Computers in the Schools: State/Provincial Implications.

ERIC Educational Resources Information Center

Thiessen, S. J.

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

76 FR 76359 - Deschutes Provincial Advisory Committee (DPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-07

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

Retail food environments, shopping experiences, First Nations and the provincial Norths.

PubMed

Burnett, Kristin; Skinner, Kelly; Hay, Travis; LeBlanc, Joseph; Chambers, Lori

2017-10-01

This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.

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

PubMed

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

2014-01-01

The financial accessibility of antimicrobial drugs to the outpatient community in Canada is governed at the provincial level through formularies. Each province may choose to list particular drugs or impose restriction criteria on products in order to guide prescribing and/or curtail costs. Although changes to formularies have been shown to change patterns in the use of individual products and alter costs, no comparison has been made among the provincial antimicrobial formularies with regards to flexibility/stringency, or an assessment of how these formularies impact overall antimicrobial use in the provinces. To summarize provincial antimicrobial formularies and assess whether their relative flexibility/stringency had a statistical impact upon provincial prescription volume during a one year period. Provincial drug plan formularies were accessed and summarized for all prescribed antimicrobials in Canada during 2010. The number of general and restricted benefits for each plan was compiled by antimicrobial classification. Population-adjusted prescription rates for all individual antimicrobials and by antimicrobial class were obtained from the Canadian Integrated Program for Antimicrobial Resistance Surveillance. Correlations between the number of general benefits, restricted benefits, and total benefits with the prescription rate in the provinces were assessed by Spearman rank correlation coefficients. Formularies varied considerably among the Canadian provinces. Quebec had the most flexible formulary, offering the greatest number of general benefits and fewest restrictions. In contrast, Saskatchewan's formulary displayed the lowest number of general benefits and most restrictions. Correlation analyses detected a single significant result; macrolide prescription rates decreased as the number of general macrolide benefits increased. All other rates of provincial antimicrobial prescribing and measures of flexibility/stringency revealed no significant correlations

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

PubMed

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

2014-01-01

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

Retail food environments, shopping experiences, First Nations and the provincial Norths

PubMed Central

Kristin, Burnett; Kelly, Skinner; Travis, Hay; Joseph, LeBlanc; Lori, Chambers

2017-01-01

Abstract Introduction: This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. Methods: We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Results: Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. Conclusion: There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition. PMID:29043760

75 FR 13252 - Oregon Coast Provincial Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

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

Capacitación-acción participativa: una experiencia de 24 años en las comunidades rurales de Oaxaca, México.

PubMed

Ysunza, Alberto M; Diez-Urdanivia, Silvia; Pérez-Gil, Sara E

2017-12-01

Resumen: En este artículo presentamos el proyecto de capacitación llevado a cabo en comunidades de la sierra y costa de Oaxaca, México, desde 1991, por el Centro de Capacitación Integral para Promotores Comunitarios (CECIPROC). La decisión de hacer este trabajo en Oaxaca responde a que ese estado ocupa uno de los primeros lugares de marginación y de desnutrición en menores de 5 años. El objetivo es describir un modelo de capacitación y compartir parte de las experiencias derivadas, tanto del modelo como del trabajo realizado en las distintas áreas (nutrición y alimentación, salud comunitaria, ecología y etnobotánica, y educación y organización), por promotores mujeres y hombres en sus comunidades. La experiencia obtenida en 24 años muestra la factibilidad técnica y social del proyecto en el ámbito de la salud, el reconocimiento social del proyecto del CECIPROC como un organismo civil que ha aportado alternativas como solución a la problemática de salud, el hacer suyo el proyecto por algunos promotores y los diferentes obstáculos a los que se ha enfrentado. Enfatizamos el hecho de que la situación socioeconómica y política prevaleciente en el estado de Oaxaca es una limitante para el buen desarrollo de los programas colectivos de salud, e insistimos en la necesidad de compartir nuestras experiencias para que puedan ser utilizadas en la planificación y ejecución de otros proyectos.

El proyecto AUGER

NASA Astrophysics Data System (ADS)

Etchegoyen, A.

Hace ya más de 30 años en Volcano Ranch, EE.UU., un extenso chubasco cósmico (ECC) fue detectado con energía en exceso de 1020 eV. Desde entonces, observatorios ubicados en Haverah Park del Reino Unido, Yakutsk de Rusia, AGASA de Japón y Dugway de EE.UU. también han observado ECC con energías mayores que 1020 eV. Poco se sabe de dichos rayos, y en particular cuál es la naturaleza del primario, de dónde provienen, y cómo son acelerados, pero su naturaleza ultrarelativista excluye la mayoría de las respuestas dejando sólo algunas plausibles de ser investigadas experimentalmente. Grupos de científicos de 20 países están trabajando con el fin de construir dos arreglos de detectores gigantes, uno en cada hemisferio a lo largo de 3000 km2 c/u. Dichas dimensiones son necesarias debido al flujo estimado de 1 rayo cósmico/centuria/km2/sr. La sede del Observatorio del Sur es la Argentina. El proyecto fue nombrado Pierre Auger en conmemoración del célebre físico francés que detectó por primera vez chubascos cósmicos en 1938. El proyecto focaliza su interés en rayos cósmicos con energías mayores que 1020 eV.

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

ERIC Educational Resources Information Center

Adamson, Martin; And Others

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

Proyecto Leer Bulletin Number 6.

ERIC Educational Resources Information Center

Tome, Martha V., Ed.

This annotated, cumulative bibliography, developed by the Proyecto Leer Program, of more than 600 selected works in Spanish focuses on works which meet the following criteria: (1) reading difficulty does not exceed 10th grade level, and (2) selections are suitable for a Spanish-American community. Books for children are listed separately from…

Accountability: Its Implications for Provincial and State Governments.

ERIC Educational Resources Information Center

Kolesar, H.

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

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

PubMed

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

2012-05-01

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

Attitudes of Employees of Provincial Directorates of National Education and School Administrators towards Strategic Planning

ERIC Educational Resources Information Center

Altinkurt, Yahya

2010-01-01

The aim of the study is to determine the attitudes of employees of Provincial Directorates of National Education and school administrators towards strategic planning. The research was designed as a survey model study. The population of the research consisted of employees of Provincial Directorate of National Education of Kutahya and school…

Back Cover: NIH MedlinePlus Salud

MedlinePlus

... page please turn Javascript on. ¡A su salud! Los Institutos Nacionales de la Salud (NIH, por sus ... Amigos de la Biblioteca Nacional de Medicina de los Estados Unidos y la Alianza Nacional para la ...

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

PubMed

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

2010-11-22

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

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

PubMed Central

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

2010-01-01

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

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

PubMed

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

2018-02-06

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

Exploring work-life issues in provincial corrections settings.

PubMed

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

2013-01-01

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

Home | Departamento de Salud de Puerto Rico

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

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

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

"Proyecto Sherezade": Teaching Spanish Literature Interactively.

ERIC Educational Resources Information Center

Fernandez, Enrique

2001-01-01

Describes "Proyecto Sherezade," an Internet-based project publicly available to anyone. Founded in 1996 by a group of Spanish language and literature academics in Canada and the United States, the project began as an Internet literary magazine that published non-established writers's short stories in Spanish and commentaries sent by readers.…

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

PubMed

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

2016-05-01

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

Categorizing Two Taiwanese Major Political Parties From Their Faces: The Influence of Provincial Appearance

PubMed Central

Chang, Chien-Kai; Ho, Mary Wen-Reng; Chien, Sarina Hui-Lin

2018-01-01

People go beyond the inferences afforded by a person’s observable features to make guesses about personality traits or even social memberships such as political affiliations. The present study extended Hu et al. (2016) to further investigate the influence of provincial appearance on differentiating KMT (Kuomintang) and DPP (Democratic Progressive Party) candidates by headshot photos with three experiments. In Experiment 1 (Membership categorization task), participants categorized the photos from the pilot study (where the difference between the perceived age of KMT and DPP candidates was reduced) and divided into four blocks by their perceived age. We found that participants were able to distinguish KMT from DPP candidates significantly better than chance, even when the perceived age difference between the two parties was minimized. In Experiment 2 (Trait rating task), we asked young and middle-aged adults to rate six traits on candidate’s photos. We found that “provincial appearance” is the core trait differentiating the two parties for both young and older participants, while “facial maturity” is another trait for older participants only. In Experiment 3 (Double categorization task), we asked participants to categorize the photos from the Exp. 1 on their membership (KMT or DPP) and on provincial appearance (mainlander or native Taiwanese) in two separate sessions. Results showed that young adults were likely to use the “provincial appearance” as the main characteristic cue to categorize candidates’ political membership. In sum, our study showed that Taiwanese adults could categorize the two parties by their headshot photos when age cue was eliminated. Moreover, provincial appearance was the most critical trait for differentiating between KMT and DPP candidates, which may reflect a piece of significant history during the development of the two parties. PMID:29618993

[History of Instituto Nacional de Salud Ocupacional del Peru].

PubMed

Cossio-Brazzan, Juan M

2012-06-01

In Peru, the industry's development has made economic improvements but at the same time, it has had a major impact on the health of the workers; for that reason, it was necessary to generate control mechanisms. So, in 1940 it was created the Departmento de Higiene Industrial, which in 1956 was changed to Instituto de Salud Ocupacional, but it was deactivated in 1994. However, in 2001 it reappeared into the Ministerio de Salud organizational structure with the name of Instituto de Salud Ocupacional "Alberto Hurtado Abadía". Actually, it is the Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), organ of the Instituto Nacional de Salud which continues working in synergy with other institutions and sectors, making research to protect the health of exposed persons (workers and community) to contamination and risks associated with economic activities.

Fostering a Provincial Identity: Two Eras in Alberta Schooling

ERIC Educational Resources Information Center

von Heyking, Amy

2006-01-01

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

Provincially and Locally Initiated Curriculum Program Assessment, Final Report.

ERIC Educational Resources Information Center

1999

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

Proyecto Aurora: Building a Community of Women.

ERIC Educational Resources Information Center

Noya, Gladys R. Capella

1997-01-01

Describes the development of Proyecto Aurora, a program to develop and implement educational, support, and research programs to benefit low-income women in Puerto Rico. Portraits of some clients illustrate the rewards and challenges of working with this community and furthering their educational experiences and opportunities. (SLD)

Provincial geology and the Industrial Revolution.

PubMed

Veneer, Leucha

2006-06-01

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

Oportunidades y Retos Metodológicos en Investigaciones de Salud en el Contexto Carcelario de Puerto Rico

PubMed Central

Previdi, Irene Lafarga; Guzzi Vasques, Ana C.; Varas-Díaz, Nelson; Albizu García, Carmen E.

2017-01-01

Resumen La población carcelaria de Puerto Rico en 2013 se compone de aproximadamente 13,000 personas. En la literatura no se encuentran documentos que describan los facilitadores y las limitaciones para realizar estudios relacionados con la salud mental en las cárceles. El artículo es una reflexión en torno a situaciones que facilitan o retan la investigación en cárceles según identificaron los/las miembros del equipo de investigación de un proyecto cuyo objetivo era validar una escala para medir estrés en los confinados. En este artículo presentamos elementos facilitadores y retantes del trabajo investigativo en prisión, que sirven para afrontar los retos que presenta este escenario particular. Estas verbalizaciones pueden servir de guía para futuras investigaciones con la población penal. Los hallazgos y recomendaciones preparan al grupo de investigación para afrontar los retos que presenta este escenario particular y a saber cómo maximizar los facilitadores para obtener productos satisfactorios. PMID:28316510

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

USGS Publications Warehouse

Quick, J.C.; Brill, T.

2002-01-01

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

Balanced Development for Provincial-Level Coordination and Higher Vocational Education

ERIC Educational Resources Information Center

Po, Yang; Yunbo, Liu

2017-01-01

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

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

ERIC Educational Resources Information Center

Roessingh, Hetty

2012-01-01

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

Knowledge and perceptions of national and provincial tuberculosis control programme managers in Pakistan about the WHO Stop TB strategy: a qualitative study.

PubMed

Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz; Hassounah, Sondus

2016-01-01

To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programmes in Pakistan. 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall

Knowledge and perceptions of national and provincial tuberculosis control programme managers in Pakistan about the WHO Stop TB strategy: a qualitative study

PubMed Central

Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz

2016-01-01

Objective To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. Design A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Participants National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Setting National and provincial tuberculosis programmes in Pakistan Main outcome measures 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. Results The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. Conclusion This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB

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

PubMed

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

2017-01-01

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

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

PubMed

Rydlewska-Liszkowska, I; Jugo, B

1999-01-01

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

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

PubMed

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

2017-11-09

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

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

PubMed

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

2017-07-26

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

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

PubMed

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

2013-05-14

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

Provincialization of terrestrial faunas following the end-Permian mass extinction

PubMed Central

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

2013-01-01

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

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

PubMed

Blecher, Mark

2002-06-01

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

Content Analysis Schedule for Bilingual Education Programs: Proyecto PAL.

ERIC Educational Resources Information Center

Gonzalez, Castor

This content analysis schedule for "Proyecto PAL" in San Jose, California, presents information on the history, funding, and scope of the project. Included are sociolinguistic process variables such as the native and dominant languages of students and their interaction. Information is provided on staff selection and the linguistic…

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

DTIC Science & Technology

2013-03-01

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

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

NASA Astrophysics Data System (ADS)

Ye, Z.; Xiang, H.

2014-04-01

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

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

PubMed

Finn, Michael A; Stark, James F

2015-02-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

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

PubMed Central

Hu, Yu; Chen, Yaping

2017-01-01

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

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

PubMed

Hu, Yu; Chen, Yaping

2017-07-11

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

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

PubMed

Barbosa, Lidiany Silva

2011-01-01

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

Translation and adaptation of the Competencias Esenciales en Salud Pública para los recursos humanos en salud.

PubMed

Almeida, Maria de Lourdes de; Peres, Aida Maris; Ferreira, Maria Manuela Frederico; Mantovani, Maria de Fátima

2017-06-05

to perform the translation and cultural adaptation of the document named Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas (Regional Framework of Core Competencies in Public Health for Health Human Resources in the Region of Americas) from Spanish to Brazilian Portuguese. a methodological study comprising the following phases: authorization for translation; initial translation; synthesis of translations and consensus; back-translation and formation of an expert committee. in the translation of domain names, there was no difference in 66.7% (N = 4); in the translation of domain description and competencies there were divergences in 100% of them (N = 6, N = 56). A consensus of more than 80% was obtained in the translation and improvement in the expert committee by the change of words and expressions for approximation of meanings to the Brazilian context. the translated and adapted document has the potential of application in research, and use in the practice of collective/public health care in Brazil. realizar a tradução e adaptação cultural do Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas, do espanhol para a língua portuguesa do Brasil. pesquisa metodológica, que seguiu as fases: autorização para tradução; tradução inicial; síntese das traduções e consenso; retrotradução e composição de um comitê de especialistas. na tradução dos nomes dos domínios, não houve diferença em 66,7 % (N=4); na tradução da descrição dos domínios e das competências ocorreram divergências em 100 % destes (N=6, N=56), obteve-se consenso acima de 80% ainda na tradução, e aprimoramento no comitê de especialistas pela alteração de palavras e expressões para aproximar os significados ao contexto brasileiro. o documento traduzido e adaptado possui potencial de aplicação em pesquisas e utilização na pr

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

PubMed

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

2018-06-01

Cesarean delivery is the most common surgical procedure in low- and middle-income countries, so provision of anesthesia services can be measured in relation to it. This study aimed to assess the type of anesthesia used for cesarean delivery, the level of training of anesthesia providers, and to document the availability of essential anesthetic drugs and equipment in provincial, district, and mission hospitals in Zimbabwe. In this cross-sectional survey of 8 provincial, 21 district, and 13 mission hospitals, anesthetic providers were interviewed on site using a structured questionnaire adapted from standard instruments developed by the World Federation of Societies of Anaesthesiologists and the World Health Organization. The anesthetic workforce for the hospitals in this survey constituted 22% who were medical officers and 77% nurse anesthetists (NAs); 55% of NAs were recognized independent anesthetic providers, while 26% were qualified as assistants to anesthetic providers and 19% had no formal training in anesthesia. The only specialist physician anesthetist was part time in a provincial hospital. Spinal anesthesia was the most commonly used method for cesarean delivery (81%) in the 3 months before interview, with 19% general anesthesia of which 4% was ketamine without airway intubation. The mean institutional cesarean delivery rate was 13.6% of live births, although 5 district hospitals were <5%. The estimated institutional maternal mortality ratio was 573 (provincial), 251 (district), and 211 (mission hospitals) per 100,000 live births. Basic monitoring equipment (oximeters, electrocardiograms, sphygmomanometers) was reported available in theatres. Several unsafe practices continue: general anesthesia without a secure airway, shortage of essential drugs for spinal anesthesia, inconsistent use of recovery area or use of table tilt or wedge, and insufficient blood supplies. Postoperative analgesia management was reported inadequate. This study identified areas

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

PubMed Central

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

2014-01-01

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

The development of floristic provinciality during the Middle and Late Paleozoic

USGS Publications Warehouse

Wnuk, C.

1996-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2013-11-01

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

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

PubMed

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

2017-07-01

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

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

PubMed

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

2018-05-04

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

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

ERIC Educational Resources Information Center

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

2017-01-01

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

Los incendios y su salud

EPA Pesticide Factsheets

El humo de los incendios puede tener un efecto adverso en la salud de las personas, especialmente en aquellas que padecen de enfermedades cardíacas y pulmonares. Vea cómo minimizar su exposición al humo.

ENVEJECIMIENTO, SALUD Y ECONOMÍA: La Encuesta Nacional sobre Salud y Envejecimiento en México*

PubMed Central

2017-01-01

RESUMEN México vive una transición demográfica en la cual el porcentaje de la población mayor de 50 años de edad crece aceleradamente como resultado de un aumento considerable en la esperanza de vida. Dicha población tiene necesidades particulares que deben ser tomadas en cuenta en la formulación de políticas, sobre todo en materia de acceso a servicios de salud y seguridad social. En este artículo presentamos una descripción general de la Encuesta Nacional de Salud y Envejecimiento (Enasem), un estudio de panel que comenzó en 2001 y que ofrece una oportunidad única para abordar temas demográficos y económicos complejos por medio de la exploración de las características personales, transferencias socioeconómicas e indicadores de salud para una muestra de 15 186 adultos de edad media y avanzada. También presentamos los resultados más relevantes de diferentes estudios que han utilizado la Enasem hasta la fecha. Nuestra revisión indica que México enfrenta desafíos considerables para satisfacer la demanda de servicios médicos para una población que es amenazada por una creciente presencia de enfermedades crónicas, sobre todo para la población de edad avanzada que no cuenta con cobertura de seguro médico. PMID:29375164

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

NASA Astrophysics Data System (ADS)

Wang, Wen; Cheng, Hui; Zhang, Li

2012-04-01

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

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

PubMed Central

Pei, X; Rodriguez, E

2006-01-01

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

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

ERIC Educational Resources Information Center

Aydogan, Hayri

2016-01-01

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

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

ERIC Educational Resources Information Center

Davydova, N. E.

2013-01-01

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

Una Red de Expertos en Salud Ambiental de Niños (2015)

EPA Pesticide Factsheets

Unidades Pediátricas de Especialidad en Salud Ambiental (PEHSU) tiene expertos en pediatria, alergias e inmunologia, desarrollo neural, toxicologia, y otras, ya que existen varios factores que afectan la salud de los ninos.

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

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

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

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

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

PubMed

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

2014-01-01

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

Portrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey.

PubMed

Fleet, Richard; Poitras, Julien; Archambault, Patrick; Tounkara, Fatoumata Korika; Chauny, Jean-Marc; Ouimet, Mathieu; Gauthier, Josée; Dupuis, Gilles; Tanguay, Alain; Lévesque, Jean-Frédéric; Simard-Racine, Geneviève; Haggerty, Jeannie; Légaré, France

2015-12-23

Rural emergency departments (EDs) constitute crucial safety nets for the 20% of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines "the provincial ED management Guide". The aim of this study was to provide a detailed description of rural EDs in Québec and utilization of the provincial ED management Guide. We selected EDs offering 24/7 medical coverage, with hospitalization beds, located in rural or small towns. We collected data via telephone, paper, and online surveys with rural ED/hospital staff. Data were also collected from Québec's Ministry of Health databases and from Statistics Canada. We computed descriptive statistics, ANOVA and t-tests were used to examine the relationship between ED census, services and inter-facility transfer requirements. A total of 23 of Québec's 26 rural EDs (88%) consented to participate in the study. The mean annual ED visits was 18 813 (Standard Deviation = 6 151). Thirty one percent of ED physicians were recent graduates with fewer than 5 years of experience. Only 6 % had residency training or certification in emergency medicine. Teams have good local access (24/7) to diagnostic equipment such as CT scanner (74%), intensive unit care (78%) and general surgical services (78%), but limited access to other consultants. Sixty one percent of participants have reported good knowledge of the provincial ED management Guide, but only 23% of them have used the guidelines. Furthermore, more than 40% of EDs were more than 300 km from levels 1 to 2 trauma centers, and only 30% had air transport access. Rural EDs in Québec are staffed by relatively new graduates working as solo physicians in well-resourced and moderately busy (by rural standards) EDs. The provincial ED management Guide may have contributed to this model of service attribution. However, the

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

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

Manténgase saludable al elegir pescado y mariscos de manera inteligente

EPA Pesticide Factsheets

Los pescados y mariscos son una parte importante de una dieta saludable. Algunos pescados y mariscos pueden contener sustancias químicas que presenten un riesgo para la salud. Información sobre el consumo seguro de pescado y mariscos.

Proyecto Energético Palmdale; Decisión del Permiso Final

EPA Pesticide Factsheets

Proyecto Energético Palmdale: EPA Región 9 por el presente emite aviso de su decisión final, el cumplimiento con la Ley Federal de Aire Limpio, para la construcción de una planta generadora de electricidad de ciclo combinado y alimentada por gas natural

El medioambiente y su salud

EPA Pesticide Factsheets

Las acciones que usted toda en su diario vivir tienen un impacto en su medioambiente y su salud. La Agencia de Protección Ambiental de EE.UU. (EPA, por sus siglas en inglés) ofrece información sobre los pasos que puede tomar para protegerse a usted y prote

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

DTIC Science & Technology

2011-06-01

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

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

PubMed

Wu, Yichao; Qi, Di

2016-10-01

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

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

PubMed

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

2014-09-01

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

Forecasting residential electricity demand in provincial China.

PubMed

Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan

2017-03-01

In China, more than 80% electricity comes from coal which dominates the CO2 emissions. Residential electricity demand forecasting plays a significant role in electricity infrastructure planning and energy policy designing, but it is challenging to make an accurate forecast for developing countries. This paper forecasts the provincial residential electricity consumption of China in the 13th Five-Year-Plan (2016-2020) period using panel data. To overcome the limitations of widely used predication models with unreliably prior knowledge on function forms, a robust piecewise linear model in reduced form is utilized to capture the non-deterministic relationship between income and residential electricity consumption. The forecast results suggest that the growth rates of developed provinces will slow down, while the less developed will be still in fast growing. The national residential electricity demand will increase at 6.6% annually during 2016-2020, and populous provinces such as Guangdong will be the main contributors to the increments.

Types of provincial structure and population health.

PubMed

Young, Frank W; Rodriguez, Eunice

2005-01-01

This paper explores the potential of using large administrative units for studies of population health within a country. The objective is to illustrate a new way of defining structural dimensions and to use them in examining variation in life expectancy rates. We use data from the 50 provinces of Spain as a case study. A factor analysis of organizational items such as schools, hotels and medical personnel is employed to define and generate "collective" measures for well-known provincial types, in this case: urban, commercial, industrial and tourist provinces. The scores derived from the factor analysis are then used in a regression model to predict life expectancy. The City-centered and Commercial provinces showed positive correlations with life expectancy while those for the Tourist provinces were negative. The industrial type was nonsignificant. Explanations of these correlations are proposed and the advantages and disadvantages of this exploratory technique are reviewed. The use of this technique for generating an overview of social organization and population health is discussed.

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

PubMed

Chen, Nengcheng; Xu, Lei

2017-01-01

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

La salud en personas con discapacidad intelectual en España: estudio europeo POMONA-II

PubMed Central

Martínez-Leal, Rafael; Salvador-Carulla, Luis; Gutiérrez-Colosía, Mencía Ruiz; Nadal, Margarida; Novell-Alsina, Ramón; Martorell, Almudena; González-Gordón, Rodrigo G.; Mérida-Gutiérrez, M. Reyes; Ángel, Silvia; Milagrosa-Tejonero, Luisa; Rodríguez, Alicia; García-Gutiérrez, Juan C.; Pérez-Vicente, Amado; García-Ibáñez, José; Aguilera-Inés, Francisco

2011-01-01

Introducción Estudios internacionales demuestran que existe un patrón diferenciado de salud y una disparidad en la atención sanitaria entre personas con discapacidad intelectual (DI) y población general. Objetivo Obtener datos sobre el estado de salud de las personas con DI y compararlos con datos de población general. Pacientes y métodos Se utilizó el conjunto de indicadores de salud P15 en una muestra de 111 sujetos con DI. Los datos de salud encontrados se compararon según el tipo de residencia de los sujetos y se utilizó la Encuesta Nacional de Salud 2006 para comparar estos datos con los de la población general. Resultados La muestra con DI presentó 25 veces más casos de epilepsia y el doble de obesidad. Un 20% presentó dolor bucal, y existió una alta presencia de problemas sensoriales, de movilidad y psicosis. Sin embargo, encontramos una baja presencia de patologías como la diabetes, la hipertensión, la osteoartritis y la osteoporosis. También presentaron una menor participación en programas de prevención y promoción de la salud, un mayor número de ingresos hospitalarios y un uso menor de los servicios de urgencia. Conclusiones El patrón de salud de las personas con DI difiere del de la población general, y éstas realizan un uso distinto de los servicios sanitarios. Es importante el desarrollo de programas de promoción de salud y de formación profesional específicamente diseñados para la atención de personas con DI, así como la implementación de encuestas de salud que incluyan datos sobre esta población. PMID:21948011

Engaging Community With Promotores de Salud to Support Infant Nutrition and Breastfeeding Among Latinas Residing in Los Angeles County: Salud con Hyland's.

PubMed

Rios-Ellis, Britt; Nguyen-Rodriguez, Selena T; Espinoza, Lilia; Galvez, Gino; Garcia-Vega, Melawhy

2015-01-01

The Salud con Hyland's Project: Comienzo Saludable, Familia Sana [Health With Hyland's Project: Healthy Start, Healthy Family],was developed to provide education and support to Latina mothers regarding healthy infant feeding practices and maternal health. The promotora-delivered intervention was comprised of two charlas (educational sessions) and a supplemental, culturally and linguistically relevant infant feeding and care rolling calendar. Results indicate that the intervention increased intention to breastfeed exclusively, as well as to delay infant initiation of solids by 5 to 6 months. Qualitative feedback identified barriers to maternal and child health education as well as highlighted several benefits of the intervention.

Strengthening rural Latinos' civic engagement for health: The Voceros de Salud project.

PubMed

López-Cevallos, Daniel; Dierwechter, Tatiana; Volkmann, Kelly; Patton-López, Megan

2013-11-01

This article describes the Latino Health Ambassadors Network (Voceros de Salud ) project created to support and mobilize Latino community leaders to address health inequalities in a rural Oregon county. Voceros de Salud is discussed as a model that other rural communities may implement towards strengthening Latino civic engagement for health.

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

PubMed

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

2014-12-01

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

A promotora de salud model for addressing cardiovascular disease risk factors in the US-Mexico border region.

PubMed

Balcázar, Héctor; Alvarado, Matilde; Cantu, Frank; Pedregon, Veronica; Fulwood, Robert

2009-01-01

In 2002, the National Heart, Lung, and Blood Institute partnered with the Health Resources and Services Administration's (HRSA's) Bureau of Primary Health Care and Office of Rural Health Policy to address cardiovascular health in the US-Mexico border region. From 2003 through 2005, the 2 agencies agreed to conduct an intervention program using Salud para su Corazón with promotores de salud (community health workers) in high-risk Hispanic communities served by community health centers (CHCs) in the border region to reduce risk factors and improve health behaviors. Promotores de salud from each CHC delivered lessons from the curriculum Your Heart, Your Life. Four centers implemented a 1-group pretest-posttest study design. Educational sessions were delivered for 2 to 3 months. To test Salud para su Corazón-HRSA health objectives, the CHCs conducted the program and assessed behavioral and clinical outcomes at baseline, 3 months, 6 months, and 12 months after the intervention. A 2-sample paired t test and analyses of variance were used to evaluate differences from baseline to postintervention. Changes in heart-healthy behaviors were observed, as they have been in previous Salud para su Corazón studies, lending credibility to the effectiveness of a promotores de salud program in a clinical setting. Positive changes were also observed in low-density lipoprotein cholesterol level, triglyceride level, waist circumference, diastolic blood pressure, weight, and glycated hemoglobin (HbA1c). Results suggest that integrating promotores de salud into clinical practices is a promising strategy for culturally competent and effective service delivery. Promotores de salud build coalitions and partnerships in the community. The Salud para su Corazón-HRSA initiative was successful in helping to develop an infrastructure to support a promotores de salud workforce in the US-Mexico border region.

James Monroe High School Proyecto Nuevos Horizontes, 1985-1986. OEA Evaluation Report.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn. Office of Educational Assessment.

Proyecto Nuevos Horizontes, a 3-year Title VII-funded bilingual education program, serves 287 Spanish speaking students at James Monroe High School (Bronx, New York). This report evaluates the project's first year of operation, 1985-86. The report contains an introduction describing the school and project goals; information on student…

[Operation directions by comparing financial ratio of 22 provincial hospitals].

PubMed

Wang, J Y; Ko, Y C; Wang, J W; Jan, L C; Chang, F M; Lin, K C

1996-12-01

Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a

[Batas Nómadas in Madrid Salud: art and artists in professional community health teams].

PubMed

Castillejo, Mar; Fernández-Cedena, Jorge; Siles, Silvia; Claver, María Dolores; Ávila, Noemí

2018-06-14

This article describes the strategy of incorporating artists into the teams of community health in the city of Madrid, specifically in the Madrid Salud Centers. The artistic colletive, Batas Nómadas, formed by three artists expertized in visual arts, has developed performances and participatory aproach to explain the incorporation of art and artists in these teams of professionals of Madrid Salud. Batas Nómadas has carried out sessions in 14 work teams of the Madrid Salud Centers and has collected data in a creative way from the 179 professionals that have participated in these sessions. These actions have shown some needs in community health, and have noticed a meaningful reflection on the usefulness of the art to develop participative strategies into the Madrid Salud teams. Copyright © 2018. Publicado por Elsevier España, S.L.U.

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

Treesearch

S. A. Vasiliauskas; L. W. Aarssen

2000-01-01

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

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

PubMed Central

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

2013-01-01

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

James Monroe High School Proyecto Nuevos Horizontes, 1986-1987. OEA Evaluation Report.

ERIC Educational Resources Information Center

Martinez, Ana L.; And Others

In its second year of Title VII funding, James Monroe High Schools's Proyecto Nuevos Horizontes (Project New Horizons) served 344 limited-English-speaking recent arrivals from Latin America and the Caribbean, in grades 9 through 12. The program has built on the strengths of the high school's extensive computer-assisted instruction (CAI) program,…

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

PubMed

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

2012-12-01

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

Provincial Coordination and Inter-Institutional Collaboration in British Columbia's College, University College and Institute System. Monograph Series.

ERIC Educational Resources Information Center

Gaber, Devron

This document addresses a study that aimed to better understand the historical development of British Columbia community college, university college, and institute system with special attention given to recent changes in inter-institutional collaboration in relation to provincial coordination. The study also addresses centralization and…

Translation and adaptation of the Competencias Esenciales en Salud Pública para los recursos humanos en salud 1

PubMed Central

de Almeida, Maria de Lourdes; Peres, Aida Maris; Ferreira, Maria Manuela Frederico; Mantovani, Maria de Fátima

2017-01-01

ABSTRACT Objective: to perform the translation and cultural adaptation of the document named Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas (Regional Framework of Core Competencies in Public Health for Health Human Resources in the Region of Americas) from Spanish to Brazilian Portuguese. Method: a methodological study comprising the following phases: authorization for translation; initial translation; synthesis of translations and consensus; back-translation and formation of an expert committee. Result: in the translation of domain names, there was no difference in 66.7% (N = 4); in the translation of domain description and competencies there were divergences in 100% of them (N = 6, N = 56). A consensus of more than 80% was obtained in the translation and improvement in the expert committee by the change of words and expressions for approximation of meanings to the Brazilian context. Conclusion: the translated and adapted document has the potential of application in research, and use in the practice of collective/public health care in Brazil. PMID:28591302

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

PubMed

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

2017-12-20

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

NURSES INFECTION PREVENTION PRACTICES IN HANDLING INJECTIONS: A CASE OF RIFT VALLEY PROVINCIAL HOSPITAL IN KENYA.

PubMed

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

2014-10-01

To analyse the infection prevention practices in handling of injections by nurses in Rift Valley Provincial Hospital in Kenya. A cross-sectional observational study. Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. A sample of 386 injection procedures attributed to the nurses in Rift Valley Provincial Hospital was considered for this study. The study established that among all the injections administered in this study, 43.7% (386) adhered to aseptic techniques. Over seventy five percent (76.9%, n = 386) of the observed injections procedures did not involve the hand-washing, 53.4% (n = 206) did not involve swabbing of a vial rubber cap with alcohol swabs and 95.1%(n = 263) involved using of multidose drug in more than one designated patient. Over ninety five percent (95.6%, n = 364) of the observed procedures involved use of sterile the syringe bit of the devices only while the rest used either clean or contaminated syringes. Around forty percent (42.2%, n = 316) of the injections preparation was done elsewhere (not at the patient bedside) before administration. Slightly over thirty five percent (36.6%, n = 386) of the injections were administered immediately upon reconstitution(at the right time). The study also established the use of aseptic techniques to reconstitute and administer was significantly related to the number of nurses to patients ratio per shift (X2(1) = 3.5: p = 0.04). The findings of this study indicate that patient safety in public hospital is still relatively low. The adherence to basic infection prevention procedures/aseptic techniques in handling of injections by health workers is still a concern. The adherence to aseptic techniques in handling injections is significantly associated with the nurses to patients ratios. Therefore, it is imperative to improve nurse to patient ratio in public health facilities in Kenya.

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

ERIC Educational Resources Information Center

Vakeva, Lauri; Kurkela, Vesa

2012-01-01

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

[Descriptive Study of the Activities Performed By the Provincial Medical Deontology Commissions].

PubMed

García-Guerrero, Julio; Tarazona López, Ernesto; Martínez Calduch, Blanca; Vera-Remartínez, Enrique Jesús; Jiménez de Aldasoro, María Antonia; Boix Rajadell, Vicente; Ventura López, Mario

2016-01-01

to describe the expedient's features those settle the medical ethics commissions of the provincial colleges (PMEC). descriptive study, retrospective from the typology of the received claims to the PMEC between 01-06-2013 and 31-05-2014. The colleges were selected by simple stratified random sample. Variables related with the origin of the claim, chapter of the Medical Ethics Code affected, resolution timescales, judgement and others; were gathered. Descriptive analysis of the variables, expressing with medians the quantitative variables and their corresponding interquartile ranges; and with absolute and relative frequencies the qualitative ones. A bivariate analysis, through Kruskal-Wallis and Chi-square tests. 10 provincial colleges participated (47.652 members, 20.2% from the Spanish total) that communicated 120 claims. Overall impact: 2.5 claims %0 members/year. The denouncers are mainly patients (80%). The family medicine is the most affected specialty (19.2% of the claims), the quality of the medical attention the most affected chapter of the CD (60% of the claims). The global resolution timescale was 115.5 days (55-187). The PMEC judged ethical failure in 17 cases (14.2), 10 of them within the private sector. 8 (6.7%) were pending on the date 01-03-2015. 8 cases (6.7%) ended in disciplinary file by the management board, one in verbal amonestation and one was pendent of resolution. the incidence of the medical ethics claims is low, as well as the proportion of disciplinary files. Too many discrepancies exist between the judgements of the PMEC and the college's management boards.

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

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

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

PubMed

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

2018-02-05

The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems

76 FR 37820 - Proyecto Informar: Food and Drug Administration Hispanic Outreach Initiative (U01)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-28

...] Proyecto Informar: Food and Drug Administration Hispanic Outreach Initiative (U01) AGENCY: Food and Drug... initiatives that will communicate risk and emergency public health information to millions of Spanish-speaking... (The Alliance). The purpose of this agreement is to support initiatives that will communicate risk and...

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

PubMed Central

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

2012-01-01

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

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

DTIC Science & Technology

2009-09-01

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

TulaSalud: An m-health system for maternal and infant mortality reduction in Guatemala.

PubMed

Martínez-Fernández, Andrés; Lobos-Medina, Isabel; Díaz-Molina, Cesar Augusto; Chen-Cruz, Moisés Faraón; Prieto-Egido, Ignacio

2015-07-01

The Guatemalan NGO (Non-Governmental Organization) TulaSalud has implemented an m-health project in the Department of Alta Verapaz. This Department has 1.2 million inhabitants (78% living in rural areas and 89% from indigenous communities) and in 2012, had a maternal mortality rate of 273 for every 100,000 live births. This m-health initiative is based on the provision of a cell phone to community facilitators (CFs). The CFs are volunteers in rural communities who perform health prevention, promotion and care. Thanks to the cell phone, the CFs have become tele-CFs who able to carry out consultations when they have questions; send full epidemiological and clinical information related to the cases they attend to; receive continuous training; and perform activities for the prevention and promotion of community health through distance learning sessions in the Q'eqchí and/or Poqomchi' languages. In this study, rural populations served by tele-CFs were selected as the intervention group while the control group was composed of the rural population served by CFs without Information and Communication Technology (ICT) tools. As well as the achievement of important process results (116,275 medical consultations, monitoring of 6,783 pregnant women, and coordination of 2,014 emergency transfers), the project has demonstrated a statistically significant decrease in maternal mortality (p < 0.05) and in child mortality (p = 0.054) in the intervention group compared with rates in the control group. As a result of the telemedicine initiative, the intervention areas, which were selected for their high maternal and infant mortality rates, currently show maternal and child mortality indicators that are not only lower than the indicators in the control area, but also lower than the provincial average (which includes urban areas). © The Author(s) 2015.

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Folic Acid Education for Hispanic Women: The Promotora de Salud Model.

PubMed

Flores, Alina L; Isenburg, Jennifer; Hillard, Christina L; deRosset, Leslie; Colen, Lisa; Bush, Troy; Mai, Cara T

2017-02-01

Although rates of neural tube defects (NTDs) have declined in the United States since fortification, disparities still exist with Hispanic women having the highest risk of giving birth to a baby with a NTD. The Promotora de Salud model using community lay health workers has been shown to be an effective tool for reaching Hispanics for a variety of health topics; however, literature on its effectiveness in folic acid interventions is limited. An intervention using the Promotora de Salud model was implemented in four U.S. counties with large populations of Hispanic women. The study comprised the following: (1) a written pretest survey to establish baseline levels of folic acid awareness, knowledge, and consumption; (2) a small group education intervention along with a 90-day supply of multivitamins; and (3) a postintervention (posttest) assessment conducted 4 months following the intervention. Statistically significant differences in pre- and posttests were observed for general awareness about folic acid and vitamins and specific knowledge about the benefits of folic acid. Statistically significant changes were also seen in vitamin consumption and multivitamin consumption. Folic acid supplement consumption increased dramatically by the end of the study. The Promotora de Salud model relies on interpersonal connections forged between promotoras and the communities they serve to help drive positive health behaviors. The findings underscore the positive impact that these interpersonal connections can have on increasing awareness, knowledge, and consumption of folic acid. Utilizing the Promotora de Salud model to reach targeted populations might help organizations successfully implement their programs in a culturally appropriate manner.

Folic Acid Education for Hispanic Women: The Promotora de Salud Model

PubMed Central

Flores, Alina L.; Isenburg, Jennifer; Hillard, Christina L.; deRosset, Leslie; Colen, Lisa; Bush, Troy; Mai, Cara T.

2017-01-01

Background Although rates of neural tube defects (NTDs) have declined in the United States since fortification, disparities still exist with Hispanic women having the highest risk of giving birth to a baby with a NTD. The Promotora de Salud model has been shown to be an effective tool for reaching Hispanics for a variety of health topics; however, literature on its effectiveness in folic acid interventions is limited. Methods An intervention using the Promotora de Salud model was implemented in four U.S. counties with large populations of Hispanic women. The study comprised: 1) a written pre-test survey to establish baseline levels of folic acid awareness, knowledge, and consumption; 2) a small group education intervention along with a 90-day supply of multivitamins; and 3) a post-intervention (post-test) assessment conducted four months following the intervention. Results Statistically significant differences in pre- and post-tests were observed for general awareness about folic acid and vitamins, and specific knowledge about the benefits of folic acid. Statistically significant changes were also seen in vitamin consumption and multivitamin consumption. Folic acid supplement consumption increased dramatically by the end of the study. Conclusions The Promotora de Salud model relies on interpersonal connections forged between promotoras and the communities they serve to help drive positive health behaviors. The findings underscore the positive impact that these interpersonal connections can have on increasing awareness, knowledge, and consumption of folic acid. Utilizing the Promotora de Salud model to reach targeted populations might help organizations successfully implement their programs in a culturally appropriate manner. PMID:28067585

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

PubMed

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

2017-01-01

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

[The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

PubMed

Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

2016-11-11

Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems

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

PubMed Central

Teng, Flora; Mitton, Craig; MacKenzie, Jennifer

2007-01-01

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

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

PubMed

Giraldo, Gloria

2009-01-01

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

Explorations of Tenth-Grade STS[E] Curricula across Three Provincial Political Landscapes

NASA Astrophysics Data System (ADS)

Phillips, Christina Ann

This thesis focuses on explorations of science, technology, society and the environment (i.e., STS[E]) outcomes/expectations in tenth-grade level science curricula across three Canadian provinces (i.e., Alberta, Manitoba & Ontario) with distinctive provincial political environments at the time of curriculum construction and/or implementation. Document analysis, discourse analysis and a range of theoretical frameworks (i.e., Levinson, 2010; Pedretti & Nazir, 2011 & Krathwohl, 2002) were used to aid in explorations of STS[E] curriculum segments and discourses in each provincial region. More detailed analysis and thematic exploration is presented for each unit associated with climate change as some interesting patterns emerged following initial analysis. My findings are presented as three comparative case studies and represent a small and original contribution to the large body of scholarly research devoted to studies of STS[E] education, where each province represents a unique case that has been explored regarding some aspects the STS[E] curriculum outcomes/expectations and general political culture as well as some other theoretical factors. Findings from this study indicate that Alberta's STS[E] outcomes may be related to Levinson's (2010) 'deliberative' citizenship focus. The following currents from Pedretti and Nazir (2011) appear to be emphasized: logical reasoning, historical, application & design and socio-cultural aligned outcomes when STS[E] is considered as an entity separate from the Alberta curriculum combination of STS and Knowledge. Ontario's STS[E] expectations may align with Levinson's (2010) 'deliberative' or in some select cases a 'deliberative'/'praxis' framework category with some emphasis related to logical reasoning and socio-cultural awareness (Pedretti & Nazir, 2011) in their STS[E] curriculum. The Manitoba STS[E] outcomes may be aligned with a more 'deliberative' approach with some associations that could intersect with the framework

Bioética y justicia ambiental en la salud de los pobladores andinos de Perú

PubMed Central

Alcantara Zapata, Diana E.; Mazzei Pimental, Marinella

2018-01-01

Este artículo intenta plasmar el panorama bioético-ambiental de la salud del poblador que habita en la sierra peruana, remarcando la inequidad en el acceso a los servicios de salud que existe en esta región y reflexionando sobre las posibles causas contextuales, históricas y actuales que han originado diferencias entre el poblador andino del incanato y el poblador andino actual, el cambio de cosmovisón sobre el ambiente y los recursos, el deterioro del enfoque de justicia, solidaridad, bienestar y respeto hacia el ser humano y la naturaleza. Además, se describe la salud desde el escenario histórico de esta región, donde la salud pública tiene y tendrá como desafío la aplicación de programas que respondan a las necesidades específicas de esta población, con un enfoque dirigido hacia lo ambiental. PMID:29708219

Obstáculos a la adherencia y retención en los sistemas de salud público y privado según pacientes y personal de salud

PubMed Central

Arístegui, Inés; Dorigo, Analía; Bofill, Lina; Bordatto, Alejandra; Lucas, Mar; Cabanillas, Graciela Fernández; Sued, Omar; Cahn, Pedro; Cassetti, Isabel; Weiss, Stephen; Jones., Deborah

2016-01-01

Resumen Introducción el Programa Nacional de Sida garantiza el acceso universal a los antirretrovirales, aun así las personas que reciben medicamentos a través del sistema público no logran obtener una carga viral indetectable en la misma proporción que los pacientes del sistema privado. Este estudio cualitativo tiene como objeto identificar los factores asociados a la adherencia y retención en la cascada de atención de VIH de los sistemas de salud público y privado de Buenos Aires, según las percepciones de pacientes y del personal de salud. Métodos se registraron datos cualitativos de 12 entrevistas semi-estructuradas a informantes clave y 4 grupos focales de pacientes y personal de salud tanto del sistema público como privado. Se codificaron y analizaron temas predeterminados sobre adherencia, utilizando el software QRS Nvivo9® de análisis de datos cualitativos. Resultados pacientes y personal de salud de ambos sistemas coinciden en la importancia del estigma asociado al VIH, la relación médicopaciente, la comunicación entre ambos y la división de responsabilidades en relación al tratamiento como aspectos fundamentales para la adherencia y retención en la cascada de atención. Se observan diferencias entre los sistemas en la forma en que algunos de estos aspectos actúan. Las barreras estructurales se presentan como principales obstáculos del sistema público. Discusión se resalta la necesidad de intervenciones focalizadas en la díada médico-paciente que considere las particularidades de cada sistema de atención para facilitar el compromiso del paciente en la adherencia. PMID:26878024

Linkage of the Canadian Study of Health and Aging to provincial administrative health care databases in Nova Scotia.

