities parallel to those of the state; c) actors deciding when emergencies begin and end without consultation; d) weak Ugandan state capacity to coordinate its own integrated response to disease; e) limited collaboration between core Ugandan planning activities and a weak, increasingly devolved district health system. These interrelated dynamics result in the global, international interventionalist mode of OWOH undermining the Coordinating Office for Control of Trypanosomiasis in Uganda (COCTU), the body within the Ugandan state mandated expressly with managing a sustainable One Health response to trypanosomiasis outbreaks in Uganda. This does two things, firstly it suggests we need a more grounded, national perspective of OWOH, where states and health systems are acknowledged and engaged with by international actors and initiatives. Secondly, it suggests that more support needs to be given to core coordinating capacity in resource-poor contexts. Supporting national coordinating bodies, focused around One Health, and ensuring that external actors engage with and through those bodies can help develop a sustained, effective OWOH presence in resource-poor countries, where after all most zoonotic disease burden remains. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015

PubMed Central

Roy, Nicole M. St. Omer; Quintiliani, Lisa M.; Truong, Ve; Feng, Yi; Bloch, Philippe P.; Russinova, Zlatka L.; Lasser, Karen E.

2016-01-01

Introduction Diabetes self-management takes place within a complex social and environmental context.  This study’s objective was to examine the perceived and actual presence of community assets that may aid in diabetes control. Methods We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts.  Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes “hot spots”).  We coded the discussions and identified relevant themes.  We further explored themes related to the built environment through community asset mapping.  Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores. Results Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church.  Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities.  Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables.  Only 1 of the exercise facilities had signage regarding hours or services.  Memberships ranged from free to $9.95 per month.  Overall, these findings were inconsistent with participants’ reports in the photovoice group. Conclusion We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes. PMID:27513998

Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action.

PubMed

de Snyder, V Nelly Salgado; Friel, Sharon; Fotso, Jean Christophe; Khadr, Zeinab; Meresman, Sergio; Monge, Patricia; Patil-Deshmukh, Anita

2011-12-01

The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a "natural" or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability, ill health, diminished life experiences, and limited life prospects. In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.

Solving nursing shortages: a common priority

PubMed Central

Buchan, James; Aiken, Linda

2009-01-01

Aims and objectives This paper provides a context for this special edition. It highlights the scale of the challenge of nursing shortages, but also makes the point that there is a policy agenda that provides workable solutions. Results An overview of nurse:population ratios in different countries and regions of the world, highlighting considerable variations, with Africa and South East Asia having the lowest average ratios. The paper argues that the ‘shortage’ of nurses is not necessarily a shortage of individuals with nursing qualifications, it is a shortage of nurses willing to work in the present conditions. The causes of shortages are multi-faceted, and there is no single global measure of their extent and nature, there is growing evidence of the impact of relatively low staffing levels on health care delivery and outcomes. The main causes of nursing shortages are highlighted: inadequate workforce planning and allocation mechanisms, resource constrained undersupply of new staff, poor recruitment, retention and ‘return’ policies, and ineffective use of available nursing resources through inappropriate skill mix and utilisation, poor incentive structures and inadequate career support. Conclusions What now faces policy makers in Japan, Europe and other developed countries is a policy agenda with a core of common themes. First, themes related to addressing supply side issues: getting, keeping and keeping in touch with relatively scarce nurses. Second, themes related to dealing with demand side challenges. The paper concludes that the main challenge for policy makers is to develop a co-ordinated package of policies that provide a long term and sustainable solution. Relevance to clinical practice This paper highlights the impact that nursing shortages has on clinical practice and in health service delivery. It outlines scope for addressing shortage problems and therefore for providing a more positive staffing environment in which clinical practice can be delivered. PMID:19146584

Towards the implementation of malaria elimination policy in South Africa: the stakeholders' perspectives.

PubMed

Hlongwana, Khumbulani Welcome; Tsoka-Gwegweni, Joyce

2017-01-01

The past decade has seen substantial global reduction in malaria morbidity and mortality due to increased international funding and decisive steps by the international malaria community to fight malaria. South Africa has been declared ready to institute malaria elimination. However, research on the factors that would affect this policy implementation is inadequate. To investigate the stakeholders' understanding of the malaria elimination policy in South Africa, including their perceived barriers and facilitators to effective policy implementation. The study followed a constructivist epistemological approach which manifests in phenomenological study design. Twelve purposively selected key informants from malaria researchers, provincial and national malaria programmes were interviewed using semi-structured interviews. Interview questions elicited interviewees' knowledge of the policy and its achievability, including any perceived barriers and facilitating factors to effective implementation. The hybrid approach was used to perform thematic data analysis. The dominant view was that malaria remains a problem in South Africa, exacerbated by staff attitudes and poor capacity, lack of resources, lack of new effective intervention tools, lack of intra- and inter-departmental collaboration, poor cross-border collaboration and weak stakeholder collaboration. Informants were concerned about the target year (2018) for elimination, and about the process followed in developing the policy, including the perceived malaria epidemiology shortfalls, regulatory issues and political context of the policy. Achievability of malaria elimination remains a subject of intense debate for a variety of reasons. These include the sporadic nature of malaria resurgence, raising questions about the contributions of malaria control interventions and climate to the transmission trends in South Africa. The shortage of resources, inadequate staff capacity, lack of any new effective intervention tools, and gaps in malaria epidemiology were key concerns, as was the superficially participative nature of the consultation process followed in developing the policy.

Current issues in determining dietary protein quality and metabolic utilization

USDA-ARS?s Scientific Manuscript database

In resource-limited settings, poor dietary quality has a marked negative impact on health, especially during the sensitive periods of pregnancy and first 2 years of life (the first 1000 days) when stunting, poor development and increased risk of later disease develop. Protein quality is often poor o...

Poverty Alleviation: Insights and Strategies.

ERIC Educational Resources Information Center

Sharma, Motilal

The development theory for progress in the countries of the Third World must be based on the aspirations of the common people; the majority poor. The poor cannot simply be provided with resources; they must also be psychologically, socially, and economically empowered. The most important conflict in poor countries is between urban and rural…

Behavioral management in children with intellectual disabilities in a resource-poor setting in Barwani, India

PubMed Central

Lakhan, Ram

2014-01-01

Background: Management of behavioral problems in children with intellectual disabilities (ID) is a great concern in resource-poor areas in India. This study attempted to analyze the efficacy of behavioral intervention provided in resource-poor settings. Objective: This study was aimed to examine the outcome of behavioral management provided to children with ID in a poor rural region in India. Materials and Methods: We analyzed data from 104 children between 3 and 18 years old who received interventions for behavioral problems in a clinical or a community setting. The behavioral assessment scale for Indian children with mental retardation (BASIC-MR) was used to quantify the study subjects’ behavioral problems before and after we applied behavioral management techniques (baseline and post-intervention, respectively). The baseline and post-intervention scores were analyzed using the following statistical techniques: Wilcoxon matched-pairs signed-rank test for the efficacy of intervention; χ2 for group differences. Results: The study demonstrated behavioral improvements across all behavior domains (P < 0.05). Levels of improvement varied for children with different severities of ID (P = 0.001), between children who did and did not have multiple disabilities (P = 0.011). Conclusion: The outcome of this behavioral management study suggests that behavioral intervention can be effectively provided to children with ID in poor areas. PMID:24574557

Amygdala activity for the modulation of goal-directed behavior in emotional contexts

PubMed Central

Kunimatsu, Jun; Hikosaka, Okihide

2018-01-01

Choosing valuable objects and rewarding actions is critical for survival. While such choices must be made in a way that suits the animal’s circumstances, the neural mechanisms underlying such context-appropriate behavior are unclear. To address this question, we devised a context-dependent reward-seeking task for macaque monkeys. Each trial started with the appearance of one of many visual scenes containing two or more objects, and the monkey had to choose the good object by saccade to get a reward. These scenes were categorized into two dimensions of emotional context: dangerous versus safe and rich versus poor. We found that many amygdala neurons were more strongly activated by dangerous scenes, by rich scenes, or by both. Furthermore, saccades to target objects occurred more quickly in dangerous than in safe scenes and were also quicker in rich than in poor scenes. Thus, amygdala neuronal activity and saccadic reaction times were negatively correlated in each monkey. These results suggest that amygdala neurons facilitate targeting saccades predictably based on aspects of emotional context, as is necessary for goal-directed and social behavior. PMID:29870524

Improving the Reading of Bisyllabic Words That Involve Context-Sensitive Spelling Rules: Focus on Successes or on Failures?

ERIC Educational Resources Information Center

Steenbeek-Planting, Esther G.; van Bon, Wim H. J.; Schreuder, Robert

2013-01-01

The effect of two training procedures on the improvement of reading accuracy in poor readers was examined in relation to their initial reading level. A randomized controlled trial was conducted with 60 poor readers. Poor readers were assigned to a control group that received no training, or one of two training conditions. One training concentrated…

Context-Aware Adaptive Hybrid Semantic Relatedness in Biomedical Science

NASA Astrophysics Data System (ADS)

Emadzadeh, Ehsan

Text mining of biomedical literature and clinical notes is a very active field of research in biomedical science. Semantic analysis is one of the core modules for different Natural Language Processing (NLP) solutions. Methods for calculating semantic relatedness of two concepts can be very useful in solutions solving different problems such as relationship extraction, ontology creation and question / answering [1--6]. Several techniques exist in calculating semantic relatedness of two concepts. These techniques utilize different knowledge sources and corpora. So far, researchers attempted to find the best hybrid method for each domain by combining semantic relatedness techniques and data sources manually. In this work, attempts were made to eliminate the needs for manually combining semantic relatedness methods targeting any new contexts or resources through proposing an automated method, which attempted to find the best combination of semantic relatedness techniques and resources to achieve the best semantic relatedness score in every context. This may help the research community find the best hybrid method for each context considering the available algorithms and resources.

Dual job holding by public sector health professionals in highly resource-constrained settings: problem or solution?

PubMed Central

Jan, Stephen; Bian, Ying; Jumpa, Manuel; Meng, Qingyue; Nyazema, Norman; Prakongsai, Phusit; Mills, Anne

2005-01-01

This paper examines the policy options for the regulation of dual job holding by medical professionals in highly resource-constrained settings. Such activity is generally driven by a lack of resources in the public sector and low pay, and has been associated with the unauthorized use of public resources and corruption. It is also typically poorly regulated; regulations are either lacking, or when they exist, are vague or poorly implemented because of low regulatory capacity. This paper draws on the limited evidence available on this topic to assess a number of regulatory options in relation to the objectives of quality of care and access to services, as well as some of the policy constraints that can undermine implementation in resource-poor settings. The approach taken in highlighting these broader social objectives seeks to avoid the value judgements regarding dual working and some of its associated forms of behaviour that have tended to characterize previous analyses. Dual practice is viewed as a possible system solution to issues such as limited public sector resources (and incomes), low regulatory capacity and the interplay between market forces and human resources. This paper therefore offers some support for policies that allow for the official recognition of such activity and embrace a degree of professional self-regulation. In providing clearer policy guidance, future research in this area needs to adopt a more evaluative approach than that which has been used to date. PMID:16283054

My Ishvara is dead: spiritual care on the fringes.

PubMed

George, Titus

2010-12-01

Human suffering speaks differently to different lived contexts. In this paper, I have taken a metaphoric representation of suffering, Ishvara, from the lived context of a Hindu immigrant woman to show that suffering is experienced and expressed within one's lived context. Further, a dominant narrative from her world is presented to show that the same lived context can be a resource for spiritual care that could reconstruct her world that has fallen apart with a suffering experience. Having argued that suffering is experienced and expressed within one's lived context, and that lived context could be a resource, in this paper I present that spiritual care is an intervention into the predicaments of human suffering and its mandate is to facilitate certain direction and a meaningful order through which experiences and expectations are rejoined. Finally, I observe that spiritual care is an engagement between the lived context where suffering is experienced and the spiritual experience and orientation of the caregiver.

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

PubMed

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favourable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.

Chapter Four: Discursive Resources

ERIC Educational Resources Information Center

Young, Richard F.

2008-01-01

In this chapter, the focus of attention moves from the contexts described in chapter 3 to the verbal, nonverbal, and interactional resources that participants employ in discursive practices. These resources are discussed within the frame of participation status and participation framework proposed by Goffman. Verbal resources employed by…

Enrichment and Ranking of the YouTube Tag Space and Integration with the Linked Data Cloud

NASA Astrophysics Data System (ADS)

Choudhury, Smitashree; Breslin, John G.; Passant, Alexandre

The increase of personal digital cameras with video functionality and video-enabled camera phones has increased the amount of user-generated videos on the Web. People are spending more and more time viewing online videos as a major source of entertainment and "infotainment". Social websites allow users to assign shared free-form tags to user-generated multimedia resources, thus generating annotations for objects with a minimum amount of effort. Tagging allows communities to organise their multimedia items into browseable sets, but these tags may be poorly chosen and related tags may be omitted. Current techniques to retrieve, integrate and present this media to users are deficient and could do with improvement. In this paper, we describe a framework for semantic enrichment, ranking and integration of web video tags using Semantic Web technologies. Semantic enrichment of folksonomies can bridge the gap between the uncontrolled and flat structures typically found in user-generated content and structures provided by the Semantic Web. The enhancement of tag spaces with semantics has been accomplished through two major tasks: (1) a tag space expansion and ranking step; and (2) through concept matching and integration with the Linked Data cloud. We have explored social, temporal and spatial contexts to enrich and extend the existing tag space. The resulting semantic tag space is modelled via a local graph based on co-occurrence distances for ranking. A ranked tag list is mapped and integrated with the Linked Data cloud through the DBpedia resource repository. Multi-dimensional context filtering for tag expansion means that tag ranking is much easier and it provides less ambiguous tag to concept matching.

Designing and evaluating Brain Powered Games for cognitive training and rehabilitation in at-risk African children.

PubMed

Giordani, B; Novak, B; Sikorskii, A; Bangirana, P; Nakasujja, N; Winn, B M; Boivin, M J

2015-01-01

Valid, reliable, accessible, and cost-effective computer-training approaches can be important components in scaling up educational support across resource-poor settings, such as sub-Saharan Africa. The goal of the current study was to develop a computer-based training platform, the Michigan State University Games for Entertainment and Learning laboratory's Brain Powered Games (BPG) package that would be suitable for use with at-risk children within a rural Ugandan context and then complete an initial field trial of that package. After game development was completed with the use of local stimuli and sounds to match the context of the games as closely as possible to the rural Ugandan setting, an initial field study was completed with 33 children (mean age = 8.55 ± 2.29 years, range 6-12 years of age) with HIV in rural Uganda. The Test of Variables of Attention (TOVA), CogState computer battery, and the Non-Verbal Index from the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) were chosen as the outcome measures for pre- and post-intervention testing. The children received approximately 45 min of BPG training several days per week for 2 months (24 sessions). Although some improvements in test scores were evident prior to BPG training, following training, children demonstrated clinically significant changes (significant repeated-measures outcomes with moderate to large effect sizes) on specific TOVA and CogState measures reflecting processing speed, attention, visual-motor coordination, maze learning, and problem solving. Results provide preliminary support for the acceptability, feasibility, and neurocognitive benefit of BPG and its utility as a model platform for computerized cognitive training in cross-cultural low-resource settings.

5 CFR 9701.408 - Developing performance and addressing poor performance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Performance Management § 9701.408...

The Multivoicedness of Game Play: Exploring the Unfolding of a Student's Learning Trajectory in a Gaming Context at School

ERIC Educational Resources Information Center

Silseth, Kenneth

2012-01-01

The purpose of this article is to gain knowledge about how interactions in a gaming context become constituted as effective resources for a student's learning trajectory. In addition, this detailed study of a learning trajectory documents how a computer game becomes a learning resource for working on a specific topic in school. The article reports…

Andriod Device-Based Cervical Cancer Screening for Resource-Poor Settings.

PubMed

Kudva, Vidya; Prasad, Keerthana; Guruvare, Shyamala

2018-05-18

Visual inspection with acetic acid (VIA) is an effective, affordable and simple test for cervical cancer screening in resource-poor settings. But considerable expertise is needed to differentiate cancerous lesions from normal lesions, which is lacking in developing countries. Many studies have attempted automation of cervical cancer detection from cervix images acquired during the VIA process. These studies used images acquired through colposcopy or cervicography. However, colposcopy is expensive and hence is not feasible as a screening tool in resource-poor settings. Cervicography uses a digital camera to acquire cervix images which are subsequently sent to experts for evaluation. Hence, cervicography does not provide a real-time decision of whether the cervix is normal or not, during the VIA examination. In case the cervix is found to be abnormal, the patient may be referred to a hospital for further evaluation using Pap smear and/or biopsy. An android device with an inbuilt app to acquire images and provide instant results would be an obvious choice in resource-poor settings. In this paper, we propose an algorithm for analysis of cervix images acquired using an android device, which can be used for the development of decision support system to provide instant decision during cervical cancer screening. This algorithm offers an accuracy of 97.94%, a sensitivity of 99.05% and specificity of 97.16%.

Genomic Programming of Human Neonatal Dendritic Cells in Congenital Systemic and In Vitro Cytomegalovirus Infection Reveal Plastic and Robust Immune Pathway Biology Responses

PubMed Central

Dantoft, Widad; Martínez-Vicente, Pablo; Jafali, James; Pérez-Martínez, Lara; Martin, Kim; Kotzamanis, Konstantinos; Craigon, Marie; Auer, Manfred; Young, Neil T.; Walsh, Paul; Marchant, Arnaud; Angulo, Ana; Forster, Thorsten; Ghazal, Peter

2017-01-01

Neonates and especially premature infants are highly susceptible to infection but still can have a remarkable resilience that is poorly understood. The view that neonates have an incomplete or deficient immune system is changing. Human neonatal studies are challenging, and elucidating host protective responses and underlying cognate pathway biology, in the context of viral infection in early life, remains to be fully explored. In both resource rich and poor settings, human cytomegalovirus (HCMV) is the most common cause of congenital infection. By using unbiased systems analyses of transcriptomic resources for HCMV neonatal infection, we find the systemic response of a preterm congenital HCMV infection, involves a focused IFN regulatory response associated with dendritic cells. Further analysis of transcriptional-programming of neonatal dendritic cells in response to HCMV infection in culture revealed an early dominant IFN-chemokine regulatory subnetworks, and at later times the plasticity of pathways implicated in cell-cycle control and lipid metabolism. Further, we identify previously unknown suppressed networks associated with infection, including a select group of GPCRs. Functional siRNA viral growth screen targeting 516-GPCRs and subsequent validation identified novel GPCR-dependent antiviral (ADORA1) and proviral (GPR146, RGS16, PTAFR, SCTR, GPR84, GPR85, NMUR2, FZ10, RDS, CCL17, and SORT1) roles. By contrast a gene family cluster of protocadherins is significantly differentially induced in neonatal cells, suggestive of possible immunomodulatory roles. Unexpectedly, programming responses of adult and neonatal dendritic cells, upon HCMV infection, demonstrated comparable quantitative and qualitative responses showing that functionally, neonatal dendritic cell are not overly compromised. However, a delay in responses of neonatal cells for IFN subnetworks in comparison with adult-derived cells are notable, suggestive of subtle plasticity differences. These findings support a set-point control mechanism rather than immaturity for explaining not only neonatal susceptibility but also resilience to infection. In summary, our findings show that neonatal HCMV infection leads to a highly plastic and functional robust programming of dendritic cells in vivo and in vitro. In comparison with adults, a minimal number of subtle quantitative and temporal differences may contribute to variability in host susceptibility and resilience, in a context dependent manner. PMID:28993767

Genomic Programming of Human Neonatal Dendritic Cells in Congenital Systemic and In Vitro Cytomegalovirus Infection Reveal Plastic and Robust Immune Pathway Biology Responses.

PubMed

Dantoft, Widad; Martínez-Vicente, Pablo; Jafali, James; Pérez-Martínez, Lara; Martin, Kim; Kotzamanis, Konstantinos; Craigon, Marie; Auer, Manfred; Young, Neil T; Walsh, Paul; Marchant, Arnaud; Angulo, Ana; Forster, Thorsten; Ghazal, Peter

2017-01-01

Neonates and especially premature infants are highly susceptible to infection but still can have a remarkable resilience that is poorly understood. The view that neonates have an incomplete or deficient immune system is changing. Human neonatal studies are challenging, and elucidating host protective responses and underlying cognate pathway biology, in the context of viral infection in early life, remains to be fully explored. In both resource rich and poor settings, human cytomegalovirus (HCMV) is the most common cause of congenital infection. By using unbiased systems analyses of transcriptomic resources for HCMV neonatal infection, we find the systemic response of a preterm congenital HCMV infection, involves a focused IFN regulatory response associated with dendritic cells. Further analysis of transcriptional-programming of neonatal dendritic cells in response to HCMV infection in culture revealed an early dominant IFN-chemokine regulatory subnetworks, and at later times the plasticity of pathways implicated in cell-cycle control and lipid metabolism. Further, we identify previously unknown suppressed networks associated with infection, including a select group of GPCRs. Functional siRNA viral growth screen targeting 516-GPCRs and subsequent validation identified novel GPCR-dependent antiviral (ADORA1) and proviral (GPR146, RGS16, PTAFR, SCTR, GPR84, GPR85, NMUR2, FZ10, RDS, CCL17, and SORT1) roles. By contrast a gene family cluster of protocadherins is significantly differentially induced in neonatal cells, suggestive of possible immunomodulatory roles. Unexpectedly, programming responses of adult and neonatal dendritic cells, upon HCMV infection, demonstrated comparable quantitative and qualitative responses showing that functionally, neonatal dendritic cell are not overly compromised. However, a delay in responses of neonatal cells for IFN subnetworks in comparison with adult-derived cells are notable, suggestive of subtle plasticity differences. These findings support a set-point control mechanism rather than immaturity for explaining not only neonatal susceptibility but also resilience to infection. In summary, our findings show that neonatal HCMV infection leads to a highly plastic and functional robust programming of dendritic cells in vivo and in vitro . In comparison with adults, a minimal number of subtle quantitative and temporal differences may contribute to variability in host susceptibility and resilience, in a context dependent manner.

Population, Resources, Environment: An Uncertain Future.

ERIC Educational Resources Information Center

Repetto, Robert

1987-01-01

The links between population growth, resource use, and environmental quality are too complex to permit straightforward generalizations about causal relationships. However, rapid population growth has increased the number of poor people in developing countries, thus contributing to the degradation of the environment and the renewable resources of…

18 CFR 701.301 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Definitions. 701.301 Section 701.301 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION... the context: (a) Council means the U.S. Water Resources Council; (b) Individual means a citizen of the...

18 CFR 701.301 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Definitions. 701.301 Section 701.301 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION... the context: (a) Council means the U.S. Water Resources Council; (b) Individual means a citizen of the...

18 CFR 701.301 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Definitions. 701.301 Section 701.301 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION... the context: (a) Council means the U.S. Water Resources Council; (b) Individual means a citizen of the...

18 CFR 701.301 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Definitions. 701.301 Section 701.301 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION... the context: (a) Council means the U.S. Water Resources Council; (b) Individual means a citizen of the...

18 CFR 701.301 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Definitions. 701.301 Section 701.301 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION... the context: (a) Council means the U.S. Water Resources Council; (b) Individual means a citizen of the...

Care of older people in migration contexts: local and transnational arrangements between Peru and Spain.

PubMed

Gorfinkiel, Magdalena Díaz; Escrivá, Ángeles

2012-01-01

Care arrangements for the elderly are becoming a main social process in contemporary societies due to socio-political and lifestyle changes over the last few decades. The family and the State play a basic role in the construction of care systems and in the establishment of strategies to access care resources. In the present context of migration, these resources interact at a transnational level, challenging family and State migratory regimes. These new realities need the recognition of basic international social rights, as the experiences of Peruvians living in a migration context in Spain show.

The Burden of Poor Mental Well-being Among Patients With Type 2 Diabetes Mellitus

PubMed Central

Bolge, Susan C.; Flores, Natalia M.; Phan, Jennifer H.

2016-01-01

Objective: The aim of this study was to evaluate the association of mental well-being with outcomes among patients with type 2 diabetes mellitus (T2DM). Methods: Seven thousand eight hundred fifty-two adults with T2DM were identified from a national, Internet-based study. Mental well-being [SF-36v2 mental component summary (MCS)] was categorized as good (MCS ≥ 50), poor (40 ≤ MCS < 50), and very poor (MCS < 40). Outcomes included past 6 months of health care resource use and lost productivity (Work Productivity and Activity Impairment questionnaire). Results: Respondents with very poor/poor versus good mental well-being were more likely to visit the emergency room (27%/18% vs 11%, P < 0.001) or be hospitalized (19%/14% vs 9%, P < 0.001). Among labor force participants, those with very poor/poor versus good mental well-being experienced greater overall work impairment (43.7/26.0 vs 10.7, P < 0.001). Conclusions: Greater resource use and work productivity impairment associated with poorer mental well-being among patients with T2DM has cost implications. PMID:27820762

Stress sensitivity in paranoia: poor-me paranoia protects against the unpleasant effects of social stress.

PubMed

Udachina, A; Bentall, R P; Varese, F; Rowse, G

2017-12-01

The attributional theory of paranoia suggests that paranoid beliefs may protect individuals from low self-esteem and distress (Bentall et al. 2001). The current study tested this theory by investigating a hypothesis that paranoid beliefs in combination with low perceived deservedness of persecution (poor-me beliefs) confer protection against the distress caused by social but not activity related stress. Paranoid symptoms, perceived deservedness of persecution, self-esteem, mood, and stress levels of individuals diagnosed with schizophrenia spectrum disorders (N = 91) and healthy controls (N = 52) were assessed in the context of daily life using the experience sampling method. Individuals holding poor-me beliefs (poor-me individuals) showed blunted sensitivity to social but not activity stress. In contrast, individuals holding paranoid beliefs in combination with high perceived deservedness of persecution (bad-me individuals) showed heightened sensitivity to social stress. No consistent differences in reactions to activity stress emerged. Although both poor-me and bad-me individuals reported low self-esteem, this disturbance was particularly characteristic of bad-me individuals. The results suggest that poor-me paranoid beliefs may protect individuals against the distress associated with unpleasant social situations. The specificity of reactions to social stress is discussed in the context of wider literature. Future directions for research are suggested.

Decisions in poverty contexts.

PubMed

Shafir, Eldar

2017-12-01

The circumstances surrounding poverty-tight financial challenges, instability of income and expenses, low savings, no insurance, and several other stressors-translate into persistent and cognitively taxing hardship for people in poverty contexts. Thoughts about money and expenses loom large, shape mental associations, interfere with other experiences, and are difficult to suppress. The persistent juggling of insufficient resources affects attention, cognitive resources, and ensuing decisions. Despite the demanding struggle with challenging circumstances, people in poverty encounter disdain rather than admiration, and obstacles rather than support. Societal appreciation for the power of context, along with behaviorally informed programs designed to facilitate life under poverty, are essential for those in poverty contexts to be able to make the most of their challenging circumstances. Copyright © 2017 Elsevier Ltd. All rights reserved.

Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework.

PubMed

Lavallée, Jacqueline F; Gray, Trish A; Dumville, Jo; Cullum, Nicky

2018-06-01

Pressure ulcers are areas of localised damage to the skin and underlying tissue; and can cause pain, immobility, and delay recovery, impacting on health-related quality of life. The individuals who are most at risk of developing a pressure ulcer are those who are seriously ill, elderly, have impaired mobility and/or poor nutrition; thus, many nursing home residents are at risk. To understand the context of pressure ulcer prevention in nursing homes and to explore the potential barriers and facilitators to evidence-informed practices. Semi-structured interviews were conducted with nursing home nurses, healthcare assistants and managers, National Health Service community-based wound specialist nurses (known in the UK as tissue viability nurses) and a nurse manager in the North West of England. The interview guide was developed using the Theoretical Domains Framework to explore the barriers and facilitators to pressure ulcer prevention in nursing home residents. Data were analysed using a framework analysis and domains were identified as salient based on their frequency and the potential strength of their impact. 25 participants (nursing home: 2 managers, 7 healthcare assistants, 11 qualified nurses; National Health Service community services: 4 tissue viability nurses, 1 manager) were interviewed. Depending upon the behaviours reported and the context, the same domain could be classified as both a barrier and a facilitator. We identified seven domains as relevant in the prevention of pressure ulcers in nursing home residents mapping to four "barrier" domains and six "facilitator" domains. The four "barrier" domains were knowledge, physical skills, social influences and environmental context and resources and the six "facilitator" domains were interpersonal skills, environmental context and resources, social influences, beliefs about capabilities, beliefs about consequences and social/professional role and identity). Knowledge and insight into these barriers and facilitators provide a theoretical understanding of the complexities in preventing pressure ulcers with reference to the staff capabilities, opportunities and motivation related to pressure ulcer prevention. Pressure ulcer prevention in nursing home residents is complex and is influenced by several factors. The findings will inform a theory and evidence-based intervention to aid the prevention of pressure ulcers in nursing home settings. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework

PubMed Central

Helfrich, Christian D; Li, Yu-Fang; Sharp, Nancy D; Sales, Anne E

2009-01-01

Background The Promoting Action on Research Implementation in Health Services, or PARIHS, framework is a theoretical framework widely promoted as a guide to implement evidence-based clinical practices. However, it has as yet no pool of validated measurement instruments that operationalize the constructs defined in the framework. The present article introduces an Organizational Readiness to Change Assessment instrument (ORCA), organized according to the core elements and sub-elements of the PARIHS framework, and reports on initial validation. Methods We conducted scale reliability and factor analyses on cross-sectional, secondary data from three quality improvement projects (n = 80) conducted in the Veterans Health Administration. In each project, identical 77-item ORCA instruments were administered to one or more staff from each facility involved in quality improvement projects. Items were organized into 19 subscales and three primary scales corresponding to the core elements of the PARIHS framework: (1) Strength and extent of evidence for the clinical practice changes represented by the QI program, assessed with four subscales, (2) Quality of the organizational context for the QI program, assessed with six subscales, and (3) Capacity for internal facilitation of the QI program, assessed with nine subscales. Results Cronbach's alpha for scale reliability were 0.74, 0.85 and 0.95 for the evidence, context and facilitation scales, respectively. The evidence scale and its three constituent subscales failed to meet the conventional threshold of 0.80 for reliability, and three individual items were eliminated from evidence subscales following reliability testing. In exploratory factor analysis, three factors were retained. Seven of the nine facilitation subscales loaded onto the first factor; five of the six context subscales loaded onto the second factor; and the three evidence subscales loaded on the third factor. Two subscales failed to load significantly on any factor. One measured resources in general (from the context scale), and one clinical champion role (from the facilitation scale). Conclusion We find general support for the reliability and factor structure of the ORCA. However, there was poor reliability among measures of evidence, and factor analysis results for measures of general resources and clinical champion role did not conform to the PARIHS framework. Additional validation is needed, including criterion validation. PMID:19594942

Organizational readiness to change assessment (ORCA): development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework.

PubMed

Helfrich, Christian D; Li, Yu-Fang; Sharp, Nancy D; Sales, Anne E

2009-07-14

The Promoting Action on Research Implementation in Health Services, or PARIHS, framework is a theoretical framework widely promoted as a guide to implement evidence-based clinical practices. However, it has as yet no pool of validated measurement instruments that operationalize the constructs defined in the framework. The present article introduces an Organizational Readiness to Change Assessment instrument (ORCA), organized according to the core elements and sub-elements of the PARIHS framework, and reports on initial validation. We conducted scale reliability and factor analyses on cross-sectional, secondary data from three quality improvement projects (n = 80) conducted in the Veterans Health Administration. In each project, identical 77-item ORCA instruments were administered to one or more staff from each facility involved in quality improvement projects. Items were organized into 19 subscales and three primary scales corresponding to the core elements of the PARIHS framework: (1) Strength and extent of evidence for the clinical practice changes represented by the QI program, assessed with four subscales, (2) Quality of the organizational context for the QI program, assessed with six subscales, and (3) Capacity for internal facilitation of the QI program, assessed with nine subscales. Cronbach's alpha for scale reliability were 0.74, 0.85 and 0.95 for the evidence, context and facilitation scales, respectively. The evidence scale and its three constituent subscales failed to meet the conventional threshold of 0.80 for reliability, and three individual items were eliminated from evidence subscales following reliability testing. In exploratory factor analysis, three factors were retained. Seven of the nine facilitation subscales loaded onto the first factor; five of the six context subscales loaded onto the second factor; and the three evidence subscales loaded on the third factor. Two subscales failed to load significantly on any factor. One measured resources in general (from the context scale), and one clinical champion role (from the facilitation scale). We find general support for the reliability and factor structure of the ORCA. However, there was poor reliability among measures of evidence, and factor analysis results for measures of general resources and clinical champion role did not conform to the PARIHS framework. Additional validation is needed, including criterion validation.

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; Mike, English C

2011-10-03

The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings.

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study

PubMed Central

2011-01-01

Background The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research. The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. Methods We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Results Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. Conclusion This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings. PMID:21961798

The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis.

PubMed

Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio

2017-07-01

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation's most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

'I'm more sick than my doctors think': ethical issues in managing somatization in developing countries.

PubMed

Chandra, Prabha S; Satyanarayana, Veena A

2013-02-01

Several ethical issues confront the healthcare professional who is managing somatization in developing countries where cost constraints, low literacy, poverty, poor nutrition and infections and inadequate access to healthcare are common. The paper discusses these in the context of the ethical principles of autonomy, beneficence, non-maleficence and justice. Some of the ethical issues in managing somatization include being influenced by patient distress rather than rational medical decision-making, inadequate attention to the cultural meaning of symptoms, psychologizing versus medicalizing, the ethics of nomenclature and labels, communicating ethically with patients, and managing them adequately given lack of evidence and training. An ethical approach to managing somatization in this context would include using an integrated and simultaneous medical and psychiatric approach. To ensure patient beneficence, the medical, psychological and social assessment should be undertaken side-by-side as much as possible and should be cost effective. Respecting patient autonomy by using adequate communication methods and the patient's cultural model of the illness as part of management is also integral to ethical practice. In the developing world, issues of equity are also an important ethical concern. When more serious illnesses are the health priority, functional syndromes may not get equal importance or resources.

The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis

PubMed Central

Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio

2018-01-01

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care. PMID:27856941

Online Resource-Based Learning Environment: Case Studies in Primary Classrooms

ERIC Educational Resources Information Center

So, Winnie Wing Mui; Ching, Fiona Ngai Ying

2012-01-01

This paper discusses the creation of learning environments with online resources by three primary school teachers for pupil's learning of science-related topics with reference to the resource-based e-learning environments (RBeLEs) framework. Teachers' choice of contexts, resources, tools, and scaffolds in designing the learning environments are…

Relationships among mental health status, social context, and demographic characteristics in Taiwanese aboriginal adolescents: a structural equation model.

PubMed

Yen, Cheng-Fang; Hsu, Chia-Chuang; Liu, Shu-Chun; Huang, Chi-Fen; Ko, Chih-Hung; Yen, Ju-Yu; Cheng, Chung-Ping

2006-10-01

The purposes of this study were to examine the relationships among mental health status, demographic characteristics, and social contexts, including family conflict and support, connectedness to school, and affiliation with peers who exhibit delinquent behavior and who use substances, among Taiwanese aboriginal adolescents. A total of 251 aboriginal junior high school students in an isolated mountainous area of southern Taiwan were recruited, and the relationships among mental health status, demographic characteristics, and social contexts among them were examined using a structural equation model (SEM). The SEM revealed that family conflict and support had direct influences on mental health status and connectedness to school. Family conflict had a direct relationship with affiliation with peers who use substances, and family conflict and support were both indirectly linked with affiliation with peers who exhibit delinquent behavior and who used substances; these were mediated by a poor mental health status. Female and older age were directly linked with a poor mental health status and were indirectly linked with a greater number of peers who exhibit delinquent behavior and who use substances via the poor mental health status. Disruptive parenting was directly linked with affiliation with peers who use substances. The authors suggest that those who devise strategies to improve aboriginal adolescents' mental health and discourage substance use should take these relationships among mental health, demographic characteristics, and social contexts into account.

Human resource configurations: investigating fit with the organizational context.

PubMed

Toh, Soo Min; Morgeson, Frederick P; Campion, Michael A

2008-07-01

The present study investigated how key organizational contextual factors relate to bundles of human resource (HR) practices. In a two-phase study of a sample of 661 organizations representing a full range of industries and organizational size, the authors found that organizations use 1 of 5 HR bundles: cost minimizers, contingent motivators, competitive motivators, resource makers, and commitment maximizers. In addition, the authors showed that the organizations that use a given type of HR bundle may be distinguished by the organizational values they pursue and their organizational structure, thus suggesting that HR choices are related to the context within which organizations operate.

Investments on Pro-poor Development Projects on Goats: Ensuring Success for Improved Livelihoods*

PubMed Central

Devendra, C.

2013-01-01

The elements that determine the success of development projects on goats and the prerequisites for ensuring this are discussed in the context of the bewildering diversity of goat genetic resources, production systems, multifunctionality, and opportunities for responding to constraints for productivity enhancement. Key determinants for the success of pro-poor projects are the imperatives of realistic project design, resolution of priorities and positive impacts to increase investments and spur agricultural growth, and appropriate policy. Throughout the developing world, there exist 97% of the total world population of 921 million goats across all agro-ecological zones (AEZs), including 570 breeds and 64% share of the breeds. They occupy a very important biological and socio-economic niche in farming systems making significant multifunctional contributions especially to food, nutrition and financial security, stability of farm households, and survival of the poor in the rural areas. Definitions are given of successful and failed projects. The analyses highlighted in successful projects the value of strong participatory efforts with farmers and climate change. Climate change effects on goats are inevitable and are mediated through heat stress, type of AEZ, water availability, quantity and quality of the available feed resources and type of production system. Within the prevailing production systems, improved integrated tree crops - ruminant systems are underestimated and are an important pathway to enhance C sequestration. Key development strategies and opportunities for research and development (R and D) are enormous, and include inter alia defining a policy framework, resolution of priority constraints using systems perspectives and community-based participatory activities, application of yield-enhancing technologies, intensification, scaling up, and impacts. The priority for development concerns the rainfed areas with large concentrations of ruminants in which goats, with a capacity to cope with heat tolerance, can be the entry point for development. Networks and networking are very important for the diffusion of information and can add value to R and D. Well formulated projects with clear priority setting and participatory R and D ensure success and the realisation of food security, improved livelihoods and self-reliance in the future. PMID:25049700

Motivational determinants among physicians in Lahore, Pakistan.

PubMed

Malik, Ahmad Azam; Yamamoto, Shelby Suzanne; Souares, Aurélia; Malik, Zeeshan; Sauerborn, Rainer

2010-07-09

Human resource crises in developing countries have been identified as a critical aspect of poor quality and low accessibility in health care. Worker motivation is an important facet of this issue. Specifically, motivation among physicians, who are an important bridge between health systems and patients, should be considered. This study aimed to identify the determinants of job motivation among physicians, a neglected perspective, especially in developing countries. A stratified random sample of 360 physicians was selected from public primary, public secondary and public and private tertiary health facilities in the Lahore district, Pakistan. Pretested, semi-structured, self-administered questionnaires were used. For the descriptive part of this study, physicians were asked to report their 5 most important work motivators and demotivators within the context of their current jobs and in general. Responses were coded according to emergent themes and frequencies calculated. Of the 30 factors identified, 10 were classified as intrinsic, 16 as organizational and 4 as socio-cultural. Intrinsic and socio-cultural factors like serving people, respect and career growth were important motivators. Conversely, demotivators across setups were mostly organizational, especially in current jobs. Among these, less pay was reported the most frequently. Fewer opportunities for higher qualifications was a demotivator among primary and secondary physicians. Less personal safety and poor working conditions were important in the public sector, particularly among female physicians. Among private tertiary physicians financial incentives other than pay and good working conditions were motivators in current jobs. Socio-cultural and intrinsic factors like less personal and social time and the inability to financially support oneself and family were more important among male physicians. Motivational determinants differed across different levels of care, sectors and genders. Nonetheless, the important motivators across setups in this study were mostly intrinsic and socio-cultural, which are difficult to affect while the demotivators were largely organizational. Many can be addressed even at the facility level such as less personal safety and poor working conditions. Thus, in resource limited settings a good strategic starting point could be small scale changes that may markedly improve physicians' motivation and subsequently the quality of health care.

Investments on Pro-poor Development Projects on Goats: Ensuring Success for Improved Livelihoods.

PubMed

Devendra, C

2013-01-01

The elements that determine the success of development projects on goats and the prerequisites for ensuring this are discussed in the context of the bewildering diversity of goat genetic resources, production systems, multifunctionality, and opportunities for responding to constraints for productivity enhancement. Key determinants for the success of pro-poor projects are the imperatives of realistic project design, resolution of priorities and positive impacts to increase investments and spur agricultural growth, and appropriate policy. Throughout the developing world, there exist 97% of the total world population of 921 million goats across all agro-ecological zones (AEZs), including 570 breeds and 64% share of the breeds. They occupy a very important biological and socio-economic niche in farming systems making significant multifunctional contributions especially to food, nutrition and financial security, stability of farm households, and survival of the poor in the rural areas. Definitions are given of successful and failed projects. The analyses highlighted in successful projects the value of strong participatory efforts with farmers and climate change. Climate change effects on goats are inevitable and are mediated through heat stress, type of AEZ, water availability, quantity and quality of the available feed resources and type of production system. Within the prevailing production systems, improved integrated tree crops - ruminant systems are underestimated and are an important pathway to enhance C sequestration. Key development strategies and opportunities for research and development (R and D) are enormous, and include inter alia defining a policy framework, resolution of priority constraints using systems perspectives and community-based participatory activities, application of yield-enhancing technologies, intensification, scaling up, and impacts. The priority for development concerns the rainfed areas with large concentrations of ruminants in which goats, with a capacity to cope with heat tolerance, can be the entry point for development. Networks and networking are very important for the diffusion of information and can add value to R and D. Well formulated projects with clear priority setting and participatory R and D ensure success and the realisation of food security, improved livelihoods and self-reliance in the future.

Social context affects tail displays by Phrynocephalus vlangalii lizards from China

PubMed Central

Peters, Richard A.; Ramos, Jose A.; Hernandez, Juan; Wu, Yayong; Qi, Yin

2016-01-01

Competition between animals for limited resources often involves signaling to establish ownership or dominance. In some species, the defended resource relates to suitable thermal conditions and refuge from predators. This is particularly true of burrow-dwelling lizards such as the Qinghai toad-headed agama (Phrynocephalus vlangalii), which are found on the Tibetan plateau of western China. Male and female lizards occupy separate burrows, which are vital for anti-predator behaviour during warmer months when lizards are active and, crucially, provide shelter from harsh winter conditions. These lizards are readily observed signaling by means of tail displays on the sand dunes they inhabit. Given the selective pressure to hold such a resource, both males and females should exhibit territorial behaviour and we considered this study system to examine in detail how social context influences motion based territorial signaling. We confirmed that territorial signaling was used by both sexes, and by adopting a novel strategy that permitted 3D reconstruction of tail displays, we identified significant variation due to social context. However, signal structure was not related to lizard morphology. Clearly, the burrow is a highly valued resource and we suggest that additional variation in signaling behaviour might be mediated by resource quality. PMID:27526625

Participation of the Private Sector in the Provision of Early Childhood Care, Development, and Education: Issues, Challenges, and Way Forward in Nigeria's Context

ERIC Educational Resources Information Center

Matthew, Ige Akindele

2015-01-01

While all children have a right to quality care and education in their early years, how to secure that right, especially in resource-limited contexts, is the subject of much debate. For some nations, private schools can seem like a good option, requiring few federal resources. However, the privatization of early education presents significant…

Institutional challenges for mining and sustainability in Peru.

PubMed

Bebbington, Anthony J; Bury, Jeffrey T

2009-10-13

Global consumption continues to generate growth in mining. In lesser developed economies, this growth offers the potential to generate new resources for development, but also creates challenges to sustainability in the regions in which extraction occurs. This context leads to debate on the institutional arrangements most likely to build synergies between mining, livelihoods, and development, and on the socio-political conditions under which such institutions can emerge. Building from a multiyear, three-country program of research projects, Peru, a global center of mining expansion, serves as an exemplar for analyzing the effects of extractive industry on livelihoods and the conditions under which arrangements favoring local sustainability might emerge. This program is guided by three emergent hypotheses in human-environmental sciences regarding the relationships among institutions, knowledge, learning, and sustainability. The research combines in-depth and comparative case study analysis, and uses mapping and spatial analysis, surveys, in-depth interviews, participant observation, and our own direct participation in public debates on the regulation of mining for development. The findings demonstrate the pressures that mining expansion has placed on water resources, livelihood assets, and social relationships. These pressures are a result of institutional conditions that separate the governance of mineral expansion, water resources, and local development, and of relationships of power that prioritize large scale investment over livelihood and environment. A further problem is the poor communication between mining sector knowledge systems and those of local populations. These results are consistent with themes recently elaborated in sustainability science.

[Exploratory analysis of work engagement: use of the Utrecht scale in Benin].

PubMed

Ahanhanzo, Yolaine Glèlè; Kittel, France; Paraïso, Noël Moussiliou; Godin, Isabelle; Wilmet-Dramaix, Michèle; Makoutodé, Michel

2014-01-01

Work engagement, an emerging concept in the field of positive psychology in the workplace is not well known in developing countries. Defined as a positive and and fulfilling mindset related to work, it recalls a positive attitude incentive of performance and need to be investigated. In the context of the socioeconomic crisis of health workers, and with the chronic issue of poor quality of data, this study was designed to identify the factors associated with work engagement among health workers. in charge of data collection in the Benin Routine Health Information System. This study was a cross-sectional and analytical study targeting health workers in charge of data collection in public and private health centres. The dependent variable was work engagement and independent variables were sociodemographic and professional features, personal and professional resources and perception of technical factors. Logistic regression was used. The adequacy of the model was tested with the Hosmer-Lemeshow goodness of fit test. The results indicate that the level of work engagement is similar with that observed in previous studies. Predictors identified in logistic regression are perception of technical factors, location of the job, and personal resources, such as level of effort and overcommitment. This study identified factors associated with work engagement in a developing country, and adds to the knowledge concerning this new concept in Benin. The findings can contribute to research for improvement of human resources management in the health sector to achieve real performance and development.

Institutional challenges for mining and sustainability in Peru

PubMed Central

Bebbington, Anthony J.; Bury, Jeffrey T.

2009-01-01

Global consumption continues to generate growth in mining. In lesser developed economies, this growth offers the potential to generate new resources for development, but also creates challenges to sustainability in the regions in which extraction occurs. This context leads to debate on the institutional arrangements most likely to build synergies between mining, livelihoods, and development, and on the socio-political conditions under which such institutions can emerge. Building from a multiyear, three-country program of research projects, Peru, a global center of mining expansion, serves as an exemplar for analyzing the effects of extractive industry on livelihoods and the conditions under which arrangements favoring local sustainability might emerge. This program is guided by three emergent hypotheses in human-environmental sciences regarding the relationships among institutions, knowledge, learning, and sustainability. The research combines in-depth and comparative case study analysis, and uses mapping and spatial analysis, surveys, in-depth interviews, participant observation, and our own direct participation in public debates on the regulation of mining for development. The findings demonstrate the pressures that mining expansion has placed on water resources, livelihood assets, and social relationships. These pressures are a result of institutional conditions that separate the governance of mineral expansion, water resources, and local development, and of relationships of power that prioritize large scale investment over livelihood and environment. A further problem is the poor communication between mining sector knowledge systems and those of local populations. These results are consistent with themes recently elaborated in sustainability science. PMID:19805172

Using Operational Analysis to Improve Access to Pulmonary Function Testing.

PubMed

Ip, Ada; Asamoah-Barnieh, Raymond; Bischak, Diane P; Davidson, Warren J; Flemons, W Ward; Pendharkar, Sachin R

2016-01-01

Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.

Learning versus Education: Rethinking Learning in Anangu Schools

ERIC Educational Resources Information Center

Osborne, Sam

2013-01-01

In the remote schooling context, much recent media attention has been directed to issues of poor attendance, low attainment rates of minimal benchmarks in literacy and numeracy, poor retention and the virtual absence of transitions from school to work. The Australian government's recent "Gonski review" ("Review of Funding for…

Information seeking and retrieval skills of nurses: Nurses readiness for evidence based practice in hospitals of a medical university in Iran.

PubMed

Farokhzadian, Jamileh; Khajouei, Reza; Ahmadian, Leila

2015-08-01

With the explosion of medical information, and emergence of evidence-based practice (EBP) in healthcare system, searching, retrieving and selecting information for clinical decision-making are becoming required skills for nurses. The aims of this study were to examine the use of different medical information resources by nurses and their information searching and retrieving skills in the context of EBP. A descriptive, cross-sectional study was conducted in four teaching hospitals in Iran. Data were collected from 182 nurses using a questionnaire in 2014. The nurses indicated that they use more human and printed resources than electronic resources to seek information (mean=2.83, SD=1.5; mean=2.77, SD=1.07; and mean=2.13, SD=0.88, respectively). To search online resources, the nurses use quick/basic search features more frequently (mean=2.45, SD=1.15) than other search features such as advanced search, index browsing and MeSH term searching. (1.74≤mean≤2.30, SD=1.01). At least 80% of the nurses were not aware of the purpose or function of search operators such as Boolean and proximity operators. In response to the question measuring skills of the nurses in developing an effective search statement by using Boolean operators, only 20% of them selected the more appropriate statement, using some synonyms of the concepts in a given subject. The study showed that the information seeking and retrieval skills of the nurses were poor and there were clear deficits in the use of updated information resources. To compensate their EBP incompetency, nurses may resort to human resources. In order to use the latest up to date evidence independently, nurses need to improve their information literacy. To reach this goal, clinical librarians, health information specialists, nursing faculties, and clinical nurse educators and mentors can play key roles by providing educational programs. Providing access to online resources in clinical wards can also encourage nurses to learn and use these resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Hospital preparedness in community measles outbreaks—challenges and recommendations for low-resource settings

PubMed Central

Shakoor, Sadia; Mir, Fatima; Zaidi, Anita K. M.; Zafar, Afia

2015-01-01

We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities. PMID:25882388

A Policy Based Approach for the Management of Web Browser Resources to Prevent Anonymity Attacks in Tor

NASA Astrophysics Data System (ADS)

Navarro-Arribas, Guillermo; Garcia-Alfaro, Joaquin

Web browsers are becoming the universal interface to reach applications and services related with these systems. Different browsing contexts may be required in order to reach them, e.g., use of VPN tunnels, corporate proxies, anonymisers, etc. By browsing context we mean how the user browsers the Web, including mainly the concrete configuration of its browser. When the context of the browser changes, its security requirements also change. In this work, we present the use of authorisation policies to automatise the process of controlling the resources of a Web browser when its context changes. The objective of our proposal is oriented towards easing the adaptation to the security requirements of the new context and enforce them in the browser without the need for user intervention. We present a concrete application of our work as a plug-in for the adaption of security requirements in Mozilla/Firefox browser when a context of anonymous navigation through the Tor network is enabled.

Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru

PubMed Central

Carnero, Andres M.; Mayta-Tristan, Percy; Konda, Kelika A.; Mezones-Holguin, Edward; Bernabe-Ortiz, Antonio; Alvarado, German F.; Canelo-Aybar, Carlos; Maguiña, Jorge L.; Segura, Eddy R.; Quispe, Antonio M.; Smith, Edward S.; Bayer, Angela M.; Lescano, Andres G.

2017-01-01

Plagiarism is a serious, yet widespread type of research misconduct, and is often neglected in developing countries. Despite its far-reaching implications, plagiarism is poorly acknowledged and discussed in the academic setting, and insufficient evidence exists in Latin America and developing countries to inform the development of preventive strategies. In this context, we present a longitudinal case study of seven instances of plagiarism and cheating arising in four consecutive classes (2011–2014) of an Epidemiology Masters program in Lima, Peru, and describes the implementation and outcomes of a multifaceted, “zero-tolerance” policy aimed at introducing research integrity. Two cases involved cheating in graded assignments, and five cases correspond to plagiarism in the thesis protocol. Cases revealed poor awareness of high tolerance to plagiarism, poor academic performance, and widespread writing deficiencies, compensated with patchwriting and copy-pasting. Depending on the events’ severity, penalties included course failure (6/7) and separation from the program (3/7). Students at fault did not engage in further plagiarism. Between 2011 and 2013, the Masters program sequentially introduced a preventive policy consisting of: (i) intensified research integrity and scientific writing education, (ii) a stepwise, cumulative writing process; (iii) honor codes; (iv) active search for plagiarism in all academic products; and (v) a “zero-tolerance” policy in response to documented cases. No cases were detected in 2014. In conclusion, plagiarism seems to be widespread in resource-limited settings and a greater response with educational and zero-tolerance components is needed to prevent it. PMID:27848191

Oil, Gas and Conflict: A Mathematical Model for the Resource Curse

PubMed Central

Cai, Yiyong; Newth, David

2013-01-01

Oil and natural gas are highly valuable natural resources, but many countries with large untapped reserves suffer from poor economic and social-welfare performance. This conundrum is known as the resource curse. The resource curse is a result of poor governance and wealth distribution structures that allow the elite to monopolize resources for self-gain. When rival social groups compete for natural resources, civil unrest soon follows. While conceptually easy to follow, there have been few formal attempts to study this phenomenon. Thus, we develop a mathematical model that captures the basic elements and dynamics of this dilemma. We show that when resources are monopolized by the elite, increased exportation leads to decreased domestic production. This is due to under-provision of the resource-embedded energy and industrial infrastructure. Decreased domestic production then lowers the marginal return on productive activities, and insurgency emerges. The resultant conflict further displaces human, built, and natural capital. It forces the economy into a vicious downward spiral. Our numerical results highlight the importance of governance reform and productivity growth in reducing oil-and-gas-related conflicts, and thus identify potential points of intervention to break the downward spiral. PMID:23826115

Achieving the same for less: improving mood depletes blood glucose for people with poor (but not good) emotion control.

PubMed

Niven, Karen; Totterdell, Peter; Miles, Eleanor; Webb, Thomas L; Sheeran, Paschal

2013-01-01

Previous studies have found that acts of self-control like emotion regulation deplete blood glucose levels. The present experiment investigated the hypothesis that the extent to which people's blood glucose levels decline during emotion regulation attempts is influenced by whether they believe themselves to be good or poor at emotion control. We found that although good and poor emotion regulators were equally able to achieve positive and negative moods, the blood glucose of poor emotion regulators was reduced after performing an affect-improving task, whereas the blood glucose of good emotion regulators remained unchanged. As evidence suggests that glucose is a limited energy resource upon which self-control relies, the implication is that good emotion regulators are able to achieve the same positive mood with less cost to their self-regulatory resource. Thus, depletion may not be an inevitable consequence of engaging in emotion regulation.

IATUL Conference 1985.

ERIC Educational Resources Information Center

Information Services and Use, 1985

1985-01-01

Summarizes presentations at conference on theme "The future of information resources for science and technology and role of libraries": industrial and commercial use of national, regional, and university resources; balance between public- and private-sector resources; local access in national and regional context; access to information…

Prevalence and Risk Factors of Hookworm-Related Cutaneous Larva Migrans (HrCLM) in a Resource-Poor Community in Manaus, Brazil.

PubMed

Reichert, Felix; Pilger, Daniel; Schuster, Angela; Lesshafft, Hannah; Guedes de Oliveira, Silas; Ignatius, Ralf; Feldmeier, Hermann

2016-03-01

Hookworm-related cutaneous larva migrans (HrCLM) is a neglected tropical skin disease associated with significant clinical pathology. Little knowledge exists about prevalence and risk factors of HrCLM in endemic regions. To understand the epidemiology of HrCLM in Amazonia, we conducted a cross-sectional study in a resource-poor township in Manaus, Brazil. HrCLM was diagnosed in 8.2% (95% CI, 6.3-10.1%) of the study population (N = 806) with a peak prevalence of 18.2% (95% CI, 9.3-27.1%) in children aged 10-14. Most of the tracks (62.4%) were located on the feet, and 10.6% were superinfected. HrCLM was associated independently with age under 15, male sex, presence of animal faeces on the compound, walking barefoot on sandy ground and poverty. HrCLM is common in resource-poor communities in Amazonia and is related to poverty. To reduce the disease burden caused by HrCLM, living conditions have to be improved.

Unsupervised self-testing as part public health screening for HIV in resource-poor environments: some ethical considerations.

PubMed

Scott, P Anne

2014-07-01

The use of unsupervised self-testing as part of a national screening program for HIV infection in resource-poor environments with high HIV prevalence may have a number of attractive aspects, such as increasing access to services for hard to reach and isolated populations. However, the presence of such technologies is at a relatively early stage in terms of use and impact in the field. In this paper, a principle-based approach, that recognizes the fundamentally utilitarian nature of public health combined with a focus on autonomy, is used as a lens to explore some of the ethical issues raised by HIV self-testing. The conclusion reached in this review is that at this point in time, on the basis of the principles of utility and respect for autonomy, it is not ethically appropriate to incorporate unsupervised HIV self-testing as part of a public health screening program in resource-poor environments.

What does quality maternity care mean in a context of medical pluralism? Perspectives of women in Nigeria

PubMed Central

Izugbara, Chimaraoke O; Wekesah, Frederick

2018-01-01

Abstract User priorities regarding quality care in contexts of medical pluralism are poorly documented. Drawing on group and individual interviews with women, we interrogate ideas of quality maternity care in the context of Nigeria’s medical pluralism. We found complex utilization patterns for conventional, complementary and alternative maternity care services as well as ideas of quality maternity care that stress effective coordination and integration of different typologies of maternity health services; socially sensitive and truthful providers; and socioeconomic, physical and parochial forms of safety. Informal providers were the commonly reported source of maternal health services in the study. Maternal health services in the country were also generally viewed as poor quality, characterized by pervasive abuse, quackery and lack of commitment to the needs and sensitivities of women. Convenience, availability and affordability of maternal health services, as well as sociocultural factors were major influences on women’s use of services. Results demonstrate the embeddedness of women’s quality of care notions in the vast socioeconomic inequities that typify Nigeria’s particular form of poorly regulated medical pluralism, raising need for strategies to strengthen the delivery, coordination and supervision of maternal health services in the country. PMID:29036530

The RISE Framework: Using Learning Analytics to Automatically Identify Open Educational Resources for Continuous Improvement

ERIC Educational Resources Information Center

Bodily, Robert; Nyland, Rob; Wiley, David

2017-01-01

The RISE (Resource Inspection, Selection, and Enhancement) Framework is a framework supporting the continuous improvement of open educational resources (OER). The framework is an automated process that identifies learning resources that should be evaluated and either eliminated or improved. This is particularly useful in OER contexts where the…

ICTs as Placed Resources in a Rural Kenyan Secondary School Journalism Club

ERIC Educational Resources Information Center

Kendrick, Maureen; Chemjor, Walter; Early, Margaret

2012-01-01

In this study, we draw on three interrelated concepts, i.e. placed resources, multiliteracies and the carnivalesque, to understand how information and communication technology (ICT) resources are taken up within the context of a print-based journalism club. Our research participants attend an under-resourced girls' residential secondary school in…

When Ethics Survive Where People Do Not

PubMed Central

Hussein, Ghaiath M. A.