PubMed

Yip, A M; Kephart, G; Rockwood, K

2001-01-01

The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health

Effectiveness of a Brief Home Parenting Intervention for Reducing Early Sexual Risks Among Latino Adolescents: Salud y Éxito.

PubMed

O'Donnell, Lydia; Fuxman, Shai

2017-11-01

Teen pregnancy rates and related risks remain elevated among Latino teens. We tested the impact on youth sexual behaviors of a brief, culturally targeted, bilingual media intervention designed for parents of young adolescents. Salud y éxito (Health & Success) uses dramatic audio stories to model positive parenting practices. After completing classroom surveys, 27 urban schools in the Northeast and Southwest serving low-income Latino communities were randomized so that all families of seventh grade students were sent either: (1) booklets on healthy eating and exercise; (2) Salud-50, where families either received booklets or the intervention, or (3) Salud-100, where all families received the intervention. Postintervention follow-up surveys were conducted at 3- and 12-months. Multilevel analyses tested intervention effects, controlling for sociodemographics. Compared with controls, at 12-months postintervention (8th grade spring), youth in Salud-100 report lower sexual risks (touching, AOR 1.46, CI 1.19-0.84, p < .001; lifetime sex (AOR 0.74, CI 0.61-0.90, p < .01); and sex intentions (AOR 0.78, CI 0.63-0.96, p < .05). Consistent with a dose-response, Salud-50 results are between those from Salud-100 and control schools. Salud y éxito is an effective parenting intervention that can augment school-based health and sexuality education and help Latino parents support their children during early adolescence. © 2017, American School Health Association.

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

ERIC Educational Resources Information Center

Selman, Gordon R.

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

Nepal, Sanjay K; Way, Paul

2007-01-01

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

Working conditions that contribute to absenteeism among nurses in a provincial hospital in the Limpopo Province.

PubMed

Nyathi, M; Jooste, K

2008-03-01

Absenteeism results in an increased workload for nurses who stand in for colleagues and can lead to situations in which a lack of motivation among nurses and a lowering of the quality of patient care may occur. The researcher observed that certain conditions, such as inflexible working schedules, were given as reasons for the absenteeism in units in a provincial hospital. A non-experimental, descriptive, quantitative study was undertaken. The purpose of the article was to describe the working conditions that contribute to absenteeism among the professional and sub-professional nurses at a provincial hospital in the Limpopo province of South Africa. The sample included 107 professional nurses and 163 sub-professional nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data, which was analysed by using descriptive and inferential statistics. The findings of this study indicated that personal and managerial characteristics, and organisational and working conditions may lead to absenteeism in the workplace. This article focuses on the working conditions that are constraints, namely inadequate group cohesion, inadequate delegation of autonomy, role ambiguity, ineffective routinisation and the effect of the workload in the workplace. Recommendations are made for improving working conditions to combat absenteeism among nurses. The limitations of this study are highlighted.

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

PubMed

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

2001-10-01

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

The Agua Salud Project, Central Panama

NASA Astrophysics Data System (ADS)

Stallard, R. F.; Elsenbeer, H.; Ogden, F. L.; Hall, J. S.

2007-12-01

The Agua Salud Project utilizes the Panama Canal's central role in world commerce to focus global attention on the ecosystem services provided by tropical forests. It will be the largest field experiment of its kind in the tropics aimed at quantifying the environmental services (water, carbon, and biodiversity) provided by tropical forests. The Agua Salud Watershed is our principal field site. This watershed and the headwaters of several adjacent rivers include both protected mature forests and a wide variety of land uses that are typical of rural Panama. Experiments at the scale of entire catchments will permit complete water and carbon inventories and exchanges for different landscape uses. The following questions will be addressed: (1) How do landscape treatments and management approaches affect ecosystem services such as carbon storage, water quality and quantity, dry- season water supply, and biodiversity? (2) Can management techniques be designed to optimize forest production along with ecosystem services during reforestation? (3) Do different tree planting treatments and landscape management approaches influence groundwater storage, which is thought to be critical to maintaining dry-season flow, thus insuring the full operation of the Canal during periods of reduced rainfall and severe climatic events such as El Niño. In addition we anticipate expanding this project to address biodiversity, social, and economic values of these forests.

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

PubMed Central

Yuan, Changwei; Liu, Hongchao

2017-01-01

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

Insights from the evaluation of a provincial healthy eating strategy in Nova Scotia, Canada.

PubMed

Sim, S Meaghan; Kirk, Sara F L

2013-10-01

Healthy Eating Nova Scotia represents the first provincial comprehensive healthy eating strategy in Canada and a strategy that is framed within a population-health model. Five years after strategy launch, our objective was to evaluate Healthy Eating Nova Scotia to determine perceptions of strategy implementation and strategy outputs. The focus of the current paper is on the findings of this evaluation. We conducted an evaluation of the strategy through three activities that included a document review, survey of key stakeholders and in-depth interviews with key strategy informants. The findings from each of the activities were integrated to determine what has worked well with strategy implementation, what could be improved and what outputs have resulted. The evaluation was conducted in the Canadian province of Nova Scotia. Participants for this evaluation included survey respondents (n 120) and key informants (n 16). A total of 156 documents were also reviewed. Significant investments have been made towards inter-sectoral partnerships and resourcing that has provided the necessary leadership and momentum for the strategy. Policy development has been leveraged through the strategy primarily in the health and education sectors and is perceived as a visible success. Clarity of human resource roles and funding within the context of a provincial strategy may be beneficial for continued strategy implementation, as is expansion of policy development. Known to be the first evaluation of its kind, these findings and related considerations will be of interest to policy makers developing and implementing similar strategies in their own jurisdictions.

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

PubMed

McNeill, R; Topping, J

2018-01-04

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

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

PubMed Central

McNeill, R; Topping, J

2018-01-01

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

Salud Para Su Corazon (Health for Your Heart) Community Health Worker Model

PubMed Central

Balcazar, H.; Alvarado, M.; Ortiz, G.

2012-01-01

This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy. PMID:21914992

Breast Cancer Epidemiology in Puerto Rico

DTIC Science & Technology

2013-06-30

Universidad de Puerto Rico Recinto de Ciencias Medicas Escuela Graduada de Salud Publica Apartado postal 365067, San Juan, Puerto Rico 00936-5067... Ciencias Medicas. Este proyecto recibe fondos del Programa de Investigacion de Cancer de Mama, bajo el mecanismo de Donativo para Adiestramiento en...minimo. Una enfermera adiestrada del Consorcio de Investigacion Clinica y Traslacional del Recinto de Ciencias Medicas (PRCTRC) tomara estas muestras

Relationship between Air Pollutants and Economic Development of the Provincial Capital Cities in China during the Past Decade

PubMed Central

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

2014-01-01

With the economic development of China, air pollutants are also growing rapidly in recent decades, especially in big cities of the country. To understand the relationship between economic condition and air pollutants in big cities, we analysed the socioeconomic indictorssuch as Gross Regional Product per capita (GRP per capita), the concentration of air pollutants (PM10, SO2, NO2) and the air pollution index (API) from 2003 to 2012 in 31 provincial capitals of mainland China. The three main industries had a quadratic correlation with NO2, but a negative relationship with PM10 and SO2. The concentration of air pollutants per ten thousand yuan decreased with the multiplying of GRP in the provinical cities. The concentration of air pollutants and API in the provincial capital cities showed a declining trend or inverted-U trend with the rise of GRP per capita, which provided a strong evidence for the Environmental Kuznets Curve (EKC), that the environmental quality first declines, then improves, with the income growth. The results of this research improved our understanding of the alteration of atmospheric quality with the increase of social economy and demonstrated the feasibility of sustainable development for China. PMID:25083711

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

PubMed

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

2016-12-01

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

A successful Charter challenge to medicare? Policy options for Canadian provincial governments.

PubMed

Flood, Colleen M; Thomas, Bryan

2018-03-26

In September 2016, a case went to trial in British Columbia that seeks to test the constitutionality of provincial laws that (1) ban private health insurance for medically necessary hospital and physician services; (2) ban extra-billing (physicians cannot charge patients more than the public tariff); and (3) require physicians to work solely for the public system or 'opt-out' and practice privately. All provinces have similar laws that have been passed to meet the requirements of federal legislation, the Canada Health Act (and thus qualify for federal funds). Consequently, a finding of unconstitutionality of one or more of these laws could have a very significant impact on the future of Canada's single-payer system ('medicare'). However, should the court find that a particular law is not in compliance with the Canadian Charter of Rights and Freedoms, the baton is then passed back to the government which may respond with other laws or policies that they believe to be constitutionally compliant. The ultimate impact of any successful Charter challenge to laws protecting medicare from privatization will thus significantly depend on how Canadian governments respond. Provincial governments could allow privatization to undercut equity and access, or they could respond creatively with new legal and policy solutions to both improve equity and access and tackle some of the problems that have long bedeviled Canadian medicare. This paper provides an understanding - grounded in comparative health systems evidence - of law and policy options available to Canadian lawmakers for limiting two-tier care in the wake of any successful challenge to existing laws. The paper presents the results of a large inter-disciplinary, comparative study, started in 2015, that systematically reviewed the legal and broader regulatory schemes used to regulate the public/private divide in 15 Organization for Economic Co-Operation and Development countries with a particular eye to what the effect of

Heterogeneity in Spinal Bone Mineral Density Among Young Adults From Three Eastern Provincial Capital Cities in Mainland China.

PubMed

Cheng, Xiao-Guang; Li, Kai; Ou, Shan-Xing; Tang, Guang-Yu; Wang, Qian-Qian; Wang, Chao; Wang, Ling; Tian, Wei

This study compares spinal volumetric bone mineral density (vBMD) with spinal areal bone mineral density (aBMD) among young adults from 3 eastern provincial capital cities in Mainland China. A total of 416 young adults (age range: 20-40 yr) from 3 eastern provincial capital cities (Beijing, Shanghai, and Guangzhou) in Mainland China were recruited in this study. From each subject, the vBMD of the lumbar spine was measured by the Mindways quantitative computed tomography system. Moreover, the aBMD of the lumbar spine, measured by the dual-energy X-ray absorptiometry, was extracted from a previous multicenter large-scale study, and the 420 participants were matched by age, gender, height, weight, as well as geographic territory. The vBMD and the aBMD values were further compared and analyzed. Generally, the bone mineral density (BMD) results were significantly different among participants from the 3 cities (p <0.05). Specifically, both vBMD and aBMD values of participants from Beijing were significantly different from those from Guangzhou (p <0.05). Additionally, a statistically significant difference in aBMD values was also found between participants from Beijing and Shanghai (p <0.05). However, no significant differences were found between participants from Shanghai and Guangzhou in terms of the aBMD and vBMD values (p 1  > 0.05 and p 2  > 0.05). Interestingly, the overall mean vBMD value was 5.9% greater in women than those in men for all the 3 cities (p <0.001). This study demonstrated an overall heterogeneity in spinal BMD among young adults from 3 eastern provincial capital cities in Mainland China. Specifically, the taller and heavier young adults from the northern part of China have smaller spinal vBMD but higher spinal aBMD values than those who were shorter and lighter from the southern part of China. Copyright © 2016 International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Proyecto Bilingüe: Constructing a Figured World of Bilingual Education for Latina/o Bilingual Teachers

ERIC Educational Resources Information Center

Ek, Lucila D.; Chávez, Guadalupe Domínguez

2015-01-01

Using theories of figured worlds, we demonstrate how Proyecto Bilingüe, a Master of Arts in Curriculum and Instruction program, constructs a figured world of bilingual education for Latina/o bilingual teachers. We drew from a larger qualitative study to conduct a thematic analysis of interviews with Latina/o bilingual teachers, their written…

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

PubMed

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

2017-10-01

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

Constructing Indicators for Measuring Provincial Sustainable Development Index in Vietnam

NASA Astrophysics Data System (ADS)

Truong, Van Canh; Lisowski, Andrzej

2018-03-01

Sustainable development is zeitgeist of our age. It is one kind of development that in this trajectory humanity can create a stable and developed socio-economic foundations, conserve environment and therefore able to continue for a long time. Using indicators is one of the best ways to monitor and measure the progress toward sustainable development. In this paper we have proposed the way to create indicators for measuring provincial sustainable development index in Vietnam. We firstly made a framework of elements for economic, social and environmental component and compiled a list of indicators of 20 national and international agencies in the world. We then applied the SMART framework (Specific, Measurable, Achievable, Relevant, and Time-related) to choose indicators which will be relevant for Vietnam and put them back to the elements. We then have 39 relevant indicators with 12 indicators for economy, 17 indicators for social and 10 indicators for environmental component. Finally, we have established the way to determine the worst and best value for each indicator from available data for countries in the world.

Secrets and Lies: Sex Education and Gendered Memories of Childhood's End in an Australian Provincial City, 1930s-1950s

ERIC Educational Resources Information Center

May, Josephine

2006-01-01

There are few historical studies about the sex education of Australian youth. Drawing on a range of sources, including the oral histories of 40 women and men who attended two single-sex, selective high schools in a provincial Australian city (Newcastle, New South Wales) in the 1930s-1950s, this paper explores the adolescent experience of sex…

Genetic counseling for schizophrenia: a review of referrals to a provincial medical genetics program from 1968–2007

PubMed Central

Hunter, MJ; Hippman, Catriona; Honer, William G; Austin, Jehannine C.

2014-01-01

Purpose Recent studies have shown that individuals with schizophrenia and their family members are interested in genetic counseling, but few have received this service. We conducted an exploratory, retrospective study to describe (a) the population of individuals who were referred to the provincial program for genetic counseling for a primary indication of schizophrenia, and (b) trends in number of referrals between 1968 and 2007. Methods Referrals for a primary indication of schizophrenia were identified through the provincial program database. Charts were reviewed and the following information was recorded: discipline of referring physician, demographics, psychiatric diagnosis, referred individual’s and partner’s (if applicable) family history, and any current pregnancy history. Data were characterized using descriptive statistics. Results Between 1968 and 2007, 288 referrals were made for a primary indication of schizophrenia. Most referrals were made: (a) for individuals who had a first-degree family member with schizophrenia, rather than for affected individuals, (b) for preconception counseling, and (c) by family physicians (69%), with only 2% by psychiatrists. Conclusions In British Columbia, individuals affected with schizophrenia and their family members are rarely referred for psychiatric genetic counseling. There is a need to identify barriers to psychiatric genetic counseling and develop strategies to improve access. PMID:20034078

Efectos de la radiación UV en la salud

EPA Pesticide Factsheets

La reducción de la capa de ozono disminuye la protección natural que ofrece nuestra atmósfera contra la radiación ultravioleta (UV) perjudicial del sol. Esta página web proporciona una descripción general de los principales problemas de salud relacionados

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

Treesearch

S. A. Vasiliauskas; L. W. Aarssen

2000-01-01

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

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

PubMed

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

2014-02-01

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

Evaluation of the community-based chronic disease prevention program Meta Salud in Northern Mexico, 2011-2012.

PubMed

Denman, Catalina A; Rosales, Cecilia; Cornejo, Elsa; Bell, Melanie L; Munguía, Diana; Zepeda, Tanyha; Carvajal, Scott; Guernsey de Zapien, Jill

2014-09-11

Meta Salud is a community health worker-facilitated intervention in Hermosillo, Sonora, Mexico, and was adapted from Pasos Adelante, a similar evidence-based intervention developed for a Latino population in the United States-Mexico border region. The objective of this study was to examine outcomes for Meta Salud and compare them with outcomes for Pasos Adelante. This pretest-posttest study took place during 13 weeks among low-income residents of an urban area. The program provided information on topics such as heart health, physical activity, nutrition, diabetes, healthy weight, community health, and emotional well-being; included individual and group activities aimed at motivating behavior change; and encouraged participants to engage in brisk physical activity. We found significant decreases from baseline to conclusion in body mass index, waist circumference, hip circumference, weight, triglycerides, and low-density lipoprotein (LDL) cholesterol. From baseline to 3-month follow-up, we found significant decreases in body mass index, waist circumference, weight, LDL cholesterol, and glucose, and an increase in high-density lipoprotein cholesterol. Outcomes for Meta Salud were similar to those found for Pasos Adelante. The physiological improvements found among participants in Meta Salud and comparable changes among participants in Pasos Adelante suggest a scalable and effective behavioral intervention for regions of the United States and Mexico that share a common boundary or have similar cultural and linguistic characteristics.

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

ERIC Educational Resources Information Center

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

2000-01-01

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

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

PubMed

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes

Efectos del material particulado (PM) sobre la salud y el medioambiente

EPA Pesticide Factsheets

El tamaño de las partículas se encuentra directamente vinculado con el potencial para provocar problemas de salud. La exposición a estas partículas puede afectar tanto a los pulmones como al corazón. También afectan el medioambiente.

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

PubMed

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

2016-01-01

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

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

PubMed

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

2016-01-01

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

Ideology and wildlands management: The case of Rondeau Provincial Park, Ontario

NASA Astrophysics Data System (ADS)

Mann, D. L.; Nelson, J. G.

1980-03-01

This is a critical examination of some of the basic concepts that have guided management of parks and related reserves, often termed wildlands. Study is focussed on Rondeau Provincial Park, Ontario, and on concepts such as wilderness, primeval forest, and the Carolinian forest. Deer culling and other management policies and practices have been based upon the idea that the highly valued sassafras, tulip, and other species of the Carolinian forest are decreasing due to browsing. Field mapping and analysis of historic vegetation records indicate that this trend is not in fact occurring. Historic research also reveals difficulties in defining the Carolinian or other perceived types of forest for management purposes. A major reassessment of ideology and management policy and practice seem to be required in Rondeau and other wildlands. Vague or general concepts such as wilderness or preservation should be strongly complemented and supported by more precise statements of objectives, a learning attitude, and experimentation and research. As a result of the technical uncertainties and value judgments frequently involved, management should also be based upon the expressed preferences and continuing involvement of citizens.

Displacement efficiency of alternative energy and trans-provincial imported electricity in China

NASA Astrophysics Data System (ADS)

Hu, Yuanan; Cheng, Hefa

2017-02-01

China has invested heavily on alternative energy, but the effectiveness of such energy sources at substituting the dominant coal-fired generation remains unknown. Here we analyse the displacement of fossil-fuel-generated electricity by alternative energy, primarily hydropower, and by trans-provincial imported electricity in China between 1995 and 2014 using two-way fixed-effects panel regression models. Nationwide, each unit of alternative energy displaces nearly one-quarter of a unit of fossil-fuel-generated electricity, while each unit of imported electricity (regardless of the generation source) displaces ~0.3 unit of fossil-fuel electricity generated locally. Results from the six regional grids indicate that significant displacement of fossil-fuel-generated electricity occurs once the share of alternative energy in the electricity supply mix exceeds ~10%, which is accompanied by 10-50% rebound in the consumption of fossil-fuel-generated electricity. These findings indicate the need for a policy that integrates carbon taxation, alternative energy and energy efficiency to facilitate China's transition towards a low-carbon economy.

Evaluation of the Community-Based Chronic Disease Prevention Program Meta Salud in Northern Mexico, 2011–2012

PubMed Central

Rosales, Cecilia; Cornejo, Elsa; Bell, Melanie L.; Munguía, Diana; Zepeda, Tanyha; Carvajal, Scott; Guernsey de Zapien, Jill

2014-01-01

Introduction Meta Salud is a community health worker–facilitated intervention in Hermosillo, Sonora, Mexico, and was adapted from Pasos Adelante, a similar evidence-based intervention developed for a Latino population in the United States–Mexico border region. The objective of this study was to examine outcomes for Meta Salud and compare them with outcomes for Pasos Adelante. Methods This pretest–posttest study took place during 13 weeks among low-income residents of an urban area. The program provided information on topics such as heart health, physical activity, nutrition, diabetes, healthy weight, community health, and emotional well-being; included individual and group activities aimed at motivating behavior change; and encouraged participants to engage in brisk physical activity. Results We found significant decreases from baseline to conclusion in body mass index, waist circumference, hip circumference, weight, triglycerides, and low-density lipoprotein (LDL) cholesterol. From baseline to 3-month follow-up, we found significant decreases in body mass index, waist circumference, weight, LDL cholesterol, and glucose, and an increase in high-density lipoprotein cholesterol. Outcomes for Meta Salud were similar to those found for Pasos Adelante. Conclusion The physiological improvements found among participants in Meta Salud and comparable changes among participants in Pasos Adelante suggest a scalable and effective behavioral intervention for regions of the United States and Mexico that share a common boundary or have similar cultural and linguistic characteristics. PMID:25211502

Usability inspection to improve an electronic provincial medication repository.

PubMed

Kitson, Nicole A; Price, Morgan; Bowen, Michael; Lau, Francis

2013-01-01

Medication errors are a significant source of actual and potential harm for patients. Community medication records have the potential to reduce medication errors, but they can also introduce unintended consequences when there is low fit to task (low cognitive fit). PharmaNet is a provincially managed electronic repository that contains the records for community-based pharmacy-dispensed medications in British Columbia. This research explores the usability of PharmaNet, as a representative community-based medication repository. We completed usability inspections of PharmaNet through vendor applications. Vendor participants were asked to complete activity-driven scenarios, which highlighted aspects of medication management workflow. Screen recording was later reviewed. Heuristics were applied to explore usability issues and improvement opportunities. Usability inspection was conducted with four PharmaNet applications. Ninety-six usability issues were identified; half of these had potential implications for patient safety. These were primarily related to login and logout procedures; display of patient name; display of medications; update and display of alert information; and the changing or discontinuation of medications. PharmaNet was designed primarily to support medication dispensing and billing activities by community pharmacies, but is also used to support care providers with monitoring and prescribing activities. As such, some of the features do not have a strong fit for other clinical activities. To improve fit, we recommend: having a Current Medications List and Displaying Medication Utilization Charts.

Radiation oncology and medical physicists quality assurance in British Columbia Cancer Agency Provincial Prostate Brachytherapy Program.

PubMed

Keyes, Mira; Morris, William James; Spadinger, Ingrid; Araujo, Cynthia; Cheung, Arthur; Chng, Nick; Crook, Juanita; Halperin, Ross; Lapointe, Vince; Miller, Stacy; Pai, Howard; Pickles, Tom

2013-01-01

To describe in detail British Columbia (BC) Cancer Agency (BCCA) Provincial Prostate Brachytherapy (PB) Quality Assurance (QA) Program. The BCCA PB Program was established in 1997. It operates as one system, unified and supported by electronic and information systems, making it a single PB treatment provider for province of BC and Yukon. To date, >4000 patients have received PB (450 implants in 2011), making it the largest program in Canada. The Program maintains a large provincial prospective electronic database with records on all patients, including disease characteristics, risk stratification, pathology, preplan and postimplant dosimetric data, follow-up of prostate-specific antigen, and toxicity outcomes. QA was an integral part of the program since its inception. A formal QA Program was established in 2002, with key components that include: unified eligibility criteria and planning system, comprehensive database, physics and oncologist training and mentorship programs, peer review process, individual performance outcomes and feedback process, structured continuing education and routine assessment of the program's dosimetry, toxicity and prostate-specific antigen outcomes, administration and program leadership that promotes a strong culture of patient safety. The emphasis on creating a robust, broad-based network of skilled providers has been achieved by the program's requirements for training, education, and the QA process. The formal QA process is considered a key factor for the success of cancer control outcomes achieved at BCCA. Although this QA model may not be wholly transferable to all PB programs, some of its key components may be applicable to other programs to ensure quality in PB and patient safety. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

I choose health (Elijo Salud: impacting youth through parish nursing.

PubMed

Oakley, Janet; Hoebeke, Roberta

2014-01-01

The 2009-2010 National Health and Nutritional Examination Survey (NHANES) found that 34% of adolescents are overweight and 18% obese. The chance of an overweight/obese adolescent becoming an overweight/obese adult by age 35 is 60%. Hispanic youth are at risk for becoming obese related to eating habits. This paper describes an intervention, I Choose Health (Elijo Salud), with Hispanic church youth.

Avisos de salud sobre el PFOA y PFOS en el agua potable

EPA Pesticide Factsheets

La EPA estableció avisos de salud sobre el ácido perfluorooctanoico (PFOA) y el sulfonato de perfluorooctano (PFOS) para proporcionar información a los operadores de sistemas de agua potable y funcionarios estatales, tribales y locales sobre los riesgos de

Analysis on Inter-Provincial Disparities of China's Rural Education and Convergence Rate: Empirical Analysis on 31 Provinces' (Municipalities') Panel Data from 2001 to 2008

ERIC Educational Resources Information Center

Xie, Tongwei

2011-01-01

Purpose: This article aims to analyze inter-provincial disparities of rural education and the convergence rate, and to discuss the effects of compulsory education reform after 2001. Design/methodology/approach: The article estimates the rural average education years and education Gini coefficients of China's 31 provinces (municipalities) beside…

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

PubMed

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

2015-07-31

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

A pilot study of Trabajadora de salud, a lay health worker intervention for Latinas/os with traumatic brain injuries and their caregivers.

PubMed

Linton, Kristen F; Kim, Bum Jung

2018-01-01

Latinas/os with traumatic brain injuries (TBIs) and their caregivers experience worse outcomes than others. The study aimed to assess the acceptability and promise of Trabajadora de Salud on the functional abilities, hospital readmission, rehabilitation, employment, depression, somatic symptoms, and caregiver burden among Latinas/os with TBIs and their caregivers. A pre-posttest experimental pilot study was conducted. A total of eight Latina/o adult patients (50% female) with mild or moderate TBI and six of their caregivers (66.7% female) were randomized to receive Trabajadora de Salud or a telephone only control group. Trabajadora de Salud, a three-month, in-home intervention administered by bilingual lay health workers, focused on: 1) providing empathy and validation of TBI symptoms, 2) addressing basic needs, 3) goal setting, and 4) improving communication with healthcare providers. Trabajadora de Salud was widely accepted by patients, caregivers, and health professionals. The functional, depression, and somatic symptoms of the patients as well as the somatic symptoms and caregiver burden of the caregivers improved more for participants in the intervention group than the control group. Trabajadora de Salud demonstrated promise in improving outcomes of Latinas/os with TBIs and their caregivers and should be further studied. Copyright © 2017 Elsevier Inc. All rights reserved.

Caries prevalence after cessation of water fluoridation in La Salud, Cuba.

PubMed

Künzel, W; Fischer, T

2000-01-01

In the past, caries has usually increased after cessation of water fluoridation. More recently an opposite trend could be observed: DMFT remaining stable or even decreasing further. The aim of the present study conducted in La Salud (Province of Habana) in March 1997 was to analyse the current caries trend under the special climatic and nutritional conditions of the subtropical sugar island Cuba, following the cessation, in 1990, of water fluoridation (0.8 ppm F). Diagnostic evaluations were carried out using the same methods as in 1973 and 1982. Boys and girls aged 6-13 years (N = 414), lifelong residents in La Salud, were examined. Between 1973 and 1982 the mean DMFT had decreased by 71.4%, the mean DMFS by 73. 3% and the percentage of caries-free children had increased from 26. 3 to 61.6%. In 1997, following the cessation of drinking water fluoridation, in contrast to an expected rise in caries prevalence, DMFT and DMFS values remained at a low level for the 6- to 9-year-olds and appeared to decrease for the 10/11-year-olds (from 1. 1 to 0.8) and DMFS (from 1.5 to 1.2). In the 12/13-year-olds, there was a significant decrease (DMFT from 2.1 to 1.1; DMFS from 3.1 to 1. 5), while the percentage of caries-free children of this age group had increased from 4.8 (1973) and 33.3 (1982) up to 55.2%. A possible explanation for this unexpected finding and for the good oral health status of the children in La Salud is the effect of the school mouthrinsing programme, which has involved fortnightly mouthrinses with 0.2% NaF solutions (i.e. 15 times/year) since 1990.

Promotores de salud and community health workers: an annotated bibliography.

PubMed

WestRasmus, Emma K; Pineda-Reyes, Fernando; Tamez, Montelle; Westfall, John M

2012-01-01

For underserved and disenfranchised communities in the United States, affordable, effective health care can be nearly inaccessible, which often leads to the exclusion of these communities from relevant medical information and care. Barriers to care are especially salient in minority communities, where language, traditions and customs, socioeconomics, and access to education can serve as additional roadblocks to accessing health care information and services. These factors have contributed to a national health disparity crisis that unnecessarily places some communities in a vulnerable position without adequate prevention and treatment opportunities. One solution to the exclusion some communities face in the health care system may be the promotores de salud (PdS)/community health worker (CHW), an approach to culturally competent health care delivery whose popularity in the mainstream health care system has been steadily growing in recent decades. Known by a wide variety of names and broad in the spectrum of health issues they address, the PdS/CHW serves as cultural brokers between their own community and the formal health care system and can play a crucial role in promoting health and wellness within their community. This annotated bibliography was created to educate the reader about the history, definition, key features, utility, outcomes, and broad potential of the CHW approach in a variety of populations. Intended to serve as a reference point to a vast body of information on the CHW/PdS approach, this document is a resource for those wishing to effect change in the disparities within the health care system, and to improve the access to, quality, and cost of health care for underserved patients and their communities. Promotores de Salud is a Spanish term that translates to Health Promoter. A female health worker may be referred to as a Promotora, a male as a Promotor, and the plural of both is Promotores. For the purposes of this bibliography, the terms community

Twelve tips for teaching in a provincially distributed medical education program.

PubMed

Wong, Roger Y; Chen, Luke; Dhadwal, Gurbir; Fok, Mark C; Harder, Ken; Huynh, Hanh; Lunge, Ryan; Mackenzie, Mark; Mckinney, James; Ovalle, William; Rauniyar, Pooja; Tse, Luke; Villanyi, Diane

2012-01-01

As distributed undergraduate and postgraduate medical education becomes more common, the challenges with the teaching and learning process also increase. To collaboratively engage front line teachers in improving teaching in a distributed medical program. We recently conducted a contest on teaching tips in a provincially distributed medical education program and received entries from faculty and resident teachers. Tips that are helpful for teaching around clinical cases at distributed teaching sites include: ask "what if" questions to maximize clinical teaching opportunities, try the 5-min short snapper, multitask to allow direct observation, create dedicated time for feedback, there are really no stupid questions, and work with heterogeneous group of learners. Tips that are helpful for multi-site classroom teaching include: promote teacher-learner connectivity, optimize the long distance working relationship, use the reality television show model to maximize retention and captivate learners, include less teaching content if possible, tell learners what you are teaching and make it relevant and turn on the technology tap to fill the knowledge gap. Overall, the above-mentioned tips offered by front line teachers can be helpful in distributed medical education.

[Cambios en la salud sexual de los pacientes obesos tras cirugía bariátrica].

PubMed

Pomares-Callejón, María A; Ferrer-Márquez, Manuel; Solvas-Salmerón, María J

2018-01-01

Los objetivos del estudio fueron: 1) evaluar la salud sexual en pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica; y 2) valorar la evolución de la salud sexual tras 12 meses de la cirugía. Estudio descriptivo, prospectivo desde febrero de 2011 hasta junio de 2014. Se valoró la actividad sexual en los hombres a través del cuestionario EVAS-H y la función sexual en la mujer a través de la escala FSM (44 pacientes). Durante el estudio basal en los hombres, un 21% de la muestra presentó disfunción sexual en diferentes dimensiones, mientras que un 43% presentó problemas de eyaculación precoz. Tras 12 meses de la intervención, se observó un incremento de la actividad sexual global (p = 0.026). En torno al 70-89% de las mujeres, previamente a la cirugía, no presentaban trastorno. En la evolución no se observaron cambios medios relevantes (p > 0.05). Los pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica presentan alteraciones considerables en diversas dimensiones de la salud sexual. Después de 12 meses de seguimiento, la salud sexual parece mejorar en los hombres. The aims of the study were: 1) to assess sexual health patients severe/morbid obesity patients candidates for bariatric surgery; and 2) to assess sexual health evolution after 12 months of surgery. Descriptive, prospective study from February 2011 to June 2014. Sexual activity in men was valued through EVAS-H questionnaire and through FSM scale on women (44 patients). During the basal study in men, a 21% of the sample showed sexual disfunction in different dimensions, while a 43% showed problems with premature ejaculation. 12 months after surgery, global sexual activity was improved significantly (p = 0,026). Approximately 70-89% of women presented no disturbance before surgery. No average relevant changes were observed within the evolution (p > 0.05). Morbid/severe obesity patients candidates to bariatric surgery, show considerable alterations on diverse

Lessons learned from the implementation of a provincial breastfeeding policy in Nova Scotia, Canada and the implications for childhood obesity prevention.

PubMed

Kirk, Sara F L; Sim, Sarah Meaghan; Hemmens, Erin; Price, Sheri L

2012-04-01

Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a provincial breastfeeding policy. This paper describes the process and outcomes of an evaluation into the implementation of the policy. This evaluation comprised focus groups held with members of provincial and district level breastfeeding committees who were tasked with promoting, protecting and supporting breastfeeding in their districts. Five key themes were identified, which were an unsupportive culture of breastfeeding; the need for strong leadership; the challenges in engaging physicians in dialogue around breastfeeding; lack of understanding around the International Code of Marketing of Breast-milk Substitutes; and breastfeeding as a way to address childhood obesity. Recommendations for other jurisdictions include the need for a policy, the value of leadership, the need to integrate policy with other initiatives across sectors and the importance of coordination and support at multiple levels. Finally, promotion of breastfeeding offers a population-based strategy for addressing the childhood obesity epidemic and should form a core component of any broader strategies or policies for childhood obesity prevention.

Lessons Learned from the Implementation of a Provincial Breastfeeding Policy in Nova Scotia, Canada and the Implications for Childhood Obesity Prevention

PubMed Central

Kirk, Sara F. L.; Sim, Sarah Meaghan; Hemmens, Erin; Price, Sheri L.

2012-01-01

Healthy public policy plays a central role in creating environments that are supportive of health. Breastfeeding, widely supported as the optimal mode for infant feeding, is a critical factor in promoting infant health. In 2005, the Canadian province of Nova Scotia introduced a provincial breastfeeding policy. This paper describes the process and outcomes of an evaluation into the implementation of the policy. This evaluation comprised focus groups held with members of provincial and district level breastfeeding committees who were tasked with promoting, protecting and supporting breastfeeding in their districts. Five key themes were identified, which were an unsupportive culture of breastfeeding; the need for strong leadership; the challenges in engaging physicians in dialogue around breastfeeding; lack of understanding around the International Code of Marketing of Breast-milk Substitutes; and breastfeeding as a way to address childhood obesity. Recommendations for other jurisdictions include the need for a policy, the value of leadership, the need to integrate policy with other initiatives across sectors and the importance of coordination and support at multiple levels. Finally, promotion of breastfeeding offers a population-based strategy for addressing the childhood obesity epidemic and should form a core component of any broader strategies or policies for childhood obesity prevention. PMID:22690194

Displacement efficiency of alternative energy and trans-provincial imported electricity in China

PubMed Central

Hu, Yuanan; Cheng, Hefa

2017-01-01

China has invested heavily on alternative energy, but the effectiveness of such energy sources at substituting the dominant coal-fired generation remains unknown. Here we analyse the displacement of fossil-fuel-generated electricity by alternative energy, primarily hydropower, and by trans-provincial imported electricity in China between 1995 and 2014 using two-way fixed-effects panel regression models. Nationwide, each unit of alternative energy displaces nearly one-quarter of a unit of fossil-fuel-generated electricity, while each unit of imported electricity (regardless of the generation source) displaces ∼0.3 unit of fossil-fuel electricity generated locally. Results from the six regional grids indicate that significant displacement of fossil-fuel-generated electricity occurs once the share of alternative energy in the electricity supply mix exceeds ∼10%, which is accompanied by 10–50% rebound in the consumption of fossil-fuel-generated electricity. These findings indicate the need for a policy that integrates carbon taxation, alternative energy and energy efficiency to facilitate China's transition towards a low-carbon economy. PMID:28211467

Displacement efficiency of alternative energy and trans-provincial imported electricity in China.

PubMed

Hu, Yuanan; Cheng, Hefa

2017-02-17

China has invested heavily on alternative energy, but the effectiveness of such energy sources at substituting the dominant coal-fired generation remains unknown. Here we analyse the displacement of fossil-fuel-generated electricity by alternative energy, primarily hydropower, and by trans-provincial imported electricity in China between 1995 and 2014 using two-way fixed-effects panel regression models. Nationwide, each unit of alternative energy displaces nearly one-quarter of a unit of fossil-fuel-generated electricity, while each unit of imported electricity (regardless of the generation source) displaces ∼0.3 unit of fossil-fuel electricity generated locally. Results from the six regional grids indicate that significant displacement of fossil-fuel-generated electricity occurs once the share of alternative energy in the electricity supply mix exceeds ∼10%, which is accompanied by 10-50% rebound in the consumption of fossil-fuel-generated electricity. These findings indicate the need for a policy that integrates carbon taxation, alternative energy and energy efficiency to facilitate China's transition towards a low-carbon economy.

Madres para la Salud: design of a theory-based intervention for postpartum Latinas.

PubMed

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-05-01

Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. This report describes the theoretical rationale, design considerations, and cultural relevance for "Madres para la Salud" [Mothers for Health]. Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using "bouts" of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. Copyright © 2011 Elsevier Inc. All rights reserved.

Regulando la Enfermedad a través de la Definición y la Restricción: Profesionales de la Salud Hablan sobre el VIH/SIDA1

PubMed Central

Rivera, Souhail Malavé; Díaz, Nelson Varas

2009-01-01

Resumen Las profesiones de la salud tienen un papel social dual. Por un lado, velan por el mantenimiento de la salud de la población protegiendo el bien común. Por el otro, dictaminan las formas saludables, y por lo tanto socialmente apropiadas, de ser, actuar y pensar. Este último papel, está más ligado al control social de la población que a una preocupación altruista hacia la misma. A través de esta supervisión y control, se construyen los sujetos a los cuales todos/as debemos aspirar a ser para gozar de aceptación social. Los/as profesionales de la salud han jugado un rol protagónico en dicho proceso, siendo los agentes que delimitan y definen lo que es enfermo vs. saludable, útil vs. inútil, apropiado vs. inapropiado. En el caso de la epidemia del VIH, este esfuerzo se ha hecho cada vez más vigente ya que estos/as profesionales juegan un papel importante en el tratamiento de las personas que viven con VIH/SIDA (PVVS). Sin embargo, su función está plasmada de definiciones que sirven para criminalizar a las PVVS. El objetivo de este estudio fue explorar la manera en que una muestra de profesionales de la salud en Puerto Rico construyen a las PVVS. Con este propósito, entrevistamos 80 profesionales de la salud y estudiantes de estas profesiones. Estas entrevistas fueron grabadas, transcritas y sometidas a un análisis de discurso. Los resultados reflejaron que según las personas participantes: 1) la PVVS no es una persona “normal” o funcional bajo los estándares sociales debido a que su salud no se los permite, 2) representa una carga para la sociedad incluyendo familiares, amigos/as, el mundo del trabajo, e incluso para el gobierno, 3) debe ser vigilada porque representa un riesgo para la persona seronegativa que es descrita como saludable y productiva, y 4) necesita que su salud y conducta sexual sean controladas por vía legal y/o por las personas que representan las instituciones sociales, como lo son los/as profesionales de la salud

Transferable Training Modules: Building Environmental Education Opportunities With and for Mexican Community Health Workers (Promotores de Salud).

PubMed

Ramírez, Denise Moreno; Vea, Lourdes; Field, James A; Baker, Paul B; Gandolfi, A Jay; Maier, Raina M

Community health workers (promotores de salud) have the ability to empower communities to mitigate negative health outcomes. Current training efforts in environmental topics are lacking. This project addressed this gap by developing 4 transferable training modules on environmental health. By applying a series of surveys, interviews, and trainings, we evaluated their relevance. Partners provided favorable feedback for 3 of the 4 modules. It was also learned that the development method could be improved by engaging technically trained promotores de salud in the role of co-creators. This project has implications for environmental justice communities as it can lessen information disparities.

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

PubMed

Purba, M

1999-09-01

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

Analyzing remote sensing geobotanical trends in Quetico Provincial Park, Ontario, Canada, using digital elevation data

NASA Technical Reports Server (NTRS)

Warner, Timothy A.; Campagna, David J.; Levandowski, Don W.; Cetin, Haluk; Evans, Carla S.

1991-01-01

A 10 x 13-km area in Quetico Provincial Park, Canada has been studied using a digital elevation model to separate different drainage classes and to examine the influence of site factors and lithology on vegetation. Landsat Thematic Mapper data have been classified into six forest classes of varying deciduous-coniferous cover through nPDF, a procedure based on probability density functions. It is shown that forests growing on mafic lithologies are enriched in deciduous species, compared to those growing on granites. Of the forest classes found on mafics, the highest coniferous component was on north facing slopes, and the highest deciduous component on south facing slopes. Granites showed no substantial variation between site classes. The digital elevation derived site data is considered to be an important tool in geobotanical investigations.

An exploration of China's mortality decline under Mao: A provincial analysis, 1950–80

PubMed Central

Babiarz, Kimberly Singer; Eggleston, Karen; Miller, Grant; Zhang, Qiong

2014-01-01

China's growth in life expectancy between 1950 and 1980 ranks as among the most rapid sustained increases in documented global history. However, no study of which we are aware has quantitatively assessed the relative importance of various explanations proposed for these gains. We create and analyse a new province-level panel data set spanning 1950-80 using historical information from Chinese public health archives, official provincial yearbooks, and infant and child mortality records contained in the 1988 National Survey of Fertility and Contraception. Although exploratory, our results suggest that increases in educational attainment and public health campaigns jointly explain 50-70 per cent of the dramatic reductions in infant and under-five mortality during our study period. These results are consistent with the importance of non-medical determinants of population health improvement – and under some circumstances, how general education may amplify the effectiveness of public health interventions. PMID:25495509

La contribución de los Centros Colaboradores de la OMS/OPS en los avances de la promoción de la salud en América Latina.

PubMed

Arroyo, Hiram V; Mantilla Uribe, Blanca P; Contreras Rengifo, Adolfo; Westphal, Marcia F; Mendes, Rosilda

2016-09-01

Los "Centros Colaboradores" de la Organización Mundial de la Salud (OMS) son instituciones designadas para prestar apoyo estratégico en el desarrollo de los objetivos y la ejecución de las actividades de la OMS, y para generar capacidad institucional en países y regiones. En las Américas existen ocho Centros Colaboradores directamente relacionados a la promoción de la salud. Cuatro centros se ubican en Norteamérica y los otros cuatro en América Latina. El propósito de este artículo es describir los Centros Colaboradores de la Región de América Latina. Los centros han sido importantes en el desarrollo de la agenda de promoción de la salud de la región, la consolidación de la estrategia de entornos saludables y el fortalecimiento de las redes académicas y profesionales de promoción de la salud. © The Author(s) 2015.