2010-01-01

The provision of health care service in resource-poor settings is associated with a broad set of ethical issues. Devakumar's case discusses the ethical issues related to the inability to treat in a cholera clinic patients who do not have cholera. This paper gives a closer look on the context in which Devakumar's case took place. It also analyses the potential local and organizational factors that gives rise to ethical dilemmas and aggravate them. It also proposes a framework to help in the proactive handling of the factors that leads to ethical dilemmas and resolving the ethical issues as they appear. It adopts the four principles of autonomy, beneficence, non-maleficence and justice as universal and prima facie principles, but with the inclusion of a local understanding of what of each of these principles means. It is based on a collaborative approach that involves the beneficiaries and other partners in the field to help share information and resources, as well as adopting the provision of a wider service to the whole community. This is done by asking three basic questions: (a) who are the relevant stakeholders? (b) what ought to be the ethical principles in place? and (c) how should we take, implement and follow the decision about service provision? PMID:20336229

"Not here": making the spaces and subjects of "global health" in Botswana.

PubMed

Brada, Betsey

2011-06-01

This essay argues that what makes "global health" "global" has more to do with configurations of space and time, and the claims to expertise and moral stances these configurations make possible, than with the geographical distribution of medical experts or the universal, if also uneven, distribution of threats to health. Drawing on a study of public-private partnerships supporting Botswana's HIV/AIDS treatment program, this essay demonstrates ethnographically the processes by which "global health" and its quintessential spaces, namely "resource-limited" or "resource-poor settings," are constituted, reinforced, and contested in the context of medical education and medical practice in Botswana's largest hospital. Using Silverstein's work on orders of indexicality, I argue that the terms of "global health" are best understood as chronotopic, and demonstrate how actors orient themselves and others spatio-temporally, morally, and professionally by using or refuting those terms. I conclude by arguing that taking "global health" on its own terms obscures the powerful forces by which it becomes intelligible. At stake are the frames within which medical anthropologists understand their objects of study, as well as the potential for the spaces of "global health" intervention to expand ever outward as American medical personnel attempt to calibrate their experiences to their expectations.

Multi-scale assessment of human-induced changes to ...

EPA Pesticide Factsheets

Context: Land use change and forest degradation have myriad effects on tropical ecosystems. Yet their consequences for low-order streams remain very poorly understood, including in the world´s largest freshwater basin, the Amazon.Objectives: Determine the degree to which physical and chemical characteristics of the instream habitat of low-order Amazonian streams change in response to past local- and catchment-level anthropogenic disturbances. Methods: To do so, we collected field instream habitat (i.e., physical habitat and water quality) and landscape data from 99 stream sites in two eastern Brazilian Amazon regions. We used random forest regression trees to assess the relative importance of different predictor variables in determining changes in instream habitat response variables. Adaptations the USEPA’s National Aquatic Resource Survey (NARS) designs, field methods, and approaches for assessing ecological condition have been applied in state and basin stream surveys throughout the U.S., and also in countries outside of the U.S. These applications not only provide valuable tests of the NARS approaches, but generate new understandings of natural and anthropogenic controls on biota and physical habitat in streams. Results from applications in Brazil, for example, not only aid interpretation of the condition of Brazilian streams, but also refine approaches for interpreting aquatic resource surveys in the U.S. and elsewhere. In this article, the authors des

Return to drug use and overdose after release from prison: a qualitative study of risk and protective factors.

PubMed

Binswanger, Ingrid A; Nowels, Carolyn; Corsi, Karen F; Glanz, Jason; Long, Jeremy; Booth, Robert E; Steiner, John F

2012-01-01

Former inmates are at high risk for death from drug overdose, especially in the immediate post-release period. The purpose of the study is to understand the drug use experiences, perceptions of overdose risk, and experiences with overdose among former prisoners. This qualitative study included former prison inmates (N=29) who were recruited within two months after their release. Interviewers conducted in-person, semi-structured interviews which explored participants' experiences and perceptions. Transcripts were analyzed utilizing a team-based method of inductive analysis. The following themes emerged: 1) Relapse to drugs and alcohol occurred in a context of poor social support, medical co-morbidity and inadequate economic resources; 2) former inmates experienced ubiquitous exposure to drugs in their living environments; 3) intentional overdose was considered "a way out" given situational stressors, and accidental overdose was perceived as related to decreased tolerance; and 4) protective factors included structured drug treatment programs, spirituality/religion, community-based resources (including self-help groups), and family. Former inmates return to environments that strongly trigger relapse to drug use and put them at risk for overdose. Interventions to prevent overdose after release from prison may benefit from including structured treatment with gradual transition to the community, enhanced protective factors, and reductions of environmental triggers to use drugs.

A Reanalysis of Occupation and Suicide: Negative Perceptions of the Workplace Linked to Suicide Attempts.

PubMed

Howard, Matt; Krannitz, Morgan

2017-11-17

Suicide is the ultimate outcome of poor psychological well-being; however, there is a paucity of research examining the link between occupation and suicide, despite early academic interest and the known importance of work to our everyday lives. We propose that this body of research was abandoned prematurely, and we provide a reanalysis by integrating the Job Characteristics Model and the Conservation of Resources model with extant suicide research. Specifically, we hypothesize that work design characteristics (job autonomy, task variety, physical demands) and threats to personal resources (absence of viewing work-as-career, work-family conflict, family-work conflict, job dissatisfaction) are linked to suicide attempts via depression and suicidal ideation. Utilizing three measurement occasions and 2,855 participants from the AddHealth database, our findings indicate that job autonomy, task variety, work-family conflict, family-work conflict, and job dissatisfaction all indirectly contribute to employees' suicide attempts via depression and suicidal ideation. Thus, negative employee perceptions of the workplace environment have much more severe consequences than is typically examined. Based on these results, we provide recommendations for developing a theoretically derived nomological net around suicidal behavior in an organizational context, and offer strategies for managers and employees to construct a work environment that is conducive to employee well-being.

Enhancing the supportive care of parents with advanced cancer: development of a self-directed educational manual.

PubMed

Turner, Jane; Clavarino, Alexandra; Yates, Patsy; Hargraves, Maryanne; Connors, Veronica; Hausmann, Sue

2008-08-01

Diagnosing and treating young patients with cancer can be stressful for health professionals; however, when the prognosis is poor and the patient has dependent children, even experienced clinicians can feel distressed and helpless. Parents with advanced cancer commonly express anxiety about the impact of the disease on their children, yet health professionals often feel unable to respond constructively because of lack of training, or concern that discussion about such difficult issues will compound parental distress. In response to this problem, an educational manual has been devised to assist oncology staff to better understand the emotional impact of parental advanced cancer, encompassing information about specific reactions of children, including strategies to help children and families cope. This paper describes the development and content of the resource which provides clinically relevant information and evidence-based recommendations to guide supportive care. The manual differs from the more traditional didactic resources in that it examines the very personal impact for professionals working with parents with advanced disease, encouraging reflection and engages the reader in clinical exercises which encourage active learning and application of knowledge into authentic clinical contexts. Although the manual is designed primarily for nurses, it is clear that much of the information is relevant for all health professionals involved in the care of parents with advanced cancer.

Re-evaluating the resource potential of lomas fog oasis environments for Preceramic hunter-gatherers under past ENSO modes on the south coast of Peru

NASA Astrophysics Data System (ADS)

Beresford-Jones, David; Pullen, Alexander G.; Whaley, Oliver Q.; Moat, Justin; Chauca, George; Cadwallader, Lauren; Arce, Susana; Orellana, Alfonso; Alarcón, Carmela; Gorriti, Manuel; Maita, Patricia K.; Sturt, Fraser; Dupeyron, Agathe; Huaman, Oliver; Lane, Kevin J.; French, Charles

2015-12-01

Lomas - ephemeral seasonal oases sustained by ocean fogs - were critical to ancient human ecology on the desert Pacific coast of Peru: one of humanity's few independent hearths of agriculture and "pristine" civilisation. The role of climate change since the Late Pleistocene in determining productivity and extent of past lomas ecosystems has been much debated. Here we reassess the resource potential of the poorly studied lomas of the south coast of Peru during the long Middle Pre-ceramic period (c. 8000-4500 BP): a period critical in the transition to agriculture, the onset of modern El Niño Southern Oscillation ('ENSO') conditions, and eustatic sea-level rise and stabilisation and beach progradation. Our method combines vegetation survey and herbarium collection with archaeological survey and excavation to make inferences about both Preceramic hunter-gatherer ecology and the changed palaeoenvironments in which it took place. Our analysis of newly discovered archaeological sites - and their resource context - show how lomas formations defined human ecology until the end of the Middle Preceramic Period, thereby corroborating recent reconstructions of ENSO history based on other data. Together, these suggest that a five millennia period of significantly colder seas on the south coast induced conditions of abundance and seasonal predictability in lomas and maritime ecosystems, that enabled Middle Preceramic hunter-gatherers to reduce mobility by settling in strategic locations at the confluence of multiple eco-zones at the river estuaries. Here the foundations of agriculture lay in a Broad Spectrum Revolution that unfolded, not through population pressure in deteriorating environments, but rather as an outcome of resource abundance.

Can legality verification enhace local rights to forest resources? Piloting the policy learning protocol in the Peruvian forest context

Treesearch

B. Cashore; I. Visseren-Hamakers; P. Caro Torres; W. de Jong; A. Denvir; D. Humphreys; Kathleen McGinley; G. Auld; S. Lupberger; C. McDermott; S. Sax; D. Yin

2016-01-01

This report, “Can Legality Verification Enhance Local Rights to Forest Resources? Piloting the policy learning protocol in the Peruvian forest context,” reports on the testing of the application of the 11-step Policy Learning Protocol in Peru in 2015-16. The Protocol (Cashore et al. 2014) enables actors to draw from international policy initiatives in order to improve...

Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework: Perceptions of stakeholders.

PubMed

Maluka, Stephen; Kamuzora, Peter; San Sebastián, Miguel; Byskov, Jens; Ndawi, Benedict; Hurtig, Anna-Karin

2010-12-01

In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania. The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees. Individual interviews were carried out with different categories of actors and stakeholders in the district. The interview guide consisted of a series of questions, asking respondents to describe their perceptions regarding each condition of the Accountability for Reasonableness framework in terms of priority setting. Interviews were analysed using thematic framework analysis. Documentary data were used to support, verify and highlight the key issues that emerged. Almost all stakeholders viewed Accountability for Reasonableness as an important and feasible approach for improving priority-setting and health service delivery in their context. However, a few aspects of Accountability for Reasonableness were seen as too difficult to implement given the socio-political conditions and traditions in Tanzania. Respondents mentioned: budget ceilings and guidelines, low level of public awareness, unreliable and untimely funding, as well as the limited capacity of the district to generate local resources as the major contextual factors that hampered the full implementation of the framework in their context. This study was one of the first assessments of the applicability of Accountability for Reasonableness in health care priority-setting in Tanzania. The analysis, overall, suggests that the Accountability for Reasonableness framework could be an important tool for improving priority-setting processes in the contexts of resource-poor settings. However, the full implementation of Accountability for Reasonableness would require a proper capacity-building plan, involving all relevant stakeholders, particularly members of the community since public accountability is the ultimate aim, and it is the community that will live with the consequences of priority-setting decisions.

Competition along productivity gradients: news from heathlands.

PubMed

Delerue, Florian; Gonzalez, Maya; Achat, David L; Puzos, Luc; Augusto, Laurent

2018-05-01

The importance of competition in low productive habitats is still debated. Studies which simultaneously evaluate preemption of resources and consequences for population dynamics are needed for a comprehensive view of competitive outcomes. We cultivated two emblematic species of European heathlands (Calluna vulgaris and Molinia caerulea) in a nursery for 2 years at two fertility levels, reproducing the productivity gradient found in phosphorus (P)-depleted heathlands in southwest France. The second year, we planted Ulex europaeus seedlings, a ubiquitous heathland species, under the cover of the two species to evaluate its ability to regenerate. Half of the seedlings were placed in tubes for exclusion of competitor roots. We measured the development of the competitors aboveground and belowground and their interception of resources (light, water, inorganic P). Ulex seedlings' growth and survival were also measured. Our results on resources interception were consistent with species distribution in heathlands. Molinia, which dominates rich heathlands, was the strongest competitor for light and water in the rich soil. Calluna, which dominates poor heathlands, increased its root allocation in the poor soil, decreasing water and inorganic P availability. However, the impact of total competition and root competition on Ulex seedlings decreased in the poor soil. Other mechanisms, especially decrease of water stress under neighbouring plant cover, appeared to have more influence on the seedlings' response. We found no formal contradiction between Tilman and Grime's theories. Root competition has a primary role in acquisition of soil resources in poor habitats. However, the importance of competition decreases with decreasing fertility.

Direct observation of respectful maternity care in five countries: a cross-sectional study of health facilities in East and Southern Africa.

PubMed

Rosen, Heather E; Lynam, Pamela F; Carr, Catherine; Reis, Veronica; Ricca, Jim; Bazant, Eva S; Bartlett, Linda A

2015-11-23

Poor quality of care at health facilities is a barrier to pregnant women and their families accessing skilled care. Increasing evidence from low resource countries suggests care women receive during labor and childbirth is sometimes rude, disrespectful, abusive, and not responsive to their needs. However, little is known about how frequently women experience these behaviors. This study is one of the first to report prevalence of respectful maternity care and disrespectful and abusive behavior at facilities in multiple low resource countries. Structured, standardized clinical observation checklists were used to directly observe quality of care at facilities in five countries: Ethiopia, Kenya, Madagascar, Rwanda, and the United Republic of Tanzania. Respectful care was represented by 10 items describing actions the provider should take to ensure the client was informed and able to make choices about her care, and that her dignity and privacy were respected. For each country, percentage of women receiving these practices and delivery room privacy conditions were calculated. Clinical observers' open-ended comments were also analyzed to identify examples of disrespect and abuse. A total of 2164 labor and delivery observations were conducted at hospitals and health centers. Encouragingly, women overall were treated with dignity and in a supportive manner by providers, but many women experienced poor interactions with providers and were not well-informed about their care. Both physical and verbal abuse of women were observed during the study. The most frequently mentioned form of disrespect and abuse in the open-ended comments was abandonment and neglect. Efforts to increase use of facility-based maternity care in low income countries are unlikely to achieve desired gains if there is no improvement in quality of care provided, especially elements of respectful care. This analysis identified insufficient communication and information sharing by providers as well as delays in care and abandonment of laboring women as deficiencies in respectful care. Failure to adopt a patient-centered approach and a lack of health system resources are contributing structural factors. Further research is needed to understand these barriers and develop effective interventions to promote respectful care in this context.

Workplace Literacy: A Resource Book.

ERIC Educational Resources Information Center

Guglielmino, Lucy Madsen; Byran, Valerie C.

This resource book provides information on developing a workplace literacy program, descriptions of Florida Workplace Literacy Programs, and an annotated bibliography of resources. An introduction discusses the problem of basic skills deficiencies, projections that indicate the problem will increase, the Florida context, and benefits realized when…

Ensembl genomes 2016: more genomes, more complexity

USDA-ARS?s Scientific Manuscript database

Ensembl Genomes (http://www.ensemblgenomes.org) is an integrating resource for genome-scale data from non-vertebrate species, complementing the resources for vertebrate genomics developed in the context of the Ensembl project (http://www.ensembl.org). Together, the two resources provide a consistent...

Factors Influencing the Academic Achievement of the Turkish Urban Poor

ERIC Educational Resources Information Center

Engin-Demir, Cennet

2009-01-01

This study estimates the individual and combined effects of selected family, student and school characteristics on the academic achievement of poor, urban primary-school students in the Turkish context. Participants of the study consisted of 719 sixth, seventh, and eighth grade primary-school students from 23 schools in inner and outer city…

Are better sleepers more engaged workers? A self-regulatory approach to sleep hygiene and work engagement.

PubMed

Barber, Larissa; Grawitch, Matthew J; Munz, David C

2013-10-01

Previous research has emphasized facets of both the organizational environment and individual differences as predictors of work engagement. This study explored sleep hygiene as another important behavioural factor that may be related to work engagement. With a sample of 328 adult workers, we tested a multiple mediator model in which sleep hygiene predicts work engagement through one's appraisals of resource depletion stemming from demands (psychological strain) and general self-regulatory capacity (self-control). Results indicated that individuals who frequently engaged in poor sleep hygiene behaviours had lower self-regulatory capacity, experienced higher subjective depletion and were less engaged at work. Additionally, the path from poor sleep hygiene to decreased work engagement was attributed to perceptions of personal resources that are needed to exert self-regulatory energy at work. This is consistent with current self-regulatory theories suggesting that individuals have a limited amount of resources to allocate to demands and that the depletion of these resources can lead to stress and lower self-regulatory functioning in response to other demands. Specifically, poor sleep hygiene results in the loss of self-regulatory resources needed to be engaged in work tasks by impairing the after-work recovery process. Practical and research implications regarding sleep hygiene interventions for well-being and productivity improvement are discussed. Copyright © 2012 John Wiley & Sons, Ltd.

Being Sticker Rich: Numerical Context Influences Children’s Sharing Behavior

PubMed Central

Posid, Tasha; Fazio, Allyse; Cordes, Sara

2015-01-01

Young children spontaneously share resources with anonymous recipients, but little is known about the specific circumstances that promote or hinder these prosocial tendencies. Children (ages 3–11) received a small (12) or large (30) number of stickers, and were then given the opportunity to share their windfall with either one or multiple anonymous recipients (Dictator Game). Whether a child chose to share or not varied as a function of age, but was uninfluenced by numerical context. Moreover, children’s giving was consistent with a proportion-based account, such that children typically donated a similar proportion (but different absolute number) of the resources given to them, regardless of whether they originally received a small or large windfall. The proportion of resources donated, however, did vary based on the number of recipients with whom they were allowed to share, such that on average, children shared more when there were more recipients available, particularly when they had more resources, suggesting they take others into consideration when making prosocial decisions. Finally, results indicated that a child’s gender also predicted sharing behavior, with males generally sharing more resources than females. Together, findings suggest that the numerical contexts under which children are asked to share, as well as the quantity of resources that they have to share, may interact to promote (or hinder) altruistic behaviors throughout childhood. PMID:26535900

Social and Economic Analysis Branch: integrating policy, social, economic, and natural science

USGS Publications Warehouse

Schuster, Rudy; Walters, Katie D.

2015-01-01

The Fort Collins Science Center's Social and Economic Analysis Branch provides unique capabilities in the U.S. Geological Survey by leading projects that integrate social, behavioral, economic, and natural science in the context of human–natural resource interactions. Our research provides scientific understanding and support for the management and conservation of our natural resources in support of multiple agency missions. We focus on meeting the scientific needs of the Department of the Interior natural resource management bureaus in addition to fostering partnerships with other Federal and State managers to protect, restore, and enhance our environment. The Social and Economic Analysis Branch has an interdisciplinary group of scientists whose primary functions are to conduct both theoretical and applied social science research, provide technical assistance, and offer training to support the development of skills in natural resource management activities. Management and research issues associated with human-resource interactions typically occur in a unique context and require knowledge of both natural and social sciences, along with the skill to integrate multiple science disciplines. In response to these challenging contexts, Social and Economic Analysis Branch researchers apply a wide variety of social science concepts and methods which complement our rangeland/agricultural, wildlife, ecology, and biology capabilities. The goal of the Social and Economic Analysis Branch's research is to enhance natural-resource management, agency functions, policies, and decisionmaking.

An Appreciation of Social Context: One Legacy of Gerald Salancik.

ERIC Educational Resources Information Center

Weick, Karl E.

1996-01-01

Evaluates Gerald Salancik's work, tracing salient themes and focusing on his constant attention to the social context of individual and organizational motivation and action. Shows the centrality of social context in his studies on priming effects, commitment, power, resource dependence, justification, decision making, and other topics. He excelled…

Humor in Context: Fire Service and Joking Culture

ERIC Educational Resources Information Center

Moran, Larry; Roth, Gene

2013-01-01

Although theorizing about humor has occurred for several decades, scant research exists that examines humor in the broad context of human resource development. Humor exists in workplaces and it is historicized in the professional and organizational contexts of workers. This paper explores aspects of a joking culture within the specific work…

Using Photo-Elicitation Methods to Understand Resilience Among Ultra-Poor Youth and Their Caregivers in Malawi.

PubMed

Barrington, Clare; Villa-Torres, Laura; Abdoulayi, Sara; Tsoka, Maxton Grant; Mvula, Peter Matthias

2017-10-01

Unconditional cash transfer programs are a form of structural intervention to address poverty, a "fundamental cause" of disease. Such programs increasingly aim to build resilience to sustain improved outcomes and provide a solid foundation for longer term transformations. As such, there is a need to understand what resilience means in specific contexts. The goal of this formative study was to explore local experiences of resilience and vulnerability among 11 youth-caregiver dyads ( n = 22) who were beneficiaries of the Malawi Social Cash Transfer Program in Balaka district. We used a photo-elicitation approach informed by the participatory, visual methodology photovoice to guide the study and conducted an iterative content analysis using thematic coding of transcripts and photos. Participants took pictures of their daily struggles and shocks and participated in audio-recorded discussions to reflect on the photos using an adapted version of the SHOWeD method. We found that participants characterized resilience as a tireless process of using all available individual, family, and community resources at all times in pursuit of survival and well-being. In the context of daily struggles, resilience was an essential part of survival. Shocks, mostly health-related, were depicted through staged images candidly highlighting individual and environmental vulnerabilities. Community support was an essential component of resilience for both daily struggles and shocks. Using photo-elicitation methods facilitated an intergenerational, community-driven reflection on the meaning of resilience and the multilevel determinants of health in a context of extreme poverty. Findings can inform the design of resilience-focused cash transfer programs to improve health equity.

Infusing Bioethics into Biology and Microbiology Courses and Curricula: A Vertical Approach

PubMed Central

Jagger, Kathleen S.; Furlong, Jack

2014-01-01

With the rise of biomedicine and biotechnology, there has been a corresponding growth in the need for better understanding of consequent ethical questions. Increasingly, biologists are being asked not only to offer technical clarifications but also to venture ethical opinions, for which most feel poorly equipped. This expectation puts pressure on biology instructors at the university level to provide biology majors the skills and experience to discuss with some confidence and competence bioethical issues which may arise in either the workplace or through public discourse in everyday contexts. Many fine curricular resources about bioethics are available for varied pedagogical purposes, but few target undergraduate biology or microbiology student audiences. When it occurs in the context of a course, bioethics instruction often is taught by non-biologists outside standard biology curricula. We propose that biologists should strive to “infuse” bioethical thinking into their courses and major curricula but not in such a way as merely to point at ethical problems, treating them at a surface level. We suggest what we call “vertical infusion”: taking one bioethical issue per course and integrating this issue within the context of a relevant biological topic, challenging students to push their thinking beyond their initial intuitions toward underlying scientific and ethical principles. While the vertical approach lacks widespread coverage of ethical issues throughout a single course, it has the advantage of taking the bioethical dimension seriously and in intimate relation to contemporary discoveries in biology and to the biological principles, processes, or procedures that occasioned the ethical quandaries in the first place. PMID:25574281

Age-friendly environments and life satisfaction among South Korean elders: person-environment fit perspective.

PubMed

Park, Sojung; Lee, Sangchul

2017-07-01

Drawing on the person-environment (P-E) fit perspective, this study examined the role of environment on the well-being of vulnerable older adults in a non-western context. Using the indicators from the World Health Organization's (WHO) framework for age friendly cities (ACF), we examined life satisfaction among South Korean older adults, exploring the extent to which multidimensional environmental characteristics are associated with low socioeconomic status (SES). Using the regionally representative data from the Seoul City-wide needs assessment of middle- and old-aged adults, an analytic sample (N = 1657) focused on community-living individuals aged 65 and older. Multilevel regression models examined interaction between SES subgroups and varying aspects of the environment (i.e. physical, social, and service environment) as related to life satisfaction. Consistent with the environmental docility hypothesis, members of the most vulnerable subgroup in the Korean context - older adults who are living alone and poor - are more likely to have higher life satisfaction when they have higher levels of support in physical and social environments. Interestingly, a higher level of support in the service environment was related to lower life satisfaction for this subgroup. This study provides an empirical foundation for efforts to identify age-friendly environmental characteristics as modifiable environmental resources that can improve older adults' psychological well-being. As the first attempt to use WHO ACF indicators within the P-E fit perspective in a non-Western context, our study provides a foundation for designing support services or programs that effectively meet the needs of vulnerable older adults.

The effect of recent competition between the native Anolis oculatus and the invasive A. cristatellus on display behavior.

PubMed

Dufour, Claire M S; Herrel, Anthony; Losos, Jonathan B

2018-01-01

Invasive species are a global threat to biodiversity. Cases where the invasion has been tracked since its beginning are rare, however, such that the first interactions between invasive and native species remain poorly understood. Communication behavior is an integral part of species identity and is subject to selection. Consequently, resource use and direct interference competition between native and invasive species may drive its evolution. Here, we tested the role of interactions between the recently introduced invasive lizard Anolis cristatellus and the native Anolis oculatus on variation in behavior and communication in Calibishie (Dominica). From May to June 2016, we filmed 122 adult males of both species displaying in banana farms under two contexts (allopatry and sympatry). We then recorded (i) the proportion of time spent displaying and (ii) the relative frequency of dewlap vs. push-up displays. To control for habitat variation, we measured and compared the habitat characteristics (canopy openness and habitat openness) of 228 males in allopatry and sympatry. While the habitat characteristics and total display-time did not differ between the contexts for the two species, the proportion of display-time spent dewlapping by A. cristatellus decreased in sympatry. The display of A. oculatus did not differ between the contexts, however. Shifts in microhabitat use, predation pressure, or interspecific interference are potential factors which might explain the behavioral changes in display observed in A. cristatellus . This study highlights the role of behavioral traits as a first response of an invasive species to recent competition with a closely related native species.

Debt relief and public health spending in heavily indebted poor countries.

PubMed Central

Gupta, Sanjeev; Clements, Benedict; Guin-Siu, Maria Teresa; Leruth, Luc

2002-01-01

The Heavily Indebted Poor Countries (HIPC) Initiative, which was launched in 1996, is the first comprehensive effort by the international community to reduce the external debt of the world's poorest countries. The Initiative will generate substantial savings relative to current and past public spending on health and education in these countries. Although there is ample scope for raising public health spending in heavily indebted poor countries, it may not be advisable to spend all the savings resulting from HIPC resources for this purpose. Any comprehensive strategy for tackling poverty should also focus on improving the efficiency of public health outlays and on reallocating funds to programmes that are most beneficial to the poor. In order to ensure that debt relief increases poverty-reducing spending and benefits the poor, all such spending, not just that financed by HIPC resources, should be tracked. This requires that countries improve all aspects of their public expenditure management. In the short run, heavily indebted poor countries can take some pragmatic tracking measures based on existing public expenditure management systems, but in the longer run they should adopt a more comprehensive approach so as to strengthen their budget formulation, execution, and reporting systems. PMID:11953794

Unemployment and self-rated health: neighborhood influence.

PubMed

Giatti, Luana; Barreto, Sandhi M; César, Cibele C

2010-08-01

This work contributes to the study of the relationship between health, work and context by investigating the interaction between them in Brazil, a country with great social inequalities. It investigates whether unemployment and socioeconomic characteristics of the neighborhoods in which people live are associated with poor self-rated health after adjustment for individual sociodemographic characteristics, behavioral risk factors and health status. Moreover, it tests whether living in an area of socioeconomic deprivation modifies the association between unemployment and self-rated health. The study involved participants whose ages ranged from 15 up to 64 years, and who lived in four Brazilian cities included in the National Household Survey on Risk Behaviors and Reported Morbidity from Non-Communicable Diseases, carried out by the Ministry of Health in 2002/2003. Data from the 2000 Brazilian Population Census were used to calculate two neighborhood socioeconomic indicators: the proportion of householders with low income, a compositional variable of individual level characteristics, and residing in slums, a contextual variable not captured by individual properties. Logistic regression analysis was estimated by Generalized Estimating Equations. Of the 6426 participants, 20.6% reported poor self-rated health. Unemployment as well as residing in slums or in low income household areas were significantly associated with poor self-rated health. The magnitudes of these associations were attenuated after adjustment for sociodemographic characteristics, behavioral risk factors and other health status indicators. However, the association between unemployment and poor self-rated health was not modified by neighborhood socioeconomic indicators. Results confirm the association between unemployment and poor self-rated health, regardless of the personal or contextual characteristics studied here. Similarly, they show a clear independent association between self-rated health and neighborhood context. Even so, they do not show that the neighborhood contexts investigated modify the associations between unemployment and poor self-rated health. (c) 2010 Elsevier Ltd. All rights reserved.

Strengthening family coping resources: the feasibility of a multifamily group intervention for families exposed to trauma.