Visual quality evaluation of urban commercial streetscape for the development of landscape visual planning system in provincial street corridors in Malang, Indonesia

NASA Astrophysics Data System (ADS)

Santosa, H.; Ernawati, J.; Wulandari, L. D.

2018-03-01

The visual aesthetic experience in urban spaces is important in establishing a comfortable and satisfying experience for the community. The embodiment of a good visual image of urban space will encourage the emergence of positive perceptions and meanings stimulating the community to produce a good reaction to its urban space. Moreover, to establish a Good Governance in urban planning and design, it is necessary to boost and promote a community participation in the process of controlling the visual quality of urban space through the visual quality evaluation on urban street corridors. This study is an early stage as part of the development of ‘Landscape Visual Planning System’ on the commercial street corridor in Malang. Accordingly, the research aims to evaluate the physical characteristics and the public preferences of the spatial and visual aspects in five provincial road corridors in Malang. This study employs a field survey methods, and an environmental aesthetics approach through semantic differential method. The result of the identification of physical characteristics and the assessment of public preferences on the spatial and visual aspects of the five provincial streets serve as the basis for constructing the 3d interactive simulation scenarios in the Landscape Visual Planning System.

[Effects of SaludArte program in feeding and nutrition components in school children in Mexico City].

PubMed

Shamah-Levy, Teresa; Cuevas-Nasu, Lucía; Gómez-Acosta, Luz María; Morales-Ruan, Ma Del Carmen; Méndez-Gómez Humarán, Ignacio; Robles-Villaseñor, Mara Nadiezhda; Hernández-Ávila, Mauricio

2017-01-01

To assess the effect of Education in Nutrition and Food Assistance components of the SaludArte program in participant schools during 2013-2015. A three cohort comparative study was used, with two type of follow-up panel structures: a complete panel and a continuous time, with a total of consisting on 1620 scholar children from 144 schools. Information on food intake, feeding behaviors, food preservation and hygiene, physical activity (PI) and anthropometry was registered. To stablish effect estimates, a difference in difference method combined with propensity score matching was carried out; as an alternative procedure, logistic-multinomial and logistic regression models were also used. Program attributable estimated effects were as follows: an increase in personal hygiene (p=0.045), increase in nutrition knowledges (p=0.003), PI (p=0.002 2013-2014; p=0.032 2015) and increase in fiber Intake (p=0.064). Sugar intake, contrary to the expected showed a significant increase (p=0.012 continuous time and; p=0.037 complete time). SaludArte shows positive effects over some components as expected. However in order to institutionalize the SaludArte program, it is necessary to consider these learned lessons, give it permanence and impulse it in the schools.

Environmental assessment and investment strategies of provincial industrial sector in China — Analysis based on DEA model

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

Wang, Juan, E-mail: wangjuan_tju@163.com; Zhao, Tao; Zhang, Xiaohu

As an energy-intensive industry, the industrial sector consumes 70% of energy consumption and causes serious environmental pollution in China. Also, the government emphasized the promotion of R&D investment in the industrial sector in China's National Plan on Climate Change (2014–2020). It is meaningful and contributes to assessing energy and environmental performance, as well as R&D and industrial pollution control (IPC) investment strategies of China's industrial sector. A non-radial DEA model, as with natural and managerial disposability, was adopted to evaluate this from provincial and regional perspectives during the 2008–2012 period. Energy and environmental performance was evaluated by unified efficiency undermore » natural disposability (UEN), unified efficiency under managerial disposability (UEM), and unified efficiency under natural and managerial disposability (UENM). The empirical results indicated that Shandong and Hainan were efficient under natural and managerial disposability, while other provinces had the potential to improve their energy and environmental performance. The number of provinces that was fit for investments of R&D and IPC increased from 2008 to 2010, then decreased in 2011 and 2012. In spite of this, many provincial industrial sectors should make efforts to reduce pollution by investment on technology. Tianjin, Heilongjiang, Jiangxi and Henan were especially the best investment objects because investments of R&D and IPC turned to be effective for them during the whole study period. Moreover, western China had the highest average UENM, followed by eastern China and central China. Eastern China and central China were rewarding to expand investments. Coal consumption was the main factor to negatively affect unified efficiency whereas the increase in economic development level was primarily responsible for the improvement of unified efficiency. According to the results, differentiated suggestions to further improve energy and

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

PubMed

Federico, Giovanna; Rizzo, Gianfranco; Traverso, Marzia

2009-06-01

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

Disparidad en Salud: Un Fenómeno Multidimensional

PubMed Central

Urrutia, Maria-Teresa; Cianelli, Rosina

2012-01-01

La Disparidad en Salud (DS) ha llamado la atención pública desde el siglo pasado, ha sido analizada desde diversas perspectivas y enfoques incluso variados términos han sido utilizados como sinónimos pudiendo llevar a confusión e inequidades al momento de su operacionalización. Sin embargo es importante señalar que las publicaciones coinciden en que la DS es uno de las determinantes esenciales a considerar al momento de definir polĺticas públicas. El propósito de esta publicación es analizar la disparidad en salud incorporando; a) los aspectos claves de su conceptualización, b) la evolución histórica del concepto, c) las estrategias que se han generado para enfrentarla, d) los factores considerados determinantes, y e) los aspectos éticos y la contribución de la investigación en la disminución de la DS. Health Disparities (HD) have been at the center of public attention for the past century. They have been analyzed from diverse perspectives utilizing various terms as synonyms that can lead to confusion and inequality at the moment of operationalization. Despite this, it is important to indicate that publications agree that HD are essential determinants that must be considered in the definition of public policy. The objective of this publication is to analyze health disparities incorporating; (a) key aspects in their conceptualization, (b) the historic evolution of the concept, (c) strategies that have been generated to confront them, (d) determining factors, and (e) ethical aspects and the contribution of research in decreasing HD. PMID:22581053

Disparidad en Salud: Un Fenómeno Multidimensional.

PubMed

Urrutia, Maria-Teresa; Cianelli, Rosina

2010-03-01

La Disparidad en Salud (DS) ha llamado la atención pública desde el siglo pasado, ha sido analizada desde diversas perspectivas y enfoques incluso variados términos han sido utilizados como sinónimos pudiendo llevar a confusión e inequidades al momento de su operacionalización. Sin embargo es importante señalar que las publicaciones coinciden en que la DS es uno de las determinantes esenciales a considerar al momento de definir polĺticas públicas. El propósito de esta publicación es analizar la disparidad en salud incorporando; a) los aspectos claves de su conceptualización, b) la evolución histórica del concepto, c) las estrategias que se han generado para enfrentarla, d) los factores considerados determinantes, y e) los aspectos éticos y la contribución de la investigación en la disminución de la DS.Health Disparities (HD) have been at the center of public attention for the past century. They have been analyzed from diverse perspectives utilizing various terms as synonyms that can lead to confusion and inequality at the moment of operationalization. Despite this, it is important to indicate that publications agree that HD are essential determinants that must be considered in the definition of public policy. The objective of this publication is to analyze health disparities incorporating; (a) key aspects in their conceptualization, (b) the historic evolution of the concept, (c) strategies that have been generated to confront them, (d) determining factors, and (e) ethical aspects and the contribution of research in decreasing HD.

HOJA INFORMATIVA Presencia de PFOA y PFOS en el agua potable Avisos de salud

EPA Pesticide Factsheets

La EPA estableció avisos de salud sobre el ácido perfluorooctanoico (PFOA) y el sulfonato de perfluorooctano (PFOS) para proporcionar información a los operadores de sistemas de agua potable y funcionarios estatales y locales para que puedan adoptar las me

Energia Renovable para Centros de Salud Rurales (Renewable Energy for Rural Health Clinics) (in Spanish)

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

Jimenez, T.; Olson, K.

Esta es la primera de una serie de guias de aplicaciones que el Programa de Energia de Villas de NREL esta comisionando para acoplar sistemas comerciales renovables con aplicaciones rurales, incluyendo agua, escuelas rurales y micro empresas. La guia esta complementada por las actividades de desarrollo del Programa de Energia de Villas de NREL, proyectos pilotos internacionales y programas de visitas profesionales.

Emission inventory and provincial distribution of short-chain chlorinated paraffins in China.

PubMed

Zhang, Boya; Zhao, Bu; Xu, Chun; Zhang, Jianbo

2017-03-01

Chlorinated paraffins (CPs) are used as flame retardants, plasticizers, and metalworking fluids, which have varying contents of toxic short-chain chlorinated paraffins (SCCPs). Based on the study of several relevant production and consumption sectors, this paper classifies the consumption of CPs among sectors and provides an emission inventory and the provincial emission distribution of SCCPs in China in 2010-2014 based on the consumption patterns and emission factors of each sector. The total emissions of SCCPs in China in 2014 were 3083.88tons, with emissions to the atmosphere and water accounting for 894.81tons and 2189.07tons, respectively. The largest emission source was from metalworking fluids, with total emissions of 2459.12tons, of which 756.65tons went to the atmosphere and 1702.47tons to water. Our results show that SCCP emissions were mainly concentrated in the eastern, more developed regions and that Jiangsu Province was the biggest producer in China, with total emissions of 1853.06tons, of which 562.61tons were to the atmosphere and 1290.46tons to water. Copyright © 2016 Elsevier B.V. All rights reserved.

Information security concepts and practices: the case of a provincial multi-specialty hospital.

PubMed

Cavalli, Enrico; Mattasoglio, Andrea; Pinciroli, Francesco; Spaggiari, Piergiorgio

2004-03-31

In recent years, major and widely accepted information security understandings and achievements confirm that the problem is complex. They clarify that technologies are fundamental tools, but management processes have even bigger relevance, as also prestigious international magazines dossier clearly explained recently. Such a magazine attention outlines the wide impact that the subject has on watchful decision makers. ISO17799 is an emerging standard in information security. In principle there are no reasons for considering it not applicable to the health care sector. In practice, because of both the just conceptual level of the standard and the peculiarities of the health care data and institutions, a lot of analysis and design work need to be invested any time a health care institution decides to deal with the subject. CEN/ENV 12924 is another emerging standard certainly more on the spot of the health care. Nevertheless, it also asks for evident further investigation. The practical case of information security design, implementation, management, and auditing inside a multi-specialty provincial Italian hospital will be described.

Capacity and principles of participation of the provincial fund of environmental protection and water management in Cracow in Cracow program of elimination of low emission sources

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

Bolek, K.; Sarzynski, H.

1995-12-31

In general, the principles of environmental protection was determined by Law issued January 31, 1980. Certain detailed solutions have been included in several amendments in subsequent years and the uniformed text of the Law on Environmental Protection and Creation was published in 1994. The Provincial Fund of Environmental Protection and Water Management was established in 1989 but until 1993 the Fund has no legal status. The main purpose of the creation of such fund was to assign certain financial means to the defined tasks related to environmental protection. This way the fund accumulates financial means from the fees paid formore » the usage of the natural environmental for business purposes and from penalties becoming due in the case of non-observance of the environmental protection standards. On the other hand, the Fund spends money for tasks in the field of environmental protection requiring urgent implementation. It should be added that - after few amendments brought into force - the Provincial Funds are able to assign a greater amount of money to the implementation of these tasks. The basic purposes of Provincial Fund activity, defined by Law, determine the policy and criteria of the selection of undertaking. This is also a base for making programs of activity and for creation of the list of priorities. The environmental protection problems in the individual provinces are different. Therefore, the scope of works partly financed by the Fund is very differentiated both in essence and in the method of financing. The former system of subsidies is now being replaced with a wide range of partial financing of undertakings in the field of environmental protection. The system of selection of these undertakings has been changed essentially. The selection of tasks and methods of their financing is based on economic criteria.« less

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

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

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

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

Salud Tiene Sabor: a model for healthier restaurants in a Latino community.

PubMed

Nevarez, Carmen R; Lafleur, Mariah S; Schwarte, Liz U; Rodin, Beth; de Silva, Pri; Samuels, Sarah E

2013-03-01

The prevalence of overweight and obesity in children has risen nationally in recent decades, and is exceptionally high in low-income communities of color such as South Los Angeles CA. Independently owned restaurants participating in the Salud Tiene Sabor program at ethnic foods marketplace Mercado La Paloma in South Los Angeles are responding to the childhood obesity crisis by posting calories for menu items and providing nutrition information to patrons. To evaluate whether menu labeling and nutrition information at point of purchase have an influence on availability of healthy food options, patron awareness of calorie information, and restaurant owners' support of the program. A case-study design using mixed methods included restaurant owner and stakeholder interviews, patron surveys, and environmental assessments. Data were collected using originally designed tools, and analyzed in 2009-2011. Healthy eating options were available at the Mercado La Paloma; restaurant owners and the larger community supported the Salud Tiene Sabor program; 33% of patrons reported calorie information-influenced purchase decisions. Owners of independent restaurants have an important role in improving access to healthy foods in low-income, Latino communities. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Explicación de las disparidades raciales en la salud neonatal en Brasil*

PubMed Central

Nyarko, Kwame A.; López-Camelo, Jorge; Castilla, Eduardo E.; Wehby, George L.

2015-01-01

Objetivos. Buscamos cuantificar la manera en que los efectos socioeconómicos, demográficos, geográficos y de atención de salud explican las disparidades raciales en las tasas de bajo peso al nacer y prematuridad en Brasil. Métodos. Utilizamos una muestra de 8 949 niños nacidos entre 1995 y el 2009 en 15 ciudades y 7 provincias de Brasil. Nos centramos en las disparidades en la prevalencia de bajo peso al nacer (< 2 500 g) y prematuridad (< 37 semanas de gestación) en recién nacidos de ascendencia solo africana o mezclada con otras ascendencias y de ascendencia solo europea. Usamos un modelo de descomposición para cuantificar la contribución de los factores conceptualmente pertinentes a esas disparidades. Resultados. El modelo permitió explicar entre 45% y 94% de las disparidades en cuanto al bajo peso al nacer y entre 64% y 94% de las disparidades en cuanto a la prematuridad entre los grupos de ascendencia africana y de ascendencia europea. Las diferencias en el uso de atención prenatal y en la ubicación geográfica fueron los factores más importantes, seguidos por las diferencias socioeconómicas. El modelo permitió explicar la mayoría de las disparidades en los recién nacidos de ascendencia africana mezclada y parte de las disparidades en los de ascendencia solo africana. Conclusiones. En las políticas públicas para mejorar la salud infantil se deben abordar las diferencias en cuanto a la atención prenatal y la ubicación geográfica a fin de reducir las disparidades en materia de salud entre los recién nacidos de ascendencia africana y los de ascendencia europea en Brasil.

United States-Mexico cross-border health insurance initiatives: Salud Migrante and Medicare in Mexico.

PubMed

Vargas Bustamante, Arturo; Laugesen, Miriam; Caban, Mabel; Rosenau, Pauline

2012-01-01

While U.S. health care reform will most likely reduce the overall number of uninsured Mexican-Americans, it does not address challenges related to health care coverage for undocumented Mexican immigrants, who will remain uninsured under the measures of the reform; documented low-income Mexican immigrants who have not met the five-year waiting period required for Medicaid benefits; or the growing number of retired U.S. citizens living in Mexico, who lack easy access to Medicare-supported services. This article reviews two promising binational initiatives that could help address these challenges-Salud Migrante and Medicare in Mexico; discusses their prospective applications within the context of U.S. health care reform; and identifies potential challenges to their implementation (legal, political, and regulatory), as well as the possible benefits, including coverage of uninsured Mexican immigrants, and their integration into the U.S. health care system (through Salud Migrante), and access to lower-cost Medicare-supported health care for U.S. retirees in Mexico (Medicare in Mexico).

United States-Mexico cross-border health insurance initiatives: Salud Migrante and Medicare in Mexico

PubMed Central

Bustamante, Arturo Vargas; Laugesen, Miriam; Caban, Mabel; Rosenau, Pauline

2014-01-01

While U.S. health care reform will most likely reduce the overall number of uninsured Mexican-Americans, it does not address challenges related to health care coverage for undocumented Mexican immigrants, who will remain uninsured under the measures of the reform; documented low-income Mexican immigrants who have not met the five-year waiting period required for Medicaid benefits; or the growing number of retired U.S. citizens living in Mexico, who lack easy access to Medicare-supported services. This article reviews two promising binational initiatives that could help address these challenges—Salud Migrante and Medicare in Mexico; discusses their prospective applications within the context of U.S. health care reform; and identifies potential challenges to their implementation (legal, political, and regulatory), as well as the possible benefits, including coverage of uninsured Mexican immigrants, and their integration into the U.S. health care system (through Salud Migrante), and access to lower-cost Medicare-supported health care for U.S. retirees in Mexico (Medicare in Mexico). PMID:22427168

The Leap of a Provincial SME into the Global Market Using E-commerce: The Success of Adequate Planning

NASA Astrophysics Data System (ADS)

Sainz de Abajo, Beatriz; García Salcines, Enrique; Burón Fernández, F. Javier; López Coronado, Miguel; de Castro Lozano, Carlos

The leap into the global market is not easy when it involves a provincial family business. This article demonstrates how adequate planning is fundamental in a small and medium-sized enterprise (SME) with the tight budget they have available to them, in order to be able to differentiate themselves in a highly competitive market, taking into accounts the benefits and risks involved. The Information Technology (IT) tools put in place will give the necessary support and allow for the possibility of increasing and improving the infrastructure as the company requires. An adequate strategy for the future to increases sales would be e-marketing techniques as well as the current promotions which contribute to diffusing the brand.

Promotora de salud: promoting folic acid use among Hispanic women.

PubMed

deRosset, Leslie; Mullenix, Amy; Flores, Alina; Mattia-Dewey, Daniel; Mai, Cara T

2014-06-01

The U.S. Public Health Service recommends that all women in the United States capable of becoming pregnant consume 400 μg of folic acid daily to reduce their risk of having a pregnancy affected by a neural tube defect (NTD). However, disparities exist in the consumption of folic acid, with Hispanic women having lower rates of folic acid consumption than non-Hispanic white women. A community-based feasibility study was designed to assess the utility of the promotora de salud model to promote consumption of multivitamins containing folic acid for the prevention of NTDs among Spanish-speaking Hispanic women in North Carolina. The study consisted of an educational intervention given by a promotora (a lay, community health worker), with data collection occurring at baseline and four months post-intervention to measure changes in knowledge and behavior. Overall, 52% (n=303) of participants completed all components of the study. Self-reported daily multivitamin consumption increased from 24% at baseline to 71% four months post-intervention. During the same time frame, awareness of folic acid increased from 78% to 98% and knowledge of the role of folic acid in the prevention of birth defects increased from 82% to 92%. The results of this study indicate that the promotora de salud model may be effective in reaching a subpopulation of women with the folic acid message. Additional studies with larger population sizes are warranted to validate these findings.

Proyecto para la medición sistemática de seeing en CASLEO

NASA Astrophysics Data System (ADS)

Fernández Lajus, E.; Forte, J. C.

La calidad del seeing astronómico es ciertamente uno de los parámetros mas importantes que caracterizan el sitio de un observatorio. Por tanto se desea determinar si el alto valor de seeing observado con el telescopio de 2.15 m se debe a efectos internos y/o del entorno a la cupula o si se debe simplemente al seeing propio del lugar. El actual mecanismo de refrigeración del espejo primario del 2.15, parece haber mejorado notablemente la calidad del seeing. Sin embargo se hace necesario saber hasta que punto el valor del seeing puede ser mejorado. La primera etapa del proyecto consistió en la puesta a punto del telescopio emplazado para este propósito y la adquisición de las primeras medidas tentativas de seeing.

Desarrollo de la Escala sobre el Estigma Relacionado con el VIH/SIDA para Profesionales de la Salud mediante el uso de métodos mixtos123

PubMed Central

Varas-Díaz, Nelson; Neilands, Torsten B.; Guilamo-Ramos, Vincent; Cintrón Bou, Francheska N.

2009-01-01

El estigma relacionado con el VIH/SIDA continúa siendo un obstáculo para la prevención primaria y secundaria del VIH. Las consecuencias para las personas que viven con la enfermedad han sido muy documentadas y continúan siendo una gran preocupación para las personas que proveen servicios de salud y para aquellas que investigan el tema. Estas consecuencias son preocupantes cuando el estigma emana de profesionales de la salud porque se puede limitar el acceso a los servicios. Uno de los principales obstáculos para la investigación del estigma relacionado con el VIH en Puerto Rico es la falta de instrumentos cuantitativos para evaluar las manifestaciones del estigma entre profesionales de la salud. El objetivo principal de este estudio fue desarrollar y probar las propiedades psicométricas de una escala sobre el estigma relacionado con el VIH/SIDA culturalmente apropiada para personas que proveen servicios de salud puertorriqueñas y desarrollar una versión corta de la escala que pudiera usarse en escenarios clínicos con tiempo limitado. El instrumento desarrollado estuvo basado en evidencia cualitativa recopilada entre profesionales y estudiantes de profesiones de la salud puertorriqueños/as (n=80) y administrado a una muestra de 421 profesionales de la salud en adiestramiento. La escala contenía 12 dimensiones del estigma relacionado con el VIH/SIDA. El análisis cuantitativo corroboró 11 de ellas, teniendo como resultado un instrumento con validez y confiabilidad satisfactoria. Estas dimensiones, a su vez, fueron subcomponentes de un factor de estigma general superior. PMID:20333258

SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011-2013.

PubMed

Frerichs, Leah; Brittin, Jeri; Robbins, Regina; Steenson, Sharalyn; Stewart, Catherine; Fisher, Christopher; Huang, Terry T-K

2015-02-12

A community's readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. The community increased in readiness from stage 3 of the Community Readiness Model, "vague awareness," at baseline to stage 5, "preparation," at follow-up. SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities.

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

The thermal comfort and its changes in the 31 provincial capital cities of mainland China in the past 30 years

NASA Astrophysics Data System (ADS)

Chi, Xiaoli; Li, Rui; Cubasch, Ulrich; Cao, Wenting

2018-04-01

The thermal comfort and its changes in the 31 provincial capital cities of mainland China in the past 30 years were comprehensively evaluated using the Physiologically Equivalent Temperature (PET) and Universal Thermal Climate Index (UTCI) indicators. The PET and UTCI values were highly correlated with each other and presented similar thermal comfort pattern, although their sensitivities might differ slightly. The results showed that these cities covered, respectively, 4-8 and 6-8 thermal comfort classes of the PET and UTCI scale. On the whole, the annual cumulative number of pleasant days was more than 160 days/year. In terms of seasonal variations in thermal comfort conditions, the 31 provincial capital cities in mainland China can be classified into 5 types, which are, respectively, characterized by pleasant summer and severe cold winter (type-I); pleasant spring, autumn, winter, and severe hot summer (type-II); pleasant spring and autumn, slightly pleasant summer, and cold winter (type-III); pleasant spring and autumn, hot stress summer, and slightly cold winter (type-IV); and pleasant spring, summer, autumn, and cool winter (type-V). Type-II cities are rare winter resorts, while type-I cities are natural summer resorts. Type-V cities are the year round pleasant resorts. In the past three decades, the cities in mainland China had experienced increasing pleasant duration in late winter and early spring and intensifying heat stress in summer. The reduction in annual cumulative number of cold stress days in higher latitude/altitude cities outweighed the increase in duration of heat stress in subtropical cities. These may provide some references for urban planning and administration in mainland China.

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

PubMed Central

Olfert, M. Rose

2015-01-01

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

Evaluating human papillomavirus vaccination programs in Canada: should provincial healthcare pay for voluntary adult vaccination?

PubMed

Llamazares, Marco; Smith, Robert J

2008-04-10

Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9-13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination. A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined. We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated, then the possibility of eradication of targeted types becomes much more favourable. We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible. If eradication is possible, then there is a critical immunogenicity such that even 100% childhood vaccination will not eradicate the targeted types of the virus and must be supplemented with voluntary adult vaccination. However, the level of adult vaccination coverage required is modest and may be achieved

SaludableOmaha: development of a youth advocacy initiative to increase community readiness for obesity prevention, 2011-2012.

PubMed

Frerichs, Leah; Brittin, Jeri; Stewart, Catherine; Robbins, Regina; Riggs, Cara; Mayberger, Susan; Cervantes, Alberto; Huang, Terry T-K

2012-01-01

Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. We used CRM to assess supply and demand for health programs, engage the community, determine the community's baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs.

El aprendizaje significativo en las ciencias al participar en proyectos de investigacion cientifica

NASA Astrophysics Data System (ADS)

Mora Polanco, Miguelena

La ciencia es el eje fundamental a traves del cual se desarrollan las habilidades necesarias para el pensar cientifico que va a la busqueda del conocimiento cientifico. La intencion de este estudio fue indagar en el tema de investigacion cientifica desde el punto de vista de los participantes en los siguientes aspectos relacionados con la experiencia de investigacion cientifica: a) conceptos, b) proceso, c) destrezas y d) disposicion. Tambien se analizaron: a) las perspectivas del metodo cientifico, b) la estrategia de ensenanza, c) la cultura cientifica y d) la exposicion del proyecto investigativo en la Feria Cientifica; como parte del aprendizaje significativo de la ciencias de los participantes. Esta investigacion cualitativa propuso como diseno el estudio de caso. Los aspectos relacionados a la experiencia de participar en proyecto de investigacion cientifica son el fenomeno o caso bajo estudio. En el estudio participaron cinco (5) estudiantes egresados de escuela publica o privada que cursaban hasta el tercer ano de estudios universitarios, conducentes a un bachillerato en educacion secundaria en ciencias o en ciencias naturales. Las tecnicas utilizadas para recopilar los datos fueron: analisis de documentos del DEPR, revision de artefactos y entrevistas profundas. Para el analisis de los datos de las entrevistas se utilizo el modelo de Wolcott (1994). Del analisis de documentos del DEPR se identificaron areas a mejorar en las guias de las cartas circulares con relacion a la investigacion escolar y la feria cientifica. El analisis de los artefactos proveyo evidencia de como los internados, simposios e investigaciones fomentan el que los estudiantes se superen en el aspecto cognitivo, se conviertan en creadores del conocimiento, al hacer suyo los conceptos para poder explicarlos al publico. De las entrevistas los participantes manifestaron que la experiencia de investigacion fue una de aprendizaje significativo que los marco para toda la vida y les expandio su

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Percepción de competencia y adiestramiento profesional especializado relativos al VIH/SIDA en estudiantes y profesionales de la salud: el estigma como un indicador de necesidad

PubMed Central

RODRÍGUEZ, Yarimar ROSA; DÍAZ, Nelson VARAS

2009-01-01

El proceso de estigmatización asume una devaluación de la persona debido a una característica o marca que haya sido identificada socialmente y que permita que se le describa como diferente. Desde que se desató la epidemia del VIH/SIDA, vivir con la enfermedad ha sido señalado de manera social como una marca estigmatizante. Las manifestaciones de dicha estigmatización se han documentado entre profesionales de la salud. Este estigma puede afectar los servicios de salud que las personas que viven con VIH/SIDA reciben de estos profesionales. Los objetivos de esta investigación fueron explorar: 1) la percepción que tienen estudiantes y profesionales de la salud sobre su nivel de competencia para ofrecer servicios a personas que viven con VIH/SIDA, 2) las opiniones de éstos sobre el tipo de adiestramiento profesional recibido y la necesidad del mismo, y 3) la manifestación de actitudes estigmatizantes como indicadores de necesidad de adiestramiento profesional. La muestra total del estudio estuvo compuesta por 80 de diversas profesiones de la salud. Los resultados reflejan que algunos/as de los/as participantes han recibido formación en VIH pero ésta no ha sido suficiente para contrarrestar las nociones estigmatizantes. Discutimos las implicaciones de los resultados para investigaciones futuras y el desarrollo de intervenciones con vías de minimizar las nociones estigmatizantes en los escenarios de salud. PMID:20011236

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

PubMed

Mou, Haizhen; Olfert, M Rose

2015-11-01

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

Between Local Culture and School Science: The Case of Provincial and Urban Students from Eastern Colombia

NASA Astrophysics Data System (ADS)

Medina-Jerez, William

2008-03-01

A lack of congruency between the teaching and learning of science and the student’s personal worlds has long been recognised by the international science education community as an issue deserving space in the research agenda. The purpose of this study was to explore the diversity of student reactions when subcultures such as family, community peers, and personal worldviews are considered along side the subculture of school science. Two-hundred and fifty students from urban and provincial schools in the northeastern region of Colombia (South America) participated. From this group, 18 students were interviewed. It was observed that students adopt a compartmentalisation of knowledge that is evident as both an avoiding strategy in the classroom and as a mechanism to differentiate between the natural world of their everyday situations and the one portrayed by a Westernised science instruction in the classroom. The findings reflect how multiple worldviews correlate with student frameworks as implanted by school science.

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

EPA Science Inventory

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

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

NASA Astrophysics Data System (ADS)

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

2015-06-01

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

NutriNet-Salud México. Prospective study online: 2018-2028. Relationship between nutrition and health and determinants of dietary habits and nutritional status.

PubMed

Barriguete-Meléndez, Jorge Armando; Hercberg, Serge; Galán, Pilar; Parodi, André; Baulieux, Jacques

2018-01-01

NutriNet-Salud Mexico is a digital health information system, e-epidemiology instrument, online, open and free, to recording and analysis the determinants of dietary habits and nutritional status of the Mexican population, for the prevention of overweight, obesity and noncommunicable diseases for the period 2018-2028. Describe the design, development and implementation of NutriNet-Salud Mexico from the French model NutriNet-Santé France 2008-2018. NutriNet-Salud Mexico platform is the basis for the development of health information system for prospective cohort study, scheduled for a period of 10 years (2018-2028), with a dedicated website, and its development will enable to have multiple study populations within an initial set of five self-applicable questionnaires validated in Mexican population. The information will enable to develop applied research, learn and monitor food contributions and nutritional status of the population, assess the impact of public health actions on feeding behavior and nutritional status, comparing populations between countries (Mexico, France, Belgium and Switzerland) and national institutes, universities and states. NutriNet-Salud Mexico will provide information for assist in research and public action, especially to guide public policies on nutrition Mexico. The scientific elements will make appropriate nutritional recommendations to different populations and access to a representative nominal population sample with low-cost, in real-time, and with dual approach to e-epidemiology: cohort study to identify causality and cross-sectional studies (descriptive research, monitoring and evaluation). Copyright: © 2018 Permanyer.

An Evaluation of Provincial Infectious Disease Surveillance Reports in Ontario.

PubMed

Chan, Ellen; Barnes, Morgan E; Sharif, Omar

Public Health Ontario (PHO) publishes various infectious disease surveillance reports, but none have yet been formally evaluated. PHO evaluated its monthly and annual infectious disease surveillance reports to assess public health stakeholders' current perception of the products and to develop recommendations for improving future products. An evaluation consisting of an online survey and a review of public Web sites of other jurisdictions with similar annual reports. For the online survey, stakeholder organizations targeted were the 36 local public health units and the Health health ministry in Ontario, Canada. Survey participants included epidemiologists, managers, directors, and other public health practitioners from participating organizations. Online survey respondents' awareness and access to the reports, their rated usefulness of reports and subsections, and suggestions for improving usefulness; timeliness of select annual reports from other jurisdictions based on the period from data described to report publication. Among 57 survey respondents, between 74% and 97% rated each report as useful; the most common use was for situational awareness. Respondents ranked timeliness as the most important attribute of surveillance reports, followed by data completeness. Among 6 annual reports reviewed, the median time to publication was 11.5 months compared with 23.2 months for PHO. Recommendations based on this evaluation have already been applied to the monthly report (eg, focusing on the most useful sections) and have become key considerations when developing future annual reports and other surveillance reporting tools (eg, need to provide more timely reports). Other public health organizations may also use this evaluation to inform aspects of their surveillance report development and evaluation. The evaluation results have provided PHO with direction on how to improve its provincial infectious disease surveillance reporting moving forward, and formed a basis for

An Evaluation of Provincial Infectious Disease Surveillance Reports in Ontario

PubMed Central

Barnes, Morgan E.; Sharif, Omar

2018-01-01

provincial infectious disease surveillance reporting moving forward, and formed a basis for future work in surveillance product development and evaluation. PMID:28141669

SaludABLEOmaha: Improving Readiness to Address Obesity Through Healthy Lifestyle in a Midwestern Latino Community, 2011–2013

PubMed Central

Frerichs, Leah; Brittin, Jeri; Robbins, Regina; Steenson, Sharalyn; Stewart, Catherine; Fisher, Christopher

2015-01-01

Background A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. Community Context This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. Methods SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. Outcome The community increased in readiness from stage 3 of the Community Readiness Model, “vague awareness,” at baseline to stage 5, “preparation,” at follow-up. Interpretation SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities. PMID:25674679

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

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

NONE

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

Microbiological baseline study of poultry slaughtered in provincially inspected abattoirs in Alberta, Canada

PubMed Central

Bohaychuk, Valerie M.; Checkley, Sylvia L.; Gensler, Gary E.; Barrios, Pablo Romero

2009-01-01

Studies to determine baseline levels of microbial contaminants and foodborne bacterial pathogens are needed to evaluate the effectiveness of Hazard Analysis Critical Control Point (HACCP) programs, Good Manufacturing/Production Practices, and various interventions. In 2004 and 2005 poultry carcass rinses from provincially inspected abattoirs in Alberta, Canada, were tested to determine the levels of aerobic plate count bacteria, coliform bacteria, and generic Escherichia coli, the prevalence and levels of Campylobacter spp., and the prevalence of Salmonella spp. and Shiga toxin-producing E. coli (STEC). Samples were collected from 3 high volume and 62 low volume abbatoirs. All samples (1296) were positive for aerobic plate count bacteria, with 98.8% of samples having counts of 100 000 or less colony forming units (CFU)/cm2. Coliform bacteria were isolated from 99.7% of the 1296 carcasses and were recovered at levels of ≤ 1000 CFU/cm2 for 98.3% of the samples. Generic E. coli were recovered from 99.1% of the 1296 carcasses at levels of ≤ 1000 CFU/cm2 for 98.6% of the samples. Seventy five percent of 1234 samples that were tested for Campylobacter were positive; 37.5% of 1295 samples that were tested for Salmonella were positive; and only 2 of 1296 samples tested for STEC were positive (0.15%). PMID:19412397

Melioidosis in lower provincial Cambodia: A case series from a prospective study of sepsis in Takeo Province

PubMed Central

Berjohn, Catherine M.; Prouty, Angela M.; Fitkariwala, Amitha; Som, Tin; Sieng, Darith; Gregory, Michael J.; Vaughn, Andrew; Kheng, Sim; Te, Vantha; Duplessis, Christopher A.; Lawler, James V.; Clark, Danielle V.

2017-01-01

Melioidosis is a severe infectious disease caused by the gram-negative soil bacterium Burkholderia pseudomallei. Melioidosis is well known to be a major cause of morbidity and mortality in Southeast Asia, particularly in Thailand. However, melioidosis remains underreported in surrounding areas such as Cambodia. We report a case series of melioidosis in seven patients from Takeo Province, Cambodia. The patients, aged 24–65 years, were enrolled from May 2014 to May 2015 during a one year prospective study of sepsis at Takeo Provincial Hospital. They presented with fever, rigors, dyspnea, fatigue, diaphoresis, productive cough, and skin abscesses. Six of the seven patients were also hyponatremic. B. pseudomallei was cultured from the blood of six patients and the sputum of one patient. In this manuscript, we provide a detailed description of the clinical presentation, case management and laboratory confirmation of B. pseudomallei, as well as discuss the difficulties of identifying and treating melioidosis in low resource settings. PMID:28902844

SaludableOmaha: Development of a Youth Advocacy Initiative to Increase Community Readiness for Obesity Prevention, 2011–2012

PubMed Central

Frerichs, Leah; Brittin, Jeri; Stewart, Catherine; Robbins, Regina; Riggs, Cara; Mayberger, Susan; Cervantes, Alberto

2012-01-01

Background Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. Community Context We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. Methods We used CRM to assess supply and demand for health programs, engage the community, determine the community’s baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. Outcome At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. Interpretation CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs. PMID:23217590

Prevalence of HIV and hepatitis C virus infections among inmates of Quebec provincial prisons

PubMed Central

Poulin, Céline; Alary, Michel; Lambert, Gilles; Godin, Gaston; Landry, Suzanne; Gagnon, Hélène; Demers, Éric; Morarescu, Elena; Rochefort, Jean; Claessens, Christiane

2007-01-01

Background To determine the prevalence of HIV and hepatitis C virus (HCV) infections and examine risk factors for these infections among inmates in Quebec provincial prisons. Methods Anonymous cross-sectional data were collected from January to June 2003 for men (n = 1357) and women (n = 250) who agreed to participate in the study and who completed a self-administrated questionnaire and provided saliva samples. Results The prevalence of HIV infection was 2.3% among the male participants and 8.8% among the female participants. The corresponding prevalence of HCV infection was 16.6% and 29.2%, respectively. The most important risk factor was injection drug use. The prevalence of HIV infection was 7.2% among the male injection drug users and 0.5% among the male non-users. Among the women, the rate was 20.6% among the injection drug users, whereas none of the non-users was HIV positive. The prevalence of HCV infection was 53.3% among the male injection drug users and 2.6% among the male non-users; the corresponding values among the women were 63.6% and 3.5%. Interpretation HIV and HCV infections constitute an important public health problem in prison, where the prevalence is affected mainly by a high percentage of injection drug use among inmates. PMID:17664448

A Path Analysis of a Randomized "Promotora de Salud" Cardiovascular Disease-Prevention Trial among At-Risk Hispanic Adults

ERIC Educational Resources Information Center

de Heer, Hendrik Dirk; Balcazar, Hector G.; Castro, Felipe; Schulz, Leslie

2012-01-01

This study assessed effectiveness of an educational community intervention taught by "promotoras de salud" in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of…

Knowledge exchange systems for youth health and chronic disease prevention: a tri-provincial case study.

PubMed

Murnaghan, D; Morrison, W; Griffith, E J; Bell, B L; Duffley, L A; McGarry, K; Manske, S

2013-09-01

The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These three knowledge exchange systems seek to generate and enhance the use of evidence in policy development, program planning and evaluation to improve youth health and chronic disease prevention. We applied a case study design to explore the lessons learned, that is, key conditions or processes contributing to the development of knowledge exchange capacity, using a multi-data collection method to gain an in-depth understanding. Data management, synthesis and analysis activities were concurrent, iterative and ongoing. The lessons learned were organized into seven "clusters." Key findings demonstrated that knowledge exchange is a complex process requiring champions, collaborative partnerships, regional readiness and the adaptation of knowledge exchange to diverse stakeholders. Overall, knowledge exchange systems can increase the capacity to exchange and use evidence by moving beyond collecting and reporting data. Areas of influence included development of new partnerships, expanded knowledge-sharing activities, and refinement of policy and practice approaches related to youth health and chronic disease prevention.

Microbiological baseline study of beef and pork carcasses from provincially inspected abattoirs in Alberta, Canada

PubMed Central

Bohaychuk, Valerie M.; Gensler, Gary E.; Barrios, Pablo Romero

2011-01-01

In 2006 and 2007 beef and pork carcass swabs from provincially inspected abattoirs in Alberta, Canada were tested to determine the levels of total aerobic bacteria, coliform bacteria, and generic Escherichia coli, and the prevalence of Salmonella spp., Campylobacter spp., and Shiga toxin-producing E. coli (STEC). Swabs from beef and pork carcasses from 48 and 34 facilities, respectively, were analyzed. All samples tested were positive for aerobic bacteria with 99.8% of beef and 96.0% of pork samples, having total counts of ≤ 100 000 CFU/cm2. Coliform bacteria were isolated from 22.4% and 42.0% of beef and pork carcass samples, respectively. Generic E. coli were recovered from 14.6% of beef and 33.7% of pork carcass samples. For beef carcasses, positive tests were obtained for 0.1% of 1036 samples tested for Salmonella spp., 1.5% of 1022 samples tested for Campylobacter spp. and 5.4% of 1018 samples tested for STEC. For pork carcasses, positive tests were obtained for 1.6 % of 1076 samples tested for Salmonella spp., 8.8% of 1070 samples tested for Campylobacter spp. and 4.8% of 1067 samples tested for STEC. PMID:22467964

Intentional tanning among adolescents in seven Canadian provinces: Provincial comparisons (CRAYS 2015).

PubMed

Nadalin, V; Marrett, L D; Cawley, C; Minaker, L M; Manske, S

2018-06-01

This report explores intentional tanning behaviors among Canadian high school students in light of provincial restrictions on UV tanning device use among youth. Data are from the Cancer Risk Assessment in Youth Survey (CRAYS), collected from January to December 2015, at randomly selected high schools in 7 provinces. Relevant variables were: tanning methods ever used, demographics, and location and refusal of UV tanning device (beds, lamps) use in the past 12 months. Data were weighted so total survey weights by male/female, grade and province equal actual enrolments in these groups. Analyses were conducted in SAS, mostly for grades 10 and 11. Rao-Scott chi squared tests and p-values were calculated. Among 6803 grade 10 and 11 participants, 82% tanned intentionally, mostly by being/playing outside, or laying in the sun. Spray/self-tanners were used by 15% of participants. UV tanning device use was uncommon (4.4%), lowest in Ontario (2.7%) and British Columbia (3.8%), which have legislation against use among youth. Of 202 who used UV tanning devices in the past 12 months, most did at salons/studios (85%), 35% at home and 30% at a gym. Two hundred and forty-nine participants (3.4%) were refused use of UV tanning devices in the past 12 months. While legislation appears to deter UV tanning device use, it appears to have no impact on UV exposure among high school students overall. Greater prevention efforts are required to deter intentional tanning among high school students. Copyright © 2018 Elsevier Inc. All rights reserved.

El Proyecto Gémini: informe actualizado y técnica de observación

NASA Astrophysics Data System (ADS)

Sahade, J.; Lapasset, E.; Levato, H.

Se describirá la situación actual en lo que se refiere al desarrollo del Proyecto Gémini en cuanto a su estructura, faz constructiva y programación general. Se informará sobre los planes a desarrollar en el tiempo de verificación científica y puesta a punto del instrumental, a partir de la primera imagen que se obtenga con el telescopio Gemini Norte. Se presentará, además, el plan operativo para observar con los telescopios Gemini tal cual está concebido hasta la fecha, describiéndose el proceso desde el mismo momento en que un investigador decide presentar una propuesta para observar con uno de los telescopios, hasta el archivo y derechos de propiedad sobre los datos. Se decribe también el ``soft" denominado Observing Tool (OT) que es clave en la planificación científica de Gemini y que puede ser utilizado ``off-line" en cualquier PC con un entorno windows.

El contexto de la familia y el vecindario en la salud de los ancianos del estudio EPESE hispano

PubMed Central

Reyes-Ortiz, Carlos A.; Camacho, María E.; Eschbach, Karl; Markides, Kyriakos S.

2014-01-01

RESUMEN En este artículo se discute el papel de la familia y el vecindario en la salud de los ancianos méjico-americanos del estudio EPESE (Established Populations for Epidemiologic Studies of the Elderly) hispano. La paradoja epidemiológica consiste en que, a pesar de estar en desventaja socioeconómica, los ancianos hispanos tienen mortalidad relativamente menor que los ancianos de raza blanca. Esto es especialmente cierto cuando el anciano vive en los vecindarios donde hay un porcentaje alto de méjico-americanos. La familia también juega un papel importante en estos ancianos al disminuir el riesgo de institucionalización o de morbilidad. Asimismo, el estrés originado en problemas económicos o al depender económicamente de la familia, habiendo inmigrado en edades tardías, puede sobrepasar la capacidad de amortiguamiento del estrés y afectar la salud del anciano méjico-americano. PMID:25190897

The effect of socioeconomic status and social inclusion on the mental health of Chinese migrants: A comparison between interprovincial and intra-provincial migrants.

PubMed

Yi, Yingying; Liang, Ying

2017-07-01

This article sought to explore the impacts of socioeconomic status and social inclusion on intra-provincial and interprovincial migrants' mental health by constructing the Bayesian structural equation model. A total of 14,584 migrants aged 15-59 years living in eight cities of China were selected. It was found that the impacts of socioeconomic status and social inclusion on mental health were converse for these two groups. And the manifest variables coefficients of socioeconomic status and social inclusion were also converse. Therefore, governments should make some policies to further improve the mental health of migrants, including strengthening the community cohesion, social atmosphere, and governmental support.

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

PubMed

Rudaś, Dariusz; Skórczewski, Krzysztof

2011-01-01

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

Amor y Salud (Love and Health): a preconception health campaign for second-generation Latinas in Oregon.

PubMed

Dixon-Gray, Lesa A; Mobley, Allison; McFarlane, Julie M; Rosenberg, Kenneth D

2013-01-01

To develop, and implement, a social marketing campaign to increase preconception health knowledge among second-generation Latinas in Oregon. Social marketing demonstration project. Latino communities in five Oregon counties. Target populations included young Latinas (18-29 years old) born in the United States of immigrant parents in five Oregon counties, and their family members. Intervention. A radionovela, Amor y Salud, was developed that featured a Latina and her fiancé preparing for marriage and family. Social media, Web sites, and culturally relevant print materials promoted the radio campaign. Process data, social media metrics, Google analytics, online and intercept surveys were collected. Basic frequencies and descriptive statistics were used. Twelve episodes were produced in English and Spanish and played on nine radio stations a total of 2098 times. The Facebook page was viewed 11,000 times, and radionovela episodes were played a total of 776 times. Amor y Salud used mixed media--radio, social media, print materials--to encourage Latinas to consider their preconception health. Anecdotally, we heard positive comments from community members and local media regarding the radionovela; however, evaluation challenges prevent us from saying conclusively that knowledge on this topic increased.

EL PROCESO DE MENTORÍA DENTRO DE UN PROYECTO PARA EL DESARROLLO DE INFRAESTRUCTURA DE INVESTIGACIÓN A NIVEL UNIVERSITARIO

PubMed Central

MÁRQUEZ, LILLIAN ARVELO; SANTIAGO, NILDA G. MEDINA

2015-01-01

This article aims to describe the experience of Proyecto VIAS - RIMI (Violence & Asthma - Research Infrastructure in Minority Institutions) of Universidad del Este in Puerto Rico to achieve one of its main objectives: the development and promotion of mentoring in research. It describes the way the project has operationalized the mentoring process to empower mentees, as well as the innovative ways in which university professors have received training to become better mentors. The authors argue that mentoring has been fundamental to achieve the goals of the students who have participated in the project and recommend continuing such initiatives in academia. PMID:27066161

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

PubMed

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

2018-06-01

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

The health sector reforms and the efficiency of public hospitals in Turkey: provincial markets.

PubMed

Sulku, Seher Nur

2012-10-01

Turkey initiated the 'Health Transformation Programme' (HTP) in 2003 to align its health care system with the European Union and OECD countries. This study investigates the impact of these reforms on the efficiency of public hospitals. Our study would contribute to the existing literature with a comprehensive analysis of the health system in a developing country. We employ the data envelopment approach and the Malmquist index to comparatively examine before and after the reform years. Our analyses compare the performances of public hospitals served in provincial markets. Inputs of number of beds, number of primary care physician, and number of specialists, and how they are used to produce outputs of inpatient discharges, outpatient visits and surgical operations are investigated. Indeed, as the performance indicators dead rate, hospital bed occupation rate and average length of stay are considered. The HTP was generally successful in boosting productivity due to advancements in technology and technical efficiency but in the socio-economically disadvantaged provinces productivity gains have not been achieved. The average technical efficiency gains took place because of the significantly improved scale efficiencies, as the average pure technical efficiency slightly improved. Lastly, the hospital performance indicators have not improved in the short run. It appears that the expected benefits from the health reforms in Turkey have been partially achieved in the short run.

FACTORES SOCIO-ESTRUCTURALES Y EL ESTIGMA HACIA EL VIH/SIDA: EXPERIENCIAS DE PUERTORRIQUEÑOS/AS CON VIH/SIDA AL ACCEDER SERVICIOS DE SALUD

PubMed Central

RIVERA-DIAZ, MARINILDA; VARAS-DIAZ, NELSON; REYES-ESTRADA, MARCOS; SURO, BEATRIZ; CORIANO, DORALIS

2013-01-01

RESUMEN El estigma relacionado al VIH/SIDA continúa afectando la prestación de servicios de salud y el bienestar físico y mental de las personas con VIH/SIDA (PVS). Recientemente la literatura científica ha señalado la importancia de comprender las manifestaciones de estigma más allá de las interacciones individuales. Por tal razón, investigaciones recientes en y fuera de Puerto Rico enfatizan la importancia de entender cómo factores socio-estructurales (FSE) influyen en los procesos de estigmatización social. Con el propósito de examinar los FSE que influyen en las manifestaciones de estigma relacionado al VIH/SIDA, realizamos y analizamos nueve grupos focales compuestos por hombres y mujeres en tratamiento para el VIH/SIDA que habían tenido experiencias estigmatizantes. Los participantes identificaron FSE relacionados a las manifestaciones de estigma, tales como el uso de viviendas especializadas, descentralización de los servicios de salud y el desarrollo de protocolos administrativos excluyentes en los servicios de salud. Los resultados demuestran la importancia de considerar los FSE en el desarrollo e implementación de intervenciones dirigidas a la población. PMID:24639599

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

PubMed

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

2004-11-01

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

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

PubMed

Park, Chang-Hyun; Kim, Seungoh

2016-12-01

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

Spatiotemporal Characteristics, Determinants and Scenario Analysis of CO2 Emissions in China Using Provincial Panel Data.

PubMed

Wang, Shaojian; Fang, Chuanglin; Li, Guangdong

2015-01-01

This paper empirically investigated the spatiotemporal variations, influencing factors and future emission trends of China's CO2 emissions based on a provincial panel data set. A series of panel econometric models were used taking the period 1995-2011 into consideration. The results indicated that CO2 emissions in China increased over time, and were characterized by noticeable regional discrepancies; in addition, CO2 emissions also exhibited properties of spatial dependence and convergence. Factors such as population scale, economic level and urbanization level exerted a positive influence on CO2 emissions. Conversely, energy intensity was identified as having a negative influence on CO2 emissions. In addition, the significance of the relationship between CO2 emissions and the four variables varied across the provinces based on their scale of economic development. Scenario simulations further showed that the scenario of middle economic growth, middle population increase, low urbanization growth, and high technology improvement (here referred to as Scenario BTU), constitutes the best development model for China to realize the future sustainable development. Based on these empirical findings, we also provide a number of policy recommendations with respect to the future mitigation of CO2 emissions.

Spatiotemporal Characteristics, Determinants and Scenario Analysis of CO2 Emissions in China Using Provincial Panel Data

PubMed Central

Wang, Shaojian

2015-01-01

This paper empirically investigated the spatiotemporal variations, influencing factors and future emission trends of China’s CO2 emissions based on a provincial panel data set. A series of panel econometric models were used taking the period 1995–2011 into consideration. The results indicated that CO2 emissions in China increased over time, and were characterized by noticeable regional discrepancies; in addition, CO2 emissions also exhibited properties of spatial dependence and convergence. Factors such as population scale, economic level and urbanization level exerted a positive influence on CO2 emissions. Conversely, energy intensity was identified as having a negative influence on CO2 emissions. In addition, the significance of the relationship between CO2 emissions and the four variables varied across the provinces based on their scale of economic development. Scenario simulations further showed that the scenario of middle economic growth, middle population increase, low urbanization growth, and high technology improvement (here referred to as Scenario BTU), constitutes the best development model for China to realize the future sustainable development. Based on these empirical findings, we also provide a number of policy recommendations with respect to the future mitigation of CO2 emissions. PMID:26397373

Significado de psicólogas/os de atención primaria de salud sobre la intervención psicosocial de grupo en el tratamiento de la depresión en Chile.

PubMed

Andrade, Gonzalo; Espinoza, Adriana

2017-11-01

En Chile, el tratamiento de la depresión en salud pública promueve la realización de Intervenciones Psicosociales en Grupo (IPG) para todos los casos diagnosticados, no obstante, se observa una baja implementación de estas prestaciones. El presente artículo describe y caracteriza, desde el punto de vista de la disciplina psicológica, el significado de psicólogas/os que trabajan en consultorios de atención primaria de salud (APS) sobre las IPG en el tratamiento de la depresión. Se entrevistaron a ocho psicólogas/os de los distintos Servicios de Salud de la Región Metropolitana de Santiago. Este estudio se basó en las premisas de la Teoría Fundamentada, utilizando sus estrategias de análisis. La categoría "los grupos no nos resultan" expone las principales barreras que impiden la realización de estas intervenciones. La carga laboral centrada en atenciones individuales, el escaso presupuesto destinado a su implementación, y la falta de instalaciones adecuadas para realizar las IPG emergen como barreras institucionales. Asi mismo, la "poca fe" en la efectividad del trabajo en grupo, la figura de las/os psicólogas/os como únicas/os profesionales capacitadas/os para trabajar con las emociones, la idea de que la baja adherencia al tratamiento no depende de su ejercicio laboral, y el hecho de que la implementación de las IPG dependa del interés individual de algunas/os profesionales, emergen como las principales resistencias profesionales a su realización. Se discuten los alcances de estas barreras, y se proponen soluciones que favorezcan el cambio cultural necesario para que las/los profesionales e instituciones de salud puedan alinearse en plenitud con el modelo comunitario de salud propuesto por el Plan Nacional de Salud Mental y Psiquiatría (PNSMP).

Effectiveness of a Brief Home Parenting Intervention for Reducing Early Sexual Risks among Latino Adolescents: "Salud y Éxito"

ERIC Educational Resources Information Center

O'Donnell, Lydia; Fuxman, Shai

2017-01-01

Background: Teen pregnancy rates and related risks remain elevated among Latino teens. We tested the impact on youth sexual behaviors of a brief, culturally targeted, bilingual media intervention designed for parents of young adolescents. Methods: "Salud y éxito" (Health & Success) uses dramatic audio stories to model positive…

Madres para la Salud: Design of a Theory-based Intervention for Postpartum Latinas

PubMed Central

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-01-01

Background Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. Objectives This report describes the theoretical rationale, design considerations, and cultural relevance for “Madres para la Salud” [Mothers for Health]. Design and Methods Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using “bouts” of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. Summary The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. PMID:21238614

Evaluation of Salud Para Su Corazón (Health for your Heart) -- National Council of La Raza Promotora Outreach Program.

PubMed

Balcázar, Héctor; Alvarado, Matilde; Hollen, Mary Luna; Gonzalez-Cruz, Yanira; Pedregón, Verónica

2005-07-01

In 2001, the National Heart, Lung, and Blood Institute partnered with the National Council of La Raza to conduct a pilot test of its community-based outreach program Salud Para Su Corazón (Health for Your Heart), which aims to reduce the burden of morbidity and mortality associated with cardiovascular disease among Latinos. The effectiveness of promotores de salud (community health workers) in improving heart-healthy behaviors among Latino families participating in the pilot program at seven sites was evaluated. Data on the characteristics of the promotores in the Salud Para Su Corazón program were compiled. Promotores collected data on family risk factors, health habits, referrals and screenings, information sharing, and program satisfaction from 223 participating Latino families (320 individual family members) through questionnaires. Paired t tests and chi-square tests were used to measure pretest-posttest differences among program participants. Results demonstrated the effectiveness of the promotora model in improving heart-healthy behaviors, promoting community referrals and screenings, enhancing information sharing beyond families, and satisfying participants' expectations of the program. The main outcome of interest was the change in heart-healthy behaviors among families. The community outreach model worked well in the seven pilot programs because of the successes of the promotores and the support of the community-based organizations. Successes stemmed in part from the train-the-trainer approach. Promotoria, as implemented in this program, has the potential to be integrated with a medical model of patient care for primary, secondary, and tertiary prevention.

Salud Para Su Corazon (health for your heart) community health worker model: community and clinical approaches for addressing cardiovascular disease risk reduction in Hispanics/Latinos.

PubMed

Balcazar, H; Alvarado, M; Ortiz, G

2011-01-01

This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating: The "Entre Familia: Reflejos de Salud" Study

ERIC Educational Resources Information Center

Schmied, Emily; Parada, Humberto; Horton, Lucy; Ibarra, Leticia; Ayala, Guadalupe

2015-01-01

"Entre Familia: Reflejos de Salud" was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker ("promotora") model with an entertainment-education…

Elucidating empowerment in El Proyecto Bienestar (the Well-Being Project).

PubMed

Postma, Julie

2008-05-01

This paper describes differences in how socioculturally diverse participants in one community-based participatory research project negotiated 'empowerment', and the implications of those differences for nurses involved in farmworker health and safety efforts. Internationally, empowerment and community participation are increasingly being used as strategies to reduce health disparities. Theories of empowerment vary in the academic literature and their connotations vary across cultures. Study participants were part of El Proyecto Bienestar, a community-based participatory research (CBPR) project whose aim was to identify and respond to occupational and environmental health threats in one Mexican-American farmworker community in the United States of America. Participant observation was used to audiorecord 18 participants in the third year (2006) of this 4-year project discussing future project activities. Discourse analysis was used to analyse the transcripts. While participants agreed that 'empowerment' was central to the project, they had different perspectives on what the term meant and the role that the project should play in empowering the farmworker community. Empowerment discourses positioned the project in three ways: (1) as an instrument used to strengthen farmworkers' collective political voice, (2) as an instrument used to represent multiple community interests and (3) as an instrument used to advocate on behalf of farmworkers. Individuals used multiple discourses signifying the complexity in participants' roles and obligations. Balancing power and developing knowledge collaboratively requires understanding multiple approaches to empowerment. Community empowerment as an outcome should not come at the expense of individual empowerment as part of the CBPR process.

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

PubMed

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

2016-11-16

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

Incentivos para atraer y retener personal de salud de zonas rurales del Perú: un estudio cualitativo

PubMed Central

Huicho, Luis; Canseco, Francisco Díez; Lema, Claudia; Miranda, J. Jaime; Lescano, Andrés G.

2014-01-01

El objetivo fue identificar incentivos de atracción y retención en zonas rurales y distantes de Ayacucho, Perú. Fueron realizadas entrevistas en profundidad con 80 médicos, enfermeras, obstetras y técnicos (20 por grupo) de las zonas más pobres y con 11 funcionarios. No existen políticas sistemáticas de atracción y retención de personal de salud en Ayacucho. Los principales incentivos, en orden de importancia, fueron mejoras salariales, oportunidades de formación y capacitación, estabilidad laboral y nombramiento, mejoras en infraestructura y equipos, e incremento del personal. Se mencionaron también mejoras en la vivienda y alimentación, mayor cercanía con la familia y reconocimiento por el sistema de salud. Existen coincidencias y singularidades entre los distintos grupos sobre los incentivos clave para estimular el trabajo rural, que deben considerarse al diseñar políticas públicas. Las iniciativas del Estado deben comprender procesos rigurosos de monitoreo y evaluación, para asegurar que las mismas tengan el impacto deseado. PMID:22488318

Lessons from an evaluation of a provincial-level smoking control policy in Shanghai, China.

PubMed

Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J; Wong, Frank Y; Berg, Carla J

2013-01-01

The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.

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

PubMed

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

2017-06-01

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

Estimation of the contribution of exports to the provincial economy: an analysis based on China's multi-regional input-output tables.

PubMed

Wu, Sanmang; Li, Shantong; Lei, Yalin

2016-01-01

This paper developed an estimation model for the contribution of exports to a country's regional economy based on the Chenery-Moses model and conducted an empirical analysis using China's multi-regional input-output tables for 1997, 2002, and 2007. The results indicated that China's national exports make significantly different contributions to the provincial economy in various regions, with the greatest contribution being observed in the eastern region and the smallest in the central region. The provinces are also subjected to significantly different export spillover effects. The boosting effect for the eastern provinces is primarily generated from local exports, whereas the western provinces primarily benefit from the export spillover effect from the eastern provinces. The eastern provinces, such as Guangdong, Zhejiang, Jiangsu, and Shanghai, are the primary sources of export spillover effects, and Guangdong is the largest source of export spillover effects for almost all of the provinces in China.

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

PubMed

Lata, Stanisław; Janiszewski, Jacek

2010-01-01

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

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

PubMed Central

Park, Chang-hyun

2016-01-01

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

Amendments to Provincial Regulations on Protecting the Legal Rights and Interests of Women and Children, November 1989.

PubMed

1989-01-01

In early November 1989 the government of Fujian, China made the following amendments to its Provincial Regulations on Protecting the Legal Rights and Interests of Women and Children: "a) if state policy on the recruitment of students and workers is violated, and if the law is broken through the imposition of restrictions on women seeking education and jobs, the party concerned or his guardian may file a complaint with the department in charge of recruitment of students or workers within 30 days after learning about the matter; the latter should handle the case within 30 days after receiving the complaint. b) when handling divorce cases the People's Court should follow the law and divide up the property jointly owned by the two sides when the husband- wife relationship still existed; the court is forbidden from increasing the unreasonable economic burden of the wife simply because it was the wife that asked for the divorce. c) in proceedings relating to saving women and children who have been abducted for purposes of selling later, it is necessary to respect the will of the abducted women; no one is allowed to demand compensation from the victimized women, children, or their families."

[Current status on management and needs related to education and training programs set for new employees at the provincial Centers for Disease Control and Prevention, in China].

PubMed

Ma, J; Meng, X D; Luo, H M; Zhou, H C; Qu, S L; Liu, X T; Dai, Z

2016-06-01

In order to understand the current management status on education/training and needs for training among new employees working at the provincial CDC in China during 2012-2014, so as to provide basis for setting up related programs at the CDC levels. Based on data gathered through questionnaire surveys run by CDCs from 32 provincial and 5 specifically-designated cities, microsoft excel was used to analyze the current status on management of education and training, for new employees. There were 156 management staff members working on education and training programs in 36 CDCs, with 70% of them having received intermediate or higher levels of education. Large differences were seen on equipment of training hardware in different regions. There were 1 214 teaching staff with 66 percent in the fields or related professional areas on public health, in 2014. 5084 new employees conducted pre/post training programs, from 2012 to 2014 with funding as 750 thousand RMB Yuan. 99.5% of the new employees expressed the needs for further training while. 74% of the new staff members expecting a 2-5 day training program to be implemented. 79% of the new staff members claimed that practice as the most appropriate method for training. Institutional programs set for education and training at the CDCs need to be clarified, with management team organized. It is important to provide more financial support on both hardware, software and human resources related to training programs which are set for new stuff members at all levels of CDCs.

[Urología Clínica, bulletin of the Urology Service of Dr. Sánchez Covisa of the Hospital Provincial of Madrid, edited between 1928 and 1936].

PubMed

Pérez-Albacete, M; Saiz, A

2012-02-01

Make known the important urological work of Sanchez Covisa, third chief of the Urology Service of the Hospital Provincial de Madrid, who beginning in 1928 was able to transform and convert it into possibly the more outstanding one of its time in Spain, comparable to the best hospitals in foreign countries. We have analyzed the contents of the publication Urología Clínica, that collect the changes introduced and the work carried out in said service between 1928 and 1936, reflected in a careful yearly statistics on the care, operations and mortality in addition to the articles published by the members of the Service together with a short bibliographic review of each one. In 1914, he became chief of the Service, and after 14 years, was able to overcome all the obstacles and to extend and modernize the surgery rooms, hospitalization wards and examination resources. In 1931, once the changes were made, he began important clinical and scientific activity, and constituted one of the principal urological schools of the first half of the XXth century in our country. The prestige reached by the Urology Unit of the Hospital Provincial of Madrid attracted patients from all over Spain, many of them treated or operated on in their place of origin. This explains why the condition was complicated with some acceptable results. The quality and honesty of the Urology unit justify its qualification. The works in general are mere reviews and those regarding surgery of the uretero-intestinal shunt stand out. Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.

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

PubMed Central

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

2014-01-01

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

El Planetario Móvil de la Municipalidad de la ciudad de Córdoba

NASA Astrophysics Data System (ADS)

Suárez, F. E.; Campos, M.; Goldes, G. V.; Carranza, G. J.; Romero, R.; Juri, H. O.

Se describen las características y operatoria del nuevo Planetario Móvil. Se trata de un equipamiento de propiedad de la Municipalidad de la Ciudad de Córdoba que es operado por personal y en el predio de la Universidad, en virtud de un convenio suscripto entre ambas instituciones. El planetario consta de una cúpula inflable y de un proyector con programas alternativos que incluyen temas de astronomía, geografía, biología y medio ambiente, entre otros. En la actualidad opera en las instalaciones del Pabellón Argentina de la Ciudad Universitaria y recibe delegaciones escolares de todo el territorio provincial. El Planetario Móvil es parte de un proyecto más amplio de divulgación científica en el cual interactúan la Universidad y el Municipio.

Innovations in graduate public health education: the Instituto Nacional de Salud Pública.

PubMed

Valladares, Laura Magaña; Ávila, Mauricio Hernández

2015-03-01

During the past 10 years, the Instituto Nacional de Salud Pública (National Institute of Public Health) in Mexico has meticulously revised its educational model. This analysis resulted in the transformation of its educational model by tracing a new path in the pedagogical structure and faculty development to meet current challenges and students' needs. The first stage dealt with the national and international accreditation standards that came with the 21st century. The second stage responded to evidence of cognitive research showing that students are better prepared when they are engaged, active, and responsible for their own learning. This transformation was grounded on the use of information and communication technologies and on a competency-based educational approach that has led the expansion and innovation of educational practice.

Lessons from an Evaluation of a Provincial-Level Smoking Control Policy in Shanghai, China

PubMed Central

Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J.; Wong, Frank Y.; Berg, Carla J.

2013-01-01

Background The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. Objective To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). Methods A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Results Six months after implementation, 82% of the participants agreed that “legislation is enforced most of the time”. The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Conclusions Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future. PMID:24058544

Provincial Human Development Index, a Guide for Efficiency Level Analysis: The Case of Iran

PubMed Central

SABERMAHANI, Asma; BAROUNI, Mohsen; SEYEDIN, Hesam; ARYANKHESAL, Aidin

2013-01-01

Background Human Development Index (HDI) is a composite indicator that can show the impact of economic strategies on human life standards. The index is calculated by three main factors of income, education and health. This research studies the status of HDI across the Iranian provinces, its changes over time and the efficiency of provinces in using resources. Methods: The data for 2001 and 2009 was obtained from the Iranian Center of Statistics. Data envelopment analysis technique was used to analyze the data. To calculate the efficiency, Banker, Charnes and Cooper’s model was used. Results: The national mean for the HDI in 2001 was 0.717 while it grew to 0.747 in 2009. Except for one province, all others had an improved human development index. Low ranked provinces such as Sistan & Baluchistan and Kurdistan stayed at the bottom in 2009 as well. Some provinces such as Bushehr with developing oil industries, or those purposively benefited from national oil income showed good growth. In some provinces, such as Hormozgan, out-migration of manpower to its neighboring province, Bushehr, was associated with decrease of the provincial income level. The number of efficient provinces increased from 5 to 13 in 2009. Conclusion: Iran falls among countries with high human development index based on the 2009 data. However, the distribution of HDI status across provinces was highly varied and the difference between high- and low-developed provinces increased in 2009. The government needs to revise policies concerning distribution of resources among the provinces. PMID:23515434

An Eco-hydrologic Assessment of Small Experimental Catchments with Various Land Uses within the Panama Canal Watershed: Agua Salud Project

NASA Astrophysics Data System (ADS)

Crouch, T. D.; Ogden, F. L.; Stallard, R. F.; Smithsonian Tropical Research Institute, Panama Canal Watershed Experiment, Agua Salud Project

2010-12-01

Hydrological processes in the humid tropics are poorly understood and an important topic when it comes to water management in the seasonal tropics. The Smithsonian Tropical Research Institute, Panama Canal Watershed Experiment, Agua Salud Project, seeks to understand these processes and quantify the long-term effects of different land cover and uses across the Panama Canal Watershed. One of the project’s main objectives is to understand how reforestation effects seasonal stream flows. To meet this objective, a baseline characterization of hydrology on the small catchment scale is being assessed across different land uses typical in rural Panama. The small experimental catchments are found within Panama’s protected Soberania National Park and the adjacent headwaters of the Agua Salud and Mendoza Rivers, all of which are part of the greater Panama Canal Watershed. The land uses being monitored include a variety of control catchments as well as treated pasture sites. The catchments used for this study include a mature old regrowth forest, a 50% deforested or mosaic regrowth site, an active pasture and a monoculture invasive grass site (saccharum spontaneum) as experimental controls and two treated catchments that were recently abandoned pastures converted to teak and native species timber plantations. Installed instrumentation includes a network of rain gauges, v-notched weirs, atmometers, an eddy covariance system and an assortment of meteorological and automated geochemical sampling systems. Spatial, rainfall, runoff and ET data across these six geologically and topographically similar catchments are available from 2009 and 2010. Classic water balance and paired catchment techniques were used to compare the catchments on an annual, seasonal, and event basis. This study sets the stage for hydrologic modeling and for better understanding the effects of vegetation and land-use history on rainfall-runoff processes for the Agua Salud Project and Panama Canal

Salud America! Developing a National Latino Childhood Obesity Research Agenda.

PubMed

Ramirez, Amelie G; Chalela, Patricia; Gallion, Kipling J; Green, Lawrence W; Ottoson, Judith

2011-06-01

U.S. childhood obesity has reached epidemic proportions, with one third of children overweight or obese. Latino children have some of the highest obesity rates, a concern because they are part of the youngest and fastest-growing U.S. minority group. Unfortunately, scarce research data on Latinos hinders the development and implementation of evidence-based, culturally appropriate childhood obesity interventions. In response, the Salud America! network conducted a national Delphi survey among researchers and stakeholders to identify research priorities to address Latino childhood obesity and compare differences by occupation and race or ethnicity. The resulting first-ever National Latino Childhood Obesity Research Agenda provides a framework to stimulate research and collaboration among investigators, providers, and communities, and inform policy makers about the epidemic's seriousness and specific needs for priority funding. The agenda ranks family as the main ecological level to prevent Latino childhood obesity--followed by community, school, society, and individual-and ranks top research priorities in each level.

[Provincial public center for crisis intervention and psycho-social rehabilitation. A path towards communitary suicidology].

PubMed

Martínez, Carlos

2014-01-01

This work on the systematic comprehensive approach towards the Prevention and Postvencion of Suicide started to develop back in mid 2011 in Río Gallegos, capital of Santa Cruz Province. The first step on this development was a Pilot Plan for the Training of Professionals and also field intervention. The Center for Crisis Intervention and Psycho-social Rehabilitation was founded eight months later. The case-client in crisis plus family group- undergoes quantitative and qualitative evaluation by means of a triage system, all of which allows starting intensive face-to-face and also phone follow up according to the Crisis Intervention Model. Such intervention is developed by means of the participation in the "Grupo Sostén", the Adolescents Group if the client fits into that age, and also family relationship interviews as well as Multi-family meetings open to the Community. There is also a Community Team in the Center which performs collective assessment in schools, in conjunction with the "Equidad en Redes" Educational Specialty Team, belonging to the Provincial Education Council. The approach takes place on the field, and works as a screening step for the early detection of risk. Such risk is dealt with by means of short term intervention group programs involving the whole of the educational community. When facing situations of committed suicide there are interventions in communities to the interior of the province, fundamentally through the Hospital Team which works as the cluster convener for the social intersectoral frame-work.

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

PubMed

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

2016-12-01

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

Marine Ostracod Provinciality in the Late Ordovician of Palaeocontinental Laurentia and Its Environmental and Geographical Expression

PubMed Central

Mohibullah, Mohibullah; Williams, Mark; Vandenbroucke, Thijs R. A.; Sabbe, Koen; Zalasiewicz, Jan A.

2012-01-01

Background We examine the environmental, climatic and geographical controls on tropical ostracod distribution in the marine Ordovician of North America. Methodology/Principal Findings Analysis of the inter-regional distribution patterns of Ordovician Laurentian ostracods, focussing particularly on the diverse Late Ordovician Sandbian (ca 461 to 456 Ma) faunas, demonstrates strong endemicity at the species-level. Local endemism is very pronounced, ranging from 25% (e.g. Foxe basin) to 75% (e.g. Michigan basin) in each basin, a pattern that is also reflected in other benthic faunas such as brachiopods. Multivariate (ordination) analyses of the ostracod faunas allow demarcation of a Midcontinent Province and a southern Marginal Province in Laurentia. While these are most clearly differentiated at the stratigraphical level of the bicornis graptolite biozone, analyses of the entire dataset suggest that these provinces remain distinct throughout the Sandbian interval. Differences in species composition between the provinces appear to have been controlled by changes in physical parameters (e.g. temperature and salinity) related to water depth and latitude and a possible regional geographic barrier, and these differences persist into the Katian and possibly the Hirnantian. Local environmental parameters, perhaps operating at the microhabitat scale, may have been significant in driving local speciation events from ancestor species in each region. Conclusions/Significance Our work establishes a refined methodology for assessing marine benthic arthropod micro-benthos provinciality for the Early Palaeozoic. PMID:22900000

Chemical Industry, the Environment, and Russian Provincial Society: The Case of the Kokshan Chemical Works (1850-1925).

PubMed

Vinogradov, Andrei; Petriashin, Stanislav

2018-05-01

This article explores interactions between the chemical industry, the environment, and Russian provincial society in the late nineteenth and early twentieth centuries, using the example of the Kokshan chemical works, in the Elabuga District, Viatka Province, Russian Empire (today Mendeleevsk District, Republic of Tatarstan, Russian Federation). The plant's location facilitated its rapid development due to a number of factors, including a cheap labour force, the availability of raw materials, and the absence of local competition. However, the factory's development came in conjunction with the deterioration of the environment and subsequent health problems for employees and the surrounding population. Conflicts connected with the Kokshan works illustrate differences between this case and similar examples in Russia and Europe. In Viatka Province, the local community remained mostly silent regarding these issues, and made no demands for improving sanitary control and working conditions or reducing pollution; rather, it was distant activists who personally suffered no harm who intervened in the interest of social justice. The history of the company reflects the contrast between the transfer of European technological innovations to Russia and laborious efforts to increase national wealth on the one hand, and the exploitation of the environment and endangerment of workers' health on the other.

Endophytic root bacteria associated with the natural vegetation growing at the hydrocarbon-contaminated Bitumount Provincial Historic site.

PubMed

Blain, Natalie P; Helgason, Bobbi L; Germida, James J

2017-06-01

The Bitumount Provincial Historic site is the location of 2 of the world's first oil-extracting and -refining operations. Despite hydrocarbon levels ranging from 330 to 24 700 mg·(kg soil) -1 , plants have been able to recolonize the site through means of natural revegetation. This study was designed to achieve a better understanding of the plant-root-associated bacterial partnerships occurring within naturally revegetated hydrocarbon-contaminated soils. Root endophytic bacterial communities were characterized from representative plant species throughout the site by both high-throughput sequencing and culturing techniques. Population abundance of rhizosphere and root endosphere bacteria was significantly influenced (p < 0.05) by plant species and sampling location. In general, members of the Actinomycetales, Rhizobiales, Pseudomonadales, Burkholderiales, and Sphingomonadales orders were the most commonly identified orders. Community structure of root-associated bacteria was influenced by both plant species and sampling location. Quantitative real-time polymerase chain reaction was used to determine the potential functional diversity of the root endophytic bacteria. The gene copy numbers of 16S rRNA and 2 hydrocarbon-degrading genes (CYP153 and alkB) were significantly affected (p < 0.05) by the interaction of plant species and sampling location. Our findings suggest that some of the bacterial communities detected are known to exhibit plant growth promotion characteristics.

Innovations in Graduate Public Health Education: The Instituto Nacional de Salud Pública

PubMed Central

Ávila, Mauricio Hernández

2015-01-01

During the past 10 years, the Instituto Nacional de Salud Pública (National Institute of Public Health) in Mexico has meticulously revised its educational model. This analysis resulted in the transformation of its educational model by tracing a new path in the pedagogical structure and faculty development to meet current challenges and students’ needs. The first stage dealt with the national and international accreditation standards that came with the 21st century. The second stage responded to evidence of cognitive research showing that students are better prepared when they are engaged, active, and responsible for their own learning. This transformation was grounded on the use of information and communication technologies and on a competency-based educational approach that has led the expansion and innovation of educational practice. PMID:25706028

Innovative Tuberculosis Symposium held during Cuba Salud 2015.

PubMed

Chapman, Helena J; Armas Pérez, Luisa

2016-12-01

The fourth Tuberculosis (TB) Symposium, held during the Cuba Salud 2015 International Convention, highlighted advancements in research on TB and Mycobacterium tuberculosis (Mtb) by interdisciplinary teams from academic and federal institutions in Cuba, Colombia, Mexico, and the Dominican Republic. Delegates focused on the targets presented in the World Health Organization End TB Strategy for 2016-2035 and elaborated on four primary themes: 1) attention to vulnerable populations such as immunocompromised individuals, health care workers, and residents of long-term institutions such as prisons and nursing homes; 2) identification of active and latent TB cases through contact investigations; 3) spread and control of drug-resistant Mtb strains; and 4) advancements in the development of novel vaccines or "booster" immunizations. This international TB forum served as a platform for experts in diverse disciplines in these Latin American countries to discuss challenges faced by TB research and control programs, proposing novel research initiatives and promoting collaborative teamwork strategies for TB elimination. In solidarity, collaborative efforts in TB control require identification of symptomatic individuals, rapid diagnostic testing for TB, drug susceptibility assays on Mtb strains, and management that provide universal and gratuitous access to directly observed short-course therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Directly Improving the Quality of Radiation Treatment Through Peer Review: A Cross-sectional Analysis of Cancer Centers Across a Provincial Cancer Program.

PubMed

Rouette, Julie; Gutierrez, Eric; O'Donnell, Jennifer; Reddeman, Lindsay; Hart, Margaret; Foxcroft, Sophie; Mitera, Gunita; Warde, Padraig; Brundage, Michael D

2017-07-01

To describe the outcomes of peer review across all 14 cancer centers in Ontario. We identified all peer-reviewed, curative treatment plans delivered in Ontario within a 3-month study period from 2013 to 2014 using a provincial cancer treatment database and collected additional data on the peer-review outcomes. Considerable variation was found in the proportion of peer-reviewed plans across the centers (average 70.2%, range 40.8%-99.2%). During the study period, 5561 curative plans underwent peer review. Of those, 184 plans (3.3%) had changes recommended. Of the 184 plans, the changes were major (defined as requiring repeat planning or having a major effect on planning or clinical outcomes, or both) in 40.2% and minor in 47.8%. For the remaining 12.0%, data were missing. The proportions of recommended changes varied among disease sites (0.0%-7.0%). The disease sites with the most recommended changes to treatment plans after peer review and with the greatest potential for benefit were the esophagus (7.0%), uterus (6.7%), upper limb (6.3%), cervix and lower limb (both 6.0%), head and neck and bilateral lung (both 5.9%), right supraclavicular lymph nodes (5.7%), rectum (5.3%), and spine (5.0%). Although the heart is an organ at risk in left-sided breast treatment plans, the proportions of recommended changes did not significantly differ between the left breast treatment plans (3.0%, 95% confidence interval 2.0%-4.5%) and right breast treatment plans (2.4%, 95% confidence interval 1.5%-3.8%). The recommended changes were more frequently made when peer review occurred before radiation therapy (3.8%) than during treatment (1.4%-2.8%; P=.0048). The proportion of plans with recommended changes was not significantly associated with patient volume (P=.23), peer-review performance (P=.36), or center academic status (P=.75). Peer review of treatment plans directly affects the quality of care by identifying important clinical and planning changes. Provincial strategies are

[Bibliometric study of the original articles published in the Revista Española de Salud Pública (1991-2000). I. General indicators].

PubMed

Pérez Andrés, Cristina; Estrada Lorenzo, José Manuel; Villar Alvarez, Fernando; Rebollo Rodríguez, M José

2002-01-01

For some time, the most of reports have been being disseminated by way of scientific journals, bibliometric studies therefore being fundamental to the characterization and evaluation thereof. The purpose of this study is that of characterizing the Revista Española de Salud Pública based on the original articles published therein throughout the 1991-2000 period. Original articles published in the Revista Española de Salud Pública throughout the 1991-2000 period, all inclusive. A study has been made of the following variables: number of original articles, collaboration index or number of signing authors per study, productivity index, geographical spread and main subject. Throughout the 1991-2000 period, 290 original studies (52.3%) of a total of 555 studies were published. The number of originals averaged 29 originals/year A 4.5 degree of collaboration was found to exist for this journal (number signing authors/number originals) for the period under study. The annual of originals by Autonomous Community reveals in the Autonomous Community of Madrid (20.7%), Autonomous Community of Valencia (16.4%), Andalusia (16.1%) and Catalunya (10.0%) have published studies every year throughout the ten-year period under study. The most prevalent subject of all was that related to "Communicable disease" (86 originals), Primary Health Care" (34) and "Environmental pollution" (21). Generally speaking, it apparently follows that the Revista Española de Salud Pública continues to fall within the output-related indicators of other Spanish and foreign journals and that it has also evolved in keeping with the trend proper of scientific output in the biomedical field. Although "Communicable diseases" are not the main cause of mortality, they continue being the main subject more frequently studied.

Effect of a provincial system of stroke care delivery on stroke care and outcomes

PubMed Central

Kapral, Moira K.; Fang, Jiming; Silver, Frank L.; Hall, Ruth; Stamplecoski, Melissa; O’Callaghan, Christina; Tu, Jack V.

2013-01-01

Background: Systems of stroke care delivery have been promoted as a means of improving the quality of stroke care, but little is known about their effectiveness. We assessed the effect of the Ontario Stroke System, a province-wide strategy of regionalized stroke care delivery, on stroke care and outcomes in Ontario, Canada. Methods: We used population-based provincial administrative databases to identify all emergency department visits and hospital admissions for acute stroke and transient ischemic attack from Jan. 1, 2001, to Dec. 31, 2010. Using piecewise regression analyses, we assessed the effect of the full implementation of the Ontario Stroke System in 2005 on the proportion of patients who received care at stroke centres, and on rates of discharge to long-term care facilities and 30-day mortality after stroke. Results: We included 243 287 visits by patients with acute stroke or transient ischemic attack. The full implementation of the Ontario Stroke System in 2005 was associated with an increase in rates of care at stroke centres (before implementation: 40.0%; after implementation: 46.5%), decreased rates of discharge to long-term care facilities (before implementation: 16.9%; after implementation: 14.8%) and decreased 30-day mortality for hemorrhagic (before implementation: 38.3%; after implementation: 34.4%) and ischemic stroke (before implementation: 16.3%; after implementation: 15.7%). The system’s implementation was also associated with marked increases in the proportion of patients who received neuroimaging, thrombolytic therapy, care in a stroke unit and antithrombotic therapy. Interpretation: The implementation of an organized system of stroke care delivery was associated with improved processes of care and outcomes after stroke. PMID:23713072

Spatial Integration Analysis of Provincial Historical and Cultural Heritage Resources Based on Geographic Information System (gis) — a Case Study of Spatial Integration Analysis of Historical and Cultural Heritage Resources in Zhejiang Province

NASA Astrophysics Data System (ADS)

Luo, W.; Zhang, J.; Wu, Q.; Chen, J.; Huo, X.; Zhang, J.; Zhang, Y.; Wang, T.

2017-08-01

In China historical and cultural heritage resources include historically and culturally famous cities, towns, villages, blocks, immovable cultural relics and the scenic spots with cultural connotation. The spatial distribution laws of these resources are always directly connected to the regional physical geography, historical development and historical traffic geography and have high research values. Meanwhile, the exhibition and use of these resources are greatly influenced by traffic and tourism and other plans at the provincial level, and it is of great realistic significance to offer proposals on traffic and so on that are beneficial to the exhibition of heritage resources based on the research of province distribution laws. This paper takes the spatial analysis of Geographic Information System (GIS) as the basic technological means and all historical and cultural resources in China's Zhejiang Province as research objects, and finds out in the space the accumulation areas and accumulation belts of Zhejiang Province's historic cities and cultural resources through overlay analysis and density analysis, etc. It then discusses the reasons of the formation of these accumulation areas and accumulation belts by combining with the analysis of physical geography and historical geography and so on, and in the end, linking the tourism planning and traffic planning at the provincial level, it provides suggestions on the exhibition and use of accumulation areas and accumulation belts of historic cities and cultural resources.

Prevalence and Molecular Characterization of Cryptosporidium in Goats across Four Provincial Level Areas in China

PubMed Central

Mi, Rongsheng; Wang, Xiaojuan; Huang, Yan; Zhou, Peng; Liu, Yuxuan; Chen, Yongjun; Chen, Jun; Zhu, Wei; Chen, Zhaoguo

2014-01-01

This study assessed the prevalence, species and subtypes of Cryptosporidium in goats from Guangdong Province, Hubei Province, Shandong Province, and Shanghai City of China. Six hundred and four fecal samples were collected from twelve goat farms, and the overall infection rate was 11.4% (69/604). Goats infected with Cryptosporidium were found in eleven farms across four provincial areas, and the infection rate ranged from 2.9% (1/35) to 25.0% (9/36). Three Cryptosporidium species were identified. Cryptosporidium xiaoi (45/69, 65.2%) was the dominant species, followed by C. parvum (14/69, 20.3%) and C. ubiquitum (10/69, 14.5%). The infection rate of Cryptosporidium spp. was varied with host age and goat kids were more susceptible to be infected than adult goats. Subtyping C. parvum and C. ubiquitum positive samples revealed C. parvum subtype IIdA19G1 and C. ubiquitum subtype XIIa were the most common subtypes. Other C. parvum subtypes were detected as well, such as IIaA14G2R1, IIaA15G1R1, IIaA15G2R1 and IIaA17G2R1. All of these subtypes have also been detected in humans, suggesting goats may be a potential source of zoonotic cryptosporidiosis. This was the first report of C. parvum subtypes IIaA14G2R1, IIaA15G1R1 and IIaA17G2R1 infecting in goats and the first molecular identification of C. parvum and its subtypes in Chinese goats. PMID:25343501

"Sitting in different chairs:" roles of the community health workers in the Poder es Salud/Power for Health Project.

PubMed

Farquhar, S A; Wiggins, N; Michael, Y L; Luhr, G; Jordan, J; Lopez, A

2008-07-01

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs also discuss their own personal and professional development. The analysis of the interviews suggests that CHWs valued their multiple roles with Poder es Salud/Power for Health and their participation on the project's Steering Committee. Based on CHWs' descriptions of their work, this type of involvement appears to build the CHWs' leadership skills and sense of efficacy to create change in their communities. By serving as community organizers and participating as producers of research, rather than acting merely as a deliverer of the intervention activities, the CHWs were able to build skills that make them more successful as CHWs.

Twelve new species and fifty-three new provincial distribution records of Aleocharinae rove beetles of Saskatchewan, Canada (Coleoptera, Staphylinidae).

PubMed

Klimaszewski, Jan; Larson, David J; Labrecque, Myriam; Bourdon, Caroline

2016-01-01

One hundred twenty species of aleocharine beetles (Staphylinidae) are recognized in the province of Saskatchewan. Sixty-five new provincial records, including twelve new species and one new North American record, are presented. Oligota inflata (Mannerheim), a Palearctic species, is newly recorded for North America. The following twelve species are described as new to science: Acrotona pseudopygmaea Klimaszewski & Larson, sp. n., Agaricomorpha pulchra Klimaszewski & Larson, sp. n. (new genus record for Canadian fauna), Aleochara elisabethae Klimaszewski & Larson, sp. n., Atheta (Dimetrota) larsonae Klimaszewski & Larson, sp. n., Atheta (Microdota) pseudopittionii Klimaszewski & Larson, sp. n., Atheta (Microdota) spermathecorum Klimaszewski & Larson, sp. n., Atheta (sensu lato) richardsoni Klimaszewski & Larson, sp. n., Brachyusa saskatchewanae Klimaszewski & Larson, sp. n., Dochmonota langori Klimaszewski & Larson, sp. n., Dochmonota simulans Klimaszewski & Larson, sp. n., Dochmonota websteri Klimaszewski & Larson, sp. n., and Oxypoda domestica Klimaszewski & Larson, sp. n. Colour images of habitus and black and white images of the median lobe of the aedeagus, spermatheca, and tergite and sternite VIII are presented for all new species, Oligota inflata Mannerheim and Dochmonota rudiventris (Eppelsheim). A new synonymy is established: Tetralina filitarsus Casey, syn. n. = Tetralina helenae Casey, now placed in the genus Brachyusa Mulsant & Rey.