PubMed

Kiser, Laurel J; Donohue, April; Hodgkinson, Stacy; Medoff, Deborah; Black, Maureen M

2010-12-01

Families exposed to urban poverty face a disproportionate risk of exposure to repeated trauma. Repeated exposures can lead to severe and chronic reactions in multiple family members with effects that ripple throughout the family system. Interventions for distressed families residing in traumatic contexts, such as low-income, urban settings are desperately needed. This report presents preliminary data in support of Strengthening Family Coping Resources, a trauma-focused, multifamily, skill-building intervention. Strengthening Family Coping Resources is designed for families living in traumatic contexts with the goal of reducing symptoms of posttraumatic stress disorder and other trauma-related disorders in children and caregivers. Results from open trials suggest Strengthening Family Coping Resources is a feasible intervention with positive effects on children's symptoms of trauma-related distress.

Business Process-Based Resource Importance Determination

NASA Astrophysics Data System (ADS)

Fenz, Stefan; Ekelhart, Andreas; Neubauer, Thomas

Information security risk management (ISRM) heavily depends on realistic impact values representing the resources’ importance in the overall organizational context. Although a variety of ISRM approaches have been proposed, well-founded methods that provide an answer to the following question are still missing: How can business processes be used to determine resources’ importance in the overall organizational context? We answer this question by measuring the actual importance level of resources based on business processes. Therefore, this paper presents our novel business process-based resource importance determination method which provides ISRM with an efficient and powerful tool for deriving realistic resource importance figures solely from existing business processes. The conducted evaluation has shown that the calculation results of the developed method comply to the results gained in traditional workshop-based assessments.

From Learning Object to Learning Cell: A Resource Organization Model for Ubiquitous Learning

ERIC Educational Resources Information Center

Yu, Shengquan; Yang, Xianmin; Cheng, Gang; Wang, Minjuan

2015-01-01

This paper presents a new model for organizing learning resources: Learning Cell. This model is open, evolving, cohesive, social, and context-aware. By introducing a time dimension into the organization of learning resources, Learning Cell supports the dynamic evolution of learning resources while they are being used. In addition, by introducing a…

Do College Students Notice Errors in Evidence When Critically Evaluating Research Findings?

ERIC Educational Resources Information Center

Rodriguez, Fernando; Ng, Annalyn; Shah, Priti

2016-01-01

The authors examined college students' ability to critically evaluate scientific evidence, specifically, whether first- and second-year students noticed when poor interpretations were drawn from research evidence. Fifty students evaluated a set of eight psychological studies, first in an informal context, then again in a critical-thinking context.…

A Randomized Trial of Contingency Management Delivered in the Context of Group Counseling

ERIC Educational Resources Information Center

Petry, Nancy M.; Weinstock, Jeremiah; Alessi, Sheila M.

2011-01-01

Objective: Contingency management (CM) is efficacious in reducing drug use. Typically, reinforcers are provided on an individual basis to patients for submitting drug-negative samples. However, most treatment is provided in a group context, and poor attendance is a substantial concern. This study evaluated whether adding CM to group-based…

Reading in a Root-Based-Morphology Language: The Case of Arabic.

ERIC Educational Resources Information Center

Abu-Rabia, S.

2002-01-01

Reviews the reading process in Arabic as a function of vowels and sentence context. Reviews reading accuracy and reading comprehension results in light of cross-cultural reading to develop a more comprehensive reading theory. Presents the phonology, morphology and sentence context of Arabic in two suggested reading models for poor/beginner Arabic…

HiCAT Software Infrastructure: Safe hardware control with object oriented Python

NASA Astrophysics Data System (ADS)

Moriarty, Christopher; Brooks, Keira; Soummer, Remi

2018-01-01

High contrast imaging for Complex Aperture Telescopes (HiCAT) is a testbed designed to demonstrate coronagraphy and wavefront control for segmented on-axis space telescopes such as envisioned for LUVOIR. To limit the air movements in the testbed room, software interfaces for several different hardware components were developed to completely automate operations. When developing software interfaces for many different pieces of hardware, unhandled errors are commonplace and can prevent the software from properly closing a hardware resource. Some fragile components (e.g. deformable mirrors) can be permanently damaged because of this. We present an object oriented Python-based infrastructure to safely automate hardware control and optical experiments. Specifically, conducting high-contrast imaging experiments while monitoring humidity and power status along with graceful shutdown processes even for unexpected errors. Python contains a construct called a “context manager” that allows you define code to run when a resource is opened or closed. Context managers ensure that a resource is properly closed, even when unhandled errors occur. Harnessing the context manager design, we also use Python’s multiprocessing library to monitor humidity and power status without interrupting the experiment. Upon detecting a safety problem, the master process sends an event to the child process that triggers the context managers to gracefully close any open resources. This infrastructure allows us to queue up several experiments and safely operate the testbed without a human in the loop.

When Care is a "Systematic Route of Torture": Conceptualizing the Violence of Medical Negligence in Resource-Poor Settings.

PubMed

Heckert, Carina

2016-12-01

Descriptions of patient mistreatment fill ethnographic accounts of healthcare in resource-poor settings. Often, anthropologists point to structural factors and the ways that the global political economy produces substandard care. This approach makes it difficult to hold parties accountable when there is blatant disregard for human life on the part of individuals providing care. In this article, I draw on the illness narrative of Magaly Chacón, the first HIV positive individual in Bolivia to file charges of medical negligence after failing to receive care to prevent mother-to-child transmission. Magaly's narrative demonstrates how structural conditions are often used to explain away poor patient outcomes, shifting attention away from and normalizing the symbolic violence that also perpetuates substandard care of marginalized patients. I use Magaly's accusations to interrogate how defining acts of mistreatment as medical negligence can be a productive exercise, even when it is difficult to disentangle structural constraints from blatant acts of negligence. Defining who is negligent in resource-poor settings is not easy, as Magaly's case demonstrates. However, Magaly's case also demonstrates that accusations of negligence themselves can demand accountability and force changes within the local structures that contribute to the systematic mistreatment of marginalized patients.

Theory of Mind is Related to Children’s Resource Allocations in Gender Stereotypic Contexts

PubMed Central

Rizzo, Michael T.; Killen, Melanie

2017-01-01

The present study investigated the relations between 4- to 6-year-old children’s (N = 67) gender stereotypes, resource allocations, and mental state knowledge in gender stereotypic contexts. Participants were told vignettes about female and male characters completing gender-stereotyped activities (making dolls or trucks). Children held stereotypic expectations regarding doll- and truck-making abilities, and these expectations predicted the degree of bias in their allocations of resources to the characters. Critically, children’s performance on a ToM scale (Diverse Desires, Contents False-Belief, Belief-Emotion) was significantly related to their allocations of resources to individuals whose effort did not fit existing gender stereotypes (e.g., a boy who was good at making dolls). With increasing ToM competence, children allocated resources based on merit (even when the character’s effort did not fit existing gender stereotypes) rather than based on stereotypes. The present results provide novel information regarding the emergence of gender stereotypes about abilities, the influence of stereotypes on children’s resource allocations, and the role of ToM in children’s ability to challenge gender stereotypes when allocating resources. PMID:29083217

Resilience amongst Australian Aboriginal Youth: An Ecological Analysis of Factors Associated with Psychosocial Functioning in High and Low Family Risk Contexts

PubMed Central

Hopkins, Katrina D.; Zubrick, Stephen R.; Taylor, Catherine L.

2014-01-01

We investigate whether the profile of factors protecting psychosocial functioning of high risk exposed Australian Aboriginal youth are the same as those promoting psychosocial functioning in low risk exposed youth. Data on 1,021 youth aged 12–17 years were drawn from the Western Australian Aboriginal Child Health Survey (WAACHS 2000–2002), a population representative survey of the health and well-being of Aboriginal children, their families and community contexts. A person-centered approach was used to define four groups of youth cross-classified according to level of risk exposure (high/low) and psychosocial functioning (good/poor). Multivariate logistic regression was used to model the influence of individual, family, cultural and community factors on psychosocial outcomes separately for youth in high and low family-risk contexts. Results showed that in high family risk contexts, prosocial friendship and low area-level socioeconomic status uniquely protected psychosocial functioning. However, in low family risk contexts the perception of racism increased the likelihood of poor psychosocial functioning. For youth in both high and low risk contexts, higher self-esteem and self-regulation were associated with good psychosocial functioning although the relationship was non-linear. These findings demonstrate that an empirical resilience framework of analysis can identify potent protective processes operating uniquely in contexts of high risk and is the first to describe distinct profiles of risk, protective and promotive factors within high and low risk exposed Australian Aboriginal youth. PMID:25068434

Context cue focality influences strategic prospective memory monitoring.

PubMed

Hunter Ball, B; Bugg, Julie M

2018-02-12

Monitoring the environment for the occurrence of prospective memory (PM) targets is a resource-demanding process that produces cost (e.g., slower responding) to ongoing activities. However, research suggests that individuals are able to monitor strategically by using contextual cues to reduce monitoring in contexts in which PM targets are not expected to occur. In the current study, we investigated the processes supporting context identification (i.e., determining whether or not the context is appropriate for monitoring) by testing the context cue focality hypothesis. This hypothesis predicts that the ability to monitor strategically depends on whether the ongoing task orients attention to the contextual cues that are available to guide monitoring. In Experiment 1, participants performed an ongoing lexical decision task and were told that PM targets (TOR syllable) would only occur in word trials (focal context cue condition) or in items starting with consonants (nonfocal context cue condition). In Experiment 2, participants performed an ongoing first letter judgment (consonant/vowel) task and were told that PM targets would only occur in items starting with consonants (focal context cue condition) or in word trials (nonfocal context cue condition). Consistent with the context cue focality hypothesis, strategic monitoring was only observed during focal context cue conditions in which the type of ongoing task processing automatically oriented attention to the relevant features of the contextual cue. These findings suggest that strategic monitoring is dependent on limited-capacity processing resources and may be relatively limited when the attentional demands of context identification are sufficiently high.

Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.

PubMed

Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes

2013-10-24

Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was reported as common practice. The resources available for these activities and which constitute potential resources for the CDI process include community volunteers, CBOs and NGOs. Others are landlords; professional, women and youth associations; social clubs, religious organisations and the available health facilities. This study's findings support the feasibility of using the CDI process in delivering health interventions in urban poor communities and show that potential resources for the strategy abound in the communities.

Current challenges in the management of sepsis in ICUs in resource-poor settings and suggestions for the future.

PubMed

Schultz, Marcus J; Dunser, Martin W; Dondorp, Arjen M; Adhikari, Neill K J; Iyer, Shivakumar; Kwizera, Arthur; Lubell, Yoel; Papali, Alfred; Pisani, Luigi; Riviello, Beth D; Angus, Derek C; Azevedo, Luciano C; Baker, Tim; Diaz, Janet V; Festic, Emir; Haniffa, Rashan; Jawa, Randeep; Jacob, Shevin T; Kissoon, Niranjan; Lodha, Rakesh; Martin-Loeches, Ignacio; Lundeg, Ganbold; Misango, David; Mer, Mervyn; Mohanty, Sanjib; Murthy, Srinivas; Musa, Ndidiamaka; Nakibuuka, Jane; Serpa Neto, Ary; Nguyen Thi Hoang, Mai; Nguyen Thien, Binh; Pattnaik, Rajyabardhan; Phua, Jason; Preller, Jacobus; Povoa, Pedro; Ranjit, Suchitra; Talmor, Daniel; Thevanayagam, Jonarthan; Thwaites, C Louise

2017-05-01

Sepsis is a major reason for intensive care unit (ICU) admission, also in resource-poor settings. ICUs in low- and middle-income countries (LMICs) face many challenges that could affect patient outcome. To describe differences between resource-poor and resource-rich settings regarding the epidemiology, pathophysiology, economics and research aspects of sepsis. We restricted this manuscript to the ICU setting even knowing that many sepsis patients in LMICs are treated outside an ICU. Although many bacterial pathogens causing sepsis in LMICs are similar to those in high-income countries, resistance patterns to antimicrobial drugs can be very different; in addition, causes of sepsis in LMICs often include tropical diseases in which direct damaging effects of pathogens and their products can sometimes be more important than the response of the host. There are substantial and persisting differences in ICU capacities around the world; not surprisingly the lowest capacities are found in LMICs, but with important heterogeneity within individual LMICs. Although many aspects of sepsis management developed in rich countries are applicable in LMICs, implementation requires strong consideration of cost implications and the important differences in resources. Addressing both disease-specific and setting-specific factors is important to improve performance of ICUs in LMICs. Although critical care for severe sepsis is likely cost-effective in LMIC setting, more detailed evaluation at both at a macro- and micro-economy level is necessary. Sepsis management in resource-limited settings is a largely unexplored frontier with important opportunities for research, training, and other initiatives for improvement.

Poverty, development, and women: why should we care?

PubMed

Thompson, Joyce E Beebe

2007-01-01

Healthy, prosperous nations require healthy women and newborns. Young girls and women in resource-poor nations suffer the greatest ill-health consequences from low status, denial of basic human rights, and poverty. Poverty and poor health result in poor economic development. The Millennium Development Goals call for immediate efforts to reduce poverty, improve health, especially of girls and women, and foster development in the world's poorest nations.

Learning in a u-Museum: Developing a Context-Aware Ubiquitous Learning Environment

ERIC Educational Resources Information Center

Chen, Chia-Chen; Huang, Tien-Chi

2012-01-01

Context-awareness techniques can support learners in learning without time or location constraints by using mobile devices and associated learning activities in a real learning environment. Enrichment of context-aware technologies has enabled students to learn in an environment that integrates learning resources from both the real world and the…

Poor Vision, Functioning, and Depressive Symptoms: A Test of the Activity Restriction Model

ERIC Educational Resources Information Center

Bookwala, Jamila; Lawson, Brendan

2011-01-01

Purpose: This study tested the applicability of the activity restriction model of depressed affect to the context of poor vision in late life. This model hypothesizes that late-life stressors contribute to poorer mental health not only directly but also indirectly by restricting routine everyday functioning. Method: We used data from a national…

Asian and Pacific Islander American Poverty: The Working Poor and the Jobless Poor.

ERIC Educational Resources Information Center

Toji, Dean S.; Johnson, James H.

1992-01-01

Assesses the incidence of Asian-American and Pacific Islander-American poverty, and offers a theoretical explanation for its existence. It is argued that poverty of Americans of Asian and Pacific Island descent is best understood in the context of the linkage of labor migration and U.S. labor market segmentation. (SLD)

Exploring the perceptions and experiences of community health workers using role identity theory

PubMed Central

Mlotshwa, Langelihle; Harris, Bronwyn; Schneider, Helen; Moshabela, Mosa

2015-01-01

Background Community health workers (CHWs) are an integral resource in many health systems, particularly in resource-poor settings. Their identities – ‘who’ they are – play an important role in their hiring, training, and retention. We explore the perceptions, experiences, and identities of CHWs as they adopt a CHW role in rural South Africa, using ‘role identity theory’. Design From April to December 2010, we conducted 18 semi-structured interviews with CHWs volunteering in non-governmental home-based care (HBC) organisations in one rural sub-district in South Africa. The role identity theory framework was used to understand the work of CHWs within their communities, addressing themes, such as entry into, and nature of, caring roles, organisational support, state resourcing, and community acceptability. A thematic content analysis was used to analyse the collected data. Results The study found that CHWs usually begin their ‘caring work’ before they formally join HBC organisations, by caring for children, neighbours, mothers, fathers, friends, and the community in some way. CHWs felt that becoming a health worker provided an elevated status within the community, but that it often led community members to believe they were able to control resources. The key role identities assumed by CHWs, as they sought to meet patients’ and their own needs, were a complex mix of community ‘insider’, ‘outsider’, and ‘broker’. Each of these role identities served as a unique way to position, from the CHW's perspective, themselves and the community, given the diversity of needs and expectations. Conclusions These role identities reveal the tensions CHWs face as ‘insider’ members of the community and yet at times being treated as ‘outsiders’, who might be regarded with suspicion, and at the same time, appreciated for the resources that they might possess. Understanding role identities, and how best to support them, may contribute to strategies of retention and sustainability of CHW programmes, as their formalisation in different contexts continues to grow. PMID:26387505

Exploring the perceptions and experiences of community health workers using role identity theory.

PubMed

Mlotshwa, Langelihle; Harris, Bronwyn; Schneider, Helen; Moshabela, Mosa

2015-01-01

Community health workers (CHWs) are an integral resource in many health systems, particularly in resource-poor settings. Their identities--'who' they are--play an important role in their hiring, training, and retention. We explore the perceptions, experiences, and identities of CHWs as they adopt a CHW role in rural South Africa, using 'role identity theory'. From April to December 2010, we conducted 18 semi-structured interviews with CHWs volunteering in non-governmental home-based care (HBC) organisations in one rural sub-district in South Africa. The role identity theory framework was used to understand the work of CHWs within their communities, addressing themes, such as entry into, and nature of, caring roles, organisational support, state resourcing, and community acceptability. A thematic content analysis was used to analyse the collected data. The study found that CHWs usually begin their 'caring work' before they formally join HBC organisations, by caring for children, neighbours, mothers, fathers, friends, and the community in some way. CHWs felt that becoming a health worker provided an elevated status within the community, but that it often led community members to believe they were able to control resources. The key role identities assumed by CHWs, as they sought to meet patients' and their own needs, were a complex mix of community 'insider', 'outsider', and 'broker'. Each of these role identities served as a unique way to position, from the CHW's perspective, themselves and the community, given the diversity of needs and expectations. These role identities reveal the tensions CHWs face as 'insider' members of the community and yet at times being treated as 'outsiders', who might be regarded with suspicion, and at the same time, appreciated for the resources that they might possess. Understanding role identities, and how best to support them, may contribute to strategies of retention and sustainability of CHW programmes, as their formalisation in different contexts continues to grow.

Effective Practices in Providing Online, In-Service Training to Health Professionals in Low-Resource Settings

ERIC Educational Resources Information Center

Chio, Karen Sherk

2012-01-01

As doctors, nurses and public health professionals are promoted into management and leadership positions in resource-poor countries around the world, they are tasked with leading teams and managing drugs and financial and material resources. These responsibilities require a set of skills and knowledge different from that needed for their clinical…

Insomnia and incident depression: role of objective sleep duration and natural history.

PubMed

Fernandez-Mendoza, Julio; Shea, Sarah; Vgontzas, Alexandros N; Calhoun, Susan L; Liao, Duanping; Bixler, Edward O

2015-08-01

Longitudinal studies that have examined the association of insomnia with incident depression using objective sleep measures are very limited. The aim of this study was to examine the predictive role of the severity of insomnia for incident depression in a general population sample using psychometric and polysomnographic data. From a random, general population sample of 1741 individuals of the Penn State Adult Cohort, 1137 adults without depression were followed up with a structured telephone interview after 7.5 years. All subjects completed a full medical evaluation, 1-night polysomnogram and Multiphasic Minnesota Personality Inventory at baseline. The incidence of depression was 15%. Poor sleep (odds ratio = 1.5, P = 0.001) and insomnia (odds ratio = 1.9, P = 0.031) were significantly associated with incident depression. The odds of incident depression were highest (odds ratio = 2.2, P = 0.019) in insomnia with objective short sleep duration and independent of Multiphasic Minnesota Personality Inventory Ego Strength scores, an index of poor coping resources. The persistence of insomnia and worsening of poor sleep into insomnia significantly increased the odds of incident depression (odds ratios ranged from 1.8 to 6.3), whereas their full remission did not (odds ratio ranged from 1.2 to 1.8). Insomnia with short sleep duration is associated with incident depression independent of poor coping resources, whereas the association of insomnia with normal sleep duration with incident depression was mediated by poor coping resources. Persistence and worsening of poor sleep or insomnia, but not their full remission, are significant predictors of incident depression. These data suggest that there is a significant relationship between the severity of insomnia and incident depression. © 2015 European Sleep Research Society.

Valuing goat genetic resources: a pro-poor growth strategy in the Kenyan semi-arid tropics.

PubMed

Omondi, I A; Baltenweck, I; Drucker, A G; Obare, G A; Zander, K K

2008-12-01

Goats, "the poor man's cow", provide very important genetic resources that can be exploited for continued improvements of the livelihoods of poor livestock keepers in the semi-arid tropics. This study presents the evaluation of the economic values of goat genetic resources (GGRs) in terms of the important non-market traits embedded in goats and how this information can be utilised to improve livelihoods in semi-arid regions. The results obtained from mixed logit models derived from stated choice data collected from 314 respondents in the semi-arid Marsabit district of Kenya reveal that disease resistance is the most highly valued trait whose resultant augmentation results into a welfare improvement of up to KShs.2899. Drought tolerance and milk traits were found to be implicitly valued at KShs.2620 and 1179 respectively. The study further revealed that improvement in milk trait in does, body size and disease resistance traits in bucks, and drought tolerance trait in both does and bucks will collectively improve the producers' welfare hence should be given priority. However, improvement in the reproduction and production ("overall body condition/ meatiness" trait) potential of goats will be worthwhile only if issues concerning access to pasture and water resources are addressed prior and simultaneously.

Leadership Learning Opportunities in Agriculture, Food, and Natural Resources Education: The Role of The Teacher

ERIC Educational Resources Information Center

McKim, Aaron J.; Pauley, C. M.; Velez, Jonathan J.; Sorensen, Tyson J.

2017-01-01

Learning environments combining agriculture, food, natural resources, and leadership knowledge and skills are increasingly essential in preparing students for future success. School-based agricultural education offers a premier context in which to teach leadership within agriculture, food, and natural resources curriculum. However, providing…

Children's Allocation of Resources in Social Dominance Situations

ERIC Educational Resources Information Center

Charafeddine, Rawan; Mercier, Hugo; Clément, Fabrice; Kaufmann, Laurence; Reboul, Anne; Van der Henst, Jean-Baptiste

2016-01-01

Two experiments with preschoolers (36 to 78 months) and 8-year-old children (Experiment 1, N = 173; Experiment 2, N = 132) investigated the development of children's resource distribution in dominance contexts. On the basis of the distributive justice literature, 2 opposite predictions were tested. Children could match resource allocation with the…

Students' and Lecturers' Views on Mathematics Resources

ERIC Educational Resources Information Center

Ní Shé, Caitríona; Mac an Bhaird, Ciarán; Ní Fhloinn, Eabhnat; O'Shea, Ann

2017-01-01

There is a general agreement that many students struggle with the transition from secondary to higher education, particularly in the context of mathematics modules. Lecturers often suggest or supply supplemental resources to give students the opportunity to overcome their difficulties. In addition, students often seek out resources independently,…

Managing Human Resources in a Multinational Context

ERIC Educational Resources Information Center

Sumetzberger, Walter

2005-01-01

Purpose: To develop more sensitivity for different patterns of human resource management in multinational companies. Design/methodology/approach: Systemic approach; the concepts and models are based on the evaluation of consulting projects in the field of human resource management. Findings: A concept of four typical varieties of human resource…

Use of Visual and Multimedia Resources in an Undergraduate Classroom: A Case Study

ERIC Educational Resources Information Center

Matusiak, Krystyna K.

2012-01-01

This paper reports the findings of a case study that examined the use of digital information resources in an undergraduate geography class. The study assumed a contextual approach and focused on the use of visual and multimedia resources in specific class contexts. The distribution of resources in the class observed for the study varied and…

Resource selection for foraging by female Merriam's wild turkeys with poults in the southern Black Hills, South Dakota

Treesearch

Chad P. Lehman; Mark A. Rumble; Lester D. Flake; Daniel J. Thompson

2011-01-01

Knowledge of Merriam's wild turkey (Meleagris gallopavo merriami) resource selection in the context of landscape attributes is an important asset for managing resources on multiple-use public lands. We investigated resource selection for foraging by Merriam's wild turkey broods in the southern Black Hills, South Dakota. We collected macro- and microhabitat...

Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya

PubMed Central

Abdulrehman, Munib Said; Woith, Wendy; Jenkins, Sheryl; Kossman, Susan; Hunter, Gina Louise

2016-01-01

In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all. PMID:28462335

Investigation of productivity in a south Indian Malabari goat herd shows opportunities for planned animal health management to improve food security.

PubMed

Sargison, N D; Ivil, S A J; Abraham, J; Abubaker, S P S; Hopker, A M; Mazeri, S; Otter, I A; Otter, N

2017-03-18

Here the authors report the objective veterinary clinical measurement of productivity in a representative south Indian Malabari goat herd. The authors show failure to meet pragmatic production targets that are commensurate with the animals' genetic potential or adequate to meet the demands of global food security. The authors suggest that this situation may have arisen as a consequence of animal husbandry constraints and protein undernutrition and imply the involvement of nematode parasitism. Benzimidazole resistance was detected in Haemonchus species, showing the need for better understanding of the principles of sustainable helminth parasite control within the southern Indian context. This study highlights the need to understand the true costs of goat production in seasonally resource-poor environments, while also considering its impact on the overall ecosystem in which the animals are placed. They conclude that pragmatic opportunities for improvements in goat production efficiency lie in the development of problem-focused planned animal health and nutrition management. British Veterinary Association.

Cost and impact of a quality improvement programme in mental health services.

PubMed

Beecham, Jennifer; Ramsay, Angus; Gordon, Kate; Maltby, Sophie; Walshe, Kieran; Shaw, Ian; Worrall, Adrian; King, Sarah

2010-04-01

To estimate the cost and impact of a centrally-driven quality improvement initiative in four UK mental health communities. Total costs in year 1 were identified using documentation, a staff survey, semi-structured interviews and discussion groups. Few outcome data were collected within the programme so thematic analysis was used to identify the programme's impact within its five broad underlying principles. The survey had a 40% response. Total costs ranged between pound164,000 and pound458,000 per site, plus staff time spent on workstreams. There was a very hazy view of the resources absorbed and poor recording of expenditure and activity. The initiative generated little demonstrable improvements in service quality but some participants reported changes in attitudes. Given the difficult contexts, short time-scales and capacity constraints, the programme's lack of impact is not surprising. It may, however, represent a worthwhile investment in cultural change which might facilitate improvements in how services are delivered.

Barriers to disseminating brief CBT for voices from a lived experience and clinician perspective

PubMed Central

Hazell, Cassie M.; Strauss, Clara; Cavanagh, Kate

2017-01-01

Access to psychological therapies continues to be poor for people experiencing psychosis. To address this problem, researchers are developing brief interventions that address the specific symptoms associated with psychosis, i.e., hearing voices. As part of the development work for a brief Cognitive Behaviour Therapy (CBT) intervention for voices we collected qualitative data from people who hear voices (study 1) and clinicians (study 2) on the potential barriers and facilitators to implementation and engagement. Thematic analysis of the responses from both groups revealed a number of anticipated barriers to implementation and engagement. Both groups believed the presenting problem (voices and psychosis symptoms) may impede engagement. Furthermore clinicians identified a lack of resources to be a barrier to implementation. The only facilitator to engagement was reported by people who hear voices who believed a compassionate, experienced and trustworthy therapist would promote engagement. The results are discussed in relation to how these barriers could be addressed in the context of a brief intervention using CBT techniques. PMID:28575094

Policing men: militarised masculinity, youth livelihoods, and security in conflict-affected northern Uganda.

PubMed

Tapscott, Rebecca

2018-01-01

Relations between militaries and masculinities-and hegemonic masculinity and the state-are well-established in the literature on gender and development. However, there is less research on how militarised masculinities relate to state governance strategies. This paper, based on qualitative research conducted in northern Uganda between 2014 and 2017, offers a gender analysis of youths participating in informal security arrangements. Civilian male youths accept poorly paid or unpaid work in the informal security sector in the hope of gaining access to livelihoods that will enable them to fulfil masculine ideal-types. However, this arrangement denies them the resources necessary to achieve the ideal-type of civilian masculinity, as well as the state's military masculinity, which produces young men as subjects of the ruling regime. To reconfigure this relationship between civilian and militarised masculinities, one should understand informal security organisations in the context of alternative livelihood arrangements and take a long-term approach to the demilitarisation of the Ugandan state. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Insecure People in Insecure Places: The Influence of Regional Unemployment on Workers' Reactions to the Threat of Job Loss.

PubMed

Glavin, Paul; Young, Marisa

2017-06-01

Social comparison theory predicts that unemployment should be less distressing when the experience is widely shared, but does this prediction extend beyond the unemployed to those who are at risk of job loss? Research demonstrates a link between aggregate unemployment and employed individuals' perceptions of job insecurity; however, less is known about whether the stress associated with these perceptions is shaped by others' unemployment experiences. We analyze a nationally representative sample of Canadian workers (Canadian Work, Stress, and Health study; N = 3,900) linked to census data and test whether regional unemployment influences the mental health consequences of job insecurity. Multilevel analyses provide more support for the social norm of insecurity hypothesis over the amplified threat hypothesis: the health penalties of job insecurity are weaker for individuals in high-unemployment regions. This contingency is partially explained by the ability of insecure workers in poor labor market contexts to retain psychological resources important for protecting mental health.

Infection prevention and control in home nursing: case study of four organisations in Australia.

PubMed

Felemban, Ohood; St John, Winsome; Shaban, Ramon Zenel

2015-09-01

The aim of this case study was to explore the environmental challenges nurses experience with infection control practice, and the strategies they use to overcome those challenges. An exploratory case study was conducted in four home visiting nursing organisations in southeast Queensland, Australia, using data triangulation (document review, individual interviews, and focus groups). Data were analysed using a framework approach to identify themes. Three major infection prevention and control challenges were experienced in the community context. The first challenge is the nature of the work environment, including: poor cleanliness in clients' home environments, pets or vermin, inadequate hand-washing facilities, and a lack of appropriate storage space for clinical materials. The second challenge occurs when nurses lack access to appropriate infection control equipment, including wound-management materials and sharps containers. The third challenge is dealing with clients' poor personal hygiene and health status. Participants addressed these issues by offering assistance, using clean surfaces at clients' homes, applying an alcohol-based hand rub, providing client education, and reducing the cost of purchasing equipment for clients. It is imperative that policy is developed to support nurses' decision making and practices as they address infection control challenges in the community environment. Ensuring staff are well-supported with resources, education, policy, and guidelines to address these challenges is important for the delivery of safe and high-quality care in community settings.

The other crisis: the economics and financing of maternal, newborn and child health in Asia.

PubMed

Anderson, Ian; Axelson, Henrik; Tan, B-K

2011-07-01

The Global Financial Crisis (GFC) of 2008/2009 was the largest economic slowdown since the Great Depression. It undermined the growth and development prospects of developing countries. Several recent studies estimate the impact of economic shocks on the poor and vulnerable, especially women and children. Infant and child mortality rates are still likely to continue to decline, but at lower rates than would have been the case in the absence of the GFC. Asia faces special challenges. Despite having been the fastest growing region in the world for decades, and even before the current crisis, this region accounted for nearly 34% of global deaths of children under 5, more than 40% of maternal deaths and 60% of newborn deaths. Global development goals cannot be achieved without much faster and deeper progress in Asia. Current health financing systems in much of Asia are not well placed to respond to the needs of women and their children, or the recent global financial and economic slowdown. Public expenditure is often already too low, and high levels of out-of-pocket health expenditure are an independent cause of inequity and impoverishment for women and their children. The GFC highlights the need for reforms that will improve health outcomes for the poor, protect the vulnerable from financial distress, improve public expenditure patterns and resource allocation decisions, and so strengthen health systems. This paper aims to highlight the most recent assessments of how economic shocks, including the GFC, affect the poor in developing countries, especially vulnerable women and children in Asia. It concludes that conditional cash transfers, increasing taxation on tobacco and increasing the level, and quality, of public expenditure through well-designed investment programmes are particularly relevant in the context of an economic shock. That is because these initiatives simultaneously improve health outcomes for the poor and vulnerable, protect them from further financial distress, improve public financing and/or provide a much-needed counter-cyclical stimulus at times of economic slowdown.

Strategies to improve the performance of learners in a nursing college. Part II: Issues pertaining to management, attitudes and values.

PubMed

Waterson, E; Harms, E; Qupe, L; Maritz, J; Manning, M; Makobe, K; Chabeli, M

2006-05-01

This article forms part two of a bigger study that was conducted in a nursing college to explore and describe the reasons for the poor performance of learners. Part one of the study dealt with the issues pertaining to education, while this article (part two) seeks to describe issues pertaining to management, attitudes and values that lead to the poor performance of learners in the nursing college under study. A qualitative, exploratory and descriptive design that was contextual in nature was employed, and three focus groups interviews were conducted. Seven tutors formed one group while other two groups were formed by fourth-year learners following a comprehensive diploma course. All participants voluntarily participated in the study. Data was analyzed using the descriptive method of open coding in accordance with Tesch's protocol (in Creswell, 1994:154-156). Trustworthiness was ensured using the following principles: credibility, conformability, transferability and dependability (Lincoln & Guba 1985:290-326). Findings were categorized into issues pertaining to management, attitudes and values that had an influence on the poor performance of learners as follows: Inadequate resources and study facilities; policies that change frequently; tutors' dissatisfaction with regard to staff development, the lack of involvement by management and lack of management support, staff shortage and maldistribution of staff members; ineffective selection process of learners; inconsistent regulations, and too many of them; policies and procedures resulting in confusion and poor discipline. Attitudes and values: Tutors' lack of motivation and interest, lack of respect by learners and no team work among tutors. Through a conceptualization process and the recommendations by participants, strategies to improve the learners' performance were described. It is recommended that these strategies be submitted to the staff development committee for implementation and future follow-up research be undertaken to determine the effectiveness of the strategies. It is also recommended that other nursing colleges replicate the study within their context.

Novelty-Induced Arousal Enhances Memory for Cued Classical Fear Conditioning: Interactions between Peripheral Adrenergic and Brainstem Glutamatergic Systems

ERIC Educational Resources Information Center

King, Stanley O., II; Williams, Cedric L.

2009-01-01

Exposure to novel contexts produce heightened states of arousal and biochemical changes in the brain to consolidate memory. However, processes permitting simple exposure to unfamiliar contexts to elevate sympathetic output and to improve memory are poorly understood. This shortcoming was addressed by examining how novelty-induced changes in…

The Influence of Information Behaviour on Information Sharing across Cultural Boundaries in Development Contexts

ERIC Educational Resources Information Center

Meyer, Hester W. J.

2009-01-01

Introduction: Sharing of information across cultural boundaries does not always live up to expectations. Information behaviour is an underlying factor, which can contribute to poor use or non-use of the information or information services at the disposal of indigenous people in a development context. Method: A literature study of information…

Invariant Spatial Context Is Learned but Not Retrieved in Gaze-Contingent Tunnel-View Search

ERIC Educational Resources Information Center

Zang, Xuelian; Jia, Lina; Müller, Hermann J.; Shi, Zhuanghua

2015-01-01

Our visual brain is remarkable in extracting invariant properties from the noisy environment, guiding selection of where to look and what to identify. However, how the brain achieves this is still poorly understood. Here we explore interactions of local context and global structure in the long-term learning and retrieval of invariant display…

Context-Specific Trophic and Functional Ecology of Fishes of Small Stream Ecosystems in the Ouachita National Forest

Treesearch

William J. Matthews; A. Maria Miller-Lemke; Melvin L. Warren; Donna Cobb; Jeffery G. Stewart; Betty Crump; Frances P. Gelwick

2004-01-01

Abstract - Fish play diverse and important roles in stream ecosystems, but details about ecosystem effects are poorly known for many freshwater fish species. A requisite first step to understanding functional roles of individual species is information on their trophic ecology in the context of particular environmental settings. Stomach contents were...

Clinical research, prophylaxis, therapy, and care for HIV disease in Africa.

PubMed Central

De Cock, K M; Lucas, S B; Lucas, S; Agness, J; Kadio, A; Gayle, H D

1993-01-01

By the end of the century, citizens of resource-poor countries will constitute 90% of the world's human immunodeficiency virus (HIV)-infected people. Clinical management of such persons in developing countries has been neglected; most AIDS research has concentrated on epidemiology, and donor agencies have generally invested in the prevention of HIV infection. The heavy burden of HIV disease in Africa requires that care for AIDS be addressed, and prevention and care should be seen as interrelated. Prevention and treatment of tuberculosis, the commonest severe infection in persons with AIDS in Africa, illustrate this interrelationship. We outline priorities for applied research on the management of HIV disease in a resource-poor environment, and discuss prophylaxis, therapy for opportunistic diseases, terminal care, and use of antiretroviral therapy. Research should define the standard of care that can realistically be demanded for HIV disease in a resource-poor environment. Research and public health programs for AIDS in developing countries must address AIDS care and attempt to reduce the widening gap between interventions available for HIV-infected persons in different parts of the world. PMID:8214225

Prevalence and Risk Factors of Hookworm-Related Cutaneous Larva Migrans (HrCLM) in a Resource-Poor Community in Manaus, Brazil

PubMed Central

Reichert, Felix; Pilger, Daniel; Schuster, Angela; Lesshafft, Hannah; Guedes de Oliveira, Silas; Ignatius, Ralf; Feldmeier, Hermann

2016-01-01

Background Hookworm-related cutaneous larva migrans (HrCLM) is a neglected tropical skin disease associated with significant clinical pathology. Little knowledge exists about prevalence and risk factors of HrCLM in endemic regions. Methodology/ Principal Findings To understand the epidemiology of HrCLM in Amazonia, we conducted a cross-sectional study in a resource-poor township in Manaus, Brazil. HrCLM was diagnosed in 8.2% (95% CI, 6.3–10.1%) of the study population (N = 806) with a peak prevalence of 18.2% (95% CI, 9.3–27.1%) in children aged 10–14. Most of the tracks (62.4%) were located on the feet, and 10.6% were superinfected. HrCLM was associated independently with age under 15, male sex, presence of animal faeces on the compound, walking barefoot on sandy ground and poverty. Conclusions/ Significance HrCLM is common in resource-poor communities in Amazonia and is related to poverty. To reduce the disease burden caused by HrCLM, living conditions have to be improved. PMID:27010204

Strengthening Family Coping Resources: The Feasibility of a Multifamily Group Intervention for Families Exposed to Trauma*

PubMed Central

Kiser, Laurel J.; Donohue, April; Hodgkinson, Stacy; Medoff, Deborah; Black, Maureen M.

2010-01-01

Families exposed to urban poverty face a disproportionate risk of exposure to repeated trauma. Repeated exposures can lead to severe and chronic reactions in multiple family members with effects that ripple throughout the family system. Interventions for distressed families residing in traumatic contexts, such as low-income, urban settings are desperately needed. This report presents preliminary data in support of Strengthening Family Coping Resources, a trauma-focused, multifamily, skill-building intervention. Strengthening Family Coping Resources is designed for families living in traumatic contexts with the goal of reducing symptoms of posttraumatic stress disorder and other trauma-related disorders in children and caregivers. Results from open trials suggest Strengthening Family Coping Resources is a feasible intervention with positive effects on children’s symptoms of trauma-related distress. PMID:21105068

The role of organizational context in moderating the effect of research use on pain outcomes in hospitalized children: a cross sectional study.

PubMed

Yamada, Janet; Squires, Janet E; Estabrooks, Carole A; Victor, Charles; Stevens, Bonnie

2017-01-23

Despite substantial research on pediatric pain assessment and management, health care professionals do not adequately incorporate this knowledge into clinical practice. Organizational context (work environment) is a significant factor in influencing outcomes; however, the nature of the mechanisms are relatively unknown. The objective of this study was to assess how organizational context moderates the effect of research use and pain outcomes in hospitalized children. A cross-sectional survey was undertaken with 779 nurses in 32 patient care units in 8 Canadian pediatric hospitals, following implementation of a multifaceted knowledge translation intervention, Evidence-based Practice for Improving Quality (EPIQ). The influence of organizational context was assessed in relation to pain process (assessment and management) and clinical (pain intensity) outcomes. Organizational context was measured using the Alberta Context Tool that includes: leadership, culture, evaluation, social capital, informal interactions, formal interactions, structural and electronic resources, and organizational slack (staff, space, and time). Marginal modeling estimated the effects of instrumental research use (direct use of research knowledge) and conceptual research use (indirect use of research knowledge) on pain outcomes while examining the effects of context. Six of the 10 organizational context factors (culture, social capital, informal interactions, resources, and organizational slack [space and time]) significantly moderated the effect of instrumental research use on pain assessment; four factors (culture, social capital, resources and organizational slack time) moderated the effect of conceptual research use and pain assessment. Only two factors (evaluation and formal interactions) moderated the effect of instrumental research use on pain management. All organizational factors except slack space significantly moderated the effect of instrumental research use on pain intensity; informal interactions and organizational slack space moderated the effect of conceptual research use and pain intensity. Many aspects of organizational context consistently moderated the effects of instrumental research use on pain assessment and pain intensity, while only a few influenced conceptual use of research on pain outcomes. Organizational context factors did not generally influence the effect of research use on pain management. Further research is required to further explore the relationships between organizational context and pain management outcomes.

Development of a Prototype Continuity of Care Record with Context-Specific Links to Meet the Information Needs of Case Managers for Persons Living with HIV

PubMed Central

Cimino, James J.; Bakken, Suzanne

2012-01-01

Objectives (1) To develop a prototype Continuity of Care Record (CCR) with context-specific links to electronic HIV information resources; and (2) to assess case managers’ perceptions regarding the usability of the prototype. Methods We integrated context-specific links to HIV case management information resources into a prototype CCR using the Infobutton Manager and Librarian Infobutton Tailoring Environment (LITE). Case managers (N=9) completed a think-aloud protocol and the Computer System Usability Questionnaire (CSUQ) to evaluate the usability of the prototype. Verbalizations from the think-aloud protocol were summarized using thematic analysis. CSUQ data were analyzed with descriptive statistics. Results Although participants expressed positive comments regarding the usability of the prototype, the think-aloud protocol also identified the need for improvement in resource labels and for additional resources. On a scale ranging from 1 (strongly agree) to 7 (strongly disagree), the average CSUQ overall satisfaction was 2.25 indicating that users (n=9) were generally satisfied with the system. Mean CSUQ factor scores were: System Usefulness (M=2.13), Information Quality (M=2.46), and Interface Quality (M=2.26). Conclusion Our novel application of the Infobutton Manager and LITE in the context of case management for persons living with HIV in community-based settings resulted in a prototype CCR with infobuttons that met the majority of case managers’ information needs and received relatively positive usability ratings. Findings from this study inform future integration of context-specific links into CCRs and electronic health records and support their use for meeting end-users information needs. PMID:22632821

Daydreaming style moderates the relation between working memory and mind wandering: Integrating two hypotheses.

PubMed

Marcusson-Clavertz, David; Cardeña, Etzel; Terhune, Devin Blair

2016-03-01

Mind wandering-mentation unrelated to one's current activity and surroundings-is a ubiquitous phenomenon, but seemingly competing ideas have been proposed regarding its relation to executive cognitive processes. The control-failure hypothesis postulates that executive processes prevent mind wandering, whereas the global availability hypothesis proposes that mind wandering requires executive resources, and thus an excess of such resources enables mind wandering. Here, we examined whether these hypotheses could be reconciled by considering the moderating influence of daydreaming style. We expected that executive resources would be positively related to mind wandering in those who typically experience positive mind wandering mentation, but negatively related in those who typically experience negative mentation. One hundred eleven participants reported mind wandering over 4 days using experience sampling and completed the sustained attention to response task (SART), the symmetry span task, and the Stroop task. There was a significant interaction between working memory and negative, but not positive, daydreaming style on mind wandering: Working memory related positively to mind wandering in those with a low negative style, but negatively in those with a high negative style. In contrast, poor Stroop performance significantly predicted increased mind wandering, but only in those with a low positive style. SART responses did not predict mind wandering although the relation was suggestively enhanced as the difficulty of daily life activities increased, indicating that the SART is more generalizable to high-demanding than low-demanding activities. These results suggest that the content and context of mind wandering episodes play important roles in the relation between executive processes and mind wandering. (c) 2016 APA, all rights reserved).

Ecohydrology of a Tropical Landscape: Hydrological Regimes and Implications for Water Resources and Ecological Dynamics in the Talgua Watershed, Honduras

NASA Astrophysics Data System (ADS)

Reyes, W. M.; Jass, T. L.; Emanuel, R. E.

2016-12-01

The tropics play a central role in regulating Earth's environmental systems, not only cycling more water than any other region in the world but also influencing global biogeochemical and energy balances. Increasing and widespread deforestation, climate change, and other disturbances are rapidly altering Earth system processes in the tropics, yet our understanding of these processes and their implications is limited for certain locations. Honduras, located within the Mesoamerican region, is one such location. A combination of rapid land use change (including deforestation at 3% y-1), hurricanes, droughts, poor access to drinking water, and poverty place Honduras among the most environmentally vulnerable countries in the world. However, these factors also create an ideal scenario for understanding complex human-environment interactions and their effects on tropical eco-hydrological systems. To this end, we collected and analyzed hydrological and meteorological data from the upper Talgua River, a forested, montane catchment in the headwaters of Honduras' Patuca River, during 2015 and 2016. We characterized the water balance and basic water quality relationships for the Talgua River, an important accomplishment for such a data-sparse region. We place our results in the context of coupled human-water dynamics in this region of Mesoamerica and discuss implications for water resources and other environmental services. Our analyses, embedded research infrastructure, and long-term partnerships with local institutions help provide valuable insights that narrow the existing knowledge gap in tropical ecohydrology and related socio-environmental dynamics. Our work also helps local communities and governments plan and make well-informed decisions about water and related resources.

Chemical and Isotopic Tracers of Groundwater Sustainability: an Overview of New Science Directions

NASA Astrophysics Data System (ADS)

Bullen, T.

2002-12-01

Groundwater sustainability is an emerging concept that is rapidly gaining attention from both scientists and water resource managers, particularly with regard to contamination and degradation of water quality in strategic aquifers. The sustainability of a groundwater resource is a complex function of its susceptibility to factors such as intrusion of poor-quality water from diverse sources, lack of sufficient recharge and reorganization of groundwater flowpaths in response to excessive abstraction. In theory the critical limit occurs when degradation becomes irreversible, such that remediative efforts may be fruitless on a reasonable human time scale. Chemical and isotopic tracers are proving to be especially useful tools for assessment of groundwater sustainability issues such as characterization of recharge, identification of potential sources, pathways and impacts of contaminants and prediction of how hydrology will change in response to excessive abstraction. A variety of relatively cost-efficient tracers are now available with which to assess the susceptibility of groundwater reserves to contamination from both natural and anthropogenic sources, and may provide valuable monitoring and regulatory tools for water resource managers. In this overview, the results of several ongoing groundwater studies by the U.S. Geological Survey will be discussed from the perspective of implications for new science directions for groundwater sustainability research that can benefit water policy development. A fundamental concept is that chemical and isotopic tracers used individually often provide ambiguous information, and are most effective when used in a rigorous "multi-tracer" context that considers the complex linkages between the hydrology, geology and biology of groundwater systems.

Linking community, parenting, and depressive symptom trajectories: testing resilience models of adolescent agency based on race/ethnicity and gender.

PubMed

Williams, Amanda L; Merten, Michael J

2014-09-01

Family stress models illustrate how communities affect youth outcomes through effects on parents and studies consistently show the enduring effects of early community context. The present study takes a different approach identifying human agency during adolescence as a potentially significant promotive factor mediating the relationship between community, parenting, and mental health. While agency is an important part of resilience, its longitudinal effects are unknown, particularly based on gender and race/ethnicity. The purpose of this research was to model the long-term effects of community structural adversity and social resources as predictors of adolescent depressive symptom trajectories via indirect effects of parental happiness, parent-child relationships, and human agency. Latent growth analyses were conducted with 1,796 participants (53% female; 56% White) across four waves of the National Longitudinal Study of Adolescent Health spanning adolescence (Wave 1) through adulthood (Wave 4). The results identified agency as an important promotive factor during adolescence with long-term mental health benefits, but only for White and male participants. For these individuals, community social resources and the quality of the parent-child relationship were related to higher levels of agency and more positive mental health trajectories. Although community social resources similarly benefitted parenting and agency among females and non-White participants, there were no significant links between agency and depressive symptoms for these youth. The results suggest that agency remains an important, but poorly understood concept and additional work is necessary to continue unpacking its meaning for diverse groups of youth.

Building nurse education capacity in India: insights from a faculty development programme in Andhra Pradesh

PubMed Central

2013-01-01

Background India faces an acute shortage of nurses. Strategies to tackle the human resource crisis depend upon scaling up nursing education provision in a context where the social status and working conditions of nurses are highly variable. Several national and regional situation assessments have revealed significant concerns about educational governance, institutional and educator capacity, quality and standards. Improving educational capacity through nursing faculty development has been proposed as one of several strategies to address a complex health human resource situation. This paper describes and critically reflects upon the experience of one such faculty development programme in the state of Andhra Pradesh. Discussion The faculty development programme involved a 2 year partnership between a UK university and 7 universities in Andhra Pradesh. It adopted a participatory approach and covered training and support in 4 areas: teaching, research/scholarship, leadership/management and clinical education. Senior hospital nurses were also invited to participate. Summary The programme was evaluated positively and some changes to educational practice were reported. However, several obstacles to wider change were identified. At the programme level, there was a need for more intensive individual and institutional mentorship as well as involvement of Indian Centres of Excellence in Nursing to provide local (as well as international) expertise. At the organisational level, the participating Colleges reported heavy workloads, lack of control over working conditions, lack of control over the curriculum and poor infra-structure/resources as ongoing challenges. In the absence of wider educational reform in nursing and government commitment to the profession, faculty development programmes alone will have limited impact. PMID:23537273

EPOS-WP16: A Platform for European Multi-scale Laboratories

NASA Astrophysics Data System (ADS)

Spiers, Chris; Drury, Martyn; Kan-Parker, Mirjam; Lange, Otto; Willingshofer, Ernst; Funiciello, Francesca; Rosenau, Matthias; Scarlato, Piergiorgio; Sagnotti, Leonardo; W16 Participants

2016-04-01

The participant countries in EPOS embody a wide range of world-class laboratory infrastructures ranging from high temperature and pressure experimental facilities, to electron microscopy, micro-beam analysis, analogue modeling and paleomagnetic laboratories. Most data produced by the various laboratory centres and networks are presently available only in limited "final form" in publications. As such many data remain inaccessible and/or poorly preserved. However, the data produced at the participating laboratories are crucial to serving society's need for geo-resources exploration and for protection against geo-hazards. Indeed, to model resource formation and system behaviour during exploitation, we need an understanding from the molecular to the continental scale, based on experimental data. This contribution will describe the work plans that the laboratories community in Europe is making, in the context of EPOS. The main objectives are: - To collect and harmonize available and emerging laboratory data on the properties and processes controlling rock system behaviour at multiple scales, in order to generate products accessible and interoperable through services for supporting research activities. - To co-ordinate the development, integration and trans-national usage of the major solid Earth Science laboratory centres and specialist networks. The length scales encompassed by the infrastructures included range from the nano- and micrometer levels (electron microscopy and micro-beam analysis) to the scale of experiments on centimetre sized samples, and to analogue model experiments simulating the reservoir scale, the basin scale and the plate scale. - To provide products and services supporting research into Geo-resources and Geo-storage, Geo-hazards and Earth System Evolution.

National policy development for cotrimoxazole prophylaxis in Malawi, Uganda and Zambia: the relationship between Context, Evidence and Links

PubMed Central

2011-01-01

Background Several frameworks have been constructed to analyse the factors which influence and shape the uptake of evidence into policy processes in resource poor settings, yet empirical analyses of health policy making in these settings are relatively rare. National policy making for cotrimoxazole (trimethoprim-sulfamethoxazole) preventive therapy in developing countries offers a pertinent case for the application of a policy analysis lens. The provision of cotrimoxazole as a prophylaxis is an inexpensive and highly efficacious preventative intervention in HIV infected individuals, reducing both morbidity and mortality among adults and children with HIV/AIDS, yet evidence suggests that it has not been quickly or evenly scaled-up in resource poor settings. Methods Comparative analysis was conducted in Malawi, Uganda and Zambia, using the case study approach. We applied the ‘RAPID’ framework developed by the Overseas Development Institute (ODI), and conducted a total of 47 in-depth interviews across the three countries to examine the influence of context (including the influence of donor agencies), evidence (both local and international), and the links between researcher, policy makers and those seeking to influence the policy process. Results Each area of analysis was found to have an influence on the creation of national policy on cotrimoxazole preventive therapy (CPT) in all three countries. In relation to context, the following were found to be influential: government structures and their focus, donor interest and involvement, healthcare infrastructure and other uses of cotrimoxazole and related drugs in the country. In terms of the nature of the evidence, we found that how policy makers perceived the strength of evidence behind international recommendations was crucial (if evidence was considered weak then the recommendations were rejected). Further, local operational research results seem to have been taken up more quickly, while randomised controlled trials (the gold standard of clinical research) was not necessarily translated into policy so swiftly. Finally the links between different research and policy actors were of critical importance, with overlaps between researcher and policy maker networks crucial to facilitate knowledge transfer. Within these networks, in each country the policy development process relied on a powerful policy entrepreneur who helped get cotrimoxazole preventive therapy onto the policy agenda. Conclusions This analysis underscores the importance of considering national level variables in the explanation of the uptake of evidence into national policy settings, and recognising how local policy makers interpret international evidence. Local priorities, the ways in which evidence was interpreted, and the nature of the links between policy makers and researchers could either drive or stall the policy process. Developing the understanding of these processes enables the explanation of the use (or non-use) of evidence in policy making, and potentially may help to shape future strategies to bridge the research-policy gaps and ultimately improve the uptake of evidence in decision making. PMID:21679387

Resource quality or competition: why increase resource acceptance in the presence of conspecifics?

PubMed Central

Nufio, César R.; Papaj, Daniel R.

2011-01-01

Some animal species increase resource acceptance rates in the presence of conspecifics. Such responses may be adaptive if the presence of conspecifics is a reliable indicator of resource quality. Similarly, these responses could represent an adaptive reduction in choosiness under high levels of scramble competition. Although high resource quality and high levels of scramble competition should both favor increased resource acceptance, the contexts in which the increase occurs should differ. In this paper, we tested the effect of social environment on egg-laying and aggressive behavior in the walnut fly, Rhagoletis juglandis, in multiple contexts to determine whether increased resource acceptance in the presence of conspecifics was better viewed as a response to increased host quality or increased competition. We found that grouped females oviposit more readily than isolated females when provided small (low-quality) artificial hosts but not when provided large (high-quality) artificial hosts, indicating that conspecific presence reduces choosiness. Increased resource acceptance was observed even when exposure to conspecifics was temporally or spatially separate from exposure to the resource. Finally, we found that individuals showed reduced aggression after being housed in groups, as expected under high levels of scramble competition. These results indicate that the pattern of resource acceptance in the presence of conspecifics may be better viewed as a response to increased scramble competition rather than as a response to public information about resource quality. PMID:22479135

Resource quality or competition: why increase resource acceptance in the presence of conspecifics?

PubMed

Davis, Jeremy M; Nufio, César R; Papaj, Daniel R

2011-07-01

Some animal species increase resource acceptance rates in the presence of conspecifics. Such responses may be adaptive if the presence of conspecifics is a reliable indicator of resource quality. Similarly, these responses could represent an adaptive reduction in choosiness under high levels of scramble competition. Although high resource quality and high levels of scramble competition should both favor increased resource acceptance, the contexts in which the increase occurs should differ. In this paper, we tested the effect of social environment on egg-laying and aggressive behavior in the walnut fly, Rhagoletis juglandis, in multiple contexts to determine whether increased resource acceptance in the presence of conspecifics was better viewed as a response to increased host quality or increased competition. We found that grouped females oviposit more readily than isolated females when provided small (low-quality) artificial hosts but not when provided large (high-quality) artificial hosts, indicating that conspecific presence reduces choosiness. Increased resource acceptance was observed even when exposure to conspecifics was temporally or spatially separate from exposure to the resource. Finally, we found that individuals showed reduced aggression after being housed in groups, as expected under high levels of scramble competition. These results indicate that the pattern of resource acceptance in the presence of conspecifics may be better viewed as a response to increased scramble competition rather than as a response to public information about resource quality.

Discrimination-related health inequality and role of social capital among marriage migrant women in South Korea.

PubMed

Kim, Chang-O

2016-10-26

This study aimed to evaluate whether social capital could alleviate health inequality against racial discrimination and identify the critical nature of social capital that generates health inequality differences within the social context of South Korea. Using the data of the 2009 National Survey of Multicultural Families, a nationally representative sample in which 40,430 foreign wives participated, the concentration index (CI) was used to measure the discrimination-related inequalities in self-rated health and was decomposed into contributing factors. The results showed a significant concentration of poor self-rated health unfavorable to foreign wives who were highly discriminated (CI 0.023, standard error [SE] 0.001, p < .001). However, when the CIs were assessed among the subgroups of different social capital, no discrimination-related inequality in health was observed among the group of linking social capital (CI 0.008, SE 0.008, p .332). The total differential decomposition method showed two major factors that generate differences in health inequality between the groups of non-linking and linking social capital: protest against discrimination (35.8 %); experiences of discrimination (28.3 %). The present results indicated that linking social capital can be a useful resource of health resilience factor that equalizes discrimination-related health inequality among marriage migrant women in South Korea. This study provides additional evidence that social capital needs to be placed in its political context.

The Sociocultural Context of Mexican-Origin Pregnant Adolescents' Attitudes Toward Teen Pregnancy and Links to Future Outcomes.

PubMed

Killoren, Sarah E; Zeiders, Katharine H; Updegraff, Kimberly A; Umaña-Taylor, Adriana J

2016-05-01

Given the negative developmental risks associated with adolescent motherhood, it is important to examine the sociocultural context of adolescent mothers' lives to identify those most at risk for poor outcomes. Our goals were to identify profiles of Mexican-origin pregnant adolescents' cultural orientations and their attitudes toward teen pregnancy, and to investigate how these profiles were linked to adolescents' pregnancy intentions, family resources, and short-term family, educational, and parenting outcomes. With a sample of 205 Mexican-origin adolescent mothers, we identified three profiles based on cultural orientations and attitudes toward teen pregnancy: Bicultural-Moderate Attitudes, Acculturated-Moderate Attitudes, and Enculturated-Low Attitudes. The results indicated that enculturated pregnant adolescents had the least favorable attitudes toward teen pregnancy, and the lowest levels of family income, pregnancy intentions, pregnancy support, and educational expectations compared to acculturated and bicultural pregnant adolescents; acculturated adolescents (with the highest family income and high levels of pregnancy support) had the highest levels of parenting efficacy 10 months postpartum. Our findings suggest that enculturated adolescent mothers (with less positive attitudes toward teen pregnancy) may benefit from educational support programs and enculturated and bicultural adolescent mothers (with moderately positive attitudes toward teen pregnancy) may benefit from programs to increase parenting efficacy. Such targeted interventions may, in turn, reduce the likelihood of adolescent mothers experiencing negative educational and parenting outcomes.

The Sociocultural Context of Mexican-origin Pregnant Adolescents’ Attitudes toward Teen Pregnancy and Links to Future Outcomes

PubMed Central

Killoren, Sarah E.; Zeiders, Katharine H.; Updegraff, Kimberly A.; Umaña-Taylor, Adriana J.