Twelve new species and fifty-three new provincial distribution records of Aleocharinae rove beetles of Saskatchewan, Canada (Coleoptera, Staphylinidae)

PubMed Central

Klimaszewski, Jan; Larson, David J.; Labrecque, Myriam; Bourdon, Caroline

2016-01-01

Abstract One hundred twenty species of aleocharine beetles (Staphylinidae) are recognized in the province of Saskatchewan. Sixty-five new provincial records, including twelve new species and one new North American record, are presented. Oligota inflata (Mannerheim), a Palearctic species, is newly recorded for North America. The following twelve species are described as new to science: Acrotona pseudopygmaea Klimaszewski & Larson, sp. n., Agaricomorpha pulchra Klimaszewski & Larson, sp. n. (new genus record for Canadian fauna), Aleochara elisabethae Klimaszewski & Larson, sp. n., Atheta (Dimetrota) larsonae Klimaszewski & Larson, sp. n., Atheta (Microdota) pseudopittionii Klimaszewski & Larson, sp. n., Atheta (Microdota) spermathecorum Klimaszewski & Larson, sp. n., Atheta (sensu lato) richardsoni Klimaszewski & Larson, sp. n., Brachyusa saskatchewanae Klimaszewski & Larson, sp. n., Dochmonota langori Klimaszewski & Larson, sp. n., Dochmonota simulans Klimaszewski & Larson, sp. n., Dochmonota websteri Klimaszewski & Larson, sp. n., and Oxypoda domestica Klimaszewski & Larson, sp. n. Colour images of habitus and black and white images of the median lobe of the aedeagus, spermatheca, and tergite and sternite VIII are presented for all new species, Oligota inflata Mannerheim and Dochmonota rudiventris (Eppelsheim). A new synonymy is established: Tetralina filitarsus Casey, syn. n. = Tetralina helenae Casey, now placed in the genus Brachyusa Mulsant & Rey. PMID:27587977

‘For me… it’s a miracle’: injecting beauty among kathoeis in a provincial Thai city

PubMed Central

Poompruek, Panoopat; Boonmongkon, Pimpawun; Guadamuz, Thomas E.

2014-01-01

Background The Thai term kathoei refers to non-gender-normative females, males and intersexual individuals at different stages of the transitional spectrum with recognized social and cultural roles in society. Nevertheless, kathoeis are only tolerated in Thai society. Many kathoeis seek social acceptance through beauty and turn to the off-label injection of various ‘beauty drugs’. Methods The first author conducted an ethnographic study of injection parties at a wedding studio in a Central Thai provincial city between April and September 2011. Data were gathered through participant observation, focus group discussions and narrative interviews with six participants. All data were collected and analyzed in Thai, and later translated. Findings While injection parties provide opportunities for kathoeis to socialize, bond, and share experiential knowledge on chemically-assisted transformation, they also reproduce ideologies of gender, beauty and sexuality that reinforce the notion that if a kathoei is to maintain her beauty, she must use medicines more frequently and in higher doses. Conclusion Injection parties among Thai kathoeis feature drug use that is entirely reasonable in terms of their own lay knowledge. Empowering kathoeis, by providing accessible information on chemicals and health in a way that reflects the complexity and diversity of their practices, would be one way to reduce health risks. Society must give more long-term options to kathoeis to build their sense of self, based on things besides being beautiful. PMID:25047007

Implementing a Randomized Controlled Trial through a Community-Academia Partnered Participatory Research: Arte con Salud Research-Informed Intervention.

PubMed

Noboa-Ortega, Patricia; Figueroa-Cosme, Wanda I; Feldman-Soler, Alana; Miranda-Díaz, Christine

2017-06-01

"Arte con Salud" is an HIV/AIDS prevention intervention tailored for Puerto Rican women who have sex with men. The intervention curriculum was refined through a community-academic collaboration between Taller Salud, the UPRCayey Campus, and the UCC-School of Medicine, subsided in 2012-13 by PRCTRC. The collaboration has been crucial to validate the impact of using art as a tool to facilitate sexual negotiation skills and safer sexual practices among adult women have sex with men participating in HIV prevention education. This article describes the vision, valley, victory phases endured to establish a community-academia partnership based on the CPPR framework as an effective mean to implement a randomized controlled trial intervention (RCT). We also discuss the barriers, outcomes, and lessons learned from this partnership. Some of the identified solutions include: setting goals to secure funding, regular meetings, and the inclusion of undergraduate level students to assist in the implementation of the intervention. These solutions helped to build trust among the community and academic partners. As a result of this collaboration, a total of 86 participants were enrolled and 5 competitive research grants have been submitted. The community-academic collaboration was essential in order to build a solid research infrastructure that addresses the complexities of HIV prevention education among groups of Puerto Rican women.

Representaciones sociales sobre la problemática de Chagas en un servicio de salud comunitaria del Gran La Plata, Buenos Aires, Argentina.

PubMed

Sanmartino, Mariana; Amieva, Carolina; Medone, Y Paula

2017-03-01

Hablar de Chagas es hablar de una problemática compleja, definida por elementos de carácter biomédico, epidemiológico, sociocultural y político, que se conjugan dinámicamente. En este trabajo buscamos identificar y analizar las representaciones sobre Chagas de los integrantes del equipo de salud de un centro de atención periurbano de la ciudad de La Plata, Argentina. Mediante un abordaje cualitativo, se realizaron entrevistas semiestructuradas y se analizaron las respuestas con la técnica del análisis de contenido. Los resultados mostraron que la mayor parte de las personas entrevistadas no contempla al Chagas como una problemática en su contexto laboral cotidiano y manifiestan un fuerte sesgo biologicista en su formación profesional. Con este trabajo señalamos la urgente necesidad de reflexionar críticamente en torno a la formación de los profesionales de la salud en relación a problemáticas socioambientales complejas de importancia regional, como lo es el Chagas.

[Field investigation of occupational disease diagnosis in Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014: an analysis of 136 cases].

PubMed

Fan, C Y; Li, X D; Wen, W; Wang, Y Y; Zhang, Y; Lang, L

2016-04-20

To investigate the characteristics of 136 patients with occupational diseases, to summarize key techniques used in field investigation, and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis. Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014. A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014, and there were 66 cases of leukemia, 18 cases of suspected occupational benzene poisoning, 12 cases of suspected occupational handarm vibration disease, and 11 cases of suspected pneumoconiosis. Of all these patients, 41.91% were engaged in at least three types of work, 70.59% were exposed to at least three types of chemicals, 25.74% experienced changes in technical processes and chemicals, and 47.06% had disputes on the chemicals they were exposed to during verification by both parties. Occupational hazard factors were detected. Most samples (358)were used to measure benzene concentration in workplace air, among which 11.7% had a benzene concentration of >6.00 mg/m(3)(exceeding standard), 13.41% had a benzene concentration of 3.26~6.00 mg/m(3), 75.42% had a benzene concentration of<0.03 to <3.25 mg/m(3). The samples of suspected occupational hand-arm vibration disease, suspected pneumoconiosis, and suspected occupational noiseinduced hearing loss had high overstandard rates (100%, 93.8%, and 83.3%, respectively). Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia, suspected occupational benzene poisoning, suspected occupational hand-arm vibration disease, and suspected pneumoconiosis. The key aspects of field investigation include confirmation of the history of occupational

Sentido de coherencia y mapa de activos para la salud en jóvenes presos de la Comunidad Valenciana en España.

PubMed

Vera-Remartínez, Enrique J; Paredes-Carbonell, Joan J; Aviñó Juan-Ulpiano, Dory; Jiménez-Pérez, Mercedes; Araujo Pérez, Rosa; Agulló-Cantos, José M; Mora Notario, Almudena

2017-09-01

Estudio realizado desde el enfoque de la salutogénesis que pretende determinar el sentido de coherencia (SOC) en jóvenes presos de la Comunidad Valenciana en España y elaborar un mapa de activos para la salud dirigido a promover la salud en esta población. Se utilizó el test "SOC-13" y un cuestionario de preguntas abiertas elaborado ad hoc, el cual autocompletaron los internos de 18 a 22 años de edad, de los tres centros penitenciarios de la región. Participaron 124 jóvenes varones (ya que no había ninguna mujer) y se recogieron variables sociodemográficas y penitenciarias. En el análisis cuantitativo, las variables categóricas se expresaron como frecuencias absolutas y relativas; y las cuantitativas, mediante medias con intervalos de confianza (IC) al 95%. Se realizó un estudio comparativo bivariante, utilizando las siguientes pruebas: Student t-test, análisis de variación (ANOVA), Wilcoxon y Ji-cuadrado. Del cuestionario de preguntas abiertas, se realizó un análisis cualitativo descriptivo temático de los activos identificados, clasificándolos en: internos (recursos personales, en relación con los demás y capacidad para realizar comportamientos saludables) y externos (personas, grupos, instituciones y espacios físicos, situados tanto dentro como fuera de prisión). La edad media fue de 21,1 años (IC 95%: 20,8-21,3); y el SOC de 52,4 (IC 95%: 50,5-54,3), de entre un valor mínimo de 13 y máximo de 91 para la prueba. Los internos del centro penitenciario que ofrecía más actividades escolares y deportivas obtuvieron una puntuación mayor en la dimensión de significatividad del SOC ( p = 0,024), y los internos inmigrantes presentaron un SOC superior ( p = 0,037) a los españoles, en los tres centros. Los jóvenes identificaron los activos internos que cualitativamente se vinculan con las dimensiones de comprensibilidad, manejabilidad y significatividad del SOC; y los activos externos, sobre todo los amigos, familiares y espacios

Erasmus Darwin, Herbert Spencer, and the origins of the evolutionary worldview in British provincial scientific culture, 1770-1850.

PubMed

Elliott, Paul

2003-03-01

The significance of Herbert Spencer's evolutionary philosophy has been generally recognized for over a century, as the familiarity of his phrase "survival of the fittest" indicates, yet accounts of the origins of his system still tend to follow too closely his own description, written many decades later. This essay argues that Spencer's own interpretation of his intellectual development gives an inadequate impression of the debt he owed to provincial scientific culture and its institutions. Most important, it shows that his evolutionism was originally stimulated by his association with the Derby philosophical community, for it was through this group--of which his father, who also appears to have espoused a deistic evolutionary theory, was a member--that he was first exposed to progressive Englightenment social and educational philosophies and to the evolutionary worldview of Erasmus Darwin, the first president of the Derby Philosophical Society. Darwin's scheme was the first to incorporate biological evolution, associationist psychology, evolutionary geology, and cosmological developmentalism. Spencer's own implicit denials of the link with Darwin are shown to be implausible in the face of Darwin's continuing influence on the Derby savants, the product of insecurity in his later years when he feared for his reputation as Lamarckism became increasingly untenable.

Atmospheric pollution reduction effect and regional predicament: An empirical analysis based on the Chinese provincial NOx emissions.

PubMed

Ding, Lei; Liu, Chao; Chen, Kunlun; Huang, Yalin; Diao, Beidi

2017-07-01

Atmospheric pollution emissions have become a matter of public concern in recent years. However, most of the existing researches on NOx pollution are from the natural science and technology perspective, few studies have been conducted from an economic point, and regional differences have not been given adequate attention. This paper adopts provincial panel data from 2006 to 2013 and the LMDI model to analyze the key driving factors and regional dilemmas of NOx emissions. The results show that significant regional disparities still exit on NO x emissions and its reduction effect 27 provinces didn't accomplish their corresponding reduction targets. Economic development factor is the dominating driving factor of NO x emissions during the study period, while energy efficiency and technology improvement factors offset total NO x emissions in the majority of provinces. In addition, the industrial structure factor plays a more significant role in reducing the NO x emissions after 2011. Therefore, the government should consider all these factors as well as regional heterogeneity in developing appropriate pollution mitigating policies. It's necessary to change NOx emissions control attitude from original key areas control to divided-zone control, not only attaches great importance to the reduction of the original key areas, but also emphasizes the new potential hotspots with high NO x emissions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program.

PubMed

Rangel Gomez, Maria Gudelia; Tonda, Josana; Zapata, G Rogelio; Flynn, Michael; Gany, Francesca; Lara, Juanita; Shapiro, Ilan; Rosales, Cecilia Ballesteros

2017-01-01

While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud -Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.

Perspectivas para mejorar la salud sexual de las minorías sexuales y de identidad de género en Guatemala

PubMed Central

Alonzo, Jorge; Mann, Lilli; Simán, Florence; Sun, Christina J.; Andrade, Mario; Villatoro, Guillermo; Rhodes, Scott D.

2016-01-01

Resumen Las minorías sexuales y de identidad de género en Guatemala son afectadas de manera desproporcionada por el VIH y otras infecciones transmitidas sexualmente (ITS). Sin embargo, poco se sabe de los factores que contribuyen al riesgo de infección en estas minorías. Investigadores de Estados Unidos y Guatemala quisimos informarnos sobre las necesidades de salud sexual e identificar características de programas de prevención de VIH/ITS para estas minorías. Llevamos a cabo 8 grupos focales con hombres gay, bisexuales y personas transgénero y entrevistas en profundidad con líderes comunitarios. Utilizamos el Método Comparativo Constante para analizar las transcripciones. Identificamos 24 factores que influyen en la salud sexual y 16 características de programas para reducir el riesgo de VIH/ITS en estas poblaciones. La identificación de factores de conductas sexuales de riesgo y de características de programas potencialmente efectivos ofrece gran potencial para desarrollar intervenciones que contribuyan a reducir el riesgo de infección por VIH/ITS en estas minorías en Guatemala. PMID:27494000

The Environmental Health/Home Safety Education Project: a successful and practical U.S.-Mexico border initiative.

PubMed

Forster-Cox, Susan C; Mangadu, Thenral; Jacquez, Benjamín; Fullerton, Lynne

2010-05-01

The Environmental Health/Home Safety Education Project (Proyecto de Salud Ambiental y Seguridad en el Hogar) has been developed in response to a wide array of severe and often preventable environmental health issues occurring in and around homes on the U.S.-Mexico border. Utilizing well-trained community members, called promotoras , homes are visited and assessed for potential environmental hazards, including home fire and food safety issues. Data analyzed from project years 2002 to 2005 shows a significant impact in knowledge levels and initial behavior change among targeted participants as it relates to fire and food safety issues. Since the initiation of the project in 1999, hundreds of participants have improved their quality of life by making their homes safer. The project has proven to be sustainable, replicable, flexible, and attractive to funders.

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

PubMed

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

2018-02-21

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

The effectiveness of a community health program in improving diabetes knowledge in the Hispanic population: Salud y Bienestar (Health and Wellness).

PubMed

Cruz, Yanira; Hernandez-Lane, Maria-Eugenia; Cohello, Janet I; Bautista, Christian T

2013-12-01

We evaluated the effectiveness of the Salud y Bienestar program to deliver diabetes education in the Hispanic population in the United States. This program uses a community outreach model where community health promoters are trained and then they deliver education to other community members regarding diabetes disease, risk factors, and ways to prevent and control disease. This intervention applies a one-group pre- and post-test design to improve diabetes knowledge. The intervention carried out in the states of California, Texas, and Washington DC. A total of 1,413 participants were enrolled. Of these, 73% were females, 46% were 65 years or older, 59% were Mexican, 64% had at least elementary education, 56% had lived in the US for more than 20 years, and 38% participants were self-reported diabetic. Among diabetic participants, a significant improvement was observed on diabetes knowledge when comparing pre- and post-test scores (13.7 vs. 18.6, P < 0.001; Cohen's d = 1.2). Among non-diabetic participants, diabetes knowledge also increased significantly after one-single training session (12.9 vs. 18.2, P < 0.001; Cohen's d = 1.2). The Salud y Bienestar program conducted by community health workers was effective approach to improving diabetes knowledge in the Hispanic population.

Salud para su Corazón: a community-based Latino cardiovascular disease prevention and outreach model.

PubMed

Alcalay, R; Alvarado, M; Balcazar, H; Newman, E; Huerta, E

1999-10-01

Cardiovascular disease (CVD) is the leading cause of death for Latinos living in the United States. This population is generally unaware of important lifestyle or behavioral changes that can prevent CVD. The National Heart, Lung, and Blood Institute (NHLBI) designed and implemented Salud para su Corazón (Health for Your Heart), a culturally appropriate, community-based, theory-driven intervention model. NHLBI's goals were: (1) to design an intervention model appropriate to Latino populations; (2) to pilot test the model in a specific community with the objectives of increasing awareness about heart disease, raising knowledge about CVD prevention, and promoting heart-healthy lifestyles; and (3) to disseminate the model and the materials developed to other communities with similar needs. An agency-community partnership, under the leadership of the Community Alliance for Heart Health, guided all stages of the community intervention project. The multimedia bilingual community intervention included television telenovela format public service announcements (PSAs), radio programs, brochures, recipe booklets, charlas, a promotores training manual, and motivational videos. An evaluation survey assessed the impact of the intervention. A pre-post intervention survey was conducted with more than 300 participants, and results showed that the respondents were substantially more aware of risk factors for CVD, and had greatly increased their knowledge of ways to prevent heart disease. Dissemination efforts have resulted in numerous requests by health organizations, universities, and health maintenance organizations (HMOs) for educational materials and communication strategies produced by Salud para su Corazón. In addition, Univision, the largest Spanish-language broadcast television network, is airing the initiative's PSAs. Also, training seminars for promotores are being conducted in different regions of the United States, and several locations are planning to replicate this

Theropod Fauna from Southern Australia Indicates High Polar Diversity and Climate-Driven Dinosaur Provinciality

PubMed Central

Benson, Roger B. J.; Rich, Thomas H.; Vickers-Rich, Patricia; Hall, Mike

2012-01-01

hallmark ‘Gondwanan’ fauna of South America and Africa may therefore reflect climate-driven provinciality, not vicariant evolution driven by continental fragmentation. However, vicariance may still be detected at lower phylogenetic levels. PMID:22615916

Improvement actions in waste management systems at the provincial scale based on a life cycle assessment evaluation

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

Rigamonti, L., E-mail: lucia.rigamonti@polimi.it; Falbo, A.; Grosso, M.

Highlights: • LCA was used for evaluating the performance of four provincial waste management systems. • Milano, Bergamo, Pavia and Mantova (Italy) are the provinces selected for the analysis. • Most of the data used to model the systems are primary. • Significant differences were found among the provinces located in the same Region. • LCA was used as a decision-supporting tool by Regione Lombardia. - Abstract: This paper reports some of the findings of the ‘GERLA’ project: GEstione Rifiuti in Lombardia – Analisi del ciclo di vita (Waste management in Lombardia – Life cycle assessment). The project was devotedmore » to support Lombardia Region in the drafting of the new waste management plan by applying a life cycle thinking perspective. The present paper mainly focuses on four Provinces in the Region, which were selected based on their peculiarities. Life cycle assessment (LCA) was adopted as the methodology to assess the current performance of the integrated waste management systems, to discuss strengths and weaknesses of each of them and to design their perspective evolution as of year 2020. Results show that despite a usual business approach that is beneficial to all the provinces, the introduction of technological and management improvements to the system provides in general additional energy and environmental benefits for all four provinces. The same improvements can be easily extended to the whole Region, leading to increased environmental benefits from the waste management sector, in line with the targets set by the European Union for 2020.« less

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

PubMed

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

2018-02-26

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

ESTIGMA Y VIH/SIDA ENTRE PADRES/MADRES Y ADOLESCENTES PUERTORRIQUEÑOS/AS

PubMed Central

Pérez, Grace Rosado; Reyes, Glendalys Rivera; Villanueva, Victoria Larrieux; Torres, Gilliam J. Torres; Díaz, Elba Betancourt; Varas-Díaz, Nelson; Villaruel, Antonia

2016-01-01

La comunicación entre padres/madres y adolescentes sobre el tema de la sexualidad es importante para el desarrollo de la salud de personas jóvenes. Dicha comunicación puede verse negativamente impactada por actitudes estigmatizantes hacia el tema del VIH/SIDA. El objetivo de este estudio fue identificar actitudes estigmatizantes hacia el VIH/SIDA entre padres/madres y adolescentes puertorriqueños/as. Este esfuerzo es parte del Proyecto Cuídalos, dirigido a probar una intervención en formato electrónico que busca aumentar la comunicación sobre sexualidad y salud entre padres/madres y adolescentes mediante un diseño experimental con 458 diadas de padres/madres y adolescentes de 13 a 17 años. Para propósitos de este artículo reportamos estadísticas descriptivas sobre estigma hacia el VIH/SIDA con la información recopilada en la medición basal. Tanto adultos/as como adolescentes mostraron actitudes estigmatizantes hacia el VIH/SIDA. A la luz de los resultados es necesario continuar desarrollando intervenciones para la reducción de estigma en esta población. Los/as padres/madres pueden ser un recurso invaluable para reducir el estigma en los/as jóvenes, y prevenir conductas sexuales de riesgo e infecciones. PMID:27099649

El rol de Ia colaboracion y el Modelo de Aprendizaje Basado en Proyectos (ABPr) mediante el lente de la Teoria de Actividad (CHAT): un estudio de caso con estudiantes de 9no grado

NASA Astrophysics Data System (ADS)

Delgado, Isabel C.

Los modelos de eensenanza y aprendizaje constructivistas conceptualizan el aprendizaje como un proceso activo. El modelo de Aprendizaje Basado en Proyectos (ABPr) se distingue por una serie de componentes, entre los cuales se destaca el aspecto colaborativo y cooperativo como un reto al momento de su implantacion. Son pocas las investigaciones que se concentran en este aspecto del modelo. En este estudio, se analizaron las diversas interacciones que surgen durante la implantacion de una unidad curricular sobre el tema de Geologia de Puerto Rico, la cual se diseno con el modelo ABPr cuyo enfoque es orientacion a proyectos. Particularmente, se examinaron las interacciones sociales que surgen entre los pares y entre pares y docente durante el proceso de planificacion y desarrollo de los productos finales, al igual que las interacciones entre los estudiantes y el material didactico en estas etapas del modelo. La investigacion es de tipo cualitativo e incorpora como diseno el estudio de caso. Las diversas interacciones constituyen la unidad de analisis. En el estudio participaron 19 estudiantes de 9no grado, a quienes se organizaron en 5 grupos colaborativos por temas de interes (Pangea, Placas tectonicas, Volcanes, Tsunamis y Terremotos). Las tecnicas que se utilizaron para recopilar los datos fueron: observaciones participativas, grupos focales y analisis de documentos (cuadernos reflexivos y respuestas de los estudiantes a la pregunta central del proyecto). Para el analisis de los datos se aplico la teoria de actividad (CHAT) que concentra la unidad de analisis en la actividad humana en un contexto particular. Los resultados del estudio senalan que las interacciones entre pares, entre pares y docente, asi como entre estudiantes y material didactico son fundamentales en el proceso de aprendizaje. Una mayor interaccion entre pares durante las etapas de planificar y desarrollar los productos finales de la unidad, promueve una mejor comprension de los conceptos de la

[Use of evidence in heath policies and programs contributions of the instituto nacional de salud].

PubMed

Gutierrez, Ericson L; Piazza, Marina; Gutierrez-Aguado, Alfonso; Hijar, Gisely; Carmona, Gloria; Caballero, Patricia; Reyes, Nora; Canelo, Carlos; Aparco, Juan Pablo; Tejada, Romina A; Bolaños-Díaz, Rafael; Saravia, Silvia; Gozzer, Ernesto

2016-01-01

This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.

[Bibliometric study of original articles in the Revista Española de Salud Pública (1991-2000). Part II: authors' productivity, their institutions and geographical areas].

PubMed

Estrada Lorenzo, José Manuel; Villar Alvarez, Fernando; Pérez Andrés, Cristina; Rebollo Rodríguez, M José

2003-01-01

When characterizing a scientific journal from the bibliometric standpoint, it is of importance to know how many authors were involved in the studies published as well as the geographical areas where these authors are located and the type of institutions by which they are employed. The aim of this article is that of analyzing the geographical spread of these authors and the institutions by which they are employed, as well as its evolution as regards the original articles published in the Revista Española de Salud Pública throughout the 1991-2000 period. Of the original articles published in the Revista Española de Salud Pública throughout the studied ten-year period, a calculation has been made as to the total number of authors, the number of occasional authors (authors having published solely one article), transitivity index, the ratio between the number of male and female authors, the productivity of the authors and their institutions and the spread of authors and the institutions by which they are employed by Autonomous Communities. Of the original articles published in the Revista Española de Salud Pública throughout the 1991-2000 period, a total of 1,052 different authors were involved, 1,000 of whom were Spanish and 52 foreigners. The ratio of male authors to female authors for the period in question was 1.29. The Autonomous Communities from which the largest number of authors came were Community of Madrid (16.3%), Andalusia (13.4%) and the Community of Valencia (12.5%). The institutions by which the authors are employed are located most often in Community of Madrid (16.5%), in Community of Valencia (11.3%) and Andalusia and Catalonia (10.5%). A total of 37.6% of the authors work at centers devoted to health care, followed by authors who work at Universities (26.3%). On calculating the spread of the type of institution by Autonomous Communities, in the Community of Madrid and in the Community of Valencia and Andalusia, the most frequent institution is

Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud.

PubMed

O'Brien, Matthew J; Garland, Joseph M; Murphy, Katie M; Shuman, Sarah J; Whitaker, Robert C; Larson, Steven C

2014-01-01

Given the large influence of social conditions on health, physicians may be more effective if they are trained to identify and address social factors that impact health. Despite increasing interest in teaching the social determinants of health in undergraduate medical education, few models exist. We present a 9-month pilot course on the social determinants of health for medical and other health professional students, which is based at Puentes de Salud, Philadelphia, PA, USA, a community health center serving a Latino immigrant population. This service-learning course, called the Health Scholars Program (HSP), was developed and implemented by volunteer medical and public health faculty in partnership with the community-based clinic. The HSP curriculum combines didactic instruction with service experiences at Puentes de Salud and opportunities for critical reflection. The HSP curriculum also includes a longitudinal project where students develop, implement, and evaluate an intervention to address a community-defined need. In our quantitative evaluation, students reported high levels of agreement with the HSP meeting stated course goals, including developing an understanding of the social determinants of health and working effectively with peers to implement community-based projects. Qualitative assessments revealed students' perception of learning more about this topic in the HSP than in their formal medical training and of developing a long-term desire to serve vulnerable communities as a result. Our experience with the HSP suggests that partnerships between academic medical centers and community-based organizations can create a feasible, effective, and sustainable platform for teaching medical students about the social determinants of health. Similar medical education programs in the future should seek to achieve a larger scale and to evaluate both students' educational experiences and community-defined outcomes.

smokeSALUD: exploring the effect of demographic change on the smoking prevalence at municipality level in Austria.

PubMed

Tomintz, Melanie; Kosar, Bernhard; Clarke, Graham

2016-10-07

Reducing the smoking population is still high on the policy agenda, as smoking leads to many preventable diseases, such as lung cancer, heart disease, diabetes, and more. In Austria, data on smoking prevalence only exists at the federal state level. This provides an interesting overview about the current health situation, but for regional planning authorities these data are often insufficient as they can hide pockets of high and low smoking prevalence in certain municipalities. This paper presents a spatial-temporal change of estimated smokers for municipalities from 2001 and 2011. A synthetic dataset of smokers is built by combining individual large-scale survey data and small area census data using a deterministic spatial microsimulation approach. Statistical analysis, including chi-square test and binary logistic regression, are applied to find the best variables for the simulation model and to validate its results. As no easy-to-use spatial microsimulation software for non-programmers is available yet, a flexible web-based spatial microsimulation application for health decision support (called simSALUD) has been developed and used for these analyses. The results of the simulation show in general a decrease of smoking prevalence within municipalities between 2001 and 2011 and differences within areas are identified. These results are especially valuable to policy decision makers for future planning strategies. This case study shows the application of smokeSALUD to model the spatial-temporal changes in the smoking population in Austria between 2001 and 2011. This is important as no data on smoking exists at this geographical scale (municipality). However, spatial microsimulation models are useful tools to estimate small area health data and to overcome these problems. The simulations and analysis should support health decision makers to identify hot spots of smokers and this should help to show where to spend health resources best in order to reduce health

[Knowledge and practices regarding cystic echinococcosis and trichinellosis in users and companions of users of the Hospital Comunitario de Salud Familiar El Carmen, Biobio Region, Chile].

PubMed

Lisboa-Navarro, Raúl; González, Jorge; Junod, Tania; Melín-Coloma, Millaray; Landaeta-Aqueveque, Carlos

2016-08-01

We surveyed users of the Hospital Comunitario de Salud Familiar El Carmen and their companions to analyze knowledge and practices regarding cystic echinococcosis and trichinellosis. Most people recognized risky practices. Previous attendance at talks and working in agricultural-livestock enhanced the knowledge. Age, sex and formal education were not associated with the knowledge. Knowledge was not associated with practices.

ACTITUDES HACIA LA COMUNICACIÓN SEXUAL ENTRE PADRES/MADRES Y ADOLESCENTES EN PUERTO RICO*

PubMed Central

Fernández, Ana Michelle; McFarlane, Melvin Negrón; González, Ricardo; Díaz, Leslie; Betancourt-Díaz, Elba; Cintrón-Bou, Francheska; Varas-Díaz, Nelson; Villarruel, Antonia

2017-01-01

RESUMEN La comunicación sobre sexualidad entre padres/madres y adolescentes enfrenta dificultades particulares producto de factores socioculturales. Este estudio tuvo como objetivo documentar las actitudes de padres/madres y adolescentes hacia la comunicación sobre temas de sexualidad. Los resultados emanan de la medición inicial del Proyecto Cuídalos. Los datos de este estudio forman parte de un estudio amplio que evaluó un módulo interactivo basado en la web para mejorar comunicación sobre temas de salud entre padres/madres y adolescentes entre 13–17 años. En este artículo, reportamos datos basales que contestaron los/as participantes sobre comodidad al hablar sobre temas de salud sexual. La muestra, de los datos aquí expuestos, estuvo compuesta por 458 diadas de madres/padres y sus hijos/as adolescentes (n=916). Se realizó análisis de frecuencias y medidas de tendencia central con los datos obtenidos inicialmente. La edad promedio de los adolescentes fue de 15 años, de los que un 15% se encontraban activos sexualmente. Los/as adolescentes tienen mejor disposición que los/as padres/madres para hablar sobre sexualidad. Sin embargo, los/as padres/madres entienden que comparten suficiente información sobre temas relacionados a la sexualidad. Los/as padres/madres y adolescentes reportaron algún grado de dificultad e incomodidad al hablar sobre métodos específicos de prevención. Los resultados destacan la necesidad de incorporar a los/as padres/madres en intervenciones con adolescentes sobre temas de salud sexual. En Puerto Rico es necesario desarrollar programas dirigidos a minimizar las conductas sexuales de alto riesgo en jóvenes. PMID:28736599

rAvis: an R-package for downloading information stored in Proyecto AVIS, a citizen science bird project.

PubMed

Varela, Sara; González-Hernández, Javier; Casabella, Eduardo; Barrientos, Rafael

2014-01-01

Citizen science projects store an enormous amount of information about species distribution, diversity and characteristics. Researchers are now beginning to make use of this rich collection of data. However, access to these databases is not always straightforward. Apart from the largest and international projects, citizen science repositories often lack specific Application Programming Interfaces (APIs) to connect them to the scientific environments. Thus, it is necessary to develop simple routines to allow researchers to take advantage of the information collected by smaller citizen science projects, for instance, programming specific packages to connect them to popular scientific environments (like R). Here, we present rAvis, an R-package to connect R-users with Proyecto AVIS (http://proyectoavis.com), a Spanish citizen science project with more than 82,000 bird observation records. We develop several functions to explore the database, to plot the geographic distribution of the species occurrences, and to generate personal queries to the database about species occurrences (number of individuals, distribution, etc.) and birdwatcher observations (number of species recorded by each collaborator, UTMs visited, etc.). This new R-package will allow scientists to access this database and to exploit the information generated by Spanish birdwatchers over the last 40 years.

rAvis: An R-Package for Downloading Information Stored in Proyecto AVIS, a Citizen Science Bird Project

PubMed Central

Varela, Sara; González-Hernández, Javier; Casabella, Eduardo; Barrientos, Rafael

2014-01-01

Citizen science projects store an enormous amount of information about species distribution, diversity and characteristics. Researchers are now beginning to make use of this rich collection of data. However, access to these databases is not always straightforward. Apart from the largest and international projects, citizen science repositories often lack specific Application Programming Interfaces (APIs) to connect them to the scientific environments. Thus, it is necessary to develop simple routines to allow researchers to take advantage of the information collected by smaller citizen science projects, for instance, programming specific packages to connect them to popular scientific environments (like R). Here, we present rAvis, an R-package to connect R-users with Proyecto AVIS (http://proyectoavis.com), a Spanish citizen science project with more than 82,000 bird observation records. We develop several functions to explore the database, to plot the geographic distribution of the species occurrences, and to generate personal queries to the database about species occurrences (number of individuals, distribution, etc.) and birdwatcher observations (number of species recorded by each collaborator, UTMs visited, etc.). This new R-package will allow scientists to access this database and to exploit the information generated by Spanish birdwatchers over the last 40 years. PMID:24626233

Performance assessment of Saskatchewan's water resource system under uncertain inter-provincial water supply

NASA Astrophysics Data System (ADS)

Hassanzadeh, Elmira; Elshorbagy, Amin; Nazemi, Ali; Wheater, Howard

2014-05-01

The trans-boundary Saskatchewan River Basin supports livelihoods and the economy of the province of Saskatchewan, Canada. Water users include irrigated agriculture, hydropower, potash mining, urban centers, and ecosystem services. Water availability in Saskatchewan is highly dependent on the flows from the upstream province of Alberta. These flows mostly originate from the Rocky Mountains headwaters and are highly regulated, due to intensive water use and redistribution before they get to the Alberta/Saskatchewan border. Warming climate and increasing water demands in Alberta have changed the incoming flow characteristics from Alberta to Saskatchewan. It is critical to assess the performance and the viability of Saskatchewan's water resources system under uncertain future inter-provincial inflows. For this purpose, a possible range of future changes in the inflows from Alberta to Saskatchewan is considered in this study. The considered changes include various combinations of shifts in the timing of the annual peak and volumetric change in the annual flow volumes. These shifts are implemented using a copula-based stochastic simulation method to generate multiple realizations of weekly flow series at two key locations of inflow to Saskatchewan's water resources system, in a way that the spatial dependencies between weekly inflows are maintained. Each flow series is of 31-years length and constitutes a possible long term water availability scenario. The stochastically generated flows are introduced as an alternative to the historical inflows for water resources planning and management purposes in Saskatchewan. Both historical and reconstructed inflows are fed into a Sustainability-oriented Water Allocation, Management, and Planning (SWAMP) model to analyze the effects of inflow changes on Saskatchewan's water resources system. The SWAMP model was developed using the System Dynamics approach and entails irrigation/soil moisture, non-irrigation uses and economic

Self-Monitoring of Blood Glucose: Impact of Quantity Limits in Public Drug Formularies on Provincial Costs Across Canada.

PubMed

Knowles, Sandra R; Lee, Kathy; Paterson, J Michael; Shah, Baiju R; Mamdani, Muhammad M; Juurlink, David N; Gomes, Tara

2017-04-01

For most patients with diabetes, routine use of blood glucose test strips (BGTS) has not been shown to be beneficial, yet the economic implications of broad publicly funded reimbursement for BGTS are substantial. We assessed the potential impact of BGTS quantity limits on utilization and costs for 6 publicly funded drug plans across Canada. A cross-sectional analysis was conducted in 6 provinces (Alberta, Saskatchewan, Manitoba, Nova Scotia, Newfoundland and Labrador and Prince Edward Island) for patients who received at least 1 prescription for BGTS in 2014 through the public drug program. We determined the number of BGTS that would have exceeded the quantity limits and the associated costs to the provincial drug program. A total of $38,051,026 was spent on BGTS reimbursed through public drug programs among the 6 provinces. In provinces where BGTS use is largely restricted to patients using insulin, the potential annual savings were minimal, ranging from 0.4% to 2.3%, whereas in provinces with more liberal listings, potential savings ranged from 12.4% to 19.8%. Combining these results with data from a previous analysis in Ontario and British Columbia, the cost savings associated with BGTS quantity limits for 8 provinces across Canada (capturing approximately three-quarters of the Canadian population) is estimated to be $30.3 million annually. The national implementation of a quantity limit policy for BGTS that aligns with evidence of efficacy, optimal prescribing and patient safety can lead to considerable savings for most public drug plans across Canada. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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

PubMed

Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai

2012-01-01

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

The Perceived Implications of an Outsourcing Model on Governance within British Columbia Provincial Parks in Canada: A Quantitative Study

NASA Astrophysics Data System (ADS)

Eagles, Paul; Havitz, Mark; McCutcheon, Bonnie; Buteau-Duitschaever, Windekind; Glover, Troy

2010-06-01

Good governance is of paramount importance to the success of parks and protected areas. This research utilized a questionnaire for 10 principles of governance to evaluate the outsourcing model used by British Columbia Provincial Parks, where profit-making corporations provide all front country visitor services. A total of 246 respondents representing five stakeholder groups evaluated the model according to each principle, using an online survey. Principal component analysis resulted in two of the 10 principles (equity and effectiveness) each being split into two categories, leading to 12 governance principles. Five of the 12 criteria received scores towards good governance: effectiveness outcome; equity general; strategic vision; responsiveness; and effectiveness process. One criterion, public participation, was on the neutral point. Six criteria received scores below neutral, more towards weak governance: transparency; rule of law; accountability; efficiency; consensus orientation; and, equity finance. The five stakeholder groups differed significantly on 10 of the 12 principles ( P < .05). The 2 exceptions were for efficiency and effectiveness process. Seven of the 12 criteria followed a pattern wherein government employees and contractors reported positive scores, visitors and representatives of NGOs reported more negative scores, and nearby residents reported mid-range scores. Three criteria had government employees and contractors reporting the most positive scores, residents and visitors the most negative scores, and NGO respondents reporting mid-range scores. This research found evidence that perceptions of governance related to this outsourcing model differed significantly amongst various constituent groups.

Do provincial policies banning smoking in cars when children are present impact youth exposure to secondhand smoke in cars?

PubMed

Elton-Marshall, Tara; Leatherdale, Scott T; Driezen, Pete; Azagba, Sunday; Burkhalter, Robin

2015-09-01

To examine youth exposure to smoking in cars following 7 provincial bans on smoking in cars with children in Canada. Repeated cross-sectional data from the 2004-2012 Youth Smoking Survey (n=91,800) were examined. Using a quasi-experimental design, contrasts of the interaction of survey year and province included in the logistic regression analyses were used to test whether exposure significantly declined pre-post implementation of a ban on smoking in cars relative to control provinces not implementing a ban. Exposure across all provinces declined from 26.5% in 2004 to 18.2% of youth in 2012. Exposure declined significantly from pre to post implementation of a ban on smoking in cars with children in Ontario at time 1 post ban (Pre-Ban=20.4% T1post=10.3%, OR=0.45), time 2 post ban (12.1%, OR=0.61) and time 3 post ban (11.6%, OR=0.58) relative to control provinces that did not implement a ban. In British Columbia exposure to smoking in cars declined significantly at pre-post ban time 3 compared to the control group (Pre-Ban=21.2%, T3post=9.6%, OR=0.51). No other provinces had a significant change in exposure pre-post ban relative to the control provinces. Although rates declined, significant differences were only found in Ontario relative to control provinces in the immediate and long term. Copyright © 2015 Elsevier Inc. All rights reserved.

Biblioteca Virtual de Salud Enfermería Regional: Trayectoria de Construcción, Fuentes de Información, Estrategias y Próximos Pasos.

PubMed Central

Lana, Francisco C. F.; Malvárez, Silvina

2012-01-01

Resumen La BVS Enfermeria constituye un nuevo paradigma en enfermería una vez que o modelo representa una expansión de la cooperación técnica y ha como objetivos centrales promover la ampliación del acceso la información sobre enfermería la través del acceso universal equitativo y construir un patrimonio informacional en enfermería, ayudando la mejorar la formación y práctica de enfermería a actuar con compromiso ético-social en el área de educación, investigación y atención a la salud. Como resultado del proceso de sensibilización, verifica-se la construcción de Bibliotecas Virtuales de Enfermería en varios países (Brasil, Argentina, Bolívia y Uruguay). La expectativa es que las BVS’s nacionais convergen a un gran portal que se está construyendo en una colaboración con BIREME/OPS/OMS, de la Asesoría Regional de Enfermería de la OPS-Washington y de Ministerio de Salud del Brasil, así como instituciones líderes en la producción del conocimiento en enfermería Iberoamérica. PMID:24199093

A promotores de salud intervention to reduce cardiovascular disease risk in a high-risk Hispanic border population, 2005-2008.

PubMed

Balcázar, Héctor G; de Heer, Hendrik; Rosenthal, Lee; Aguirre, Melissa; Flores, Leticia; Puentes, Flor A; Cardenas, Victor M; Duarte, Maria O; Ortiz, Melchor; Schulz, Leslie O

2010-03-01

The high prevalence of cardiovascular disease (CVD) in the Hispanic population of the United States, together with low rates of health insurance coverage, suggest a potential cardiovascular health crisis. The objective of Project HEART (Health Education Awareness Research Team) was to promote behavior changes to decrease CVD risk factors in a high-risk Hispanic border population. Project HEART took place from 2005 through 2008 as a randomized community trial with a community-based participatory research framework using promotores de salud (community health workers). A total of 328 participants with at least 1 CVD risk factor were selected by randomizing 10 US Census tracts in El Paso, Texas, to either the experimental or the control group. The experimental group (n = 192) was assigned to a series of 8 health classes using the Su Corazón, Su Vida curriculum. After 2 months of educational sessions, the group was followed for 2 months. The control group (n = 136) was given basic educational materials at baseline, and no other intervention was used. Main outcomes of interest included changes in health behaviors and clinical measures. Participants in the experimental group showed more awareness of CVD risk factors, more confidence in the control of these factors, and improved dietary habits (ie, lower salt and cholesterol intake, better weight-control practices) compared with the control group. Total cholesterol was 3% lower in the experimental than in the control participants, and nonhigh-density lipoprotein cholesterol and low-density lipoprotein cholesterol were both 5% lower. The HEART trial suggests that community health education using promotores de salud is a viable strategy for CVD risk reduction in a Hispanic border community.

Improved provincial emission inventory and speciation profiles of anthropogenic non-methane volatile organic compounds: a case study for Jiangsu, China

NASA Astrophysics Data System (ADS)

Zhao, Yu; Mao, Pan; Zhou, Yaduan; Yang, Yang; Zhang, Jie; Wang, Shekou; Dong, Yanping; Xie, Fangjian; Yu, Yiyong; Li, Wenqing

2017-06-01

Non-methane volatile organic compounds (NMVOCs) are the key precursors of ozone (O3) and secondary organic aerosol (SOA) formation. Accurate estimation of their emissions plays a crucial role in air quality simulation and policy making. We developed a high-resolution anthropogenic NMVOC emission inventory for Jiangsu in eastern China from 2005 to 2014, based on detailed information of individual local sources and field measurements of source profiles of the chemical industry. A total of 56 NMVOCs samples were collected in nine chemical plants and were then analyzed with a gas chromatography - mass spectrometry system (GC-MS). Source profiles of stack emissions from synthetic rubber, acetate fiber, polyether, vinyl acetate and ethylene production, and those of fugitive emissions from ethylene, butanol and octanol, propylene epoxide, polyethylene and glycol production were obtained. Various manufacturing technologies and raw materials led to discrepancies in source profiles between our domestic field tests and foreign results for synthetic rubber and ethylene production. The provincial NMVOC emissions were calculated to increase from 1774 Gg in 2005 to 2507 Gg in 2014, and relatively large emission densities were found in cities along the Yangtze River with developed economies and industries. The estimates were larger than those from most other available inventories, due mainly to the complete inclusion of emission sources and to the elevated activity levels from plant-by-plant investigation in this work. Industrial processes and solvent use were the largest contributing sectors, and their emissions were estimated to increase, respectively, from 461 to 958 and from 38 to 966 Gg. Alkanes, aromatics and oxygenated VOCs (OVOCs) were the most important species, accounting for 25.9-29.9, 20.8-23.2 and 18.2-21.0 % to annual total emissions, respectively. Quantified with a Monte Carlo simulation, the uncertainties of annual NMVOC emissions vary slightly through the years

REFORZANDO LAS CAPACIDADES EN INVESTIGACIÓN EN INFORMÁTICA PARA LA SALUD GLOBAL EN LA REGIÓN ANDINA A TRAVÉS DE LA COLABORACIÓN INTERNACIONAL

PubMed Central

Curioso, Walter H.; García, Patricia J.; Castillo, Greta M.; Blas, Magaly M.; Perez-Brumer, Amaya; Zimic, Mirko

2011-01-01

RESUMEN Para mejorar la salud global y bienestar de una población se requiere de recursos humanos capacitados, no solo en el campo de la medicina y salud, sino también en el campo de la informática. Desafortunadamente, los programas de entrenamiento e investigación en informática biomédica en países en desarrollo son escasos y poco documentados. El objetivo del presente trabajo es reportar los resultados del primer Taller Internacional de Expertos en Informática para la región andina que se llevó a cabo en marzo de 2010 en Lima y que incluye la descripción de nueve casos de estudio procedentes de instituciones de América Latina. En el taller participaron 23 expertos latinoamericanos, quienes discutieron la necesidad de entrenamiento e investigación multidisciplinaria en informática biomédica en áreas prioritarias para América Latina. Además, se estableció la Red QUIPU debido a la necesidad de ampliar y consolidar una red de investigación y entrenamiento a nivel regional y global. PMID:21152740

High-resolution satellite remote sensing of provincial PM2.5 trends in China from 2001 to 2015

NASA Astrophysics Data System (ADS)

Lin, C. Q.; Liu, G.; Lau, A. K. H.; Li, Y.; Li, C. C.; Fung, J. C. H.; Lao, X. Q.