2016-01-01

Given the negative developmental risks associated with adolescent motherhood, it is important to examine the sociocultural context of adolescent mothers’ lives to identify those most at risk for poor outcomes. Our goals were to identify profiles of Mexican-origin pregnant adolescents’ cultural orientations and their attitudes toward teen pregnancy, and to investigate how these profiles were linked to adolescents’ pregnancy intentions, family resources, and short-term family, educational, and parenting outcomes. With a sample of 205 Mexican-origin adolescent mothers, we identified three profiles based on cultural orientations and attitudes toward teen pregnancy: Bicultural-Moderate Attitudes, Acculturated-Moderate Attitudes, and Enculturated-Low Attitudes. The results indicated that enculturated pregnant adolescents had the least favorable attitudes toward teen pregnancy, and the lowest levels of family income, pregnancy intentions, pregnancy support, and educational expectations compared to acculturated and bicultural pregnant adolescents; acculturated adolescents (with the highest family income and high levels of pregnancy support) had the highest levels of parenting efficacy 10 months postpartum. Our findings suggest that enculturated adolescent mothers (with less positive attitudes toward teen pregnancy) may benefit from educational support programs and enculturated and bicultural adolescent mothers (with moderately positive attitudes toward teen pregnancy) may benefit from programs to increase parenting efficacy. Such targeted interventions may, in turn, reduce the likelihood of adolescent mothers experiencing negative educational and parenting outcomes. PMID:26573862

Approaches to improve the quality of maternal and newborn health care: an overview of the evidence.

PubMed

Austin, Anne; Langer, Ana; Salam, Rehana A; Lassi, Zohra S; Das, Jai K; Bhutta, Zulfiqar A

2014-09-04

Despite progress in recent years, an estimated 273,500 women died as a result of maternal causes in 2010. The burden of these deaths is disproportionately bourne by women who reside in low income countries or belong to the poorest sectors of the population of middle or high income ones, and it is particularly acute in regions where access to and utilization of facility-based services for childbirth and newborn care is lowest. Evidence has shown that poor quality of facility-based care for these women and newborns is one of the major contributing factors for their elevated rates of morbidity and mortality. In addition, women who perceive the quality of facilty-based care to be poor,may choose to avoid facility-based deliveries, where life-saving interventions could be availble. In this context, understanding the underlying factors that impact the quality of facility-based services and assessing the effectiveness of interventions to improve the quality of care represent critical inputs for the improvement of maternal and newborn health. This series of five papers assesses and summarizes information from relevant systematic reviews on the impact of various approaches to improve the quality of care for women and newborns. The first paper outlines the conceptual framework that guided this study and the methodology used for selecting the reviews and for the analysis. The results are described in the following three papers, which highlight the evidence of interventions to improve the quality of maternal and newborn care at the community, district, and facility level. In the fifth and final paper of the series, the overall findings of the review are discussed, research gaps are identified, and recommendations proposed to impove the quality of maternal and newborn health care in resource-poor settings.

Marriage patterns in a Mesoamerican peasant community are biologically adaptive.

PubMed

Little, Bertis B; Malina, Robert M

2010-12-01

Differential investment in offspring by parental and progeny gender has been discussed and periodically analyzed for the past 80 years as an evolutionary adaptive strategy. Parental investment theory suggests that parents in poor condition have offspring in poor condition. Conversely, parents in good condition give rise to offspring in good condition. As formalized in the Trivers-Willard hypothesis (TWH), investment in daughters will be greater under poor conditions while sons receive greater parental investment under good conditions. Condition is ultimately equated to offspring reproductive fitness, with parents apparently using a strategy to maximize their genetic contribution to future generations. Analyses of sex ratio have been used to support parental investment theory and in many instances, though not all, results provide support for TWH. In the present investigation, economic strategies were analyzed in the context of offspring sex ratio and survival to reproductive age in a Zapotec-speaking community in the Valley of Oaxaca, southern Mexico. Growth status of children, adult stature, and agricultural resources were analyzed as proxies for parental and progeny condition in present and prior generations. Traditional marriage practice in Mesoamerican peasant communities is patrilocal postnuptial residence with investments largely favoring sons. The alternative, practiced by ∼25% of parents, is matrilocal postnuptial residence which is an investment favoring daughters. Results indicated that sex ratio of offspring survival to reproductive age was related to economic strategy and differed significantly between the patrilocal and matrilocal strategies. Variance in sex ratio was affected by condition of parents and significant differences in survival to reproductive age were strongly associated with economic strategy. While the results strongly support TWH, further studies in traditional anthropological populations are needed.

Mental health among adolescents living with HIV in Namibia: the role of poverty, orphanhood and social support.

PubMed

Gentz, Shelene G; Calonge-Romano, Isabel; Martínez-Arias, Rosario; Zeng, Chengbo; Ruiz-Casares, Mónica

2018-05-30

The mental health needs of children and adolescents living with HIV (ALHIV) in Namibia are poorly understood, despite the dramatic improvement in their survival. ALHIV in resource poor contexts face particular risk factors, such as poverty, orphanhood, and poor social support. This study examines the mental health of ALHIV in Namibia, and the factors that contribute to mental health problems. A case-control design assessed emotional and behavioural symptoms of distress, risk and protective factors among adolescents aged 12-18 years. Case participants were 99 HIV-positive adolescents. Case controls were 159 adolescents from the same community who were not known to be HIV seropositive at the time of the study. Control group participants were selected from schools using a stratified random sampling. A larger proportion of HIV-positive adolescents were orphaned (62.6% vs. 20.8%, p < .001); the groups showed no differences in poverty factors. HIV-positive adolescents scored lower than the control group on total perceived social support (p < .05) and caregiver support (p < .05), but no differences in perceived friend support and support from a self-selected person were present. HIV-positive adolescents reported significantly more total emotional and behavioural difficulties (p = .027) and conduct problems (p = .025), even after controlling for socio-demographic factors. However, after controlling for the effects of orphanhood, group differences in mental health outcomes were no longer significant. Furthermore, mediation analysis suggested that social support completely mediated the relationship between HIV status and mental health (standardised pathway coefficients = .05, p = .021). Policies and programmes that aim to strengthen social support and take orphanhood status into consideration may improve the mental health of adolescents living with HIV.

Reviewing evidence on complex social interventions: appraising implementation in systematic reviews of the health effects of organisational-level workplace interventions

PubMed Central

Egan, M; Bambra, C; Petticrew, M; Whitehead, M

2009-01-01

Background: The reporting of intervention implementation in studies included in systematic reviews of organisational-level workplace interventions was appraised. Implementation is taken to include such factors as intervention setting, resources, planning, collaborations, delivery and macro-level socioeconomic contexts. Understanding how implementation affects intervention outcomes may help prevent erroneous conclusions and misleading assumptions about generalisability, but implementation must be adequately reported if it is to be taken into account. Methods: Data on implementation were obtained from four systematic reviews of complex interventions in workplace settings. Implementation was appraised using a specially developed checklist and by means of an unstructured reading of the text. Results: 103 studies were identified and appraised, evaluating four types of organisational-level workplace intervention (employee participation, changing job tasks, shift changes and compressed working weeks). Many studies referred to implementation, but reporting was generally poor and anecdotal in form. This poor quality of reporting did not vary greatly by type or date of publication. A minority of studies described how implementation may have influenced outcomes. These descriptions were more usefully explored through an unstructured reading of the text, rather than by means of the checklist. Conclusions: Evaluations of complex interventions should include more detailed reporting of implementation and consider how to measure quality of implementation. The checklist helped us explore the poor reporting of implementation in a more systematic fashion. In terms of interpreting study findings and their transferability, however, the more qualitative appraisals appeared to offer greater potential for exploring how implementation may influence the findings of specific evaluations. Implementation appraisal techniques for systematic reviews of complex interventions require further development and testing. PMID:18718981

Reviewing evidence on complex social interventions: appraising implementation in systematic reviews of the health effects of organisational-level workplace interventions.

PubMed

Egan, M; Bambra, C; Petticrew, M; Whitehead, M

2009-01-01

The reporting of intervention implementation in studies included in systematic reviews of organisational-level workplace interventions was appraised. Implementation is taken to include such factors as intervention setting, resources, planning, collaborations, delivery and macro-level socioeconomic contexts. Understanding how implementation affects intervention outcomes may help prevent erroneous conclusions and misleading assumptions about generalisability, but implementation must be adequately reported if it is to be taken into account. Data on implementation were obtained from four systematic reviews of complex interventions in workplace settings. Implementation was appraised using a specially developed checklist and by means of an unstructured reading of the text. 103 studies were identified and appraised, evaluating four types of organisational-level workplace intervention (employee participation, changing job tasks, shift changes and compressed working weeks). Many studies referred to implementation, but reporting was generally poor and anecdotal in form. This poor quality of reporting did not vary greatly by type or date of publication. A minority of studies described how implementation may have influenced outcomes. These descriptions were more usefully explored through an unstructured reading of the text, rather than by means of the checklist. Evaluations of complex interventions should include more detailed reporting of implementation and consider how to measure quality of implementation. The checklist helped us explore the poor reporting of implementation in a more systematic fashion. In terms of interpreting study findings and their transferability, however, the more qualitative appraisals appeared to offer greater potential for exploring how implementation may influence the findings of specific evaluations. Implementation appraisal techniques for systematic reviews of complex interventions require further development and testing.

Influence of gender roles and rising food prices on poor, pregnant women's eating and food provisioning practices in Dhaka, Bangladesh.

PubMed

Levay, Adrienne V; Mumtaz, Zubia; Faiz Rashid, Sabina; Willows, Noreen

2013-09-26

Maternal malnutrition in Bangladesh is a persistent health issue and is the product of a number of complex factors, including adherence to food 'taboos' and a patriarchal gender order that limits women's mobility and decision-making. The recent global food price crisis is also negatively impacting poor pregnant women's access to food. It is believed that those who are most acutely affected by rising food prices are the urban poor. While there is an abundance of useful quantitative research centered on maternal nutrition and food insecurity measurements in Bangladesh, missing is an understanding of how food insecurity is experienced by people who are most vulnerable, the urban ultra-poor. In particular, little is known of the lived experience of food insecurity among pregnant women in this context. This research investigated these lived experiences by exploring food provisioning strategies of urban, ultra-poor, pregnant women. This knowledge is important as discussions surrounding the creation of new development goals are currently underway. Using a focused-ethnographic approach, household food provisioning experiences were explored. Data from participant observation, a focus group discussion and semi-structured interviews were collected in an urban slum in Dhaka, Bangladesh. Interviews were undertaken with 28 participants including 12 pregnant women and new mothers, two husbands, nine non-pregnant women, and five health care workers. The key findings are: 1) women were aware of the importance of good nutrition and demonstrated accurate, biomedically-based knowledge of healthy eating practices during pregnancy; 2) the normative gender rules that have traditionally constrained women's access to nutritional resources are relaxing in the urban setting; however 3) women are challenged in accessing adequate quality and quantities of food due to the increase in food prices at the market. Rising food prices and resultant food insecurity due to insufficient incomes are negating the recent efforts that have increased women's knowledge of healthy eating during pregnancy and their gendered empowerment. In order to maintain the gains in nutritional knowledge and women's increased mobility and decision-making capacity; policy must also consider the global political economy of food in the creation of the new development goals.

Addressing the Rural Context in Literacies Research: A Call to Action

ERIC Educational Resources Information Center

Azano, Amy Price

2015-01-01

The article features a discussion about rural contexts in literacy research. Rural students compose a significant portion of K-12 students, and rural schools have unique challenges, such as limited funding and resources. However, as a field of literacy researchers, we do not privilege place equitably across multiple contexts. The article serves as…

Opportunities for making ends meet and upward mobility: differences in organizational deprivation across urban and suburban poor neighborhoods.

PubMed

Murphy, Alexandra K; Wallace, Danielle

2010-01-01

Objectives. Given the recent rise of poverty in U.S. suburbs, this study asks: What poor neighborhoods are most disadvantageous, those in the city or those in the suburbs? Building on recent urban sociological work demonstrating the importance of neighborhood organizations for the poor, we are concerned with one aspect of disadvantage—the lack of availability of organizational resources oriented toward the poor. By breaking down organizations into those that promote mobility versus those that help individuals meet their daily subsistence needs, we seek to explore potential variations in the type of disadvantage that may exist.Methods. We test whether poor urban or suburban neighborhoods are more likely to be organizationally deprived by breaking down organizations into three types: hardship organizations, educational organizations, and employment organizations. We use data from the 2000 U.S. County Business Patterns and the 2000 U.S. Census and test neighborhood deprivation using logistic regression models.Results. We find that suburban poor neighborhoods are more likely to be organizationally deprived than are urban poor neighborhoods, especially with respect to organizations that promote upward mobility. Interesting racial and ethnic composition factors shape this more general finding.Conclusion. Our findings suggest that if a poor individual is to live in a poor neighborhood, with respect to access to organizational resources, he or she would be better off living in the central city. Suburban residence engenders isolation from organizations that will help meet one's daily needs and even more so from those offering opportunities for mobility.

Psychosocial mechanisms linking the social environment to mental health in African Americans

USDA-ARS?s Scientific Manuscript database

Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African Amer...

Population-level approaches to universal health coverage in resource-poor settings: lessons from tobacco control policy in Vietnam.

PubMed

Higashi, Hideki; Khuong, Tuan A; Ngo, Anh D; Hill, Peter S

2011-07-01

Population-based health promotion and disease prevention approaches are essential elements in achieving universal health coverage; yet they frequently do not appear on national policy agendas. This paper suggests that resource-poor countries should take greater advantage of such approaches to reach all segments of the population to positively affect health outcomes and equity, especially considering the epidemic of chronic non-communicable diseases and associated modifiable risk factors. Tobacco control policy development and implementation in Vietnam provides a case study to discuss opportunities and challenges associated with such strategies.

Climbers' attitudes toward recreation resource impacts in the Adirondack Park

Treesearch

Christopher A. Monz; Katherine E. Smith; Leah Knickerbocker

2006-01-01

Climbers arriving at trailheads to popular climbing areas in Adirondack Park, NY were surveyed as to the types of resource impacts they found to be offensive. Climbers were also asked about their degree of concern regarding crowding, noise and management of climbing areas. Some resource impacts, such as damage to trees as a result of poor climbing practices, are...

"Don't Know Much about History": The New York Times 1943 Survey of U.S. History and the Controversy It Generated

ERIC Educational Resources Information Center

Halvorsen, Anne-Lise

2012-01-01

Background/Context: Educators, parents, politicians, and the media often complain that young people know little history and compare them unfavorably to better-educated, earlier generations. However, the charge is exaggerated. Young people have performed poorly on history tests for decades. Students' poor scores on one test in particular, the focus…

What does productivity really mean? Towards an integrative paradigm in the search for biodiversity-productivity relationships

Treesearch

Liangjun Hu; Qinfeng Guo

2013-01-01

How species diversity relates to productivity remains a major debate. To date, however, the underlying mechanisms that regulate the ecological processes involved are still poorly understood. Three major issues persist in early efforts at resolution. First, in the context that productivity drives species diversity, how the pathways operate is poorly-explained. Second,...

Teaching Poor Ethnic Minority Students: A Critical Realist Interpretation of Disempowerment

ERIC Educational Resources Information Center

Stylianou, Areti; Scott, David

2018-01-01

This article aims to supplement the literature on the role of school context with regards to the disempowerment of teachers in their work with poor ethnic minority students. We use a critical realist framework to analyse the empirical data collected for an in-depth school case study and we suggest the existence of real, interrelated, emergent and…

Teaching New Words to Children with Poor Existing Vocabulary Knowledge: A Controlled Evaluation of the Definition and Context Methods

ERIC Educational Resources Information Center

Nash, Hannah; Snowling, Margaret

2006-01-01

Background: Children who have poor vocabulary knowledge are at risk of wider language weaknesses and reading comprehension difficulties, which will impact upon their educational achievement. The central question addressed in this paper is how best to teach new vocabulary items to these children. Aims: To investigate the effects of two different…

The Psychosocial Context Impacts Medication Adherence after Acute Coronary Syndrome

PubMed Central

Kronish, Ian M.; Rieckmann, Nina; Burg, Matthew M.; Alcántara, Carmela; Davidson, Karina W.

2013-01-01

Background Depression is associated with poor adherence to medications and worse prognosis in patients with acute coronary syndrome (ACS). Purpose To determine whether cognitive, behavioral, and/or psychosocial vulnerabilities for depression explain the association between depression and medication adherence among ACS patients. Methods 169 ACS patients who agreed to have their aspirin adherence measured using an electronic pill bottle for 3 months were enrolled within 1 week of hospitalization. Linear regression was used to determine whether depression vulnerabilities predicted aspirin adherence after adjustment for depressive symptoms, demographics, and comorbidity. Results Of the depression vulnerabilities, only role transitions (beta = −3.32; p=0.02) and interpersonal conflict (beta −3.78; p=0.03) predicted poor adherence. Depression vulnerabilities did not mediate the association between depressive symptoms and medication adherence. Conclusions Key elements of the psychosocial context preceding the ACS including major role transitions and conflict with close contacts place ACS patients at increased risk for poor medication adherence independent of depressive symptoms. PMID:24163188

PS-CARA: Context-Aware Resource Allocation Scheme for Mobile Public Safety Networks.

PubMed

Kaleem, Zeeshan; Khaliq, Muhammad Zubair; Khan, Ajmal; Ahmad, Ishtiaq; Duong, Trung Q

2018-05-08

The fifth-generation (5G) communications systems are expecting to support users with diverse quality-of-service (QoS) requirements. Beside these requirements, the task with utmost importance is to support the emergency communication services during natural or man-made disasters. Most of the conventional base stations are not properly functional during a disaster situation, so deployment of emergency base stations such as mobile personal cell (mPC) is crucial. An mPC having moving capability can move in the disaster area to provide emergency communication services. However, mPC deployment causes severe co-channel interference to the users in its vicinity. The problem in the existing resource allocation schemes is its support for static environment, that does not fit well for mPC. So, a resource allocation scheme for mPC users is desired that can dynamically allocate resources based on users’ location and its connection establishment priority. In this paper, we propose a public safety users priority-based context-aware resource allocation (PS-CARA) scheme for users sum-rate maximization in disaster environment. Simulations results demonstrate that the proposed PS-CARA scheme can increase the user average and edge rate around 10.3% and 32.8% , respectively because of context information availability and by prioritizing the public safety users. The simulation results ensure that call blocking probability is also reduced considerably under the PS-CARA scheme.

PS-CARA: Context-Aware Resource Allocation Scheme for Mobile Public Safety Networks

PubMed Central

Khaliq, Muhammad Zubair; Khan, Ajmal; Ahmad, Ishtiaq

2018-01-01

The fifth-generation (5G) communications systems are expecting to support users with diverse quality-of-service (QoS) requirements. Beside these requirements, the task with utmost importance is to support the emergency communication services during natural or man-made disasters. Most of the conventional base stations are not properly functional during a disaster situation, so deployment of emergency base stations such as mobile personal cell (mPC) is crucial. An mPC having moving capability can move in the disaster area to provide emergency communication services. However, mPC deployment causes severe co-channel interference to the users in its vicinity. The problem in the existing resource allocation schemes is its support for static environment, that does not fit well for mPC. So, a resource allocation scheme for mPC users is desired that can dynamically allocate resources based on users’ location and its connection establishment priority. In this paper, we propose a public safety users priority-based context-aware resource allocation (PS-CARA) scheme for users sum-rate maximization in disaster environment. Simulations results demonstrate that the proposed PS-CARA scheme can increase the user average and edge rate around 10.3% and 32.8% , respectively because of context information availability and by prioritizing the public safety users. The simulation results ensure that call blocking probability is also reduced considerably under the PS-CARA scheme. PMID:29738499

Challenges to managing natural resource information

Treesearch

William L. Halvorson

2005-01-01

One of the most important issues facing resource managers today is that of information. In order to handle the numerous and diverse requirements for information, landscape-scale information management systems are needed that allow individual land management units to view their resource information in a regional context. The characteristics of such a system are: (1) the...

Human Resources Management in Educational Faculties of State Universities in Turkey

ERIC Educational Resources Information Center

Öztürk, Sevim

2016-01-01

This study aims to evaluate the human resources management in the faculties of education of state universities in Turkey within the context of Human Resources Management Principles. The study population consisted of 40 academic members in the faculties of education of 20 different state universities and 10 academic unit administrators at different…

A Meta-Data Driven Approach to Searching for Educational Resources in a Global Context.

ERIC Educational Resources Information Center

Wade, Vincent P.; Doherty, Paul

This paper presents the design of an Internet-enabled search service that supports educational resource discovery within an educational brokerage service. More specifically, it presents the design and implementation of a metadata-driven approach to implementing the distributed search and retrieval of Internet-based educational resources and…

Essays on Pricing of Information Goods and Services

ERIC Educational Resources Information Center

Lahiri, Atanu

2010-01-01

This dissertation consists of three essays that examine, in three specific contexts, issues related to pricing of information goods and services. As the ability to measure technology resource usage gets easier with increased connectivity, the question whether a technology resource should be priced by the amount of the resource used or by the…

A "Simple Query Interface" Adapter for the Discovery and Exchange of Learning Resources

ERIC Educational Resources Information Center

Massart, David

2006-01-01

Developed as part of CEN/ISSS Workshop on Learning Technology efforts to improve interoperability between learning resource repositories, the Simple Query Interface (SQI) is an Application Program Interface (API) for querying heterogeneous repositories of learning resource metadata. In the context of the ProLearn Network of Excellence, SQI is used…

Guide to Resources for ESL Literacy Facilitators.

ERIC Educational Resources Information Center

Gaber-Katz, Elaine; Zettel, Kathryn

This resource guide, for English-as-a-Second-Language (ESL) literacy facilitators, reviews a variety of resources for ESL literacy. The guide contains three sections. The first section cites four books that provide a theoretical context for literacy work: "Ah-Hah! A New Approach to Popular Education" (Gatt-Fly); "Approaches and Methods in Language…

The Outcomes of Resource Use in Migrant Families

ERIC Educational Resources Information Center

Kotler, Tamara; Hammond, S. B.

1975-01-01

A sample of 41 migrant mothers and their sons is used to develop an analysis of family environment and parental competence, using the concept of resources as a conceptual framework that includes and extends beyond socioeconomic indicators of family contexts. Also discussed are the relation of this resources scale to other family attributes, the…

Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques

ERIC Educational Resources Information Center

Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

2006-01-01

This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

African land ecology: opportunities and constraints for agricultural development.

PubMed

Voortman, Roelf L; Sonneveld, Ben G J S; Keyzer, Michiel A

2003-08-01

Compared to other continents, the economic growth performance of Sub-Saharan Africa has been poor over the last four decades. Likewise, progress in agricultural development has been limited and the Green Revolution left Africa almost untouched. The question raised in the literature is whether the poor performance is a question of poor policies or of an unfavorable biophysical environment (policy versus destiny). This paper, with a broad perspective, analyzes adaptation of current land use to environmental conditions in Africa and compares the physical resource base of Africa with Asia. In doing so, we search for unifying principles that can have operational consequences for agricultural development. We argue that some specificities of the natural resource base, namely local homogeneity and spatial diversity of the predominant Basement Complex soils, imply that simple fertilizer strategies may not produce the yield increases obtained elsewhere.

Management of aplastic anaemia in pregnancy in a resource poor centre.

PubMed

John, Celestine Osita; Korubo, Kaladada; Ogu, Rosemary; Mmom, Chigozirim Faith; Mba, Alpheus Gogo; Chidiadi, Ezenwa-Ahanene; Akani, Chris

2016-01-01

Aplastic anaemia occurring in pregnancy is a rare event with life threatening challenges for both mother and child. We present a successful fetomaternal outcome despite the challenges in the management of this rare condition in a tertiary but resource poor centre. This is case of a 37 year old Nigerian woman G6P0 +5 managed with repeated blood transfusions from 28 weeks of gestation for bone marrow biopsy confirmed aplastic anaemia following presentation with weakness and gingival bleeds. She had a cesarean section at 37 weeks for pre-eclampsia and oligohydraminous with good feto-maternal outcome. She was managed entirely with fresh whole blood and received 21 units. Aplastic Anaemia in Pregnancy is a rare event with poor feto maternal prognosis. Successful management is possible with good multi-disciplinary approach and availability of supportive comprehensive obstetric care.

Context reinstatement and memory for intrinsic versus extrinsic context: the role of item generation at encoding or retrieval.

PubMed

Nieznański, Marek

2014-10-01

According to many theoretical accounts, reinstating study context at the time of test creates optimal circumstances for item retrieval. The role of context reinstatement was tested in reference to context memory in several experiments. On the encoding phase, participants were presented with words printed in two different font colors (intrinsic context) or two different sides of the computer screen (extrinsic context). At test, the context was reinstated or changed and participants were asked to recognize words and recollect their study context. Moreover, a read-generate manipulation was introduced at encoding and retrieval, which was intended to influence the relative salience of item and context information. The results showed that context reinstatement had no effect on memory for extrinsic context but affected memory for intrinsic context when the item was generated at encoding and read at test. These results supported the hypothesis that context information is reconstructed at retrieval only when context was poorly encoded at study. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Threat to democracy: Physical and mental health impact of democracy movement in Hong Kong.

PubMed

Hou, Wai Kai; Hall, Brian J; Canetti, Daphna; Lau, Kam Man; Ng, Sin Man; Hobfoll, Stevan E

2015-11-01

This study examined the prevalence and critical predictors of anxiety and depressive symptoms and self-rated health, following the Umbrella Movement in Hong Kong. Random digit dialing recruited a population-representative sample of 1208 Chinese Hong Kong citizens (mean age=46.89 years; 63% female) in the first two weeks of February 2015. Respondents gave their informed consent and reported personal, social, and economic resource loss since the Umbrella Movement (Conservation of Resources-Evaluation), current anxiety symptoms (State-Trait Anxiety Inventory) and depressive symptoms (Patient Health Questionnaire-9), and self-rated health (1=very good, 4=very bad). A total of 47.35% (95% CI=44.55, 50.17) respondents reported moderate/severe anxiety symptoms and 14.4% (95% CI=12.54, 16.50) reported moderate/severe depressive symptoms; 9.11% (95% CI=7.61, 10.86) reported "poor" or "very poor" health. Multivariable regressions revealed that personal and social resource loss was associated with higher anxiety and depressive symptoms and greater odds of "very poor" health (adjusted odds ratios/incidence rate ratios=5-102%), independent of lower education level and income and being unmarried. This study was cross-sectional in nature and thus could not determine causality from the associations between resource loss and outcome variables. Second, the telephone survey relied on self-reports; response bias and social desirability could influence respondents' answers and discount data validity. Third, potential confounders such as preexisting mental and physical health issues and concurrent predictors like exposure to the Umbrella Movement were not assessed. This is one of the first studies following any recent political movement (e.g., The Arab Spring) to quantify distress and the associated correlates of distress among affected citizens. Perceived psychosocial resource losses were critical predictors of poor outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

Contributing towards the betterment of translational epilepsy research in Africa: needs, challenges, resources, and opportunities.

PubMed

Woldeamanuel, Yohannes W; Girma, Belaineh

2014-08-01

Epilepsy affects approximately 50 million people worldwide. Among them, at least 40 million people are currently living in the developing world, where resources and standards of care are suboptimal. Around 90 % of people with epilepsy in resource-poor countries do not currently receive appropriate treatments, at a time when two thirds of these patients could have achieved good control of their epileptic seizures had they had access to appropriate therapies. Scarcity of epilepsy specialists, poor availability or access to diagnostic facilities and treatments, poor community knowledge about epilepsy-related issues, stigma, and other societal and cultural barriers are only some of the issues contributing to this deficiency. These issues in epilepsy treatment have been well recognized, and ongoing concerted efforts to address them have been undertaken by both local authorities and international organizations. In many cases, patients resort to the use of traditional local and alternative medicines (herbs, religious practices, etc.) that are closer to indigenous cosmovision, are more holistic, and are more culture-friendly, preserving an optimum subtlety of Afrocentric character shading. Compared with imported Western medicines, patients find these approaches to be more relevant to their ways of thinking, their ways of being, and their belief systems, more accessible, and more acceptable methods of dealing with health and disease states. The impressive local wealth in these natural resources has established them as a preferred source of healing in these regions, but has also fueled interest in exploring their therapeutic potential in the very few existing local research centers. In this review, we discuss the known issues related to the epilepsy treatment gap in resource-poor regions, focusing in particular on African countries, introduce the role and issues related to the use and validation of alternative medical therapies in epilepsy, and comment on the importance and repercussions of initiatives to validate such therapies, primarily for local practices, but also for possible wider international applications.

Mixed methods evaluation of targeted selective anthelmintic treatment by resource-poor smallholder goat farmers in Botswana

PubMed Central

Walker, Josephine G.; Ofithile, Mphoeng; Tavolaro, F. Marina; van Wyk, Jan A.; Evans, Kate; Morgan, Eric R.

2015-01-01

Due to the threat of anthelmintic resistance, livestock farmers worldwide are encouraged to selectively apply treatments against gastrointestinal nematodes (GINs). Targeted selective treatment (TST) of individual animals would be especially useful for smallholder farmers in low-income economies, where cost-effective and sustainable intervention strategies will improve livestock productivity and food security. Supporting research has focused mainly on refining technical indicators for treatment, and much less on factors influencing uptake and effectiveness. We used a mixed method approach, whereby qualitative and quantitative approaches are combined, to develop, implement and validate a TST system for GINs in small ruminants, most commonly goats, among smallholder farmers in the Makgadikgadi Pans region of Botswana, and to seek better understanding of system performance within a cultural context. After the first six months of the study, 42 out of 47 enrolled farmers were followed up; 52% had monitored their animals using the taught inspection criteria and 26% applied TST during this phase. Uptake level showed little correlation with farmer characteristics, such as literacy and size of farm. Herd health significantly improved in those herds where anthelmintic treatment was applied: anaemia, as assessed using the five-point FAMACHA© scale, was 0.44–0.69 points better (95% confidence interval) and body condition score was 0.18–0.36 points better (95% C.I., five-point scale) in treated compared with untreated herds. Only targeting individuals in greatest need led to similar health improvements compared to treating the entire herd, leading to dose savings ranging from 36% to 97%. This study demonstrates that TST against nematodes can be implemented effectively by resource-poor farmers using a community-led approach. The use of mixed methods provides a promising system to integrate technical and social aspects of TST programmes for maximum uptake and effect. PMID:26493540

Mixed methods evaluation of targeted selective anthelmintic treatment by resource-poor smallholder goat farmers in Botswana.