2018-05-01

Given the vast territory of China, the long-term PM2.5 trends may substantially differ among the provinces. In this study, we aim to assess the provincial PM2.5 trends in China during the past few Five-Year Plan (FYP) periods. The lack of long-term PM2.5 measurements, however, makes such assessment difficult. Satellite remote sensing of PM2.5 concentration is an important step toward filling this data gap. In this study, a PM2.5 data set was built over China at a resolution of 1 km from 2001 to 2015 using satellite remote sensing. Analyses show that the national average of PM2.5 concentration increased by 0.04 μg·m-3·yr-1 during the 10th FYP period (2001-2005) and started to decline by -0.65 μg·m-3·yr-1 and -2.33 μg·m-3·yr-1 during the 11th (2006-2010) and the 12th (2011-2015) FYP period, respectively. In addition, substantial differences in the PM2.5 trends were observed among the provinces. Provinces in the Beijing-Tianjin-Hebei (BTH) region had the largest reduction of PM2.5 concentrations during the 10th and 12th FYP period. The greatest reduction rate of PM2.5 concentration during the 10th and 12th FYP period was observed in Beijing (-3.68 μg·m-3·yr-1) and Tianjin (-6.62 μg·m-3·yr-1), respectively. In contrast, PM2.5 concentrations remained steady for provinces in eastern and southeastern China (e.g., Shanghai) during the 12th FYP period. In overall, great efforts are still required to effectively reduce the PM2.5 concentrations in future.

How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study.

PubMed

Norris, Jill M; White, Deborah E; Nowell, Lorelli; Mrklas, Kelly; Stelfox, Henry T

2017-08-01

Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various

Lifetime risk of stroke in young-aged and middle-aged Chinese population: the Chinese Multi-Provincial Cohort Study

PubMed Central

Wang, Ying; Liu, Jing; Wang, Wei; Wang, Miao; Qi, Yue; Xie, Wuxiang; Li, Yan; Sun, Jiayi; Liu, Jun; Zhao, Dong

2016-01-01

Objective: Stroke is a major cause of premature death in China. Early prevention of stroke requires a more effective method to differentiate the stroke risk among young-aged and middle-aged individuals than the 10-year risk of cardiovascular disease. This study aimed to establish a lifetime stroke risk model and risk charts for the young-aged and middle-aged population in China. Methods: The Chinese Multi-Provincial Cohort Study participants (n = 21 953) aged 35–84 years without cardiovascular disease at baseline were followed for 18 years (263 016 person-years). Modified Kaplan–Meier method was used to estimate the mean lifetime stroke risk up to age of 80 years and the lifetime stroke risk according to major stroke risk factors for the population aged 35–60 years. Results: A total of 917 participants developed first-ever strokes. For the participants aged 35–40 years (98 stroke cases), the lifetime stroke risk was 18.0 and 14.7% in men and women, respectively. Blood pressure most effectively discriminated the lifetime stroke risk. The lifetime risk of stroke for the individuals with all risk factors optimal was 8–10 times lower compared with those with two or more high risk factors at age 35–60 years at baseline. Conclusion: In young-aged and middle-aged population, the lifetime stroke risk will keep very low if major risk factors especially blood pressure level is at optimal levels, but the risk substantially increases even with a slight elevation of major risk factors, which could not be identified using 10-year risk estimation. PMID:27512963

Spatio-temporal scan statistics for the detection of outbreaks involving common molecular subtypes: using human cases of Escherichia coli O157:H7 provincial PFGE pattern 8 (National Designation ECXAI.0001) in Alberta as an example.

PubMed

So, H C; Pearl, D L; von Königslöw, T; Louie, M; Chui, L; Svenson, L W

2013-08-01

Molecular typing methods have become a common part of the surveillance of foodborne pathogens. In particular, pulsed-field gel electrophoresis (PFGE) has been used successfully to identify outbreaks of Escherichia coli O157:H7 in humans from a variety of food and environmental sources. However, some PFGE patterns appear commonly in surveillance systems, making it more difficult to distinguish between outbreak and sporadic cases based on molecular data alone. In addition, it is unknown whether these common patterns might have unique epidemiological characteristics reflected in their spatial and temporal distributions. Using E. coli O157:H7 surveillance data from Alberta, collected from 2000 to 2002, we investigated whether E. coli O157:H7 with provincial PFGE pattern 8 (national designation ECXAI.0001) clustered in space, time and space-time relative to other PFGE patterns using the spatial scan statistic. Based on our purely spatial and temporal scans using a Bernoulli model, there did not appear to be strong evidence that isolates of E. coli O157:H7 with provincial PFGE pattern 8 are distributed differently from other PFGE patterns. However, we did identify space-time clusters of isolates with PFGE pattern 8, using a Bernoulli model and a space-time permutation model, which included known outbreaks and potentially unrecognized outbreaks or additional outbreak cases. There were differences between the two models in the space-time clusters identified, which suggests that the use of both models could increase the sensitivity of a quantitative surveillance system for identifying outbreaks involving isolates sharing a common PFGE pattern. © 2012 Blackwell Verlag GmbH.

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

NASA Astrophysics Data System (ADS)

Kurniawan, T.

2018-03-01

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

Provincial Comparison of Pharmacist Prescribing in Canada Using Alberta’s Model as the Reference Point

PubMed Central

Bhatia, Surya; Simpson, Scot H; Bungard, Tammy

2017-01-01

Background In the past decade, pharmacist practice has evolved tremendously in Canada, but the scope of practice varies substantially from one province to another. Objective To describe pharmacists’ scopes of practice relevant to prescribing within various jurisdictions of Canada, using the prescribing model in Alberta (authors’ province) as the reference point. Methods This cross-sectional survey consisted of clinical scenarios for emergency prescribing, adapting or renewing a prescription, and initial-access prescribing for a chronic disease. Pharmacists were asked about their ability to administer injections and to order or access the results of laboratory tests, as well as certification and training requirements and reimbursement models. Results Thirteen pharmacists representing Canadian provinces other than Alberta were surveyed in late 2015, for comparison with Alberta. With specific reference to the scenarios presented, pharmacists were able to prescribe in an emergency in 9 of the 10 provinces, renew prescriptions in all provinces, and adapt prescriptions in 6 provinces. Three provinces required that pharmacists have collaborative practice agreements identifying a specific practice area in order to initiate a prescription for a chronic disease (with 6–12 pharmacists per province having such agreements). Alberta required pharmacists to have authorization, based on a detailed application, in order to initiate any provincially regulated drug (with about 1150 pharmacists having this authorization). Pharmacists were allowed to administer vaccines in 9 provinces, and 5 provinces allowed pharmacists to administer drugs by injection. Three provinces had systems in place for pharmacists to access laboratory test results, and 2 allowed pharmacists to order laboratory tests. Five provinces had government-reimbursed programs in place for select prescribing services; however, all 9 provinces with public vaccination programs reimbursed pharmacists for this service

[Levels of dissatisfaction of external users of the Instituto Nacional de Salud del Niño (National Institute of Child Health) in Lima, Peru].

PubMed

Shimabuku, Roberto; Huicho, Luis; Fernández, Danitza; Nakachi, Graciela; Maldonado, Ruth; Barrientos, Armando

2012-01-01

To determine the changes in the levels of dissatisfaction of the external users of the Instituto Nacional de Salud del Niño, in Lima, Peru. Observational study based on a software to evaluate surveys completed by health care users (Software de Evaluación de Encuestas de Usuarios en Salud - SEEUS). The population consisted of every person accompanying external users to outpatient visits, inpatient visits or emergency treatment in the years 2008, 2009 and 2010. To calculate the sample size, last year's proportion of users dissatisfied with each service was used, with an estimated error of 5% at a 95% confidence level. A sample of 2051 people was obtained, which revealed a decreasing trend in the levels of dissatisfaction with outpatient visits, and an increased dissatisfaction in the medical capabilities dimension for hospitalization and emergency services. In addition, a dissatisfaction index lower than 0.20 was registered in the medical capabilities dimension for outpatient visits. In contrast, the highest dissatisfaction indexes were registered in the hygiene dimension for 2009 (0.25) and 2010 (0.25), and in the others dimension for emergency services in 2009 (0.25). The dimensions showing an increase in the dissatisfaction index were tangible aspects, hygiene and others for hospitalization and emergency services. On the other hand, the medical capabilities dimension for outpatient visits showed a decrease in the level of dissatisfaction over the evaluated period.

Las mujeres saludables: reaching Latinas for breast, cervical and colorectal cancer prevention and screening.

PubMed

Larkey, Linda

2006-02-01

Community health advisors have effectively promoted breast and cervical cancer prevention and screening among low-income Latina women. Specific elements of such programs, such as enhanced social support, may explain successes. Promotion of colorectal cancer screening has been less studied. Promotoras de Salud (i.e., Latina health advisors) implemented a 12-week program among women recruited from community-based organizations. The program educated 366 Latinas in breast, cervical and colorectal cancer prevention and screening and emphasized social support among class members. Pre- and post-intervention assessments demonstrated significant increases for fruit and vegetable consumption (3.05 to 3.60 servings/day), and physical activity (65.15 to 122.40 minutes/week). Of women previously non-compliant, 39 percent, 31 percent and 4 percent received Pap tests, mammography, and fecal occult blood test (FOBT), respectively. A culturally aligned education program using community health advisors and emphasizing social support among participants may improve prevention and selected screening behaviors, but more intensive interventions may be required for colorectal cancer screening compliance.

A collaborative quality improvement model and electronic community of practice to support sepsis management in emergency departments: investigating care harmonization for provincial knowledge translation.

PubMed

Ho, Kendall; Marsden, Julian; Jarvis-Selinger, Sandra; Novak Lauscher, Helen; Kamal, Noreen; Stenstrom, Rob; Sweet, David; Goldman, Ran D; Innes, Grant

2012-07-12

Emergency medicine departments within several organizations are now advocating the adoption of early intervention guidelines for patients with the signs and symptoms of sepsis. This proposed research will lead to a comprehensive understanding of how diverse emergency department (ED) sites across British Columbia (BC), Canada, engage in a quality improvement collaborative to lead to improvements in time-based process measures and clinical outcomes for septic patients in EDs. To address the challenge of sepsis management, in 2007, the BC Ministry of Health began working with emergency health professionals, including health administrators, to establish a provincial ED collaborative: Evidence to Excellence (E2E). The E2E initiative employs the Institute for Healthcare Improvement (IHI) model and is supported by a Web-based community of practice (CoP) in emergency medicine. It aims to (1) support clinicians in accessing and applying evidence to clinical practice in emergency medicine, (2) support system change and clinical process improvement, and (3) develop resources and strategies to facilitate knowledge translation and process improvement. Improving sepsis management is one of the central foci of the E2E initiative. The primary purpose of our research is to investigate whether the application of sepsis management protocols leads to improved time-based process measures and clinical outcomes for patients presenting to EDs with sepsis. Also, we seek to investigate the implementation of sepsis protocols among different EDs. For example: (1) How can sepsis protocols be harmonized among different EDs? (2) What are health professionals' perspectives on interprofessional collaboration with various EDs? and (3) What are the factors affecting the level of success among EDs? Lastly, working in collaboration with the BC Ministry of Health as our policy-maker partner, the research will investigate how the demonstrated efficacy of this research can be applied on a provincial and

Use of SERTS (Socio-Economic, health Resources and Technologic Supplies) models to estimate cancer survival at provincial geographical level.

PubMed

Vercelli, Marina; Lillini, Roberto; Capocaccia, Riccardo; Quaglia, Alberto

2012-12-01

The main aim of this work is to compute expected cancer survival for Italian provinces by Socio-Economic and health Resources and Technologic Supplies (SERTS) models, based on demographic, socioeconomic variables and information describing the health care system (SEH). Five-year age-standardised relative survival rates by gender for 11 cancer sites and all cancers combined of patients diagnosed in 1995-1999, were obtained from the Italian Association of Cancer Registries (CRs) database. The SEH variables describe at provincial level macro-economy, demography, labour market, health resources in 1995-2005. A principal components factor analysis was applied to the SEH variables to control their strong mutual correlation. For every considered cancer site, linear regression models were estimated considering the 5-RS% as dependent variable and the principal components factors of the SEH variables as independent variables. The model composition was correlated to the characteristics of take in charge of patients. SEH factors were correlated with the observed survival for all cancer combined and colon-rectum in both sexes, prostate, kidney and non Hodgkin's lymphomas in men, breast, corpus uteri and melanoma in women (R(2) from 40% to 85%). In the provinces without any CR the survival was very similar with that of neighbouring provinces with analogous social, economic and health characteristics. The SERTS models allowed us to interpret the survival outcome of oncologic patients with respect to the role of the socio-economic and health related system characteristics, stressing how the peculiarities of the take in charge at the province level could address the decisions regarding the allocation of resources. Copyright © 2012 Elsevier Ltd. All rights reserved.

NEGOTIATING STRUCTURAL VULNERABILITY FOLLOWING REGULATORY CHANGES TO A PROVINCIAL METHADONE PROGRAM IN VANCOUVER, CANADA: A QUALITATIVE STUDY

PubMed Central

McNeil, Ryan; Kerr, Thomas; Anderson, Solanna; Maher, Lisa; Keewatin, Chereece; Milloy, MJ; Wood, Evan; Small, Will

2015-01-01

While regulatory frameworks governing methadone maintenance therapy (MMT) require highly regimented treatment programs that shape treatment outcomes, little research has examined the effects of regulatory changes to these programs on those receiving treatment, and located their experiences within the wider context of socialstructural inequities. In British Columbia (BC), Canada, provincial regulations governing MMT have recently been modified, including: replacing the existing methadone formulation with Methadose® (pre-mixed and 10 times more concentrated); prohibiting pharmacy delivery of methadone; and, prohibiting pharmacies incentives for methadone dispensation. We undertook this study to examine the impacts of these changes on a structurally vulnerable population enrolled in MMT in Vancouver, BC. Qualitative interviews were conducted with 34 people enrolled in MMT and recruited from two ongoing observational prospective cohort studies comprised of drug-using individuals in the six-month period in 2014 following these regulatory changes. Interview transcripts were analyzed thematically, and by drawing on the concept of ‘structural vulnerability’. Findings underscore how these regulatory changes disrupted treatment engagement, producing considerable health and social harms. The introduction of Methadose® precipitated increased withdrawal symptoms. The discontinuation of pharmacy delivery services led to interruptions in MMT and codispensed HIV medications due to constraints stemming from their structural vulnerability (e.g., poverty, homelessness). Meanwhile, the loss of pharmacy incentives limited access to material supports utilized by participants to overcome barriers to MMT, while diminishing their capacity to assert some degree of agency in negotiating dispensation arrangements with pharmacies. Collectively, these changes functioned to compromise MMT engagement and increased structural vulnerability to harm, including re-initiation of injection drug

Supporting chronic pain management across provincial and territorial health systems in Canada: Findings from two stakeholder dialogues.

PubMed

Wilson, Michael G; Lavis, John N; Ellen, Moriah E

2015-01-01

Chronic pain is a serious health problem given its prevalence, associated disability, impact on quality of life and the costs associated with the extensive use of health care services by individuals living with it. To summarize the research evidence and elicit health system policymakers', stakeholders' and researchers' tacit knowledge and views about improving chronic pain management in Canada and engaging provincial and territorial health system decision makers in supporting comprehensive chronic pain management in Canada. For these two topics, the global and local research evidence regarding each of the two problems were synthesized in evidence briefs. Three options were generated for addressing each problem, and implementation considerations were assessed. A stakeholder dialogue regarding each topic was convened (with 29 participants in total) and the deliberations were synthesized. To inform the first stakeholder dialogue, the authors found that systematic reviews supported the use of evidence-based tools for strengthening chronic pain management, including patient education, self-management supports, interventions to implement guidelines and multidisciplinary approaches to pain management. While research evidence about patient registries/treatment-monitoring systems is limited, many dialogue participants argued that a registrysystem is needed. Many saw a registry as a precondition for moving forward with other options, including creating a national network of chronic pain centres with a coordinating 'hub' to provide chronic pain-related decision support and a cross-payer, cross-discipline model of patient-centred primary health care-based chronic pain management. For the second dialogue, systematic reviews indicated that traditional media can be used to positively influence individual health-related behaviours, and that multistakeholder partnerships can contribute to increasing attention devoted to issues on policy agendas. Dialogue participants emphasized the

Salud mental en desastres naturales: estrategias interventivas con adultos mayores en sectores rurales de Chile.

PubMed

Osorio-Parraguez, Paulina; Espinoza, Adriana

2016-06-01

En el presente artículo se da a conocer una estrategia de intervención llevada a cabo con adultos mayores en la comuna de Paredones, sexta región de Chile, con posterioridad al terremoto y tsunami del 27 de febrero 2010 en Chile, en el contexto de una investigación sobre fortalezas y vulnerabilidades desplegadas por este grupo etario, con posterioridad a un desastre natural. Se presenta una descripción del desarrollo metodológico de la intervención y de los sustentos teóricos y conceptuales en los que se basa. Como resultado de este proceso, se propone una estrategia que trabaje a través de la identificación de las propias experiencias y fortalezas de los sujetos. De tal forma se minimizan los efectos negativos de los determinantes sociales de la salud (como la edad y el lugar de residencia) en contexto de crisis; permitiendo a los adultos mayores fortalecer sus recursos individuales y colectivos, en pro de su bienestar psicosocial. © The Author(s) 2015.

[Productivity, visibility and citation analysis of the Revista Peruana de Medicina Experimental y Salud Pública, 2002-2009].

PubMed

Huamaní, Charles

2010-09-01

Biomedical journals are the most used and important venue to disseminate and interchange scientific information, and evaluation is an important component. A bibliometric study was conducted on the productivity, visibility and citation analysis of the Revista Peruana de Medicina Experimental y Salud Pública (RPMESP), from 2002 to 2009. During this period, the RPMESP published about 62 documents per year, 55.3% were research articles. The visibility of RPMESP, determined among three databases (SISBIB-UNMSM, SciELO-Peru, and REDALYC), was irregular, increasing on July 2006, with the highest access on October 2009 (117,618 hits). 43.0% of publications were cited. The calculated impact factor in ISI journals was 0.04 in 2009. In conclusion, the citation of RPMESP shows a slowly growing during the period 2002-2009. It is hoped that the RPMESP increase its visibility and impact after its inclusion in MEDLINE.

'Proyecto Orgullo', an HIV prevention, empowerment and community mobilisation intervention for gay men and transgender women in Callao/Lima, Peru.

PubMed

Maiorana, Andres; Kegeles, Susan; Salazar, Ximena; Konda, Kelika; Silva-Santisteban, Alfonso; Cáceres, Carlos

2016-01-01

We used qualitative, quantitative, and observational methods to assess the feasibility, acceptability, and potential efficacy of Proyecto Orgullo (PO), a pilot community mobilisation intervention to decrease sexual risk, promote health-seeking behaviours, and facilitate personal and community empowerment among gay men (GM) and transgender women (TW) in Peru. PO was adapted from Mpowerment and Hermanos de Luna y Sol, two US interventions. PO included six interrelated core elements: (1) Self-reflection Small Group sessions; (2) Supporting peers in HIV prevention; (3) Mobilisation Activities addressing HIV, GM/TW issues, and community empowerment; (4) A Core Group (staff + GM/TW volunteers) designing/implementing those activities; (5) A Project Space; (6) Publicity. PO included specific components for TW, but promoted that GM/TW, who historically have not worked well together, collaborate for a common goal. We found that PO was embraced by GM/TW. PO positively influenced GM/TW's HIV prevention beliefs, self-efficacy, and behaviours; provided social support and created community; facilitated individual and community empowerment; achieved that GM/TW collaborate; and established a functional Community Centre for socialising/conducting mobilisation activities. Community mobilisation strategies, lacking from HIV prevention efforts in Peru but considered key to HIV prevention, can help improve health-seeking behaviours and consolidate social norms supporting preventive behaviours among GM/TW.

Improving heart healthy lifestyles among participants in a Salud para su Corazón promotores model: the Mexican pilot study, 2009-2012.

PubMed

Balcázar, Héctor; Fernández-Gaxiola, Ana Cecilia; Pérez-Lizaur, Ana Bertha; Peyron, Rosa Adriana; Ayala, Carma

2015-03-12

In Mexico, cardiovascular disease and its risk factors are growing problems and major public health concerns. The objective of this study was to implement cardiovascular health promotion and disease prevention activities of the Salud para su Corazón model in a high-risk, impoverished, urban community in Mexico City. We used a pretest-posttest (baseline to 12-week follow-up) design without a control group. Material from Salud para su Corazón was validated and delivered by promotores (community health workers) to community members from 6 geographic areas. Two validated, self-administered questionnaires that assessed participants' knowledge and behaviors relating to heart health were administered. We used t tests and χ(2) tests to evaluate pretest and posttest differences, by age group (≤60 and >60 years), for participants' 3 heart-healthy habits, 3 types of physical activity, performance skills, and anthropometric and clinical measurements. A total of 452 (82%) adult participants completed the program. Heart-healthy habits from pretest to posttest varied by age group. "Taking action" to modify lifestyle behaviors increased among adults aged 60 or younger from 31.5% to 63.0% (P < .001) and among adults older than 60 from 30.0% to 45.0% (P < .001). Positive responses for cholesterol and fat consumption reduction were seen among participants 60 or younger (P = .03). Among those older than 60, salt reduction and weight control increased (P = .008). Mean blood glucose concentration among adults older than 60 decreased postintervention (P = .03). Significant improvements in some heart-healthy habits were seen among adult participants. The model has potential to improve heart-healthy habits and facilitate behavioral change among high-risk adults.

The implementation of health promotion in primary and community care: a qualitative analysis of the 'Prescribe Vida Saludable' strategy.

PubMed

Martinez, Catalina; Bacigalupe, Gonzalo; Cortada, Josep M; Grandes, Gonzalo; Sanchez, Alvaro; Pombo, Haizea; Bully, Paola

2017-02-17

The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices. Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable) is focused on designing, planning, implementing and evaluating innovative programs to promote multiple healthy habits, feasible to be performed in routine primary health care conditions. After 2 years of piloting, centers were categorized as having high, medium, or low implementation effectiveness. We completed qualitative inductive and deductive analysis of five focus groups with the staff of the centers. Themes generated through consensual grounded qualitative analysis were compared between centers to identify the dimensions that explain the variation in actual implementation of PVS, and retrospectively organized and assessed against the Consolidated Framework for Implementation Research (CFIR). Of the 36 CFIR constructs, 11 were directly related to the level of implementation performance: intervention source, evidence strength and quality, adaptability, design quality and packaging, tension for change, learning climate, self-efficacy, planning, champions, executing, and reflecting and evaluating, with -organizational tracking added as a new sub-construct. Additionally, another seven constructs emerged in the participants' discourse but were not related to center performance: relative advantage, complexity, patients' needs and resources, external policy and incentives, structural characteristics, available resources, and formally appointed internal implementation

[Bibliometric study of the original articles published in Revista Española de Salud Púiblica (1991-2000). Part III: reference analysis].

PubMed

Villar Alvarez, Fernando; Estrada Lorenzo, José Manuel; Peréz Andrés, Christina; Rebollo Rodríguez, M José

2007-01-01

The advancement of knowledge is based on the results of previously conducted research studies, which are reflected in the reference sources listed in a scientific article. This study is aimed at studying the scientific information used in the Revista Española de Salud Pública based on the references cited in the original articles published during the 1991-2000 period. The data regarding the year and where published, document type, language and country in which published was taken from the reference sources listed in the 290 original articles published, the obsolescence, Price and isolation indexes being calculated, and the Bradford core distribution being established according to the source journals. The self-citing rate was also calculated. A total of 7465 references were cited in the Reference section of the 290 original articles. An average of 25.7 references were cited per article. The Price index was 40.7. The scientific articles showed an obsolescence index of 5, the books and book chapters having an index of 6. A total 50.6% of the citations were from studies published in Spanish. The isolation index of the references was 48.1. The first Bradford core is comprised of 10 journals, the first four of which are Spanish. The self-citing rate was 3.8%. The information consumption of the original articles published in the Revista Española de Salud Pública show parameters similar to those of other Spanish health sciences journals for those same years, and the parameters regarding which this Journal differs from other Spanish health sciences journals seem to be justified by those particular aspects unique to public health, which does not fall within the patterns inherent to the clinical disciplines.

Proyecto MercadoFRESCO: a multi-level, community-engaged corner store intervention in East Los Angeles and Boyle Heights.

PubMed

Ortega, Alexander N; Albert, Stephanie L; Sharif, Mienah Z; Langellier, Brent A; Garcia, Rosa Elena; Glik, Deborah C; Brookmeyer, Ron; Chan-Golston, Alec M; Friedlander, Scott; Prelip, Michael L

2015-04-01

Urban food swamps are typically situated in low-income, minority communities and contribute to overweight and obesity. Changing the food landscape in low income and underserved communities is one strategy to combat the negative health consequences associated with the lack of access to healthy food resources and an abundance of unhealthy food venues. In this paper, we describe Proyecto MercadoFRESCO (Fresh Market Project), a corner store intervention project in East Los Angeles and Boyle Heights in California that used a multi-level approach with a broad range of community, business, and academic partners. These are two neighboring, predominantly Latino communities that have high rates of overweight and obesity. Located in these two communities are approximately 150 corner stores. The project used a community-engaged approach to select, recruit, and convert four corner stores, so that they could become healthy community assets in order to improve residents' access to and awareness of fresh and affordable fruits and vegetables in their immediate neighborhoods. We describe the study framework for the multi-level intervention, which includes having multiple stakeholders, expertise in corner store operations, community and youth engagement strategies, and social marketing campaigns. We also describe the evaluation and survey methodology to determine community and patron impact of the intervention. This paper provides a framework useful to a variety of public health stakeholders for implementing a community-engaged corner store conversion, particularly in an urban food swamp.

Proyecto MercadoFRESCO: A Multi-level, Community-Engaged Corner Store Intervention in East Los Angeles and Boyle Heights

PubMed Central

Albert, Stephanie L.; Sharif, Mienah Z.; Langellier, Brent A.; Garcia, Rosa Elena; Glik, Deborah C.; Brookmeyer, Ron; Chan-Golston, Alec M.; Friedlander, Scott; Prelip, Michael L.

2014-01-01

Urban food swamps are typically situated in low-income, minority communities and contribute to overweight and obesity. Changing the food landscape in low income and underserved communities is one strategy to combat the negative health consequences associated with the lack of access to healthy food resources and an abundance of unhealthy food venues. In this paper, we describe Proyecto MercadoFRESCO (Fresh Market Project), a corner store intervention project in East Los Angeles and Boyle Heights in California that used a multi-level approach with a broad range of community, business, and academic partners. These are two neighboring, predominantly Latino communities that have high rates of overweight and obesity. Located in these two communities are approximately 150 corner stores. The project used a community-engaged approach to select, recruit, and convert four corner stores, so that they could become healthy community assets in order to improve residents’ access to and awareness of fresh and affordable fruits and vegetables in their immediate neighborhoods. We describe the study framework for the multi-level intervention, which includes having multiple stakeholders, expertise in corner store operations, community and youth engagement strategies, and social marketing campaigns. We also describe the evaluation and survey methodology to determine community and patron impact of the intervention. This paper provides a framework useful to a variety of public health stakeholders for implementing a community-engaged corner store conversion, particularly in an urban food swamp. PMID:25209600

[Networks of experiences on community health as an information system in health promotion: lessons learned in Aragon (Spain)].

PubMed

Gállego-Diéguez, Javier; Aliaga Traín, Pilar; Benedé Azagra, Carmen Belén; Bueno Franco, Manuel; Ferrer Gracia, Elisa; Ipiéns Sarrate, José Ramón; Muñoz Nadal, Pilar; Plumed Parrilla, Manuela; Vilches Urrutia, Begoña

2016-11-01

Networks of community health experiences promote interaction and knowledge management in health promotion among their participants. These networks integrate both professionals and social agents who work directly on the ground in small environments, with defined objectives and inclusion criteria and voluntary participation. In this article, networks in Aragon (Spain) are reviewed in order to analyse their role as an information system. The Health Promotion Projects Network of Aragon (Red Aragonesa de Proyectos de Promoción de la Salud, RAPPS) was launched in 1996 and currently includes 73 projects. The average duration of projects is 12.7 years. RAPPS interdisciplinary teams involve 701 people, of which 89.6% are professionals and 10.6% are social agents. The Aragon Health Promoting Schools Network (Red Aragonesa de Escuelas Promotoras de Salud, RAEPS) integrates 134 schools (24.9% of Aragon). The schools teams involve 829 teachers and members of the school community, students (35.2%), families (26.2%) and primary care health professionals (9.8%). Experiences Networks boost citizen participation, have an influence in changing social determinants and contribute to the formulation of plans and regional strategies. Networks can provide indicators for a health promotion information and monitoring system on: capacity building services in the territory, identifying assets and models of good practice, cross-sectoral and equity initiatives. Experiences Networks represent an opportunity to create a health promotion information system, systematising available information and establishing quality criteria for initiatives. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Engaging men as promotores de salud: perceptions of community health workers among Latino men in North Carolina.

PubMed

Villa-Torres, Laura; Fleming, Paul J; Barrington, Clare

2015-02-01

The promotor de salud, or community health worker (CHW) role, is highly feminized and little is known about how men view their participation in CHW programs. We conducted in-depth interviews with Latino men in North Carolina to explore this gap. We used systematic coding and display procedures informed by Grounded Theory to analyze the data. Men described their communities as lacking cohesion, making integration of Latino immigrants difficult. Most did not consider themselves leaders or feel they had leaders in their communities. Their perceptions of the feminized CHW role as well as the volunteer or low-paid nature of CHW work conflicted with men's provider role. They also did not think they could perform the CHW role because they lacked education, skills, and broad networks. Efforts to increase male participation in CHW programs in new Latino immigrant destinations will need to understand and address these gender and migration-related dynamics in order to engage both women and men in improving the health of their communities.

Salud Para Su Corazon-NCLR: a comprehensive Promotora outreach program to promote heart-healthy behaviors among hispanics.

PubMed

Balcazar, Hector; Alvarado, Matilde; Hollen, Mary Luna; Gonzalez-Cruz, Yanira; Hughes, Odelinda; Vazquez, Esperanza; Lykens, Kristine

2006-01-01

This article describes results of year-1 implementation of the Salud Para Su Corazón (Health For Your Heart)-National Council of la Raza (NCLR) promotora (lay health worker) program for promoting heart-healthy behaviors among Latinos. Findings of this community outreach initiative include data from promotora pledges and self-skill behaviors, cardiovascular disease risk factors of Latino families, family heart-health education delivery, and program costs associated with promotora time. Participation included 29 trained promotoras serving 188 families from three NCLR affiliates in Escondido, California; Chicago, Illinois; and Ojo Caliente, New Mexico. Using several evaluation tools, the results showed that the promotora approach worked based on evidence obtained from the following indicators: changes in promotora's pre-post knowledge and performance skills, progress toward their pledge goals following training, recruiting and teaching families, providing follow-up, and organizing or participating in community events. Strengths and limitations of the promotora model approach are also discussed.

Using Job Analysis Techniques to Understand Training Needs for Promotores de Salud.

PubMed

Ospina, Javier H; Langford, Toshiko A; Henry, Kimberly L; Nelson, Tristan Q

2018-04-01

Despite the value of community health worker programs, such as Promotores de Salud, for addressing health disparities in the Latino community, little consensus has been reached to formally define the unique roles and duties associated with the job, thereby creating unique job training challenges. Understanding the job tasks and worker attributes central to this work is a critical first step for developing the training and evaluation systems of promotores programs. Here, we present the process and findings of a job analysis conducted for promotores working for Planned Parenthood. We employed a systematic approach, the combination job analysis method, to define the job in terms of its work and worker requirements, identifying key job tasks, as well as the worker attributes necessary to effectively perform them. Our results suggest that the promotores' job encompasses a broad range of activities and requires an equally broad range of personal characteristics to perform. These results played an important role in the development of our training and evaluation protocols. In this article, we introduce the technique of job analysis, provide an overview of the results from our own application of this technique, and discuss how these findings can be used to inform a training and performance evaluation system. This article provides a template for other organizations implementing similar community health worker programs and illustrates the value of conducting a job analysis for clarifying job roles, developing and evaluating job training materials, and selecting qualified job candidates.

‘Proyecto Orgullo’, an HIV prevention, empowerment and community mobilisation intervention for gay men and transgender women in Callao/Lima, Peru

PubMed Central

Kegeles, Susan; Salazar, Ximena; Konda, Kelika; Silva-Santiesteban, Alfonso; Cáceres, Carlos

2016-01-01

We used qualitative, quantitative and observational methods to assess the feasibility, acceptability, and potential efficacy of Proyecto Orgullo (PO), a pilot community mobilisation intervention to decrease sexual risk, promote health-seeking behaviours, and facilitate personal and community empowerment among gay men (GM) and transgender women (TW) in Peru. PO was adapted from Mpowerment and Hermanos de Luna y Sol, two US interventions. PO included six interrelated core elements: 1) Self-reflection Small Group sessions; 2) Supporting peers in HIV prevention; 3) Mobilisation Activities addressing HIV, GM/TW issues, and community empowerment; 4) A Core Group (staff + GM/TW volunteers) designing/implementing those activities; 5) A Project Space; 6) Publicity. PO included specific components for TW, but promoted that GM/TW, who historically have not worked well together, collaborate for a common goal. We found that PO was embraced by GM/TW. PO positively influenced GM/TW's HIV prevention beliefs, self-efficacy, and behaviours; provided social support and created community; facilitated individual and community empowerment; achieved that GM/TW collaborate; and established a functional Community Centre for socializing/conducting mobilisation activities. Community mobilisation strategies, lacking from HIV prevention efforts in Peru but considered key to HIV prevention, can help improve health-seeking behaviours and consolidate social norms supporting preventive behaviours among GM/TW. PMID:27373578

Using intervention mapping to develop a breast and cervical cancer screening program for Hispanic farmworkers: Cultivando La Salud.

PubMed

Fernández, Maria E; Gonzales, Alicia; Tortolero-Luna, Guillermo; Partida, Sylvia; Bartholomew, L Kay

2005-10-01

This article describes the development of the Cultivando La Salud program, an intervention to increase breast and cervical cancer screening for Hispanic farmworker women. Processes and findings of intervention mapping (IM), a planning process for development of theory and evidence-informed program are discussed. The six IM steps are presented: needs assessment, preparation of planning matrices, election of theoretic methods and practical strategies, program design, implementation planning, and evaluation. The article also describes how qualitative and quantitative findings informed intervention development. IM helped ensure that theory and evidence guided (a) the identification of behavioral and environmental factors related to a target health problem and (b) the selection of the most appropriate methods and strategies to address the identified determinants. IM also guided the development of program materials and implementation by lay health workers. Also reported are findings of the pilot study and effectiveness trial.

Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China.

PubMed

Yao, Hong; Li, Weixin; Qian, Xin

2015-08-21

Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

Hydrometric, Hydrochemical, and Hydrogeophysical Runoff Characterization Across Multiple Land Covers in the Agua Salud Project, Panama

NASA Astrophysics Data System (ADS)

Litt, Guy Finley

As the Panama Canal Authority faces sensitivity to water shortages, managing water resources becomes crucial for the global shipping industry's security. These studies address knowledge gaps in tropical water resources to aid hydrological model development and validation. Field-based hydrological investigations in the Agua Salud Project within the Panama Canal Watershed employed multiple tools across a variety of land covers to investigate hydrological processes. Geochemical tracers informed where storm runoff in a stream comes from and identified electrical conductivity (EC) as an economical, high sample frequency tracer during small storms. EC-based hydrograph separation coupled with hydrograph recession rate analyses identified shallow and deep groundwater storage-discharge relationships that varied by season and land cover. A series of plot-scale electrical resistivity imaging geophysical experiments coupled with rainfall simulation characterized subsurface flow pathway behavior and quantified respectively increasing infiltration rates across pasture, 10 year old secondary succession forest, teak (tectona grandis), and 30 year old secondary succession forest land covers. Additional soil water, groundwater, and geochemical studies informed conceptual model development in subsurface flow pathways and groundwater, and identified future research needs.

[A set of quality and safety indicators for hospitals of the "Agencia Valenciana de Salud"].

PubMed

Nebot-Marzal, C M; Mira-Solves, J J; Guilabert-Mora, M; Pérez-Jover, V; Pablo-Comeche, D; Quirós-Morató, T; Cuesta Peredo, D

2014-01-01

To prepare a set of quality and safety indicators for Hospitals of the «Agencia Valenciana de Salud». The qualitative technique Metaplan® was applied in order to gather proposals on sustainability and nursing. The catalogue of the «Spanish Society of Quality in Healthcare» was adopted as a starting point for clinical indicators. Using the Delphi technique, 207 professionals were invited to participate in the selecting the most reliable and feasible indicators. Lastly, the resulting proposal was validated with the managers of 12 hospitals, taking into account the variability, objectivity, feasibility, reliability and sensitivity, of the indicators. Participation rates varied between 66.67% and 80.71%. Of the 159 initial indicators, 68 were prioritized and selected (21 economic or management indicators, 22 nursing indicators, and 25 clinical or hospital indicators). Three of them were common to all three categories and two did not match the specified criteria during the validation phase, thus obtaining a final catalogue of 63 indicators. A set of quality and safety indicators for Hospitals was prepared. They are currently being monitored using the hospital information systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Gasto catastrófico en salud en México y sus factores determinantes, 2002-2014.

PubMed

Rodríguez-Aguilar, Román; Rivera-Peña, Gustavo

2017-01-01

To assess the financial protection of public health insurance by analyzing the percentage of households with catastrophic health expenditure (HCHE) in Mexico and its relationship with poverty status, size of locality, federal entity, insurance status and items of health spending. Mexican National Survey of Income and Expenditures 2002-2014 was used to estimate the percentage of HCHE. Through a probit model, factors associated with the occurrence of catastrophic spending are identified. Analysis was performed using Stata-SE 12. In 2014 there were 2.08% of HCHE (1.82-2.34%; N = 657,474). The estimated probit model correctly classified 98.2% of HCHE (Pr (D) ≥ 0.5). Factors affecting the catastrophic expenditures were affiliation, presence of chronic disease, hospitalization expenditure, rural condition and that the household is below the food poverty line. The percentage of HCHE decreased in recent years, improving financial protection in health. This decline seems to have stalled, keeping inequities in access to health services, especially in rural population without affiliation to any health institution, below the food poverty line and suffering from chronic diseases. Copyright: © 2017 SecretarÍa de Salud

[Angel Pulido Martín (1878-1970). 4th Chief of the Urology Service of the Provincial Hospital of Madrid].

PubMed

Sáiz Carrero, Ataúlfo

2003-05-01

To review the biography and scientific contributions of Dr. Angel Pulido Martin, fourth chairman of the Department of Urology at the Hospital Provincial of Madrid, and formerly at the Urology Clinic at the San Juan de Dios Hospital of Madrid. In addition, to show a panoramic view on how doctors who obtained scholarships to study outside Spain were trained in a specialty at the beginning of the 20th century. We reviewed memoirs books from Dr. Pulido Martin ("Medical letters", "Dr. Pulido and his time", and "Memoirs of a doctor"), his Ph.D. thesis and other works. We also reviewed biographic data obtained from his contemporaries in different publications. We report his experiences as a student in the specialities of Urology and Gynecology, since he first thought about taking this last one. Main european urologic and gynecologic centers of that time are represented, as well as some of the main characters in these specialties. We appreciate his great working spirit, which was inculcated into him by his father Dr. Pulido Fernandez, his enterprising desire, and the great professional he was, creating departments of urology which were school and model for many urologists of his time. A sincere clinician, Dr. Pulido Martin liked accuracy and daily self-improvement. He also was exceptional for his kindness treating patients and disciples. His publications on urologic topics were numerous; he also was fluent and entertaining as a non medical writer. He was an outstanding urologist in the early 20th century; he was member of the committee which elaborated the statutes of the Spanish Society of Urology, in which he was President for 11 years. He was also one of the founding members of the International Society of Urology and delegate of its Spanish chapter. He was official lecturer in several meetings, and also member of the Spanish Academy of Medicine and Surgery.

Efficiency of "Prescribe Vida Saludable", a health promotion innovation. Pilot phase.

PubMed

Sanz-Guinea, Aitor; Espinosa, Maite; Grandes, Gonzalo; Sáncheza, Álvaro; Martínez, Catalina; Pombo, Haizea; Bully, Paola; Cortada, Josep

"Prescribe Vida Saludable" (PVS) is an organisational innovation designed to optimise the promotion of multiple healthy habits in primary healthcare. It aims to estimate the cost effectiveness and cost-utility of prescribing physical activity in the pilot phase of the PVS programme, compared to the routine clinical practice of promoting physical activity in primary healthcare. An economic evaluation of the quasi-experimental pilot phase of PVS was carried out. In the four control centres, a systematic sample was selected of 194 patients who visited the centre in a single year and who did not comply with physical activity recommendations. In the four intervention centres, 122 patients who received their first physical activity prescription were consecutively enrolled. The costs were evaluated from the perspective of the PVS programme using bottom-up methodology. The effectiveness (proportion of patients who changed their physical activity) as well as the utility were evaluated at baseline and after 3 months. The incremental cost-utility ratio (ICUR) and the incremental cost-effectiveness ratio (ICER) were calculated and a sensitivity analysis was performed with bootstrapping and 1,000 replications. Information was obtained from 35% of control cases and 62% of intervention cases. The ICUR was €1,234.66/Quality Adjusted Life Years (QALY) and the ICER was €4.12. In 98.3% of the simulations, the ICUR was below the €30,000/QALY threshold. The prescription of physical activity was demonstrably within acceptable cost-utility limits in the pilot PVS phase, even from a conservative perspective. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Improving Heart Healthy Lifestyles Among Participants in a Salud Para Su Corazón Promotores Model: The Mexican Pilot Study, 2009–2012

PubMed Central

Fernández-Gaxiola, Ana Cecilia; Pérez-Lizaur, Ana Bertha; Peyron, Rosa Adriana; Ayala, Carma

2015-01-01

Introduction In Mexico, cardiovascular disease and its risk factors are growing problems and major public health concerns. The objective of this study was to implement cardiovascular health promotion and disease prevention activities of the Salud para su Corazón model in a high-risk, impoverished, urban community in Mexico City. Methods We used a pretest–posttest (baseline to 12-week follow-up) design without a control group. Material from Salud para su Corazón was validated and delivered by promotores (community health workers) to community members from 6 geographic areas. Two validated, self-administered questionnaires that assessed participants’ knowledge and behaviors relating to heart health were administered. We used t tests and χ2 tests to evaluate pretest and posttest differences, by age group (≤60 and >60 years), for participants’ 3 heart-healthy habits, 3 types of physical activity, performance skills, and anthropometric and clinical measurements. Results A total of 452 (82%) adult participants completed the program. Heart-healthy habits from pretest to posttest varied by age group. “Taking action” to modify lifestyle behaviors increased among adults aged 60 or younger from 31.5% to 63.0% (P < .001) and among adults older than 60 from 30.0% to 45.0% (P < .001). Positive responses for cholesterol and fat consumption reduction were seen among participants 60 or younger (P = .03). Among those older than 60, salt reduction and weight control increased (P = .008). Mean blood glucose concentration among adults older than 60 decreased postintervention (P = .03). Conclusion Significant improvements in some heart-healthy habits were seen among adult participants. The model has potential to improve heart-healthy habits and facilitate behavioral change among high-risk adults. PMID:25764140

FREQUENCY OF ANTI- Toxocara spp. ANTIBODIES IN INDIVIDUALS ATTENDED BY THE CENTRO DE SALUD FAMILIAR AND ENVIRONMENTAL CONTAMINATION WITH Toxocara canis EGGS IN DOG FECES, IN THE COASTAL NIEBLA TOWN, CHILE

PubMed Central

VARGAS, Catalina; TORRES, Patricio; JERCIC, María Isabel; LOBOS, Marta; OYARCE, Alan; MIRANDA, Juan Carlos; AYALA, Salvador

2016-01-01

SUMMARY The frequency of anti-Toxocara spp. antibodies in individuals attended by the Centro de Salud Familiar in the coastal Niebla town, Chile, was related to the host and to environmental factors. IgG anti- Toxocara antibodies were detected with a commercial ELISA kit (SCIMEDX Corporation, USA). Samples with undetermined absorbance values were subjected to an additional ELISA standardized by the Instituto de Salud Pública, Chilean Health Ministry, a commercial ELISA (NOVATEC, Germany), and a commercial Western blot kit (LDBio Diagnostics, France). Hematological exams were performed using an automated blood counter and blood smears. Dog feces were collected from the ground along the main road in Niebla, including rural and urban locations. Ninety (25.4%) of the 355 examined individuals were positive by the ELISA test. The frequency of anti-Toxocara antibodies and the infection risk were significantly higher (p < 0.05) among those individuals ≥ 40 years old with respect to the 20-39 years old group, in individuals from rural locations, those who did not have a safe drinking water supply in the house or who presented blood eosinophilia. The proportion of positive samples of dog feces and the mean number of Toxocara canis eggs/g of feces in urban and rural areas were similar (p > 0.05). PMID:27680167

FREQUENCY OF ANTI- Toxocara spp. ANTIBODIES IN INDIVIDUALS ATTENDED BY THE CENTRO DE SALUD FAMILIAR AND ENVIRONMENTAL CONTAMINATION WITH Toxocara canis EGGS IN DOG FECES, IN THE COASTAL NIEBLA TOWN, CHILE.

PubMed

Vargas, Catalina; Torres, Patricio; Jercic, María Isabel; Lobos, Marta; Oyarce, Alan; Miranda, Juan Carlos; Ayala, Salvador

2016-09-22

The frequency of anti-Toxocara spp. antibodies in individuals attended by the Centro de Salud Familiar in the coastal Niebla town, Chile, was related to the host and to environmental factors. IgG anti- Toxocara antibodies were detected with a commercial ELISA kit (SCIMEDX Corporation, USA). Samples with undetermined absorbance values were subjected to an additional ELISA standardized by the Instituto de Salud Pública, Chilean Health Ministry, a commercial ELISA (NOVATEC, Germany), and a commercial Western blot kit (LDBio Diagnostics, France). Hematological exams were performed using an automated blood counter and blood smears. Dog feces were collected from the ground along the main road in Niebla, including rural and urban locations. Ninety (25.4%) of the 355 examined individuals were positive by the ELISA test. The frequency of anti-Toxocara antibodies and the infection risk were significantly higher (p < 0.05) among those individuals ≥ 40 years old with respect to the 20-39 years old group, in individuals from rural locations, those who did not have a safe drinking water supply in the house or who presented blood eosinophilia. The proportion of positive samples of dog feces and the mean number of Toxocara canis eggs/g of feces in urban and rural areas were similar (p > 0.05).

[The "Instituto de Salud Carlos III" and the public health in Spain. Origin of laboratory medicine and of the central laboratories and research in public health].

PubMed

Nájera Morrondo, Rafael

2006-01-01

The "Instituto de Salud Carlos III" is the Central Public Health Laboratory in Spain with an important component of scientific research in health related areas, such as cancer, cardiovascular diseases, infectious diseases and environmental health. The article describes the development of the Public Health Institutes. arising from the introduction and development of scientific and laboratory based medicine and the introduction of vaccination and sanitation with the control of water and food. At about the same time, the discoveries in microbiology and immunology were produced, being the research activities incardinated with the practical advances in the control of products. To cope with the practical needs, Institutions were created with the responsibility of providing smallpox vaccine but incorporating very soon production of sera and other vaccines and water and sanitation control and foods control. At the same time. colonization of countries specially in Africa, South East Asia and explorations in Central America confront the Europeans with new diseases and the need of laboratories where to study them. These circumstances gave rise to the birth of the Central Public Health Laboratories and the National institutes of Health at the beginning of the XX century in many countries. In Spain, the Spanish Civil War was a breaking point in the development of such an institution that finally was reinvented with the creation of the Instituto de Salud Carlos III, in 1986, incorporating research and epidemiological surveillance and control of diseases and also the responsibilities of the Food and Drug Control, lately separated from it.

PROJECT SALUD: EFFICACY OF A COMMUNITY-BASED HIV PREVENTION INTERVENTION FOR HISPANIC MIGRANT WORKERS IN SOUTH FLORIDA

PubMed Central

Sánchez, Jesús; De La Rosa, Mario; Serna, Claudia A.

2014-01-01

Project Salud evaluates the efficacy of a community-based intervention to reduce risk behaviors and enhance factors for HIV-preventative behaviors. A randomized controlled trial of 278 high risk Latino migrant workers was conducted between 2008 and 2010. Participants completed an audio computer-assisted self-interview questionnaire at baseline and 3- and 9-month post-intervention follow-ups. Participants were randomly assigned to the community-based intervention (A-SEMI) or the health promotion condition (HPC). Both interventions consisted of four 2.5–hour interactive sessions and were structurally equivalent in administration and format. Relative to the comparison condition, A-SEMI participants reported more consistent condom use, were less likely to report never having used condoms, and were more likely to have used condoms at last sexual encounter during the past 90 and 30 days. A-SEMI participants also experienced a positive change in regard to factors for HIV-preventive behaviors over the entire 9-month period. Our results support the implementation of community-based, culturally tailored interventions among Latino migrant workers. PMID:24059875

Engaging Men as Promotores de Salud: Perceptions of Community Health Workers among Latino Men in North Carolina*

PubMed Central

Villa-Torres, Laura; Fleming, Paul; Barrington, Clare

2016-01-01

The promotor de salud, or community health worker (CHW) role, is highly feminized and little is known about how men view their participation in CHW programs. We conducted in-depth interviews with Latino men in North Carolina to explore this gap. We used systematic coding and display procedures informed by Grounded Theory to analyze the data. Men described their communities as lacking cohesion, making integration of Latino immigrants difficult. Most did not consider themselves leaders or feel they had leaders in their communities. Their perceptions of the feminized CHW role as well as the volunteer or low-paid nature of CHW work conflicted with men’s provider role. They also did not think they could perform the CHW role because they lacked education, skills, and broad networks. Efforts to increase male participation in CHW programs in new Latino immigrant destinations will need to understand and address these gender and migration-related dynamics in order to engage both women and men in improving the health of their communities. PMID:24989349

Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China

PubMed Central

Yao, Hong; Li, Weixin; Qian, Xin

2015-01-01

Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution. PMID:26308032

Toward Advanced Nursing Practice along with People-Centered Care Partnership Model for Sustainable Universal Health Coverage and Universal Access to Health.

PubMed

Kamei, Tomoko; Takahashi, Keiko; Omori, Junko; Arimori, Naoko; Hishinuma, Michiko; Asahara, Kiyomi; Shimpuku, Yoko; Ohashi, Kumiko; Tashiro, Junko

2017-01-30

. o cuidado centrado nas pessoas começa quando os membros da comunidade e os profissionais de saúde colocam em primeiro plano as questões sociais entre os membros da comunidade e das famílias. Esse modelo aborda essas questões, a criação de novos valores relativos à saúde e forma um sistema social que melhora a qualidade de vida e dá apoio social para sustentar o sistema de saúde universal por meio da construção de parcerias com as comunidades. um modelo de parceria CCP aborda os desafios das mudanças sociais que afetam a saúde geral e o novo papel das enfermeiras de prática avançada em sustentar a UHC. este estudio desarrolló un modelo de alianza para el cuidado centrado en las personas (CCP) para una sociedad envejecida, que haga frente a los retos de los cambios sociales que afectan a la salud de las personas y el nuevo papel de las enfermeras de práctica avanzada para apoyar la cobertura universal de salud. un modelo de alianza para el cuidado centrado en las personas fue desarrollado sobre la base de la meta-síntesis cualitativa de la literatura y la evaluación de 14 proyectos relacionados. Los proyectos en curso dieron lugar a la transformación individual y social mejorando la "alfabetización sanitaria" de la comunidad y los comportamientos, utilizando los cuidados centrados en las personas y aumentando la colaboración entre los profesionales sanitarios y miembros de la comunidad a través de las enfermeras de práctica avanzada. el cuidado centrado en las personas comienza cuando los miembros de la comunidad y los profesionales sanitarios ponen en primer plano a la salud y las cuestiones sociales entre los miembros de la comunidad y las familias. Este modelo aborda estas cuestiones, creando nuevos valores relativos a la salud y formando un sistema social que mejora la calidad de vida y el apoyo social para hacer sostenible la atención sanitaria universal a través del proceso de construcción de alianzas con las comunidades. un modelo

Trends in Epidemiology of Pediatric Inflammatory Bowel Disease in Canada: Distributed Network Analysis of Multiple Population-Based Provincial Health Administrative Databases

PubMed Central

Benchimol, Eric I; Bernstein, Charles N; Bitton, Alain; Carroll, Matthew W; Singh, Harminder; Otley, Anthony R; Vutcovici, Maria; El-Matary, Wael; Nguyen, Geoffrey C; Griffiths, Anne M; Mack, David R; Jacobson, Kevan; Mojaverian, Nassim; Tanyingoh, Divine; Cui, Yunsong; Nugent, Zoann J; Coulombe, Janie; Targownik, Laura E; Jones, Jennifer L; Leddin, Desmond; Murthy, Sanjay K; Kaplan, Gilaad G

2017-01-01

Objectives: The incidence of pediatric-onset inflammatory bowel disease (IBD) is increasing worldwide. We used population-based health administrative data to determine national Canadian IBD incidence, prevalence, and trends over time of childhood-onset IBD. Methods: We identified children <16 years (y) diagnosed with IBD 1999–2010 from health administrative data in five provinces (Alberta, Manitoba, Nova Scotia, Ontario, Quebec), comprising 79.2% of the Canadian population. Standardized incidence and prevalence were calculated per 100,000 children. Annual percentage change (APC) in incidence and prevalence were determined using Poisson regression analysis. Provincial estimates were meta-analyzed using random-effects models to produce national estimates. Results: 5,214 incident cases were diagnosed during the study period (3,462 Crohn’s disease, 1,382 ulcerative colitis, 279 type unclassifiable). The incidence in Canada was 9.68 (95% CI 9.11 to 10.25) per 100,000 children. Incidence was similar amongst most provinces, but higher in Nova Scotia. APC in incidence did not significantly change over the study period in the overall cohort (+2.06%, 95% CI −0.64% to +4.76%). However, incidence significantly increased in children aged 0–5y (+7.19%, 95% +2.82% to +11.56%). Prevalence at the end of the study period in Canada was 38.25 (95% CI 35.78 to 40.73) per 100,000 children. Prevalence increased significantly over time, APC +4.56% (95% CI +3.71% to +5.42%). Conclusions: Canada has amongst the highest incidence of childhood-onset IBD in the world. Prevalence significantly increased over time. Incidence was not statistically changed with the exception of a rapid increase in incidence in the youngest group of children. PMID:28417994

Assessing Infant Feeding Attitudes of Expectant Women in a Provincial Population in Canada: Validation of the Iowa Infant Feeding Attitude Scale.

PubMed

Twells, Laurie K; Midodzi, William K; Ludlow, Valerie; Murphy-Goodridge, Janet; Burrage, Lorraine; Gill, Nicole; Halfyard, Beth; Schiff, Rebecca; Newhook, Leigh Anne

2016-08-01

Maternal attitudes to infant feeding are predictive of intent and initiation of breastfeeding. The Iowa Infant Feeding Attitude Scale (IIFAS) has not been validated in the Canadian population. This study was conducted in Newfoundland and Labrador, a Canadian province with low breastfeeding rates. Objectives were to assess the reliability and validity of the IIFAS in expectant mothers; to compare attitudes to infant feeding in urban and rural areas; and to examine whether attitudes are associated with intent to breastfeed. The IIFAS assessment tool was administered to 793 pregnant women. Differences in the total IIFAS scores were compared between urban and rural areas. Reliability and validity analysis was conducted on the IIFAS. The receiver operating characteristic (ROC) of the IIFAS was assessed against mother's intent to breastfeed. The mean ± SD of the total IIFAS score of the overall sample was 64.0 ± 10.4. There were no significant differences in attitudes between urban (63.9 ± 10.5) and rural (64.4 ± 9.9) populations. There were significant differences in total IIFAS scores between women who intend to breastfeed (67.3 ± 8.3) and those who do not (51.6 ± 7.7), regardless of population region. The high value of the area under the curve (AUC) of the ROC (AUC = 0.92) demonstrates excellent ability of the IIFAS to predict intent to breastfeed. The internal consistency of the IIFAS was strong, with a Cronbach's alpha greater than .80 in the overall sample. The IIFAS examined in this provincial population provides a valid and reliable assessment of maternal attitudes toward infant feeding. This tool could be used to identify mothers less likely to breastfeed and to inform health promotion programs. © The Author(s) 2014.

A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers.

PubMed

Kanamori, Mariano; De La Rosa, Mario; Diez, Stephanie; Weissman, Jessica; Trepka, Mary Jo; Sneij, Alicia; Schmidt, Peter; Rojas, Patria

2016-12-30

Throughout the past decade, HIV rates in Florida-particularly South Florida, where many Latina seasonal farmworkers reside and work-have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings.

¡Cocinar Para Su Salud!: Randomized Controlled Trial of a Culturally Based Dietary Intervention among Hispanic Breast Cancer Survivors.

PubMed

Greenlee, Heather; Gaffney, Ann Ogden; Aycinena, A Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M; Lim, Emerson; Tsai, Wei-Yann; Crew, Katherine; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L

2015-05-01

There is a need for culturally relevant nutrition programs targeted to underserved cancer survivors. Our aim was to examine the effect of a culturally based approach to dietary change on increasing fruit/vegetable (F/V) intake and decreasing fat intake among Hispanic breast cancer survivors. Participants were randomized to Intervention and Control groups. Diet recalls, detailed interviews, fasting blood, and anthropometric measures were collected at baseline, 3, 6, and 12 months. Hispanic women (n=70) with stage 0 to III breast cancer who completed adjuvant treatment and lived in New York City were randomized between April 2011 and March 2012. The Intervention group (n=34) participated in ¡Cocinar Para Su Salud!, a culturally based nine-session (24 hours over 12 weeks) intervention including nutrition education, cooking classes, and food-shopping field trips. The Control group (n=36) received written dietary recommendations for breast cancer survivors. Change at 6 months in daily F/V servings and percent calories from total fat were the main outcome measures. Linear regression models adjusted for stratification factors and estimated marginal means were used to compare changes in diet from baseline to 3 and 6 months. Baseline characteristics were the following: mean age 56.6 years (standard deviation 9.7 years), mean time since diagnosis 3.4 years (standard deviation 2.7 years), mean body mass index (calculated as kg/m²) 30.9 (standard deviation 6.0), 62.9% with annual household income ≤$15,000, mean daily servings of all F/V was 5.3 (targeted F/V 3.7 servings excluding legumes/juices/starchy vegetables/fried foods), and 27.7% of daily calories from fat. More than 60% in the Intervention group attended seven or more of nine classes, with overall study retention of 87% retention at 6 months. At month 6, the Intervention group compared with Control group reported an increase in mean servings of F/V from baseline (all F/V: +2.0 vs -0.1; P=0.005; targeted F/V: +2

Long-term diet and biomarker changes after a short-term intervention among Hispanic breast cancer survivors: The ¡Cocinar Para Su Salud! randomized controlled trial

PubMed Central

Greenlee, Heather; Gaffney, Ann Ogden; Aycinena, A. Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M.; Shi, Zaixing; Lim, Emerson; Tsai, Wei-Yann; Santella, Regina M.; Blaner, William S.; Clugston, Robin D.; Cremers, Serge; Pollak, Susan; Sirosh, Iryna; Crew, Katherine D.; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L.

2017-01-01

Background Among Hispanic breast cancer (BC) survivors, we examined the long-term effects of a short-term culturally-based dietary intervention on increasing fruits/vegetables (F/V), decreasing fat and changing biomarkers associated with BC recurrence risk. Methods Spanish-speaking women (n=70) with a history of stage 0-III BC who completed treatment were randomized to ¡Cocinar Para Su Salud! (n=34), a culturally-based 9-session program (24 hours over 12 weeks, including nutrition education, cooking classes, and food-shopping field trips), or a control group (n=36, written dietary recommendations for BC survivors). Diet recalls, fasting blood, and anthropometric measures were collected at baseline, 6, and 12 months. We report changes between groups at 12 months in dietary intake and biomarkers using 2-sample Wilcoxon t-tests and Generalized Estimating Equation (GEE) models. Results At 12 months, the intervention group compared to the control group reported higher increases in mean daily F/V servings (total: +2.0 vs. −0.4; P=0.006), and non-significant decreases in percent calories from fat (−2.2% vs. −1.1%; P=0.69) and weight (−2.6 kg vs. −1.5 kg; P=0.56). Compared to controls, participants in the intervention group had higher increases in plasma lutein (+20.4% vs. −11.5%; P=0.002), and borderline significant increases in global DNA methylation (+0.8% vs. −0.5%; P=0.06). Conclusions The short-term ¡Cocinar Para Su Salud! program was effective at increasing long-term F/V intake in Hispanic BC survivors and changed biomarkers associated with BC recurrence risk. Impact It is possible for short-term behavioral interventions to have long-term effects on behaviors and biomarkers in minority cancer patient populations. Results can inform future study designs. PMID:27461049

Supply-side interventions to improve health: Findings from the Salud Mesoamérica Initiative.

PubMed

Mokdad, Ali H; Palmisano, Erin B; Zúñiga-Brenes, Paola; Ríos-Zertuche, Diego; Johanns, Casey K; Schaefer, Alexandra; Desai, Sima S; Haakenstad, Annie; Gagnier, Marielle C; McNellan, Claire R; Colombara, Danny V; López Romero, Sonia; Castillo, Leolin; Salvatierra, Benito; Hernandez, Bernardo; Betancourt-Cravioto, Miguel; Mujica-Rosales, Ricardo; Regalia, Ferdinando; Tapia-Conyer, Roberto; Iriarte, Emma

2018-01-01

Results-based aid (RBA) is increasingly used to incentivize action in health. In Mesoamerica, the region consisting of southern Mexico and Central America, the RBA project known as the Salud Mesoamérica Initiative (SMI) was designed to target disparities in maternal and child health, focusing on the poorest 20% of the population across the region. Data were first collected in 365 intervention health facilities to establish a baseline of indicators. For the first follow-up measure, 18 to 24 months later, 368 facilities were evaluated in these same areas. At both stages, we measured a near-identical set of supply-side performance indicators in line with country-specific priorities in maternal and child health. All countries showed progress in performance indicators, although with different levels. El Salvador, Honduras, Nicaragua, and Panama reached their 18-month targets, while the State of Chiapas in Mexico, Guatemala, and Belize did not. A second follow-up measurement in Chiapas and Guatemala showed continued progress, as they achieved previously missed targets nine to 12 months later, after implementing a performance improvement plan. Our findings show an initial success in the supply-side indicators of SMI. Our data suggest that the RBA approach can be a motivator to improve availability of drugs and services in poor areas. Moreover, our innovative monitoring and evaluation framework will allow health officials with limited resources to identify and target areas of greatest need.

Project Salud: Using community-based participatory research to culturally adapt an HIV prevention intervention in the Latino migrant worker community.

PubMed

Sánchez, Jesús; Serna, Claudia A; de La Rosa, Mario

2012-01-01

Despite the unique and challenging circumstances confronting Latino migrant worker communities in the U.S., debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Project Salud adopted a community-based participatory research model and utilized focus group methodology with 83 Latino migrant workers to explore the relevance of culturally adapting an evidence-based HIV prevention intervention to be disseminated within this population. Findings from this study indicate that, despite early reservations, Latino migrant workers wanted to participate in the cultural adaptation that would result in an intervention that was culturally relevant, respectful, responsive to their life experiences, and aligned with their needs. This study contributes to the cultural adaptation/fidelity debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance without sacrificing high fidelity to the core components that have established efficacy for evidence-based HIV prevention interventions.

[Rethinking how health is promoted in the Colombian general health-related social security system (Sistema General de Seguridad Social en Salud)].

PubMed

Eslava-Castañeda, Juan C

2006-12-01

This article takes stock of how promoting health (PH) (promoción de la salud - PS) has been understood within an international setting and gives three meanings for promotion: as general policy orientation, as a set of actions and as a special dimension of sanitary work. Interest expressed in giving it a specific basis distinguishing it from prevention, transcending educational work, has emerged from the subtle differences established from such different ways of coming to terms with PH. After recognising the challenge posed by PH in the field of health, the text succinctly describes how discourse regarding PH has been introduced in Colombia and discusses how an attempt has been made to be more precise regarding its place in the general health-related social security system. Efforts currently being made in Colombia regarding making PH become a reality within the Colombian health system are then mentioned.

A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers

PubMed Central

Kanamori, Mariano; De La Rosa, Mario; Diez, Stephanie; Weissman, Jessica; Trepka, Mary Jo; Sneij, Alicia; Schmidt, Peter; Rojas, Patria

2016-01-01

Throughout the past decade, HIV rates in Florida—particularly South Florida, where many Latina seasonal farmworkers reside and work—have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings. PMID:28042852

Health and wealth in Mesoamerica: findings from Salud Mesomérica 2015.

PubMed

Mokdad, Ali H; Gagnier, Marielle C; Colson, K Ellicott; Zúñiga-Brenes, Paola; Ríos-Zertuche, Diego; Haakenstad, Annie; Palmisano, Erin B; Anderson, Brent W; Desai, Sima S; Gillespie, Catherine W; Murphy, Tasha; Naghavi, Paria; Nelson, Jennifer; Ranganathan, Dharani; Schaefer, Alexandra; Usmanova, Gulnoza; Wilson, Shelley; Hernandez, Bernardo; Lozano, Rafael; Iriarte, Emma

2015-07-14

Individual income and poverty are associated with poor health outcomes. The poor face unique challenges related to access, education, financial capacity, environmental effects, and other factors that threaten their health outcomes. We examined the variation in the health outcomes and health behaviors among the poorest quintile in eight countries of Mesoamerica using data from the Salud Mesomérica 2015 baseline household surveys. We used multivariable logistic regression to measure the association between delivering a child in a health facility and select household and maternal characteristics, including education and measures of wealth. Health indicators varied greatly between geographic segments. Controlling for other demographic characteristics, women with at least secondary education were more likely to have an in-facility delivery compared to women who had not attended school (OR: 3.20, 95 % confidence interval [CI]: 2.56-3.99, respectively). Similarly, women from households with the highest expenditure were more likely to deliver in a health facility compared to those from the lowest expenditure households (OR 3.06, 95 % CI: 2.43-3.85). Household assets did not impact these associations. Moreover, we found that commonly-used definitions of poverty do not align with the disparities in health outcomes observed in these communities. Although poverty measured by expenditure or wealth is associated with health disparities or health outcomes, a composite indicator of health poverty based on coverage is more likely to focus attention on health problems and solutions. Our findings call for the public health community to define poverty by health coverage measures rather than income or wealth. Such a health-poverty metric is more likely to generate attention and mobilize targeted action by the health communities than our current definition of poverty.

Physical activity and sedentary behaviors in postpartum Latinas: Madres para la Salud.

PubMed

Ainsworth, Barbara E; Keller, Colleen; Herrmann, Stephen; Belyea, Michael; Records, Kathryn; Nagle-Williams, Allison; Vega-López, Sonia; Permana, Paska; Coonrod, Dean V

2013-07-01

To describe the physical activity (PA) and sedentary behaviors of postpartum Latinas who are overweight or obese before initiating Madres para la Salud, a social support-mediated walking intervention to promote postpartum weight loss. One hundred thirty-nine postpartum women (13.6 ± 7.7 wk since childbirth, age = 28.3 ± 5.6 yr, BMI = 29.7 ± 3.5 kg · m(-2); mean ± SD), recruited from organizations serving Latino residents in the Phoenix, Arizona, area completed the Stanford Brief Activity Survey and concurrently wore an accelerometer (ActiGraph) and a pedometer for 7 d and kept a PA record. Most were classified as inactive and lightly active on the Stanford Brief Activity Survey (51% inactive, 37% light, 11% moderate). Most time was spent in sedentary (512.0 ± 169.9 min · d(-1)) and light-intensity PA (242.4 ± 51.4 min · d(-1)) with less time in moderate-intensity lifestyle (78.3 ± 39.9 min · d(-1)), moderate-intensity walking (16.6 ± 14.4 min · d(-1)), and vigorous-intensity PA (0.34 ± 1.5 min · d(-1)). Pedometer steps per day were low (total = 4973 ± 2202 steps, aerobic = 412 ± 774 steps), with most participants rated as sedentary (61%) or low active (28.1%). Consistent with objective PA measures, PA records showed more time spent in light-intensity PA such as home care, cooking, child care and self-care tasks, occupation, religious events, and watching television. By and large, the postpartum Latinas enrolled spent most of their day in low-intensity activity levels with little time spent in health-enhancing PA levels/behaviors. This demographic should be the focus of PA interventions to increase PA to health-enhancing levels.

Salud es Vida: a Cervical Cancer Screening Intervention for Rural Latina Immigrant Women.

PubMed

Luque, John S; Tarasenko, Yelena N; Reyes-Garcia, Claudia; Alfonso, Moya L; Suazo, Norma; Rebing, Laura; Ferris, Daron G

2017-12-01

This study examined the feasibility and efficacy of Salud es Vida-a promotora-led, Spanish language educational group session on cervical cancer screening (Pap tests)-self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014-2015. Hispanic/Latina immigrant women aged 21-65 years and overdue for a Pap test were included as intervention (N = 38) and control (N = 52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Twelve (32 %) intervention group participants received the Pap test compared to 10 (19 %) control group participants (p = 0.178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < 0.001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. The group intervention approach was associated with increased cervical cancer knowledge but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

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

PubMed Central

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

2018-01-01

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

Mujeres felices por ser saludables: a breast cancer risk reduction program for Latino women.

PubMed

Fitzgibbon, Marian L; Gapstur, Susan M; Knight, Sara J

2003-05-01

Breast cancer is the most commonly diagnosed cancer and the most common cause of cancer mortality among Latino women. Several behavioral factors such as early detection and dietary practices could help decrease morbidity and mortality associated with breast cancer in this population. Unfortunately, there are few data regarding the efficacy of health-related interventions for young Latino women. Mujeres Felices por ser Saludables is a randomized intervention project designed to assess breast cancer risk reduction behavior among Latino women ages 20-40 years. The primary objectives of the project were to determine whether an 8-month integrated dietary/breast health intervention could lead to a greater reduction in dietary fat, increase in dietary fiber, increase in the frequency and proficiency of breast self examination (BSE), and reduction in anxiety related to BSE compared to controls. Herein we describe the overall design of the project and present baseline characteristics of the 256 randomized women. Our results suggest that the average daily intake of dietary fat (percentage of total energy) was slightly below 30% (percentage of total energy) among the women randomized. While over half of these women reported that they practice BSE, and few reported anxiety related to BSE, less than 27% of women were proficient in the recommended BSE technique. There are few data on the dietary and breast health behaviors of young low-acculturated Latino women. This study documents the feasibility of recruiting, randomizing, and obtaining both baseline dietary and breast health data on this unique and underserved population.

¡Cocinar Para Su Salud!: Randomized Controlled Trial of a Culturally Based Dietary Intervention among Hispanic Breast Cancer Survivors.

PubMed

Greenlee, Heather; Gaffney, Ann Ogden; Aycinena, A Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M; Lim, Emerson; Tsai, Wei-Yann; Crew, Katherine; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L

2015-05-01

There is a need for culturally relevant nutrition programs targeted to underserved cancer survivors. Our aim was to examine the effect of a culturally based approach to dietary change on increasing fruit/vegetable (F/V) intake and decreasing fat intake among Hispanic breast cancer survivors. Participants were randomized to Intervention and Control groups. Diet recalls, detailed interviews, fasting blood, and anthropometric measures were collected at baseline, 3, 6, and 12 months. Hispanic women (n=70) with stage 0 to III breast cancer who completed adjuvant treatment and lived in New York City were randomized between April 2011 and March 2012. The Intervention group (n=34) participated in ¡Cocinar Para Su Salud!, a culturally based nine-session (24 hours over 12 weeks) intervention including nutrition education, cooking classes, and food-shopping field trips. The Control group (n=36) received written dietary recommendations for breast cancer survivors. Change at 6 months in daily F/V servings and percent calories from total fat were the main outcome measures. Linear regression models adjusted for stratification factors and estimated marginal means were used to compare changes in diet from baseline to 3 and 6 months. Baseline characteristics were the following: mean age 56.6 years (standard deviation 9.7 years), mean time since diagnosis 3.4 years (standard deviation 2.7 years), mean body mass index (calculated as kg/m(2)) 30.9 (standard deviation 6.0), 62.9% with annual household income ≤$15,000, mean daily servings of all F/V was 5.3 (targeted F/V 3.7 servings excluding legumes/juices/starchy vegetables/fried foods), and 27.7% of daily calories from fat. More than 60% in the Intervention group attended seven or more of nine classes, with overall study retention of 87% retention at 6 months. At month 6, the Intervention group compared with Control group reported an increase in mean servings of F/V from baseline (all F/V: +2.0 vs -0.1; P=0.005; targeted F

Individuals with Mental Retardation from the Perspective of Turkish People

ERIC Educational Resources Information Center

Güner Yildiz, Nevin

2015-01-01

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

Experiencias sobre el impacto del Programa de Formación en Ética de la Investigación Biomédica y Psicosocial en el ámbito de la salud mental y la investigación conductual.

PubMed

Barrios, Liliana Mondragón

2012-01-01

El propósito de este trabajo es presentar el impacto y la integración que los conocimientos adquiridos en el Programa Internacional de Formación en Ética de la Investigación Biomédica y Psicosocial de la Universidad de Chile han tenido en mi experiencia profesional, en el ámbito de la investigación psicosocial en un Instituto de Salud de México. Para este objetivo, expondré tres áreas en las cuales se ha podido evidenciar tal impacto: trabajo en los comités de ética, desarrollo de programas de académicos en bioética e investigación y publicación sobre ética y bioética. El motivo que me llevó a incursionar en el Programa fue que su enseñanza vincula la investigación psicosocial con la ética y la bioética, lo cual me permitió dirigir este tipo de reflexión hacia problemas como violencia, suicidio, adicciones, depresión y salud mental, y a nuevos campos como los estudios comunitarios, con poblaciones en riesgo o vulnerables, en los cuales las diversas implicaciones son difíciles de indagar.

Experiencias sobre el impacto del Programa de Formación en Ética de la Investigación Biomédica y Psicosocial en el ámbito de la salud mental y la investigación conductual

PubMed Central

Barrios, Liliana Mondragón

2012-01-01

El propósito de este trabajo es presentar el impacto y la integración que los conocimientos adquiridos en el Programa Internacional de Formación en Ética de la Investigación Biomédica y Psicosocial de la Universidad de Chile han tenido en mi experiencia profesional, en el ámbito de la investigación psicosocial en un Instituto de Salud de México. Para este objetivo, expondré tres áreas en las cuales se ha podido evidenciar tal impacto: trabajo en los comités de ética, desarrollo de programas de académicos en bioética e investigación y publicación sobre ética y bioética. El motivo que me llevó a incursionar en el Programa fue que su enseñanza vincula la investigación psicosocial con la ética y la bioética, lo cual me permitió dirigir este tipo de reflexión hacia problemas como violencia, suicidio, adicciones, depresión y salud mental, y a nuevos campos como los estudios comunitarios, con poblaciones en riesgo o vulnerables, en los cuales las diversas implicaciones son difíciles de indagar. PMID:22754085

Long-term Diet and Biomarker Changes after a Short-term Intervention among Hispanic Breast Cancer Survivors: The ¡Cocinar Para Su Salud! Randomized Controlled Trial.

PubMed

Greenlee, Heather; Ogden Gaffney, Ann; Aycinena, A Corina; Koch, Pam; Contento, Isobel; Karmally, Wahida; Richardson, John M; Shi, Zaixing; Lim, Emerson; Tsai, Wei-Yann; Santella, Regina M; Blaner, William S; Clugston, Robin D; Cremers, Serge; Pollak, Susan; Sirosh, Iryna; Crew, Katherine D; Maurer, Matthew; Kalinsky, Kevin; Hershman, Dawn L

2016-11-01

Among Hispanic breast cancer survivors, we examined the long-term effects of a short-term culturally based dietary intervention on increasing fruits/vegetables (F/V), decreasing fat, and changing biomarkers associated with breast cancer recurrence risk. Spanish-speaking women (n = 70) with a history of stage 0-III breast cancer who completed treatment were randomized to ¡Cocinar Para Su Salud! (n = 34), a culturally based 9-session program (24 hours over 12 weeks, including nutrition education, cooking classes, and food-shopping field trips), or a control group (n = 36, written dietary recommendations for breast cancer survivors). Diet recalls, fasting blood, and anthropometric measures were collected at baseline, 6, and 12 months. We report changes between groups at 12 months in dietary intake and biomarkers using 2-sample Wilcoxon t tests and generalized estimating equation (GEE) models. At 12 months, the intervention group compared with the control group reported higher increases in mean daily F/V servings (total: +2.0 vs. -0.4; P < 0.01), and nonsignificant decreases in the percentage of calories from fat (-2.2% vs. -1.1%; P = 0.69) and weight (-2.6 kg vs. -1.5 kg; P = 0.56). Compared with controls, participants in the intervention group had higher increases in plasma lutein (+20.4% vs. -11.5%; P < 0.01), and borderline significant increases in global DNA methylation (+0.8% vs. -0.5%; P = 0.06). The short-term ¡Cocinar Para Su Salud! program was effective at increasing long-term F/V intake in Hispanic breast cancer survivors and changed biomarkers associated with breast cancer recurrence risk. It is possible for short-term behavioral interventions to have long-term effects on behaviors and biomarkers in minority cancer patient populations. Results can inform future study designs. Cancer Epidemiol Biomarkers Prev; 25(11); 1491-502. ©2016 AACR. ©2016 American Association for Cancer Research.

[Mental health problems among female staff in a provincial maternal and child health hospital: an investigation of 647 individuals].

PubMed

He, W J; Xia, J H; Lv, X; Li, L M

2018-02-20

Objective: To investigate the current status of depression and anxiety among female staff in a maternal and child health hospital, and to provide a basis for developing related prevention and intervention measures and promoting the mental health of female staff. Methods: The female staff from a provincial maternal and child health hospital completed a psycho-health questionnaire survey on Internet from June to October, 2016. The questionnaires used in the survey consisted of Patient Health Questionnaire (PHQ-9) , Generalized Anxiety Disorder Scale (GAD-7) , and Symptom Checklist-90 (SCL-90) . The distribution features of mental health problems such as depression and anxiety were analyzed according to the results: of the questionnaire survey. Results Of all female staff surveyed, 42.04% showed depression symptoms, 28.90% showed anxiety symptoms, and 26.12% showed comorbid symptoms of depression and anxiety. Moderate or severe depression (anxiety) was mainly distributed among the female staff with comorbid symptoms (90.63% and 97.01%, respectively) . There were significant differences in the distribution of moderate or severe anxiety symptoms between the medical staff and nursing staff (χ(2)= 5.81, P =0.05) and between those with intermediate and junior professional titles (χ(2)=7.99, P =0.018) . As for SCL-90 results, the total score, total average score, and scores on factors of somatization, compulsion, interpersonal sensitivity, depression, and anxiety in the female staff with comorbid symptoms, moderate or severe depression, and moderate or severe anxiety were significantly higher than the national norm ( P <0.01) , while the scores on paranoid and psychotic factors were significantly lower than the national norm ( P <0.01) . The numbers of cases of positive factors were significantly higher in the female staff with comorbid symptoms than in the female staff with a single symptom and asymptomatic female staff (both P <0.01) , and positive cases were mainly

Salud Mesoamérica 2015 Initiative: design, implementation, and baseline findings.

PubMed

Mokdad, Ali H; Colson, Katherine Ellicott; Zúñiga-Brenes, Paola; Ríos-Zertuche, Diego; Palmisano, Erin B; Alfaro-Porras, Eyleen; Anderson, Brent W; Borgo, Marco; Desai, Sima; Gagnier, Marielle C; Gillespie, Catherine W; Giron, Sandra L; Haakenstad, Annie; Romero, Sonia López; Mateus, Julio; McKay, Abigail; Mokdad, Ali A; Murphy, Tasha; Naghavi, Paria; Nelson, Jennifer; Orozco, Miguel; Ranganathan, Dharani; Salvatierra, Benito; Schaefer, Alexandra; Usmanova, Gulnoza; Varela, Alejandro; Wilson, Shelley; Wulf, Sarah; Hernandez, Bernardo; Lozano, Rafael; Iriarte, Emma; Regalia, Ferdinando

2015-01-01

Health has improved markedly in Mesoamerica, the region consisting of southern Mexico and Central America, over the past decade. Despite this progress, there remain substantial inequalities in health outcomes, access, and quality of medical care between and within countries. Poor, indigenous, and rural populations have considerably worse health indicators than national or regional averages. In an effort to address these health inequalities, the Salud Mesoamérica 2015 Initiative (SM2015), a results-based financing initiative, was established. For each of the eight participating countries, health targets were set to measure the progress of improvements in maternal and child health produced by the Initiative. To establish a baseline, we conducted censuses of 90,000 households, completed 20,225 household interviews, and surveyed 479 health facilities in the poorest areas of Mesoamerica. Pairing health facility and household surveys allows us to link barriers to care and health outcomes with health system infrastructure components and quality of health services. Indicators varied significantly within and between countries. Anemia was most prevalent in Panama and least prevalent in Honduras. Anemia varied by age, with the highest levels observed among children aged 0 to 11 months in all settings. Belize had the highest proportion of institutional deliveries (99%), while Guatemala had the lowest (24%). The proportion of women with four antenatal care visits with a skilled attendant was highest in El Salvador (90%) and the lowest in Guatemala (20%). Availability of contraceptives also varied. The availability of condoms ranged from 83% in Nicaragua to 97% in Honduras. Oral contraceptive pills and injectable contraceptives were available in just 75% of facilities in Panama. IUDs were observed in only 21.5% of facilities surveyed in El Salvador. These data provide a baseline of much-needed information for evidence-based action on health throughout Mesoamerica. Our baseline

Interaction between Breathers and Rogue Waves in a Nonlinear Optical Fiber

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Uneasy money: the Instituto Carlos Slim de la Salud, tobacco philanthropy and conflict of interest in global health

PubMed Central

Burch, Tiffany; Wander, Nathaniel; Collin, Jeff

2015-01-01

In May 2007, the Instituto Carso de la Salud—now Instituto Carlos Slim de la Salud (ICSS)—was endowed with US$500 million to focus on priority health issues in Latin America, notably issues of ‘globalisation and non-communicable diseases’. ICSS was soon criticised, however, on the grounds that its funding was derived from tobacco industry profits and that its founder Carlos Slim Hélu remained an active industry principal. Collaboration with ICSS was said to run counter to the WHO Framework Convention on Tobacco Control. The Institute's then Executive President Julio Frenk disputed these charges. This research employs an archive of tobacco industry documents triangulated with materials from commercial, media, regulatory and NGO sources to examine the financial relations between Slim and the tobacco industry. The paper analyses Slim's continuing service to the industry and role in ICSS. It demonstrates a prima facie conflict of interest between ICSS's health mission and its founder's involvement in cigarette manufacturing and marketing, reflected on ICSS's website as a resounding silence on issues of tobacco and health. It is concluded that the reliance of international health agencies upon the commercial sector requires more robust institutional policies to effectively regulate conflicts of interest. PMID:21088061

[Dietary training for school food service providers in support of the Acuerdo Nacional para la Salud Alimentaria].

PubMed

Muñoz-Dávila, Carolina; Rangel-Peniche, Diana Beatriz

2015-01-01

To address the problem of overweight and obesity in Mexico, in 2010 the Acuerdo Nacional para la Salud Alimentaria was published. At school level, food service providers were considered essential to comply with certain commitments. The goal of this intervention was to train school food service providers in school eating establishments (SEE) as to the criteria in the general guidelines for the sale and distribution of food in schools of basic education. 13 SEE in San Luis Potosi participated. Based on an initial diagnosis, a class-workshop of 5 sessions was designed. Knowledge regarding food was evaluated at the beginning and end of the sessions. The percentage of adherence regarding general hygiene and food preparation and distribution was obtained at the beginning, one month, and two months post-intervention. School food service providers had little knowledge on the objectives of the Acuerdo in food groups and combination, as well as reading labels; there were significant changes in the last two after intervention. The initial percentage of overall hygiene compliance was 60 %, with an increase of almost 20 % post-training. The preparation and distribution of food did not show significant changes. School food service providers acquired knowledge about the guidelines that a SEE comply with, without putting them into practice, given the economic impact that it implies.

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

PubMed

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

2017-01-01

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

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

PubMed

Forest, Pierre-Gerlier; Palley, Howard A

2008-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

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

[The overweight, the obesity and the glycemic control among diabetics of the provincial reference center of diabetes (CRD), Kenitra, Morocco].

PubMed

Lotfi, Zeghari; Aboussaleh, Youssef; Sbaibi, Rachid; Achouri, Imane; Benguedour, Rachid

2017-01-01

Diabetes is a disorder of assimilation, use and storage of sugars provided in the diet. Its management is based on follow-up of overweight and obese patients and on regular glycemic control. This study aimed to analyze overweight, obesity and glycemic control in 2227 patients with different types of diabetes (type 1, 2 and gestational) presenting to the Provincial referral center of diabetes (RCD) in Kenitra, Morocco. We conducted a study over the period January-December 2015. Overweight and obesity assessment was performed using Body Mass Index calculator (BMI = weight/height 2 (kg/m 2 ). Overweight and obesity were defined by BMI > 25 kg/m 2 and BMI > 30 kg/m 2 respectively; the weight and the height were measured according to World Health Organization's recommendations. Glycemic control was based on glycated hemoglobin levels and fasting blood glucose test. Current guidelines recommend a glycosylated hemoglobin level of 7% and a fasting blood glucose of 0.70g/l - 1.10g/L. The age of patients ranged from 8 months to 80 years, with a prevalence of diabetic patients from the urban environment (74%) compared to those from the rural areas (26%). The entire study population was overweight. The average BMI of women showed a trend toward obesity (BMI≈30): (29.21 kg/m 2 ± 3,1) in patients with gestational diabetes and (29.15 kg/m 2 ± 3.2) in patients with type 2 diabetes. Blood sugar levels were above the standards: 8.5% ± 2.6 > 7% for glycosylated hemoglobin and 1.5 g/L ± 1.3>1.10g/L for fasting blood glucose. The difference between glycosylated hemoglobin levels between men (8.57% ± 2.6) and women (8.1% ± 2.3) were not significant (p > 0.05), it was the same with fasting blood glucose: men (1.44 g/L ± 1,1) and women (1.43 g/L ± 1.2). Pearson's correlation coefficients were highly significant (p<0.005); on the one hand between BMI and fasting blood glucose(r = 0.5) and on the other hand between BMI and glycosylated hemoglobin levels (r = 0.4). The entire study

Distribution of ophthalmologists and optometrists in Islamic Republic of Iran and their associated factors.