PubMed

Walker, Josephine G; Ofithile, Mphoeng; Tavolaro, F Marina; van Wyk, Jan A; Evans, Kate; Morgan, Eric R

2015-11-30

Due to the threat of anthelmintic resistance, livestock farmers worldwide are encouraged to selectively apply treatments against gastrointestinal nematodes (GINs). Targeted selective treatment (TST) of individual animals would be especially useful for smallholder farmers in low-income economies, where cost-effective and sustainable intervention strategies will improve livestock productivity and food security. Supporting research has focused mainly on refining technical indicators for treatment, and much less on factors influencing uptake and effectiveness. We used a mixed method approach, whereby qualitative and quantitative approaches are combined, to develop, implement and validate a TST system for GINs in small ruminants, most commonly goats, among smallholder farmers in the Makgadikgadi Pans region of Botswana, and to seek better understanding of system performance within a cultural context. After the first six months of the study, 42 out of 47 enrolled farmers were followed up; 52% had monitored their animals using the taught inspection criteria and 26% applied TST during this phase. Uptake level showed little correlation with farmer characteristics, such as literacy and size of farm. Herd health significantly improved in those herds where anthelmintic treatment was applied: anaemia, as assessed using the five-point FAMACHA(©) scale, was 0.44-0.69 points better (95% confidence interval) and body condition score was 0.18-0.36 points better (95% C.I., five-point scale) in treated compared with untreated herds. Only targeting individuals in greatest need led to similar health improvements compared to treating the entire herd, leading to dose savings ranging from 36% to 97%. This study demonstrates that TST against nematodes can be implemented effectively by resource-poor farmers using a community-led approach. The use of mixed methods provides a promising system to integrate technical and social aspects of TST programmes for maximum uptake and effect. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Upscaling the recruitment and retention of human resources for health at primary healthcare centres in Lebanon: a qualitative study.

PubMed

Alameddine, Mohamad; Khodr, Hiba; Mourad, Yara; Yassoub, Rami; Abi Ramia, Jinane

2016-05-01

The sustainability of primary healthcare (PHC) worldwide has been challenged by a global shortage in human resources for health (HRH). This study is a unique attempt at systematically soliciting and synthesising the voice of PHC and community stakeholders on the HRH recruitment and retention strategies at the PHC sector in Lebanon, the obstacles and challenges hindering their optimisation and the recommendations to overcome such obstacles. A qualitative design was utilised, involving 22 semi-structured interviews with PHC experts in Lebanon conducted in 2013. Nvivo qualitative data analysis software was employed for the thematic analysis of data collected from interviews. Five comprehensive themes emerged: understanding PHC scope, HRH recruitment issues, HRH retention challenges, rural areas' specific challenges and stakeholders' recommendations. Analysis of stakeholders' responses revealed a lack of a unified understanding of the PHC scope impacting the capacity for appropriate HRH planning. Identified impediments to recruitment included the suboptimal supply of HRH, financial constraints and poor management. Retention difficulties were attributed to poor working environments, financial constraints and lack of professional development. There was consensus that HRH challenges faced were aggravated in rural areas, jeopardising the equitable access to PHC services of quality. Equitable access was also jeopardised by the reported shortage of female HRH in a sociocultural context where many females prefer providers of the same gender. The study sets the path towards upscaling recruitment and retention policies and practices through the endorsement of a nationally acknowledged PHC definition and scope, the sustainable development of the PHC workforce and through the implementation of targeted recruitment and retention strategies addressing rural settings and gender equity. Decision-makers and planners are urged to identify HRH as the most important input for the success of PHC programmes and interventions, especially in the growing fields of mental health and geriatric care. © 2015 John Wiley & Sons Ltd.

Potential cost-effectiveness of maternal and infant antiretroviral interventions to prevent mother-to-child transmission during breast-feeding.

PubMed

Maclean, Courtney C; Stringer, Jeffrey S A

2005-04-15

One-third of maternal-to-child HIV transmission occurs during breast-feeding (BF). Several trials are currently evaluating the efficacy of postpartum antiretrovirals to reduce BF transmission. This study used Markov modeling to define the circumstances under which the following interventions would be cost-effective: BF for 6 months with daily infant nevirapine (NVP) prophylaxis; maternal combination antiretroviral therapy (ART) during pregnancy and for 6 months of BF; and maternal combination ART only for women who meet CD4 criteria. Each was compared to: BF for 12 months; BF for 6 months; and formula feeding for 12 months. Strategies were evaluated for a hypothetical cohort of 40,000 pregnant women in sub-Saharan Africa, in the context of available voluntary counseling and testing in antenatal care. Model estimates were derived from the literature and local sources. Sensitivity analyses were performed on uncertain estimates. The perspective used was that of a government health district. Using base case estimates, BF for 6 months was the economically preferred strategy: it cost 806,995 dollars and generated 446,208 quality-adjusted life-years (QALYs). Providing daily infant NVP cost an additional 93,638 dollars and generated 1183 additional QALYs, but its incremental cost-effectiveness ratio (ICER) of 79 dollars/QALY exceeded the standard willingness to pay (64 dollars/QALY) for most resource-poor settings. Maternal combination ART was potentially very effective but too costly for most resource-poor settings (ICER: 87 dollars/QALY). In order for daily infant NVP during BF to be preferred, it must have >/=44% relative efficacy or cost

Promoting community participation in priority setting in district health systems: experiences from Mbarali district, Tanzania

PubMed Central

Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict; Byskov, Jens; Hurtig, Anna-Karin

2013-01-01

Background Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions. Design Key informant interviews were conducted with the Council Health Management Team (CHMT), community representatives, namely women, youth, elderly, disabled, and people living with HIV/AIDS, and other stakeholders who participated in the preparation of the district annual budget and health plans. Additionally, minutes from the Action Research Team and planning and priority-setting meeting reports were analyzed. Results A number of benefits were reported: better identification of community needs and priorities, increased knowledge of the community representatives about priority setting, increased transparency and accountability, promoted trust among health systems and communities, and perceived improved quality and accessibility of health services. However, lack of funds to support the work of the selected community representatives, limited time for deliberations, short notice for the meetings, and lack of feedback on the approved priorities constrained the performance of the community representatives. Furthermore, the findings show the importance of external facilitation and support in enabling health professionals and community representatives to arrive at effective working arrangement. Conclusion Community participation in priority setting in developing countries, characterized by weak democratic institutions and low public awareness, requires effective mobilization of both communities and health systems. In addition, this study confirms that community participation is an important element in strengthening health systems. PMID:24280341

Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings.

PubMed

Van Rie, A; Fitzgerald, D; Kabuya, G; Van Deun, A; Tabala, M; Jarret, N; Behets, F; Bahati, E

2008-03-01

Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories.

Considering the case for vitamin B12 fortification of flour

USDA-ARS?s Scientific Manuscript database

Reasons to fortify flour with vitamin B12 are considered, which include the high prevalence of depletion and deficiency of this vitamin that occurs in persons of all ages in resource-poor countries and in elderly in wealthier countries, as well as the adverse functional consequences of poor vitamin ...

Anna's Story of Life in Prison

ERIC Educational Resources Information Center

Boodle, Anna; Ellem, Kathy; Chenoweth, Lesley

2014-01-01

People with an intellectual disability in prison can be at increased risk of victimisation, segregation and isolation (Mullen ). Prison systems usually have very few resources to cater to this group's particular needs, and many people may re-enter the community with little or no rehabilitation, poor social connections, poor mental health and…

Sorghum response to foliar application of phosphorus and potassium with saline water irrigation

USDA-ARS?s Scientific Manuscript database

Increasing demand for fresh water resources for urban and industrial uses is leading to limited availability of better quality water for crop irrigation. Therefore, crop response to poor quality irrigation water (ex: saline water), and strategies to mitigate the negative effects of poor quality irri...

The Diffusion of IT in the Historical Context of Innovations from Developed Countries

ERIC Educational Resources Information Center

James, Jeffrey

2013-01-01

The well-known s-shaped diffusion of technology curve generally works well in developed countries. But how does it perform in the very different context of developing countries? Across a wide range of new technologies imported from the developed countries it works poorly. In most cases the penetration rate fails to reach 25% of the population. The…

Miseducating Teachers about the Poor: A Critical Analysis of Ruby Payne's Claims about Poverty

ERIC Educational Resources Information Center

Bomer, Randy; Dworin, Joel E.; May, Laura; Semingson, Peggy

2008-01-01

Background/Context: This is the first research study to examine the content basis of Payne's in-service teacher education program, A Framework for Understanding Poverty, though others who have reviewed the book have agreed with our analysis. The study took place within a policy context in which the federal government, with the passage of the No…

Profiles of Kindergarten Classroom and Elementary School Contexts: Associations with the First-Grade Outcomes of Children Transitioning from Head Start

ERIC Educational Resources Information Center

Lee, Phyllis; Bierman, Karen L.

2016-01-01

Poor-quality classroom and school contexts may impede the academic and behavioral adjustment of low-income students when they transition into kindergarten. Several studies have examined the impact of teacher-student interactions on student progress, whereas others have explored the impact of school-level adversity (e.g., student poverty, school…

Interpersonal Sources of Conflict in Young People with and without Mild to Moderate Intellectual Disabilities at Transition from Adolescence to Adulthood

ERIC Educational Resources Information Center

Larkin, P.; Jahoda, A.; MacMahon, K.; Pert, C.

2012-01-01

Background: Interpersonal conflict is a source of stress and contributes to poor mental health in people with mild to moderate intellectual disabilities. Understanding the contexts in which conflict typically occurs can better equip services to help people with such difficulties. However, existing studies into the contexts of conflict have…

Selecting Teaching Practice Schools across Social Contexts: Conceptual and Policy Challenges from South Africa

ERIC Educational Resources Information Center

Robinson, Maureen

2014-01-01

In a country like South Africa, as in many other countries around the world, there is an imperative to prepare student teachers for a wide variety of social contexts, as part of breaking the cycle of disadvantage for poor learners. This article explores the challenge of placing student teachers for their field experience in schools that differ…

Cross-National Variations in Student Employment and Academic Performance: The Roles of National Context and International Law

ERIC Educational Resources Information Center

Byun, Soo-yong; Henck, Adrienne; Post, David

2014-01-01

Most existing research indicates that working students perform more poorly than do full-time students on standardized achievement tests. However, we know there are wide international variations in this gap. This article shows that national and international contexts help to explain the gap in the academic performance between working and nonworking…

American Progressive Education and the Schooling of Poor Children: A Brief History of a Philosophy in Practice

ERIC Educational Resources Information Center

Garte, Rebecca

2017-01-01

This paper provides a historical analysis of the past century of progressive education, within the general socio-political context of schooling within the US. The purpose of this review is to create a social, historical and philosophical context for understanding the current narrative of progressive education that exists in educational policy…

The Role of Context in Risk for Pediatric Injury: Influences from the Home and Child Care Environments

ERIC Educational Resources Information Center

Schwebel, David C.; Brezausek, Carl M.

2007-01-01

Unintentional injury is the leading cause of pediatric mortality among American children, but the role of environmental context remains poorly understood as a risk for child injury. Couched in Bronfenbrenner's (1977) ecological theory, this study analyzed data from a sample of almost 900 children to identify relations between the home and…

Understanding of Idiomatic Expressions in Context in Skilled and Less Skilled Comprehenders: Online Processing and Interpretation

ERIC Educational Resources Information Center

Oakhill, Jane; Cain, Kate; Nesi, Barbara

2016-01-01

This article reports a study in which good and poor comprehenders (in 2 age groups: 8- and 10-year-olds) read short passages containing phrases that could be interpreted as idiomatic or not, depending on the context. Familiarity was manipulated by including real (English) idioms and novel (translations of Italian) idioms. Reading times for the…

The Balanced Development of Basic Education in the Context of Globalization

ERIC Educational Resources Information Center

Sun, Qi-lin; Kong, Kai

2006-01-01

Basic education is not only an essential means for eliminating stratification and differences in society but also one of the main reasons for the enlargement of the gap between the rich and the poor. Because it faces pressure in the context of globalization, a balanced development of basic education would be a good way to relieve this pressure.…

A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients.

PubMed

DeMeester, Rachel H; Lopez, Fanny Y; Moore, Jennifer E; Cook, Scott C; Chin, Marshall H

2016-06-01

Shared decision making (SDM) occurs when patients and clinicians work together to reach care decisions that are both medically sound and responsive to patients' preferences and values. SDM is an important tenet of patient-centered care that can improve patient outcomes. Patients with multiple minority identities, such as sexual orientation and race/ethnicity, are at particular risk for poor SDM. Among these dual-minority patients, added challenges to clear and open communication include cultural barriers, distrust, and a health care provider's lack of awareness of the patient's minority sexual orientation or gender identity. However, organizational factors like a culture of inclusion and private space throughout the visit can improve SDM with lesbian, gay, bisexual, and transgender ("LGBT") racial/ethnic minority patients who have faced stigma and discrimination. Most models of shared decision making focus on the patient-provider interaction, but the health care organization's context is also critical. Context-an organization's structure and operations-can strongly influence the ability and willingness of patients and clinicians to engage in shared decision making. SDM is most likely to be optimal if organizations transform their contexts and patients and providers improve their communication. Thus, we propose a conceptual model that suggests ways in which organizations can shape their contextual structure and operations to support SDM. The model contains six drivers: workflows, health information technology, organizational structure and culture, resources and clinic environment, training and education, and incentives and disincentives. These drivers work through four mechanisms to impact care: continuity and coordination, the ease of SDM, knowledge and skills, and attitudes and beliefs. These mechanisms can activate clinicians and patients to engage in high-quality SDM. We provide examples of how specific contextual changes could make SDM more effective for LGBT racial/ethnic minority populations, focusing especially on transformations that would establish a safe environment, build trust, and decrease stigma.

Advising and Optimizing the Deployment of Sustainability-Oriented Technologies in the Integrated Electricity, Light-Duty Transportation, and Water Supply System

NASA Astrophysics Data System (ADS)

Tarroja, Brian

The convergence of increasing populations, decreasing primary resource availability, and uncertain climates have drawn attention to the challenge of shifting the operations of key resource sectors towards a sustainable paradigm. This is prevalent in California, which has set sustainability-oriented policies such as the Renewable Portfolio Standards and Zero-Emission Vehicle mandates. To meet these goals, many options have been identified to potentially carry out these shifts. The electricity sector is focusing on accommodating renewable power generation, the transportation sector on alternative fuel drivetrains and infrastructure, and the water supply sector on conservation, reuse, and unconventional supplies. Historical performance evaluations of these options, however, have not adequately taken into account the impacts on and constraints of co-dependent infrastructures that must accommodate them and their interactions with other simultaneously deployed options. These aspects are critical for optimally choosing options to meet sustainability goals, since the combined system of all resource sectors must satisfy them. Certain operations should not be made sustainable at the expense of rendering others as unsustainable, and certain resource sectors should not meet their individual goals in a way that hinders the ability of the entire system to do so. Therefore, this work develops and utilizes an integrated platform of the electricity, transportation, and water supply sectors to characterize the performance of emerging technology and management options while taking into account their impacts on co-dependent infrastructures and identify synergistic or detrimental interactions between the deployment of different options. This is carried out by first evaluating the performance of each option in the context of individual resource sectors to determine infrastructure impacts, then again in the context of paired resource sectors (electricity-transportation, electricity-water), and finally in the context of the combined tri-sector system. This allows a more robust basis for composing preferred option portfolios to meet sustainability goals and gives a direction for coordinating the paradigm shifts of different resource sectors. Overall, it is determined that taking into account infrastructure constraints and potential operational interactions can significantly change the evaluation of the preferred role that different technologies should fulfill in contributing towards satisfying sustainability goals in the holistic context.

Woodlands Grazing Issues in Mediterranean Basin

NASA Astrophysics Data System (ADS)

Campos, P.

2009-04-01

In Mediterranean basin, woodlands grazing still continue to be important commercial owners' benefits. These owners manage woodlands vegetations as if they were not at risk of degradation and declining. Frequently, no temporally grazing set-aside is taken into account to avoid overgrazing of annual and perennial vegetations. Although less common, in the northern shore of Mediterranean basin undergrazing might increase the frequency and the number of catastrophic forest fires. This under/over grazing regime occurs in the Mediterranean basin woodlands with contrasted differences on land property rights, local economies and government livestock policy incentives. Spain and Tunisia are examples of these Mediterranean livestock contrasts. Most of Spanish Mediterranean woodlands and livestock herds are large private ownerships and owners could maintain their lands and livestock herds properties on the basis of moderate cash-income compensation against land revaluation and exclusive amenity self-consumption. The later is less tangible benefit and it could include family land legacy, nature enjoyment, country stile of life development, social status and so on. In public woodlands, social and environmental goals -as they are cultural heritage, biodiversity loss mitigation, soil conservation and employment- could maintain market unprofitable woodlands operations. Last three decades Spanish Mediterranean woodlands owners have increased the livestock herds incentivized by government subsidies. As result, grazing rent is pending on the level of European Union and Spanish government livestock subsidies. In this context, Spanish Mediterranean woodlands maintain a high extensive livestock stoking population, which economy could be called fragile and environmentally unsustainable because forest degradation and over/under grazing practices. Tunisian Mediterranean woodlands are state properties and livestock grazing is practice as a free private regimen. Livestock herds are small herd's family ownerships. These poor livestockeepers could maintain their livestock regimen on the basis of low cash-income earnings and crops self-consumption in extremely poor family living conditions. In this state woodlands, social an environmental goals -as they were noted above- could generate high trade off between family basic needs and soil degradation because woodlands and crops operations. As result, grazing rent is pending on the low opportunity cost for family labour. In this context, Tunisian Mediterranean woodlands maintain the highest livestock rate population, which woodland economy could be called for poor people subsistence and environmentally unsustainable because soil erosion, forest degradation and over/under grazing. These study present three study cases where Mediterranean basin grazing resources economies are analyzed in the contexts of Tunisian developing economy (Iteimia woodlands, North West of Tunisia) and Spanish developed economy (Jerez de la Frontera and Monfragüe woodlands, South and West of Spain). The results show the crucial role that livestock (goat, sheep and cattle) play in maintaining the working Mediterranean woodlands landscape. People, woodlands and livestock grazing dependences are changing so fast in Mediterranean basin that they appear too complex for being accurately forecasting by rangeland economists. In this context, perhaps a question might be a more suitable concluding remark: ¿will does woodlands extensive livestock become a quasi-wild management for urban landowners pleasure aims in rich Mediterranean basin countries?

Contextual cueing: implicit learning and memory of visual context guides spatial attention.

PubMed

Chun, M M; Jiang, Y

1998-06-01

Global context plays an important, but poorly understood, role in visual tasks. This study demonstrates that a robust memory for visual context exists to guide spatial attention. Global context was operationalized as the spatial layout of objects in visual search displays. Half of the configurations were repeated across blocks throughout the entire session, and targets appeared within consistent locations in these arrays. Targets appearing in learned configurations were detected more quickly. This newly discovered form of search facilitation is termed contextual cueing. Contextual cueing is driven by incidentally learned associations between spatial configurations (context) and target locations. This benefit was obtained despite chance performance for recognizing the configurations, suggesting that the memory for context was implicit. The results show how implicit learning and memory of visual context can guide spatial attention towards task-relevant aspects of a scene.

Diagnostic accuracy of self-administered urine glucose test strips as a diabetes screening tool in a low-resource setting in Cambodia.

PubMed

Storey, Helen L; van Pelt, Maurits H; Bun, Socheath; Daily, Frances; Neogi, Tina; Thompson, Matthew; McGuire, Helen; Weigl, Bernhard H

2018-03-22

Screening for diabetes in low-resource countries is a growing challenge, necessitating tests that are resource and context appropriate. The aim of this study was to determine the diagnostic accuracy of a self-administered urine glucose test strip compared with alternative diabetes screening tools in a low-resource setting of Cambodia. Prospective cross-sectional study. Members of the Borey Santepheap Community in Cambodia (Phnom Penh Municipality, District Dangkao, Commune Chom Chao). All households on randomly selected streets were invited to participate, and adults at least 18 years of age living in the study area were eligible for inclusion. The accuracy of self-administered urine glucose test strip positivity, Hemoglobin A1c (HbA1c)>6.5% and capillary fasting blood glucose (cFBG) measurement ≥126 mg/dL were assessed against a composite reference standard of cFBGmeasurement ≥200 mg/dL or venous blood glucose 2 hours after oral glucose tolerance test (OGTT) ≥200 mg/dL. Of the 1289 participants, 234 (18%) had diabetes based on either cFBG measurement (74, 32%) or the OGTT (160, 68%). The urine glucose test strip was 14% sensitive and 99% specific and failed to identify 201 individuals with diabetes while falsely identifying 7 without diabetes. Those missed by the urine glucose test strip had lower venous fasting blood glucose, lower venous blood glucose 2 hours after OGTT and lower HbA1c compared with those correctly diagnosed. Low cost, easy to use diabetes tools are essential for low-resource communities with minimal infrastructure. While the urine glucose test strip may identify persons with diabetes that might otherwise go undiagnosed in these settings, its poor sensitivity cannot be ignored. The massive burden of diabetes in low-resource settings demands improvements in test technologies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Human resource development for a community-based health extension program: a case study from Ethiopia.

PubMed

Teklehaimanot, Hailay D; Teklehaimanot, Awash

2013-08-20

Ethiopia is one of the sub-Saharan countries most affected by high disease burden, aggravated by a shortage and imbalance of human resources, geographical distance, and socioeconomic factors. In 2004, the government introduced the Health Extension Program (HEP), a primary care delivery strategy, to address the challenges and achieve the World Health Organization Millennium Development Goals (MDGs) within a context of limited resources. The health system was reformed to create a platform for integration and institutionalization of the HEP with appropriate human capacity, infrastructure, and management structures. Human resources were developed through training of female health workers recruited from their prospective villages, designed to limit the high staff turnover and address gender, social and cultural factors in order to provide services acceptable to each community. The service delivery modalities include household, community and health facility care. Thus, the most basic health post infrastructure, designed to rapidly and cost-effectively scale up HEP, was built in each village. In line with the country's decentralized management system, the HEP service delivery is under the jurisdiction of the district authorities. The nationwide implementation of HEP progressed in line with its target goals. In all, 40 training institutions were established, and over 30,000 Health Extension Workers have been trained and deployed to approximately 15,000 villages. The potential health service coverage reached 92.1% in 2011, up from 64% in 2004. While most health indicators have improved, performance in skilled delivery and postnatal care has not been satisfactory. While HEP is considered the most important institutional framework for achieving the health MDGs in Ethiopia, quality of service, utilization rate, access and referral linkage to emergency obstetric care, management, and evaluation of the program are the key challenges that need immediate attention. This article describes the strategies, human resource developments, service delivery modalities, progress in service coverage, and the challenges in the implementation of the HEP. The Ethiopian approach of revitalization of primary care through innovative, locally appropriate and acceptable strategies will provide important lessons to other poorly resourced countries. It is hoped that the approaches and strategies described in this paper will aid in that process.

Health Services for Migrant Children.

ERIC Educational Resources Information Center

Bove, Beverly A.

Intended as a resource for administrators, teachers, nurses, paraprofessionals, health coordinators, and community action personnel who are interested in meeting the health needs of migrant children, this handbook offers suggestions for organizing community resources in providing health care to migrant children. Poor nutrition, the lack of dental…

Incorporating seascape connectivity in conservation prioritisation.

PubMed

Weeks, Rebecca

2017-01-01

In conservation prioritisation, it is often implicit that representation targets for individual habitat types act as surrogates for the species that inhabit them. Yet for many commercially and ecologically important coral reef fish species, connectivity among different habitats in a seascape may be more important than any single habitat alone. Approaches to conservation prioritisation that consider seascape connectivity are thus warranted. I demonstrate an approach that can be implemented within a relatively data-poor context, using widely available conservation planning software. Based on clearly stated assumptions regarding species' habitat usage and movement ability, this approach can be adapted to different focal species and contexts, or refined as further data become available. I first derive a seascape connectivity metric based on area-weighted proximity between juvenile and adult habitat patches, and then apply this during spatial prioritisation using the decision-support software Marxan. Using a case study from Micronesia, I present two applications: first, to inform prioritisation for a network of marine protected areas to achieve regional objectives for habitat representation; and second, to identify nursery habitat patches that are most likely to supply juveniles to adult populations on reefs within existing protected areas. Incorporating seascape connectivity in conservation prioritisation highlights areas where small marine protected areas placed on coral reefs might benefit from proximity to other habitats in the seascape, and thus be more effective. Within the context of community tenure over resources, identification of critical nursery habitats to improve the effectiveness of existing marine protected areas indicates where collaboration across community boundaries might be required. Outputs from these analyses are likely to be most useful in regions where management is highly decentralised, imposing spatial constraints on the size of individual protected areas.

Incorporating seascape connectivity in conservation prioritisation

PubMed Central

2017-01-01

In conservation prioritisation, it is often implicit that representation targets for individual habitat types act as surrogates for the species that inhabit them. Yet for many commercially and ecologically important coral reef fish species, connectivity among different habitats in a seascape may be more important than any single habitat alone. Approaches to conservation prioritisation that consider seascape connectivity are thus warranted. I demonstrate an approach that can be implemented within a relatively data-poor context, using widely available conservation planning software. Based on clearly stated assumptions regarding species’ habitat usage and movement ability, this approach can be adapted to different focal species and contexts, or refined as further data become available. I first derive a seascape connectivity metric based on area-weighted proximity between juvenile and adult habitat patches, and then apply this during spatial prioritisation using the decision-support software Marxan. Using a case study from Micronesia, I present two applications: first, to inform prioritisation for a network of marine protected areas to achieve regional objectives for habitat representation; and second, to identify nursery habitat patches that are most likely to supply juveniles to adult populations on reefs within existing protected areas. Incorporating seascape connectivity in conservation prioritisation highlights areas where small marine protected areas placed on coral reefs might benefit from proximity to other habitats in the seascape, and thus be more effective. Within the context of community tenure over resources, identification of critical nursery habitats to improve the effectiveness of existing marine protected areas indicates where collaboration across community boundaries might be required. Outputs from these analyses are likely to be most useful in regions where management is highly decentralised, imposing spatial constraints on the size of individual protected areas. PMID:28753647

Quality of life from the perspective of the palliative care patient in a resource-poor community in South Africa.

PubMed

Jansen van Rensburg, Jacoba J M; Maree, Johanna E; van Belkum, Corrien

2013-02-01

Quality of life is an ill-defined term, as it means different things to different people. Quality of life has been well researched, especially with respect to people with cancer, but not necessarily from the perspective of the patient, and also, not in Third World, resource-poor countries. The objective of this study was to explore quality of life from the perspective of palliative care patients managed at a palliative care clinic serving a resource-poor community in Tshwane, South Africa. An exploratory, qualitative phenomenological study was conducted. The target population for this study was all patients managed at a palliative care clinic serving a resource-poor community in Tshwane. Self-report data were gathered by means of in-depth interviews. The data were analyzed using a template analysis style as well as content analysis using open coding. Data analysis was done concurrently with data gathering. Data saturation was reached after 10 interviews (n = 10). Three themes arose from the data: factors that had a positive influence on quality of life, factors that had a negative influence on quality of life, and experience of quality of life. Work played the most important role in quality of life whereas only one participant linked symptom control with quality of life. Experiencing symptoms, rejection, and stigmatization had a negative influence on quality of life. Friends and religion played a significant role and added to quality of life. Life was a daily struggle for survival. Poverty was so overwhelming that quality of life was primarily measured in terms of the ability to buy food and other basic commodities.

Randomized trial of plastic bags to prevent term neonatal hypothermia in a resource-poor setting.

PubMed

Belsches, Theodore C; Tilly, Alyssa E; Miller, Tonya R; Kambeyanda, Rohan H; Leadford, Alicia; Manasyan, Albert; Chomba, Elwyn; Ramani, Manimaran; Ambalavanan, Namasivayam; Carlo, Waldemar A

2013-09-01

Term infants in resource-poor settings frequently develop hypothermia during the first hours after birth. Plastic bags or wraps are a low-cost intervention for the prevention of hypothermia in preterm and low birth weight infants that may also be effective in term infants. Our objective was to test the hypothesis that placement of term neonates in plastic bags at birth reduces hypothermia at 1 hour after birth in a resource-poor hospital. This parallel-group randomized controlled trial was conducted at University Teaching Hospital, the tertiary referral center in Zambia. Inborn neonates with both a gestational age ≥37 weeks and a birth weight ≥2500 g were randomized 1:1 to either a standard thermoregulation protocol or to a standard thermoregulation protocol with placement of the torso and lower extremities inside a plastic bag within 10 minutes after birth. The primary outcome was hypothermia (<36.5°C axillary temperature) at 1 hour after birth. Neonates randomized to plastic bag (n = 135) or to standard thermoregulation care (n = 136) had similar baseline characteristics (birth weight, gestational age, gender, and baseline temperature). Neonates in the plastic bag group had a lower rate of hypothermia (60% vs 73%, risk ratio 0.76, confidence interval 0.60-0.96, P = .026) and a higher axillary temperature (36.4 ± 0.5°C vs 36.2 ± 0.7°C, P < .001) at 1 hour after birth compared with infants receiving standard care. Placement in a plastic bag at birth reduced the incidence of hypothermia at 1 hour after birth in term neonates born in a resource-poor setting, but most neonates remained hypothermic.

Patient Information about Gout: An International Review of Existing Educational Resources.

PubMed

Johnston, Megan E; Treharne, Gareth J; Chapman, Peter T; Stamp, Lisa K

2015-06-01

Inadequate patient information about gout may contribute to poor disease outcomes. We reviewed existing educational resources for gout to identify strengths and weaknesses and compare resources cross-nationally. Content, readability, and dietary recommendations were reviewed using a sample of 30 resources (print and Web-based) from 6 countries. More than half of the resources were written at a highly complex level. Some content areas were lacking coverage, including comorbidity risks, uric acid target levels, and continuing allopurinol during acute attacks. Our findings suggest significant room for improvement in gout patient educational resources, particularly regarding self-management.

Social Capital and Educational Aspiration of Students: Does Family Social Capital Affect More Compared to School Social Capital?

ERIC Educational Resources Information Center

Shahidul, S. M.; Karim, A. H. M. Zehadul; Mustari, S.

2015-01-01

Resources from multiple social contexts influence students' educational aspiration. In the field of social capital a neglected issue is how students obtain social capital from varying contexts and which contexts benefit them more to shape their future educational plan which consequently affects their level of aspiration. In this study, we aim to…

What Would Grade 8 to 10 Learners Prefer as Context for Mathematical Literacy? The Case of Masilakele Secondary School

ERIC Educational Resources Information Center

Julie, Cyril; Mbekwa, Monde

2005-01-01

Contexts are currently enjoying much prominence in school mathematics. Generally, the contextual issues and situations learners are exposed to and deal with in Mathematical Literacy are, with good reason, determined by curriculum, learning resource and test designers. This article reports on a study that investigated contexts that learners would…

Earth Science Contexts for Teaching Physics. Part 2: Contexts Relating to the Teaching of Energy, Earth and Beyond and Radioactivity.

ERIC Educational Resources Information Center

King, Chris; Kennett, Peter

2002-01-01

Explains how physics teaching can be more relevant for elementary and secondary students by integrating physics and earth science content that students can relate to and understand. Identifies and explains Earth contexts that can be appropriately implemented into the physics curriculum such as energy resources and radioactivity. (Author/YDS)

"Etxadi-Gangoiti" Scale: A Proposal to Evaluate the Family Contexts of Two-Year-Old Children

ERIC Educational Resources Information Center

Arranz Freijo, Enrique B.; Olabarrieta Artetxe, Fernando; Manzano Fernández, Ainhoa; Martín Ayala, Juan luís; Galende Pérez, Nuria

2014-01-01

This paper makes a proposal for the comprehensive assessment of the family context of children aged two years. It offers an updated resource based on recent research into the assessment of family contexts and their influence on children's psychological development. The proposal explores the following areas: Presence of learning materials;…

Is E-health Progressing Faster Than E-health Researchers?

PubMed Central

2006-01-01

Formal Internet interventions exist in a broad context of diverse online health resources, which share elements in common like information, advice and peer support. However, most online health resources are not created by healthcare professionals. Internet interventions need to be designed to “compete” in that wider context. The democratization of production and distribution is central to the transformative effect of the Internet on society, yet potentially conflicts with healthcare’s need for an evidence base and safe practice. This is a core challenge for healthcare on the Internet. PMID:17032640

Self-Assessed Disability and Self-Rated Health among Rural Villagers in Peru: A Brief Report

ERIC Educational Resources Information Center

Rohrer, James E.; Merry, Stephen P.; Thacher, Thomas D.; Summers, Matthew R.; Alpern, Jonathan D.; Contino, Robert W.

2010-01-01

Context: Risks for poor self-rated overall health in rural areas of developing nations have not been thoroughly investigated. Purpose: The objective of this study was to assess potential risk factors for poor self-rated health among rural villagers in Peru. Methods: A door-to-door survey of villagers residing in the Pampas Grande region in Peru,…

The Poor Ye Need Not Have with You; Lessons from the War on Poverty.

ERIC Educational Resources Information Center

Levine, Robert A.

The book provides a dichotomy of the general technique of problem handling in the United States; i.e., getting even or punishing the adversary, and the reverse of this, problem solving; and discusses the two aspects in the context of the war on poverty. The second and third chapters discuss various definitions of the Poor, and provide objectives…

"If the Social Worker Had Called at Least It Would Show They Cared". Young Care Leaver's Perspectives on the Importance of Care

ERIC Educational Resources Information Center

Gaskell, Carolyn

2010-01-01

Young people leaving local authority care are frequently discussed in terms of being socially excluded and having "poor life outcomes". In terms of educational achievement, employment and involvement in the criminal justice system, those with an experience of the care system fare the worst. Within the context of these poor outcomes, the Government…

Interaction of Students' Academic Background and Support Levels in a Resource-Based Learning Environment on Earth's Movement

ERIC Educational Resources Information Center

So, Wing Mui Winnie; Kong, Siu Cheung

2010-01-01

This research aims to study how a resource-based learning environment (RBLE) helps primary students develop better understanding of the Earth's movement. One objective of the study is to establish an RBLE by creating authentic contexts, selecting appropriate resources, designing relevant tools and adopting necessary scaffolds. The other objective…

Web-Based Learning Materials for Higher Education: The MERLOT Repository

ERIC Educational Resources Information Center

Orhun, Emrah

2004-01-01

MERLOT (Multimedia Educational Resource for Learning and Online Teaching) is a web-based open resource designed primarily for faculty and students in higher education. The resources in MERLOT include over 8,000 learning materials and support materials from a wide variety of disciplines that can be integrated within the context of a larger course.…

Perspectives on the Present State and Future of Higher Education Faculty Development in Kazakhstan: Implications for National Human Resource Development

ERIC Educational Resources Information Center

Seitova, Dinara

2016-01-01

The article aims at examining the present state of higher education faculty development in Kazakhstan in the context of multidimensional nationwide development reforms and exploring implications for the National Human Resource Development of the country. For the purpose of this research, theoretical human resource development (HRD) and…

Human Sexuality. A Resource Guide for Parents and Teachers on Teaching...High School Level.

ERIC Educational Resources Information Center

Utah State Office of Education, Salt Lake City.

This guide provides information and resources that will facilitate parents' ability to help adolescents understand human sexuality within the context of home and family values and ideals. It provides teachers with resources to facilitate the decision making process. Contents are organized within a framework of objectives and guidelines for both…

Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process.

PubMed

Etiaba, Enyi; Uguru, Nkoli; Ebenso, Bassey; Russo, Giuliano; Ezumah, Nkoli; Uzochukwu, Benjamin; Onwujekwe, Obinna

2015-05-06

In Nigeria, there is a high burden of oral health diseases, poor coordination of health services and human resources for delivery of oral health services. Previous attempts to develop an Oral Health Policy (OHP) to decrease the oral disease burden failed. However, a policy was eventually developed in November 2012. This paper explores the role of contextual factors, actors and the policy process in the development of the OHP and possible reasons why the current approved OHP succeeded. The study was undertaken across Nigeria; information gathered through document reviews and in-depth interviews with five groups of purposively selected respondents. Analysis of the policy development process was guided by the policy triangle framework, examining context, policy process and actors involved in the policy development. The foremost enabling factor was the yearning among policy actors for a policy, having had four failed attempts. Other factors were the presence of a democratically elected government, a framework for health sector reform instituted by the Federal Ministry of Health (FMOH). The approved OHP went through all stages required for policy development unlike the previous attempts. Three groups of actors played crucial roles in the process, namely academics/researchers, development partners and policy makers. They either had decision making powers or influenced policy through funding or technical ability to generate credible research evidence, all sharing a common interest in developing the OHP. Although evidence was used to inform the development of the policy, the complex interactions between the context and actors facilitated its approval. The OHP development succeeded through a complex inter-relationship of context, process and actors, clearly illustrating that none of these factors could have, in isolation, catalyzed the policy development. Availability of evidence is necessary but not sufficient for developing policies in this area. Wider socio-political contexts in which actors develop policy can facilitate and/or constrain actors' roles and interests as well as policy process. These must be taken into consideration at stages of policy development in order to produce policies that will strengthen the health system, especially in low and middle-income countries, where policy processes and influences can be often less than transparent.

History of Mathematics: Resources on the World Wide Web.

ERIC Educational Resources Information Center

Barrow-Green, June

1998-01-01

Offers a guide to some available resources on the internet to help teachers judge how best to use new technology for the benefit of their students in the context of adding a historical dimension to mathematical studies. (ASK)

Gender Differences among Contributing Leadership Development Resources

ERIC Educational Resources Information Center

Thompson, Michael D.

2012-01-01

Gender differences among contributing student leadership development resources were examined within the context of theory-based perspectives of leadership-related attributes. The findings suggest that students' increased engagement with institutional constituencies cultivates an environment conducive to students' cognitive development toward…

Task Shifting in Dermatology: A Call to Action.

PubMed

Brown, Danielle N; Langan, Sinéad M; Freeman, Esther E

2017-11-01

Can task shifting be used to improve the delivery of dermatologic care in resource-poor settings worldwide? Task shifting is a means of redistributing available resources, whereby highly trained individuals train an available workforce to provide necessary care in low-resource settings. Limited evidence exists for task shifting in dermatology; however, studies from psychiatry demonstrate its efficacy. In the field of dermatology there is a need for high-quality evidence including randomized clinical trials to validate the implementation of task shifting in low-resource settings globally.

Children's understanding of equity in the context of inequality.

PubMed

Rizzo, Michael T; Killen, Melanie

2016-11-01

In the context of a pre-existing resource inequality, the concerns for strict equality (allocating the same number of resources to all recipients) conflict with the concerns for equity (allocating resources to rectify the inequality). This study demonstrated age-related changes in children's (3-8 years old, N = 133) ability to simultaneously weigh the concerns for equality and equity through the analysis of children's judgements, allocations, and reasoning in the context of a pre-existing inequality. Three- to 4-year-olds took equity into account in their judgements of allocations, but allocated resources equally in a behavioural task. In contrast, 5- to 6-year-olds rectified the inequality in their allocations, but judged both equitable and equal allocations to be fair. It was not until 7-8 years old that children focused on rectifying the inequality in their allocations and judgements, as well as judged equal allocations less positively than equitable allocations, thereby demonstrating a more complete understanding of the necessity of rectifying inequalities. The novel findings revealed age-related changes from 3 to 8 years old regarding how the concerns for equity and equality develop, and how children's judgements, allocations, and reasoning are coordinated when making allocation decisions. © 2016 The British Psychological Society.

Community responses to government defunding of watershed projects: a comparative study in India and the USA.

PubMed

Koontz, Tomas M; Sen, Sucharita

2013-03-01

When central governments decentralize natural resource management (NRM), they often retain an interest in the local efforts and provide funding for them. Such outside investments can serve an important role in moving community-based efforts forward. At the same time, they can represent risks to the community if government resources are not stable over time. Our focus in this article is on the effects of withdrawal of government resources from community-based NRM. A critical question is how to build institutional capacity to carry on when the government funding runs out. This study compares institutional survival and coping strategies used by community-based project organizations in two different contexts, India and the United States. Despite higher links to livelihoods, community participation, and private benefits, efforts in the Indian cases exhibited lower survival rates than did those in the U.S. cases. Successful coping strategies in the U.S. context often involved tapping into existing institutions and resources. In the Indian context, successful coping strategies often involved building broad community support for the projects and creatively finding additional funding sources. On the other hand, the lack of local community interest, due to the top-down development approach and sometimes narrow benefit distribution, often challenged organizational survival and project maintenance.

Community Responses to Government Defunding of Watershed Projects: A Comparative Study in India and the USA

NASA Astrophysics Data System (ADS)

Koontz, Tomas M.; Sen, Sucharita

2013-03-01

When central governments decentralize natural resource management (NRM), they often retain an interest in the local efforts and provide funding for them. Such outside investments can serve an important role in moving community-based efforts forward. At the same time, they can represent risks to the community if government resources are not stable over time. Our focus in this article is on the effects of withdrawal of government resources from community-based NRM. A critical question is how to build institutional capacity to carry on when the government funding runs out. This study compares institutional survival and coping strategies used by community-based project organizations in two different contexts, India and the United States. Despite higher links to livelihoods, community participation, and private benefits, efforts in the Indian cases exhibited lower survival rates than did those in the U.S. cases. Successful coping strategies in the U.S. context often involved tapping into existing institutions and resources. In the Indian context, successful coping strategies often involved building broad community support for the projects and creatively finding additional funding sources. On the other hand, the lack of local community interest, due to the top-down development approach and sometimes narrow benefit distribution, often challenged organizational survival and project maintenance.

Gene context conservation of a higher order than operons.

PubMed

Lathe, W C; Snel, B; Bork, P

2000-10-01

Operons, co-transcribed and co-regulated contiguous sets of genes, are poorly conserved over short periods of evolutionary time. The gene order, gene content and regulatory mechanisms of operons can be very different, even in closely related species. Here, we present several lines of evidence which suggest that, although an operon and its individual genes and regulatory structures are rearranged when comparing the genomes of different species, this rearrangement is a conservative process. Genomic rearrangements invariably maintain individual genes in very specific functional and regulatory contexts. We call this conserved context an uber-operon.

Incidence of Haemonchus spp. and effect on haematocrit and eye colour in goats farmed under resource-poor conditions in South Africa.

PubMed

Vatta, A F; Krecek, R C; Letty, B A; van der Linde, M J; Grimbeek, R J; de Villiers, J F; Motswatswe, P W; Molebiemang, G S; Boshoff, H M; Hansen, J W

2002-01-03

The diversity and predominance of nematode genera in goats of resource-poor farmers at Rust de Winter, Gauteng Province, Impendle, KwaZulu-Natal Province, and Kraaipan, North-West Province, South Africa, was determined by means of a longitudinal study of the nematode faecal egg counts (FECs) and differential third-stage nematode larvae. The animals were bled for haematocrit determination and scored for pallor of ocular mucous membranes using the FAMACHA( Copyright) method, an assay for clinical evaluation of anaemia caused by Haemonchus spp. Animals considered to be in danger of dying from anaemia caused by haemonchosis were selectively treated with an anthelmintic. Lower haematocrit values were registered during periods of heavier Haemonchus infection, which occurred from December/January to March for Rust de Winter; from December to March/April for Impendle; and from November/December to February or April for Kraaipan. There was agreement too between the lower haematocrits and paler mucous membranes scored according to the FAMACHA( Copyright) method. The use of this system may be recommended as part of an integrated approach to worm control in goats kept in the resource-poor areas studied.

E-health systems for management of MDR-TB in resource-poor environments: a decade of experience and recommendations for future work.

PubMed

Fraser, Hamish S F; Habib, Ali; Goodrich, Mark; Thomas, David; Blaya, Joaquin A; Fils-Aime, Joseph Reginald; Jazayeri, Darius; Seaton, Michael; Khan, Aamir J; Choi, Sharon S; Kerrison, Foster; Falzon, Dennis; Becerra, Mercedes C

2013-01-01

Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring. Over the last decade we have developed the PIH-EMR electronic medical record system, and subsequently OpenMRS-TB, to support the treatment of MDR-TB in Peru, Haiti, Pakistan, and other resource-poor environments. We describe here the experience with implementing these systems and evaluating many aspects of their performance, and review other systems for MDR-TB management. We recommend a new approach to information systems to address the barriers to scale up MDR-TB treatment, particularly access to the appropriate drugs and lab data. We propose moving away from fragmented, vertical systems to focus on common platforms, addressing all stages of TB care, support for open data standards and interoperability, care for a wide range of diseases including HIV, integration with mHealth applications, and ability to function in resource-poor environments.

Patient's Self-Assessment of Social-Approval After Mandibulectomy with Disarticulation: the Necessity for Jaw Reconstruction Following Loss of Facial Symmetry in a Resource-Poor African Setting.

PubMed

Aluko-Olokun, Bayo; Olaitan, Ademola A

2017-12-01

Mandibulectomy with disarticulation is usually carried out without reconstruction in Low-Income-Countries. Lower standards of living are usually acceptable and adapted to, in poor societies. This study compares patient's self-assessment of social approval among reconstructed and non-reconstructed cases of mandibulectomy with disarticulation in a resource-poor African setting. This questionnaire-based study documented patient's self-assessment of social approval of themselves following mandibulectomy with disarticulation. 12 derived queries were administered on each patient, to test what they perceived of social acceptability of their facial features following mandibulectomy. All 10 patients who underwent mandibular reconstruction reported that they felt confident engaging in all forms of social activity, while all 10 who had resection without reconstruction did not. The low social approval perceived by patients who have undergone mandibulectomy with disarticulation without reconstruction necessitates that surgeons must strive to reconstruct this anatomical region even under circumstances of severe resource-constraint. The culture in the third-world is not supportive of patients who have not undergone reconstruction following resection, in spite of being victims of all-pervading poverty. Level IV, investigative study.

Resilient Learners in Schools Serving Poor Communities

ERIC Educational Resources Information Center

Frempong, G.; Visser, M.; Feza, Nosisi; Winnaar, L.; Nuamah, S.

2016-01-01

Introduction: Through the education for all initiative, a number of education systems have been able to provide access to their students at the basic education level. The major challenge is that most of these learners, especially, those from poor families who attend schools with limited resources are often not successful. However, in South Africa,…

Marital Quality as a Moderator of the Effects of Poor Vision on Quality of Life Among Older Adults

PubMed Central

2011-01-01

Objectives. This study assessed the moderating role of marital quality in the effects of subjective and objective vision on functional limitations, social isolation, and depressive symptomatology. Method. Data from 738 married older adults drawn from a probability-based representative sample of elders residing in the United States were used. Assessments included subjective and objective vision, marital quality variables (relationship satisfaction, supportive spouse behaviors, and free time spent with one’s spouse), and three aspects of quality of life (functional limitations, social isolation, and depressive symptomatology). Results. Moderated regression analyses found that relationship satisfaction and supportive spouse behaviors moderated the effects of poor self-reported vision on functional limitations and depressive symptoms and the effects of poor visual acuity on functional limitations. As hypothesized, poorer vision was unrelated to functional limitations and depressive symptoms in more satisfying marriages but predicted higher levels of both outcomes in less satisfying marriages. Contrary to expectations, higher levels of supportive spouse behaviors were associated with more functional limitations in respondents who reported poorer subjective and objective vision. Discussion. A marriage that is highly satisfying can mitigate the adverse effects of poor vision on functional limitations and depressive symptomatology in late life. The moderating role of supportive spouse behaviors in the link between poor vision and quality of life is less intuitive, however. Whereas relationship satisfaction may operate as a traditional buffer in the context of poor vision, supportive spouse behaviors may increase in response to or be ineffective in this context. PMID:21840838

Knowledge translation in Uganda: a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework.

PubMed

Bergström, Anna; Peterson, Stefan; Namusoko, Sarah; Waiswa, Peter; Wallin, Lars

2012-12-03

A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the sub-elements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. The sub-elements of organizational context in the PARIHS framework-i.e., receptive context, culture, leadership, and evaluation-also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings-resources, community involvement, and commitment and informal payment-should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate sub-element of the PARIHS framework as a whole.

Knowledge translation in Uganda: a qualitative study of Ugandan midwives’ and managers’ perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

PubMed Central

2012-01-01

Background A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this ‘know-do’ gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the sub-elements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. Methods This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. Results The sub-elements of organizational context in the PARIHS framework—i.e., receptive context, culture, leadership, and evaluation—also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. Conclusions In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings—resources, community involvement, and commitment and informal payment—should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate sub-element of the PARIHS framework as a whole. PMID:23206670

Lexical Resources and Their Application.

ERIC Educational Resources Information Center

Gellerstam, Martin

This paper discusses computer-based resources for lexical data and their uses. First, the kinds of lexical data available are described, including those related to form (spelling, pronunciation, inflection, word class), meaning (definition/equivalent, synonyms/antonyms/hyperonyms, thesaurus classification), context (grammatical collocations,…

What makes Great Basin sagebrush ecosystems invasible by Bromus tectorum?

Treesearch

Jeanne C. Chambers; Bruce A. Roundy; Robert R. Blank; Susan E. Meyer; A. Whittaker

2007-01-01

Ecosystem susceptibility to invasion by nonnative species is poorly understood, but evidence is increasing that spatial and temporal variability in resources has large-scale effects. We conducted a study in Artemisia tridentata ecosystems at two Great Basin locations examining differences in resource availability and invasibility of Bromus...

Fort Collins Science Center- Policy Analysis and Science Assistance Branch : Integrating social, behavioral, economic and biological sciences

USGS Publications Warehouse

2010-01-01

The Fort Collins Science Center's Policy Analysis and Science Assistance (PASA) Branch is a team of approximately 22 scientists, technicians, and graduate student researchers. PASA provides unique capabilities in the U.S. Geological Survey by leading projects that integrate social, behavioral, economic, and biological analyses in the context of human-natural resource interactions. Resource planners, managers, and policymakers in the U.S. Departments of the Interior (DOI) and Agriculture (USDA), State and local agencies, as well as international agencies use information from PASA studies to make informed natural resource management and policy decisions. PASA scientists' primary functions are to conduct both theoretical and applied social science research, provide technical assistance, and offer training to advance performance in policy relevant research areas. Management and research issues associated with human-resource interactions typically occur in a unique context, involve difficult to access populations, require knowledge of both natural/biological science in addition to social science, and require the skill to integrate multiple science disciplines. In response to these difficult contexts, PASA researchers apply traditional and state-of-the-art social science methods drawing from the fields of sociology, demography, economics, political science, communications, social-psychology, and applied industrial organization psychology. Social science methods work in concert with our rangeland/agricultural management, wildlife, ecology, and biology capabilities. The goal of PASA's research is to enhance natural resource management, agency functions, policies, and decision-making. Our research is organized into four broad areas of study.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

PubMed

Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-10-01

Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province.

PubMed

Mushtaq, Muhammad Umair; Shahid, Ubeera; Majrooh, Muhammad Ashraf; Shad, Mushtaq Ahmad; Siddiqui, Arif Mahmood; Akram, Javed

2010-08-23

The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI) to ultimately provide evidence for designing future interventions. A qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts) and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis. The main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs), unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization. The study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should be considered in prioritizing future strategies.

Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia

PubMed Central

Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

2017-01-01

Background Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. Methodology A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. Results A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). Conclusion In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system. PMID:29075171

From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province

PubMed Central

2010-01-01

Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI) to ultimately provide evidence for designing future interventions. Methods A qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts) and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis. Results The main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs), unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization. Conclusion The study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should be considered in prioritizing future strategies. PMID:20731832

Prediction of Outcome From Adult Bacterial Meningitis in a High-HIV-Seroprevalence, Resource-Poor Setting Using the Malawi Adult Meningitis Score (MAMS).

PubMed

Wall, Emma C; Mukaka, Mavuto; Scarborough, Matthew; Ajdukiewicz, Katherine M A; Cartwright, Katharine E; Nyirenda, Mulinda; Denis, Brigitte; Allain, Theresa J; Faragher, Brian; Lalloo, David G; Heyderman, Robert S

2017-02-15

Acute bacterial meningitis (ABM) in adults residing in resource-poor countries is associated with mortality rates >50%. To improve outcome, interventional trials and standardized clinical algorithms are urgently required. To optimize these processes, we developed and validated an outcome prediction tool to identify ABM patients at greatest risk of death. We derived a nomogram using mortality predictors derived from a logistic regression model of a discovery database of adult Malawian patients with ABM (n = 523 [65%] cerebrospinal fluid [CSF] culture positive). We validated the nomogram internally using a bootstrap procedure and subsequently used the nomogram scores to further interpret the effects of adjunctive dexamethasone and glycerol using clinical trial data from Malawi. ABM mortality at 6-week follow-up was 54%. Five of 15 variables tested were strongly associated with poor outcome (CSF culture positivity, CSF white blood cell count, hemoglobin, Glasgow Coma Scale, and pulse rate), and were used in the derivation of the Malawi Adult Meningitis Score (MAMS) nomogram. The C-index (area under the curve) was 0.76 (95% confidence interval, .71-.80) and calibration was good (Hosmer-Lemeshow C-statistic = 5.48, df = 8, P = .705). Harmful effects of adjunctive glycerol were observed in groups with relatively low predicted risk of poor outcome (25%-50% risk): Case Fatality Rate of 21% in the placebo group and 52% in the glycerol group (P < .001). This effect was not seen with adjunctive dexamethasone. MAMS provides a novel tool for predicting prognosis and improving interpretation of ABM clinical trials by risk stratification in resource-poor settings. Whether MAMS can be applied to non-HIV-endemic countries requires further evaluation. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

On the context-dependent scaling of consumer feeding rates.

PubMed

Barrios-O'Neill, Daniel; Kelly, Ruth; Dick, Jaimie T A; Ricciardi, Anthony; MacIsaac, Hugh J; Emmerson, Mark C

2016-06-01

The stability of consumer-resource systems can depend on the form of feeding interactions (i.e. functional responses). Size-based models predict interactions - and thus stability - based on consumer-resource size ratios. However, little is known about how interaction contexts (e.g. simple or complex habitats) might alter scaling relationships. Addressing this, we experimentally measured interactions between a large size range of aquatic predators (4-6400 mg over 1347 feeding trials) and an invasive prey that transitions among habitats: from the water column (3D interactions) to simple and complex benthic substrates (2D interactions). Simple and complex substrates mediated successive reductions in capture rates - particularly around the unimodal optimum - and promoted prey population stability in model simulations. Many real consumer-resource systems transition between 2D and 3D interactions, and along complexity gradients. Thus, Context-Dependent Scaling (CDS) of feeding interactions could represent an unrecognised aspect of food webs, and quantifying the extent of CDS might enhance predictive ecology. © The Authors. Ecology Letters published by CNRS and John Wiley & Sons Ltd.

The importance of the community context in the epidemiology of early adolescent substance use and delinquency in a rural sample.

PubMed

Chilenski, Sarah M; Greenberg, Mark T

2009-12-01

Considerable research has demonstrated that substance use and delinquency during early adolescence can have long-term negative health consequences. As the correlates of these behaviors cross levels and contexts, it is likely that a social ecological approach will provide insight to inform community prevention. This approach informs the present study, which focuses on developing a multiple-method measurement strategy to examine associations among community risks, resources, and rates of early adolescent substance use and delinquency in 28 rural and small town communities. Measures include five domains of community risk, four domains of community resources, and population rates of early adolescent substance use and delinquency. Results demonstrated that several measures of context were significantly associated with community rates of adolescent substance use and delinquency, and different risks and resources appear important for different outcomes. Multiple associations were curvilinear, and interactions may also be important. Findings suggest that it may be worthwhile to create and test new intervention strategies that target community factors in the pursuit of prevention.

Immunization, urbanization and slums - a systematic review of factors and interventions.

PubMed

Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra

2017-06-08

In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context. Interventions should be designed and tested to increase immunization in migrants from rural areas.

Context processing in adolescents with autism spectrum disorder: How complex could it be?

PubMed

Ben-Yosef, Dekel; Anaki, David; Golan, Ofer

2017-03-01

The ability of individuals with Autism Spectrum Disorder (ASD) to process context has long been debated: According to the Weak Central Coherence theory, ASD is characterized by poor global processing, and consequently-poor context processing. In contrast, the Social Cognition theory argues individuals with ASD will present difficulties only in social context processing. The complexity theory of autism suggests context processing in ASD will depend on task complexity. The current study examined this controversy through two priming tasks, one presenting human stimuli (facial expressions) and the other presenting non-human stimuli (animal faces). Both tasks presented visual targets, preceded by congruent, incongruent, or neutral auditory primes. Local and global processing were examined by presenting the visual targets in three spatial frequency conditions: High frequency, low frequency, and broadband. Tasks were administered to 16 adolescents with high functioning ASD and 16 matched typically developing adolescents. Reaction time and accuracy were measured for each task in each condition. Results indicated that individuals with ASD processed context for both human and non-human stimuli, except in one condition, in which human stimuli had to be processed globally (i.e., target presented in low frequency). The task demands presented in this condition, and the performance deficit shown in the ASD group as a result, could be understood in terms of cognitive overload. These findings provide support for the complexity theory of autism and extend it. Our results also demonstrate how associative priming could support intact context processing of human and non-human stimuli in individuals with ASD. Autism Res 2017, 10: 520-530. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Children's Evaluations of Resource Allocation in the Context of Group Norms

ERIC Educational Resources Information Center

Cooley, Shelby; Killen, Melanie

2015-01-01

This study investigated children's evaluations of peer group members who deviated from group norms about equal and unequal allocation of resources. Children, ages 3.5 to 4 years and 5 to 6 years (N = 73), were asked to evaluate a peer group member who deviated from 1 of 2 group allocation norms: (a) equal allocation of resources, or (b) unequal…

The Role of Temporal Context and Expectancy in Resource Allocation to and Perception of Rapid Serial Events

ERIC Educational Resources Information Center

Kranczioch, Cornelia; Dhinakaran, Janani

2013-01-01

The perception of target events presented in a rapid stream of non-targets is impaired for early target positions, but then gradually improves, a phenomenon known as attentional awakening. This phenomenon has been associated with better resource allocation. It is unclear though whether improved resource allocation and attentional awakening are a…