PubMed

Mohammadi, S-F; Lashay, M-R; Ashrafi, E; Haghdoust, A-A; Alinia, C; Lashay, A-R; Asadi-Lari, M; Mohammadi, S-M; Hatef, E

2017-02-01

We aimed to determine the distribution of ophthalmic care providers and its correlation with health and socioeconomic status and health system indicators. Data were gathered from the Iran Medical Council and the Iranian Societies of Ophthalmology and Optometry. Concurrent indicators were collected from the Statistical Center of Iran and national studies. A population-adjusted number of combined ophthalmologists and optometrists was used as the main dependent variable. Optometrist/ophthalmologist ratio was 0.9. We had 1 ophthalmologist and 1 optometrist for every 40 000 and 45 000 individuals, respectively. We observed a direct correlation between the number of ophthalmologists, optometrists and life expectancy at the provincial level. Gross provincial income and expenditure and provincial literacy were correlated as well. Provincial unemployment had a negative correlation. Provincial hospital statistics and population density were also significantly correlated. The Islamic Republic of Iran has met the World Health Organization's desired per capita number of ophthalmologists and optometrists, but there is wide variation in their density.

China Report Economic Affairs

DTIC Science & Technology

1985-02-22

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

Integrating family planning with other social services.

PubMed

Bernales, E H

1982-01-01

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

CHINA Report, Political, Sociological and Military Affairs

DTIC Science & Technology

1985-03-18

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

The Sangre Por Salud Biobank: Facilitating Genetic Research in an Underrepresented Latino Community.

PubMed

Shaibi, Gabriel; Singh, Davinder; De Filippis, Eleanna; Hernandez, Valentina; Rosenfeld, Bill; Otu, Essen; Montes de Oca, Gregorio; Levey, Sharon; Radecki Breitkopf, Carmen; Sharp, Richard; Olson, Janet; Cerhan, James; Thibodeau, Stephen; Winkler, Erin; Mandarino, Lawrence

2016-01-01

The Sangre Por Salud (Blood for Health; SPS) Biobank was created for the purpose of expanding precision medicine research to include underrepresented Latino patients. It is the result of a unique collaboration between Mayo Clinic and Mountain Park Health Center, a federally qualified community health center in Phoenix, Arizona. This report describes the rationale, development, implementation, and characteristics of the SPS Biobank. Latino adults (ages 18-85 years) who were active patients within Mountain Park Health Center's internal medicine practice in Phoenix, Ariz., and had no history of diabetes were eligible. Participants provided a personal and family history of chronic disease, completed a sociodemographic, psychosocial, and behavioral questionnaire, underwent a comprehensive cardiometabolic risk assessment (anthropometrics, blood pressure and labs), and provided blood samples for banking. Laboratory results of cardiometabolic testing were returned to the participants and their providers through the electronic health record. During the first 2 years of recruitment into the SPS Biobank, 2,335 patients were approached and 1,432 (61.3%) consented to participate; 1,354 (94.5%) ultimately completed all requisite questionnaires and medical evaluations. The cohort is primarily Spanish-speaking (72.9%), female (73.3%), with a mean age of 41.3 ± 12.5 years. Most participants were born outside of the US (77.9%) and do not have health insurance (77.5%). The prevalence of overweight (35.5%) and obesity (45.0%) was high, as was previously unidentified prediabetes (55.9%), type 2 diabetes (7.4%), prehypertension (46.8%), and hypertension (16.2%). The majority of participants rated their health as good to excellent (72.1%) and, as a whole, described their overall quality of life as high (7.9/10). Collaborative efforts such as the SPS Biobank are critical for ensuring that underrepresented minority populations are included in precision medicine initiatives and biomedical

The Sangre Por Salud Biobank: Facilitating Genetic Research in an Underrepresented Latino Community

PubMed Central

Shaibi, Gabriel; Singh, Davinder; De Filippis, Eleanna; Hernandez, Valentina; Rosenfeld, Bill; Otu, Essen; de Oca, Gregorio Montes; Levey, Sharon; Breitkopf, Carmen Radecki; Sharp, Richard; Olson, Janet; Cerhan, James; Thibodeau, Stephen; Winkler, Erin; Mandarino, Lawrence

2018-01-01

Background/Aims The Sangre Por Salud (Blood for Health; SPS) Biobank was created for the purpose of expanding precision medicine research to include underrepresented Latino patients. It is the result of a unique collaboration between Mayo Clinic and Mountain Park Health Center, a federally qualified community health center in Phoenix, Arizona. This report describes the rationale, development, implementation, and characteristics of the SPS Biobank. Methods Latino adults (ages 18–85 years) who were active patients within Mountain Park Health Center’s internal medicine practice in Phoenix, Ariz., and had no history of diabetes were eligible. Participants provided a personal and family history of chronic disease, completed a sociodemographic, psychosocial, and behavioral questionnaire, underwent a comprehensive cardiometabolic risk assessment (anthropometrics, blood pressure and labs), and provided blood samples for banking. Laboratory results of cardiometabolic testing were returned to the participants and their providers through the electronic health record. Results During the first 2 years of recruitment into the SPS Biobank, 2,335 patients were approached and 1,432 (61.3%) consented to participate; 1,354 (94.5%) ultimately completed all requisite questionnaires and medical evaluations. The cohort is primarily Spanish-speaking (72.9%), female (73.3%), with a mean age of 41.3 ± 12.5 years. Most participants were born outside of the US (77.9%) and do not have health insurance (77.5%). The prevalence of overweight (35.5%) and obesity (45.0%) was high, as was previously unidentified prediabetes (55.9%), type 2 diabetes (7.4%), prehypertension (46.8%), and hypertension (16.2%). The majority of participants rated their health as good to excellent (72.1%) and, as a whole, described their overall quality of life as high (7.9/10). Conclusion Collaborative efforts such as the SPS Biobank are critical for ensuring that underrepresented minority populations are included in

[Strategy to strengthen health research capabilities in regional public universities: the role of the Mining Canon and the Instituto Nacional de Salud].

PubMed

Romaní, Franco; Cabezas, César; Espinoza, Manuel; Minaya, Gabriela; Huaripata, José; Ureta, Juan Manuel; Yazuda, Myriam; Gastañaga, María del Carmen; Miraval, María Luz; Aparco, Juan Pablo; Anaya, Elizabeth; Castro, José; Esquivel, Silvia

2012-01-01

The development of scientific health research requires a sustained and articulated research system that is consistent with the research priorities, as well as both internal and external funding, and availability of competent human resources. The Mining Canon, a constitutional right, has been partly used to foster applied scientific research in public universities (PU). In addition, the National Health Institute (INSTITUTO NACIONAL DE SALUD - INS) is devoted, among others, to promoting, managing and disseminating health research development at a national level. As part of these activities, a technical team was created to provide technical assistance to PU for research development using Mining Canon funds by making local adjustments to research protocols promoted by the INS and assumed by the professors-researchers at the Universities. This article aims at describing the reality of research at Peruvian public universities that have access to Mining Canon funds, as well as to elaborate on the work the INS is carrying out in order to strengthen research capabilities, starting with the development of research proposals that could potentially be funded by the Mining Canon.

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

PubMed

Asante, Augustine; Roberts, Graham; Hall, John

2012-04-01

ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially in rural and remote areas. There is one doctor for 3,300 people and approximately 13 nurses and midwives for 10,000 people. Despite limitations 87% of people seek health care when sick. FINANCING THE HEALTH SYSTEM: The SIG placed a series of reservations on ministerial goods and services budgets that effectively the budget by 33%, severely impacting provincial budgets and resulting in acquired debts. Shortfalls have been addressed by allocating Health Sector Support Program funds to the provinces to allow services to continue, a strategy that will likely recur, but by which donor support replaces government provision Provincial health accountants have received training in MYOB in 2009 but acquittal systems require higher level accounting skills for reports to be submitted on time to permit the release of subsequent funding tranches. HUMAN RESOURCES FOR HEALTH: The shortage of doctors and specialists is a key challenge. As at December 2010, there were a total of 2,728 health workers in the public sector in Solomon Islands. Staff costs consume on average 55% of provincial health grants Filled Public Service Division staff establishments and budgetary reservations have reduced the ability to meet the salary and wage costs of new graduates. Solomon Islands is currently negotiating to assist Vanuatu in filling its nursing staff vacancies with its surplus The return of 75 Cuban trained medical officers from 2013 presents the management challenge of accessing budget provisions for so many new positions and in funding the infrastructure needed to house, equip and maintain them in service. HEALTH MANAGEMENT STRUCTURE: Provincial health managers are operationally responsive to local needs, managerially responsible to provincial governments, while being concerned with adherence to central MHMS policy

Long-term mortality benefits of air quality improvement during the twelfth five-year-plan period in 31 provincial capital cities of China

NASA Astrophysics Data System (ADS)

Liu, Tao; Cai, Yuanyuan; Feng, Baixiang; Cao, Ganxiang; Lin, Hualiang; Xiao, Jianpeng; Li, Xing; Liu, Sha; Pei, Lei; Fu, Li; Yang, Xinyi; Zhang, Bo; Ma, Wenjun

2018-01-01

The severe air pollution across China in the past several years has made the Chinese government recognize its significant impacts on public health and society, and take enormous efforts to improve the air quality all over the country, especially during the Twelfth Five-Year Plan (12th FYP). However, the overall effectiveness of these air pollution control policies remains unclear. In this study, we selected the 31 municipalities and provincial capital cities in mainland China as study settings. We collected the annual average population size, mortality rates (total mortality and mortality due to cardiovascular diseases, respiratory diseases, total cancer, lung cancer and breast cancer) and concentrations of air pollutants (PM10, PM2.5, SO2 and NO2) in each capital city from 2010 to 2015 from national or local Statistical Yearbooks. The effect sizes of air pollutants on mortality were obtained from previously published meta analyses or cohort studies. We first estimated the annual mortality rates attributed to the changes in air pollutant concentrations for every city in each year. Then, we further estimated the mortality benefits in the scenarios where the air quality had reached the grade II levels of Chinese Ambient Air Quality Standards (CAAQS) and World Health Organization (WHO) guidelines. In most capital cities, we observed dominant decreases in air pollutant concentrations during the 12th FYP, particularly from 2013 to 2015, which has led to significant mortality benefits for the public. A total of 121,658 deaths (0.441‰) have been prevented due to the decrease of PM2.5concentrations from 2013 to 2015 in all included cities. The morality benefits were larger in capital cities located in the key regions (the three main regions and ten city groups) than the other cities. In addition, more mortality benefits could be obtained in the future if the air quality reaches the grade II levels of Chinese Ambient Air Quality Standards (CAAQS) or WHO guidelines. We

Building Bridges to Address Health Disparities in Puerto Rico: the "Salud para Piñones" Project.

PubMed

García-Rivera, Enid J; Pacheco, Princess; Colón, Marielis; Mays, Mary Helen; Rivera, Maricruz; Munet-Díaz, Verónica; González, María Del R; Rodríguez, María; Rodríguez, Rebecca; Morales, Astrid

2017-06-01

Over the past several decades, Puerto Ricans have faced increased health threats from chronic diseases, particularly diabetes and hypertension. The patient-provider relationship is the main platform for individual disease management, whereas the community, as an agent of change for the community's health status, has been limited in its support of individual health. Likewise, traditional research approaches within communities have placed academic researchers at the center of the process, considering their knowledge was of greater value than that of the community. In this paradigm, the academic researcher frequently owns and controls the research process. The primary aim is contributing to the scientific knowledge, but not necessarily to improve the community's health status or empower communities for social change. In contrast, the community-based participatory research (CBPR) model brings community members and leaders together with researchers in a process that supports mutual learning and empowers the community to take a leadership role in its own health and well-being. This article describes the development of the community-campus partnership between the University of Puerto Rico School of Medicine and Piñones, a semi-rural community, and the resulting CBPR project: "Salud para Piñones". This project represents a collaborative effort to understand and address the community's health needs and health disparities based on the community's participation as keystone of the process. This participatory approach represents a valuable ally in the development of long-term community-academy partnerships, thus providing opportunities to establish relevant and effective ways to translate evidence-based interventions into concrete actions that impact the individual and community's wellbeing.

¡Cocinar Para Su Salud! Development of a Culturally Based Nutrition Education Curriculum for Hispanic Breast Cancer Survivors Using a Theory-Driven Procedural Model.

PubMed

Aycinena, Ana Corina; Jennings, Kerri-Ann; Gaffney, Ann Ogden; Koch, Pamela A; Contento, Isobel R; Gonzalez, Monica; Guidon, Ela; Karmally, Wahida; Hershman, Dawn; Greenlee, Heather

2017-02-01

We developed a theory-based dietary change curriculum for Hispanic breast cancer survivors with the goal of testing the effects of the intervention on change in dietary intake of fruits/vegetables and fat in a randomized, clinical trial. Social cognitive theory and the transtheoretical model were used as theoretical frameworks to structure curriculum components using the Nutrition Education DESIGN Procedure. Formative assessments were conducted to identify facilitators and barriers common to Hispanic women and test the degree of difficulty and appropriateness of program materials. Focus groups provided valuable insight and informed preimplementation modifications to the dietary program. The result was a systematically planned, evidence-based, culturally tailored dietary intervention for Hispanic breast cancer survivors, ¡Cocinar Para Su Salud! (Cook for Your Health!). The methodology described here may serve as a framework for the development of future dietary interventions among diverse and minority populations. Short- and long-term study results will be reported elsewhere.

Astronomía para ciegos y amblíopes. Proyecto de construcción de un planetario especial en la ciudad de Mar del Plata

NASA Astrophysics Data System (ADS)

Musso, S.

?`Qué es la Astronomía para Ciegos?. El trabajo es una adaptación en base a la escala de magnitudes de Hipparco que cambia el concepto de luz por una adaptación sonora, donde las estrellas de magnitud 6 se escuchan en 10 dB, más o menos lo que consideramos el umbral de la audición humana. Quienes no escuchan muy bien no pueden escuchar las magnitudes 6, de la misma manera que muchos de nosotros, que no poseemos una visión perfecta, no podemos observar esas mismas estrellas en el cielo (más allá de la polución). A los astros de magnitud 5 vamos a relacionarlos a un sonido en 20 dB. Y así sucesivamente. También los colores estarán representados en una convención de graves a agudos y lo mismo algunas características del cielo. Por ejemplo, la Vía Láctea se mostrará como un ``ruido", como bien nos lo hicieron ver nuestros futuros destinatarios. En Mar del Plata nos encontramos ya trabajando en un proyecto que tiene como objetivo final la construcción del Primer Planetario Acústico del Mundo, una herramienta para la enseñanza de la astronomía, un espacio para la lucha contra la discriminación del discapacitado y una posibilidad de ``ver el cielo de un modo diferente".

Historical geographies of provincial science: themes in the setting and reception of the British Association for the Advancement of Science in Britain and Ireland, 1831-c.1939.

PubMed

Withers, Charles; Higgitt, Rebekah; Finnegan, Diarmid

2008-09-01

The British Association for the Advancement of Science sought to promote the understanding of science in various ways, principally by having annual meetings in different towns and cities throughout Britain and Ireland (and, from 1884, in Canada, South Africa and Australia). This paper considers how far the location of its meetings in different urban settings influenced the nature and reception of the association's activities in promoting science, from its foundation in 1831 to the later 1930s. Several themes concerning the production and reception of science--promoting, practising, writing and receiving--are examined in different urban contexts. We consider the ways in which towns were promoted as venues for and centres of science. We consider the role of local field sites, leading local practitioners and provincial institutions for science in attracting the association to different urban locations. The paper pays attention to excursions and to the evolution and content of the BAAS meeting handbook as a 'geographical' guide to the significance of the regional setting and to appropriate scientific venues. The paper considers the reception of BAAS meetings and explores how far the association's intentions for the promotion of science varied by location and by section within the BAAS. In examining these themes--the geographical setting of the association's meetings, the reception of association science in local civic and intellectual context and the importance of place to an understanding of what the BAAS did and how it was received--the paper extends existing knowledge of the association and contributes to recent work within the history of science which has emphasized the 'local' nature of science's making and reception and the mobility of scientific knowledge.

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

PubMed Central

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

2017-01-01

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

Estudio participativo para el desarrolllo de un instrumento de observación de violencia escolar

PubMed Central

Medina Santiago, Nilda G.; Rivera, Tania Cruz; Rodríguez, Maryanes Trenche; Báez Ávila, Loggina S.

2018-01-01

La violencia en las escuelas es reconocida como un problema de salud pública a nivel mundial que impacta negativamente el proceso de enseñanza-aprendizaje. Sin embargo, en Puerto Rico las estadísticas oficiales y los medios de comunicación generalmente se enfocan en hechos aislados de violencia extrema donde se utilizan armas o se destruye propiedad y no recogen formas de violencia más comunes que suelen ocurrir a diario en las escuelas. En este estudio se utilizó el Instrumento de Observación de Violencia Escolar (INOVE), preparado con el insumo de las comunidades escolares participantes del Proyecto VIAS (Violence and Asthma Health Disparity Network) de la Universidad del Este (UNE), para recopilar información acerca de las características de la violencia en dos escuelas puertorriqueñas. Entre los hallazgos del estudio se destacan diferencias por sexo en cuanto a categorías de violencia observadas y la observación de agresividad en juegos e interacciones entre estudiantes. Los datos recopilados han servido de base para la toma de decisiones en cuanto a la prevención de la violencia en las escuelas participantes y tienen implicaciones para el desarrollo de estrategias y programas de prevención. PMID:29643972

Adaptaciones al ejercicio físico en el perfil lipídico y la salud cardiovascular de obesos mórbidos.

PubMed

Delgado-Floody, Pedro; Caamaño-Navarrete, Felipe; Jerez-Mayorga, Daniel; Martínez-Salazar, Cristian; García-Pinillos, Felipe; Latorre-Román, Pedro

2017-01-01

To assess the effects of a physical exercise program on the lipid profile, weight status and the cardiovascular health of obese candidates for bariatric surgery. 22 morbidly obese patients participated in a 6-month physical exercise program. 16 formed the adherent group (attendance ≥ 80%; age: 37.81 ± 11.90 years) and six the non-adherent group (attendance < 80%; age: 45.83 ± 14.23 years). Before and 72 h after the last session were evaluated: weight, body mass index (BMI), contour waist, blood pressure, fasting, cardio respiratory fitness, cholesterol and triglycerides. Weight, BMI and WC showed significant changes (p < 0.05) in both groups, with the results of the adherent group being better. In the adherent group, cardiorespiratory capacity (p = 0.001) was also increased, while diastolic pressure (p = 0.011), basal glycemia (p = 0.021) and triglycerides decreased significantly (p < 0.001). The non-adherent group did not present significant changes in these variables (p ≥ 0.05). The intervention was feasible to perform without negative effects for the participants, and it is possible to recommend improving the cardiovascular health of these of patients. Copyright: © 2017 SecretarÍa de Salud

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

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

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

PubMed

Nishtar, Sania

2006-12-01

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

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

PubMed

Sieng, Sokha; Hurst, Cameron

2017-08-07

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

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

PubMed

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

2015-01-01

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

Efectos combinados de la ampliación de la atención primaria de salud y de las transferencias condicionadas de dinero en efectivo sobre la mortalidad infantil en Brasil, 1998–2010*

PubMed Central

Guanais, Frederico C.

2015-01-01

Objetivos. Examiné los efectos combinados del acceso a la atención primaria mediante el Programa de Salud Familiar (PSF) y las transferencias condicionadas de dinero en efectivo del Programa Bolsa Familia (PBF) sobre la mortalidad infantil posneonatal (MIPN) en Brasil. Métodos. Empleé un análisis ecológico longitudinal usando datos en panel de 4 583 municipios brasileños de 1998 al 2010, con 54 253 observaciones en total. Estimé modelos de regresión de efectos fijos por mínimos cuadrados ordinarios, con la tasa de MIPN como la variable dependiente y el PSF, el PBF y sus interacciones como las principales variables independientes de interés. Resultados. La asociación de una mayor cobertura del PSF con una menor tasa de MIPN se volvió más fuerte conforme aumentaba la cobertura del PBF. En los promedios de todas las demás variables, cuando la cobertura de PBF era 25%, la MIPN predicha fue 5,24 (intervalo de confianza [IC] de 95% = 4,95, 5,53) para una cobertura del PSF de 0%, y de 3,54 (IC de 95% = 2,77, 4,31) para una cobertura del PSF de 100%. Cuando la cobertura del PBF era de 60%, la MIPN predicha fue 4,65 (IC de 95% = 4,36, 4,94) para una cobertura del PSF de 0%, y de 1,38 (IC de 95% = 0,88, 1,89) para una cobertura del PSF de 100%. Conclusiones. El efecto del PSF depende de la ampliación del PBF. Para las poblaciones empobrecidas y subatendidas, la combinación de intervenciones tanto del lado de la oferta como del lado de la demanda podría ser necesaria para mejorar los resultados en salud.

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

DTIC Science & Technology

2010-03-16

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

Study of the quasi-tragic snow-avalanche event occurred on August 2009 at Aconcagua Provincial Park, Mendoza, Argentina

NASA Astrophysics Data System (ADS)

Leiva, J. C.; Casteller, A.; Martínez, H. H.; Norte, F. A.; Simonelli, S. C.

2010-03-01

Snow avalanches commonly threaten people and infrastructure in mountainous areas worldwide. Winter precipitation events in the Central Andes are caused by the interaction of the atmospheric general circulation and their steep orography. Almost every winter season snow storms and winds cause the blockage of routes and lead to the snowpack conditions that generate avalanche events. The amount of winter snow accumulation is highly variable and is one of the most important factors for assessing the impacts of climate change not only on the water availability, but also to plan future mitigation measures to reduce the avalanche hazard. The authors have conducted studies on snow avalanches that regularly affect the international route linking Mendoza (Argentina) with Santiago de Chile (Chile) but none of them was done at the Aconcagua Provincial Park The park is nearby this route, about 13 km kilometers east from the international border, which in this sector of the Andes coincides with the continental divide. On the night of 17 August 2009, seven people were caught by an avalanche that hit the Aconcagua Park rangers refuge (32° 48' 40'' S, 69° 56' 33'' W; 2950 masl).This paper describes the meteorological and snow precipitation conditions originating the event. On August 14 th. the synoptic surface and upper-air conditions from NCEP reanalysis were those associated with a severe Zonda wind occurrence in the region, that is: a 500 hPa level trough, a deep low-pressure surface system located over the Pacific Ocean close to the Chilean coast, approximately over 48 ° S and 80° W, and a jet stream at middle upper-air levels. The avalanche event occurred during a new and very heavy snowfall a while more than two days later of these extreme episodes. The topographical characteristics of the avalanche path, the snow storm intensity and the snow accumulation on the avalanche starting zone allowed the authors to simulate the avalanche flow. Snow storm intensity and snow

Healthy competition drives success in results-based aid: Lessons from the Salud Mesoamérica Initiative.

PubMed

El Bcheraoui, Charbel; Palmisano, Erin B; Dansereau, Emily; Schaefer, Alexandra; Woldeab, Alexander; Moradi-Lakeh, Maziar; Salvatierra, Benito; Hernandez-Prado, Bernardo; Mokdad, Ali H

2017-01-01

The Salud Mesoamérica Initiative (SMI) is a three-operation strategy, and is a pioneer in the world of results-based aid (RBA) in terms of the success it has achieved in improving health system inputs following its initial operation. This success in meeting pre-defined targets is rare in the world of financial assistance for health. We investigated the influential aspects of SMI that could have contributed to its effectiveness in improving health systems, with the aim of providing international donors, bilateral organizations, philanthropies, and recipient countries with new perspectives that can help increase the effectiveness of future assistance for health, specifically in the arena of RBA. Qualitative methods based on the criteria of relevance and effectiveness proposed by the Development Assistance Committee of the Organization for Economic Co-operation and Development. Our methods included document review, key informant interviews, a focus group discussion, and a partnership analysis. A purposive sample of 113 key informants, comprising donors, representatives from the Inter-American Development Bank, ministries of health, technical assistance organizations, evaluation organizations, and health care providers. During May-October 2016, we interviewed regarding the relevance and effectiveness of SMI. Themes emerged relative to the topics we investigated, and covered the design and the drivers of success of the initiative. The success is due to 1) the initiative's regional approach, which pressured recipient countries to compete toward meeting targets, 2) a robust and flexible design that incorporated the richness of input from stakeholders at all levels, 3) the design-embedded evaluation component that created a culture of accountability among recipient countries, and 4) the reflective knowledge environment that created a culture of evidence-based decision-making. A regional approach involving all appropriate stakeholders, and based on knowledge sharing and

Annual and diurnal variations of gaseous and particulate pollutants in 31 provincial capital cities based on in situ air quality monitoring data from China National Environmental Monitoring Center.

PubMed

Zhao, Suping; Yu, Ye; Yin, Daiying; He, Jianjun; Liu, Na; Qu, Jianjun; Xiao, Jianhua

2016-01-01

Long-term air quality data with high temporal and spatial resolutions are needed to understand some important processes affecting the air quality and corresponding environmental and health effects. The annual and diurnal variations of each criteria pollutant including PM2.5 and PM10 (particulate matter with aerodynamic diameter less than 2.5 μm and 10 μm, respectively), CO (carbon monoxide), NO2 (nitrogen dioxide), SO2 (sulfur dioxide) and O3 (ozone) in 31 provincial capital cities between April 2014 and March 2015 were investigated by cluster analysis to evaluate current air pollution situations in China, and the cities were classified as severely, moderately, and slightly polluted cities according to the variations. The concentrations of air pollutants in winter months were significantly higher than those in other months with the exception of O3, and the cities with the highest CO and SO2 concentrations were located in northern China. The annual variation of PM2.5 concentrations in northern cities was bimodal with comparable peaks in October 2014 and January 2015, while that in southern China was unobvious with slightly high PM2.5 concentrations in winter months. The concentrations of particulate matter and trace gases from primary emissions (SO2 and CO) and NO2 were low in the afternoon (~16:00), while diurnal variation of O3 concentrations was opposite to that of other pollutants with the highest values in the afternoon. The most polluted cities were mainly located in North China Plain, while slightly polluted cities mostly focus on southern China and the cities with high altitude such as Lasa. This study provides a basis for the formulation of future urban air pollution control measures in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating: The Entre Familia: Reflejos de Salud Study.

PubMed

Schmied, Emily; Parada, Humberto; Horton, Lucy; Ibarra, Leticia; Ayala, Guadalupe

2015-10-01

Entre Familia: Reflejos de Salud was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker (promotora) model with an entertainment-education component. This process evaluation examined intervention implementation and assessed relationships between implementation factors and dietary change. Participants included 180 mothers randomized to an intervention condition. Process evaluation measures were obtained from participant interviews and promotora notes and included fidelity, dose delivered (i.e., minutes of promotora in-person contact with families, number of promotora home visits), and dose received (i.e., participant use of and satisfaction with intervention materials). Outcome variables included changes in vegetable intake and the use of behavioral strategies to increase dietary fiber and decrease dietary fat intake. Participant satisfaction was high, and fidelity was achieved; 87.5% of families received the planned number of promotora home visits. In the multivariable model, satisfaction with intervention materials predicted more frequent use of strategies to increase dietary fiber (p ≤ .01). Trends suggested that keeping families in the prescribed intervention timeline and obtaining support from other social network members through sharing of program materials may improve changes. Study findings elucidate the relationship between specific intervention processes and dietary changes. © 2015 Society for Public Health Education.

Building Bridges to Address Health Disparities in Puerto Rico: the “Salud para Piñones” Project

PubMed Central

García-Rivera, Enid J.; Pacheco, Princess; Colón, Marielis; Mays, Mary Helen; Rivera, Maricruz; Munet-Díaz, Verónica; González, María del R.; Rodríguez, María; Rodríguez, Rebecca; Morales, Astrid

2017-01-01

Over the past several decades, Puerto Ricans have faced increased health threats from chronic diseases, particularly diabetes and hypertension. The patient-provider relationship is the main platform for individual disease management, whereas the community, as an agent of change for the community’s health status, has been limited in its support of individual health. Likewise, traditional research approaches within communities have placed academic researchers at the center of the process, considering their knowledge was of greater value than that of the community. In this paradigm, the academic researcher frequently owns and controls the research process. The primary aim is contributing to the scientific knowledge, but not necessarily to improve the community’s health status or empower communities for social change. In contrast, the community-based participatory research (CBPR) model brings community members and leaders together with researchers in a process that supports mutual learning and empowers the community to take a leadership role in its own health and well-being. This article describes the development of the community-campus partnership between the University of Puerto Rico School of Medicine and Piñones, a semi-rural community, and the resulting CBPR project: “Salud para Piñones”. This project represents a collaborative effort to understand and address the community’s health needs and health disparities based on the community’s participation as keystone of the process. This participatory approach represents a valuable ally in the development of long-term community-academy partnerships, thus providing opportunities to establish relevant and effective ways to translate evidence-based interventions into concrete actions that impact the individual and community’s wellbeing. PMID:28622406

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-05-01

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

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

PubMed

Reese, Gerhard; Loew, Kristina; Steffgen, Georges

2014-01-01

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

Trends in Canadian School Finance.

ERIC Educational Resources Information Center

Atherton, Peter J.

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

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

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

Proyecto Costa Escondida: Interdisciplinary Research at the Ancient Maya Port Site of Vista Alegre, Quintana Roo, Mexico

NASA Astrophysics Data System (ADS)

Glover, J.; Rissolo, D.; Beddows, P. A.; Goodman, B.; Smith, D.

2013-05-01

At the northeast tip of the Yucatan Peninsula - where the Caribbean meets the Gulf - lies the ancient Maya port site of Vista Alegre. The inhabitants of this site, much like the people living nearby today, were forced to contend with the challenging coastal environment of Laguna Holbox. The sediment-rich, low gradient of the north coast presents a contrasting landscape compared to the Caribbean coast, where water resources are of much larger magnitude and evident in the extensive systems of cenotes (sinkholes) and underground rivers that supported pre-Columbian sites along this eastern rocky sediment-poor coastline. For past inhabitants the north coast was a mosaic of low-lying, non-arable zones where access to potable water was a challenge for inhabitants well into the 20th century. By bringing together scholars from the fields of archaeology, coastal ecology, geoarchaeology, and hydrogeology, the Proyecto Costa Escondida is focusing on the dynamic relationship between the Maya and their coastal landscape over the past 3000 years. To date we have collected 12 manual push-cores from the shallow waters surrounding Vista Alegre, which have been analyzed at 1 cm resolution using standard methods for Loss on Ignition (LOI), δ18Ocarb and δ13Ccarb of bulk carbonate, granulometry, micropalentology, and AMS radiocarbon dating. In addition to have baseline comparative data, we have conducted near-shore and terrestrial coastal ecological surveys along with the mapping of coastal water salinity and temperatures in the dry and wet seasons. Overall, the chemical proxies, lithology, and paleosalinity model reconstructed to date reveal four onlapping parasequences representing an overall transgression of the coastline with strong seasonality of water chemistry that has been changing under the control of rising sea levels over the past 3000 years. The sedimentation rate and timing of the transition to marine is in reasonable agreement with local sea level curves meaning that the

Quantifying Hydrological Ecosystem Services of Various Land Covers and Uses on Small Experimental Catchments within the Panama Canal Watershed: The Agua Salud Project

NASA Astrophysics Data System (ADS)

Crouch, T. D.; Ogden, F. L.; Agua Salud Project

2011-12-01

As a part of the Agua Salud Project, a baseline characterization of hydrologic processes on the small catchment scale (~0.24 to 2.0 km2) is assessed across different land uses and covers typical to rural Panama. The land covers being monitored include a mature secondary forest, a disturbed catchment with a mosaic of various aged secondary growth and agricultural use, an active pasture and a monoculture invasive grass site as experimental controls, and two treated catchments that were recently abandoned pastures converted to teak and native species timber plantations. The catchments are found within Panama's protected Soberania National Park and the adjacent headwaters of the Agua Salud and Mendoza Rivers, all part of the greater Panama Canal Watershed. Using hydrological data from the first two and a half years of the project, three main ecosystem services are observed. The forested area exhibited lower storm event peaks, decreased flashiness, and greater stream flow during the dry season compared to the disturbed mosaic site. Lower hydrograph peaks and flashiness mitigate the risk of substantial flood damage during the major flood events generally seen in Panama between October and December. The mature forest (1.35 km2) catchment has shown lower average flood peaks in comparison to the disturbed site. For storm peaks less than 6 mm/hr, flood peaks are on average 51% lower. For storm peaks greater than 6 mm/hr, flood peaks are approximately 40% lower. In 1998, draft restrictions were imposed in the Panama Canal because of a deficit of dry season water after an El Niño-Southern Oscillation resulted in decreased wet season rainfall. The water that is available during the end of the dry season has the potential to insure the full operation of the Canal during El Niño drought years. Toward the end of the dry season (March through May) our data shows that roughly 34% more water was available during a relatively dry year with respect to antecedent wet season rainfall

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

ERIC Educational Resources Information Center

Thom, Douglas J.

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

School Life and Community Economic Challenge: A Newfoundland Case Study

ERIC Educational Resources Information Center

Fowler, Ken

2007-01-01

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

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

ERIC Educational Resources Information Center

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

2018-01-01

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

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

ERIC Educational Resources Information Center

Edmunds, Alan

2003-01-01

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

JPRS Report, Near East & South Asia.

DTIC Science & Technology

1988-02-12

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

Intergovernmental Relations in Education.

ERIC Educational Resources Information Center

Bartunek, Frank

1994-01-01

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

Effects of Acculturation on Prenatal Anxiety among Latina Women

PubMed Central

de Mendoza, Veronica Barcelona; Harville, Emily; Theall, Katherine; Buekens, Pierre; Chasan-Taber, Lisa

2016-01-01

Purpose Anxiety in pregnancy has been associated with adverse birth outcomes. Relatively few studies have investigated how acculturation affects mental health in pregnancy among Latinas. The goal of this study was to determine if acculturation was associated with anxiety over the course of pregnancy in a sample of predominantly Puerto Rican women. Methods Women were recruited in pregnancy for participation in Proyecto Buena Salud, a prospective cohort study of Latina women (n=1412). Acculturation was measured via the Psychological Acculturation Scale (PAS), language preference and generation in the US. Anxiety was measured using the State-Trait Anxiety Instrument. Linear and logistic multivariable regression were used to investigate associations. Results After adjustment, women with bicultural identification had significantly lower trait anxiety scores in early pregnancy (beta −3.62, SE 1.1, p<0.001) than low acculturated women. Women with higher levels of acculturation as indicated by English language preference (β=1.41, SE 0.7, p=0.04) and second or third generation in the US had significantly higher trait anxiety scores in early pregnancy (β=1.83, SE 0.6, p<.01). Conclusions Bicultural psychological acculturation was associated with lower trait anxiety in early pregnancy, while English language preference and higher generation in the US were associated with higher trait anxiety in early pregnancy. PMID:26790686

Effects of acculturation on prenatal anxiety among Latina women.

PubMed

Barcelona de Mendoza, Veronica; Harville, Emily; Theall, Katherine; Buekens, Pierre; Chasan-Taber, Lisa

2016-08-01

Anxiety in pregnancy has been associated with adverse birth outcomes. Relatively few studies have investigated how acculturation affects mental health in pregnancy among Latinas. The goal of this study was to determine if acculturation was associated with anxiety over the course of pregnancy in a sample of predominantly Puerto Rican women. Women were recruited in pregnancy for participation in Proyecto Buena Salud, a prospective cohort study of Latina women (n = 1412). Acculturation was measured via the Psychological Acculturation Scale (PAS), language preference and generation in the USA. Anxiety was measured using the State-Trait Anxiety Instrument. Linear and logistic multivariable regressions were used to investigate associations. After adjustment, women with bicultural identification had significantly lower trait anxiety scores in early pregnancy (β = -3.62, SE = 1.1, p < 0.001) than low acculturated women. Women with higher levels of acculturation as indicated by English-language preference (β = 1.41, SE = 0.7, p = 0.04) and second or third generation in the USA had significantly higher trait anxiety scores in early pregnancy (β = 1.83, SE = 0.6, p < 0.01). Bicultural psychological acculturation was associated with lower trait anxiety in early pregnancy, while English-language preference and higher generation in the USA were associated with higher trait anxiety in early pregnancy.

Acculturation and Intention to Breastfeed among a Population of Predominantly Puerto Rican Women.

PubMed

Barcelona de Mendoza, Veronica; Harville, Emily; Theall, Katherine; Buekens, Pierre; Chasan-Taber, Lisa

2016-03-01

Latinas have high overall breastfeeding initiation rates, yet Puerto Ricans have among the lowest exclusive breastfeeding rates. This study sought to determine if acculturation was associated with intent to breastfeed in a predominantly Puerto Rican population. A cohort of Latina women were enrolled in Proyecto Buena Salud, and provided information on infant feeding intent (n = 1,323). Acculturation was assessed via the Psychological Acculturation Scale (PAS), language preference, and generation in the United States. Increasing acculturation as measured by English language preference (aOR 0.61 [95% CI 0.42-0.88]) and second or third generation in the United States (aOR 0.70 [95% CI 0.52-0.95)] was inversely associated with odds of intending to exclusively breastfeed. Similarly, women with higher levels of acculturation as measured by the PAS (aOR 0.67 [95% CI 0.45-0.99]), English language preference (aOR 0.48 [95% CI 0.33-0.70]) and second or third generation in the United States (aOR 0.42 [95% CI 0.31-0.58]) were less likely to report intent to combination feed as compared with women with lower acculturation. Acculturation was inversely associated with intent to exclusively breastfeed and intent to combination feed in this predominantly Puerto Rican sample. © 2015 Wiley Periodicals, Inc.

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

PubMed

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

2013-01-01

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

75 FR 26845 - Unblocking of Specially Designated Nationals and Blocked Persons Pursuant to Executive Order 12978

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... S.A., Madrid, Spain; c/o SOCIEDAD INVERSORA EN PROYECTOS DE INTERNET S.A., Madrid, Spain; D.N.I... PROYECTOS DE INTERNET, S.A., Calle Segre 25, Madrid 28002, Spain [SDNT] Dated: May 6, 2010. Adam J. Szubin...

Biosafety evaluation of the DNA extraction protocol for Mycobacterium tuberculosis complex species, as implemented at the Instituto Nacional de Salud, Colombia.

PubMed

Castro, Claudia; González, Liliana; Rozo, Juan Carlos; Puerto, Gloria; Ribón, Wellman

2009-12-01

Manipulating Mycobacterium tuberculosis clinical specimens and cultures represents a risk factor for laboratory personnel. One of the processes that requires high concentrations of microorganisms is DNA extraction for molecular procedures. Pulmonary tuberculosis cases have occurred among professionals in charge of molecular procedures that require manipulation of massive quantities of microorganisms. This has prompted research studies on biosafety aspects of extraction protocols; however, as yet, no consensus has been reached regarding risks associated with the process. The biosafety was evaluated for the DNA extraction protocol of van Soolingen, et al. 2002 by determining M. tuberculosis viability at each process stage. Eight hundred eighty cultures were grown from 220 M. tuberculosis clinical isolates that had been processed through the first three DNA extraction stages. Molecular identifications of positive cultures used a PCR isolation of a fragment of the heat shock protein PRA-hsp65 and examination of its restriction enzyme profile (spoligotyping). Growth was seen in one culture with one of the procedures used. The molecular characterization did not correspond to the initially analyzed isolate, and therefore was deduced to be the product of a cross-contamination. The DNA extraction protocol, as described by van Soolingen, et al. 2002 and as implemented at the Instituto Nacional de Salud, was established to be safe for laboratory personnel as well as for the environment.

Quaternary geology and geomorphology of the Dinosaur Provincial Park area and surrounding plains, Alberta, Canada: the identification of former glacial lobes, drainage diversions and meltwater flood tracks

NASA Astrophysics Data System (ADS)

Evans, David J. A.

2000-06-01

The Quaternary geology and geomorphology of the lower Red Deer River drainage basin, centred on the Dinosaur Provincial Park badlands, provides information on pre-Late Wisconsinan drainage patterns and the dynamics of former lobes of the Laurentide Ice Sheet in western Canada. Patterns of deglaciation, proglacial lake evolution and spillway incision are also reconstructed based upon the distribution of surface materials and glacial/glaciofluvial landforms. The Empress Group fluvial and glaciolacustrine sediments, which could be as young as 27 ka BP, infill the precursor Red Deer River and its tributaries and document the initial advance of glacier ice into southern Alberta. Glaciotectonic disturbance of older sediments and bedrock, the production of deformation tills and the construction of a megafluting complex and cupola hills record the advances of a glacier lobe centred over the study area. Stratified inter- and intra-till beds record pulses of subglacial meltwater between phases of subsole deformation. The thickening of tills towards the margin of the lobe represents a till wedge, an expected product of sediment advection by glaciers moving over deformable beds. The eastern margin of the glacier lobe is demarcated by the interlobate Suffield hummocky moraine belt which contains overprinted thrust ridges, which record diachronous oscillations of neighbouring lobes within the ice sheet. Proglacial and glaciofluvial sediments were deposited in the area in association with proglacial Lake Bassano/Patricia, which drained eastwards when the Suffield moraine was dissected by spillways. Changes in the size of glacial lake Bassano/Patricia are clearly documented by a sequence of spillway incisions which culminated in the erosion of scabland topography and the initiation of a new course for the Red Deer River, a 15 km southward diversion of the main channel. In distinct contrast to the documented incision histories of other small rivers in Alberta, One Tree Creek and

Results of Mujeres Felices por ser Saludables: a dietary/breast health randomized clinical trial for Latino women.

PubMed

Fitzgibbon, Marian L; Gapstur, Susan M; Knight, Sara J

2004-10-01

Data are limited on the efficacy of health-focused interventions for young, low-acculturated Latino women. Because breast cancer is the most commonly diagnosed cancer and the most common cause of cancer mortality in this population, combined interventions that address both early detection and dietary patterns could help reduce both morbidity and mortality associated with breast cancer in this underserved population. Mujeres Felices por ser Saludables was randomized intervention study designed to assess the efficacy of an 8-month combined dietary and breast health intervention to reduce fat and increase fiber intake as well as to increase the frequency and proficiency of breast self-examination (BSE) and reduce anxiety related to BSE among Latinas. Blocked randomization in blocks of 6 was used to randomize 256 20- to 40-year-old Latinas to the intervention (n = 127) or control group (n = 129). The intervention group attended an 8-month multicomponent education program designed specifically for low-acculturated Latinas. The control group received mailed health education material on a schedule comparable to the intervention. A total of 195 women (76.2%) completed both the baseline and 8-month follow-up interviews. The intervention and control groups were similar on baseline sociodemographic characteristics. At the 8-month follow up, the intervention group reported lower dietary fat (P < .001) and higher fiber intake (p = .06); a higher proportion reported practicing BSE at the recommended interval (p < .001) and showed improved BSE proficiency (p < .001) compared to the control group. BSE-related anxiety was low for both groups at baseline, and no difference in reduction was observed. This project provides a successful model for achieving dietary change and improving breast health behavior in young, low-acculturated Latinas.

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

ERIC Educational Resources Information Center

British Columbia Ministry of Education, 2014

2014-01-01

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

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

ERIC Educational Resources Information Center

Hayes, Brigid

2012-01-01

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

JPRS Report, China, Selected Provincial Reports.

DTIC Science & Technology

1991-07-26

114.8 billion yuan. The province’s gross value of the scientific and technological sector, vast numbers of industrial output totalled 219.77 billion...and technological progress made increasingly were valued at 57.04 billion yuan, increasing at an important contributions to economic growth. Educa...outlook and investment environment showed new fairly comfortable life. In 1990, urban people’s per- improvements. The pace of technological transforma

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

PubMed

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

2013-05-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

E-Learning in Canada

ERIC Educational Resources Information Center

McGreal, Rory; Anderson, Terry

2007-01-01

A principal characteristic of the Canadian experience with e-learning is the uniquely Canadian feature of provincial jurisdiction over education. Canada is the only country that does not have a national department or ministry of education. Therefore, any investigation of e-learning in Canada must focus more on specific provincial initiatives in…

Process evaluation of a promotora de salud intervention for improving hypertension outcomes for Latinos living in a rural U.S.-Mexico border region.

PubMed

Sánchez, Victoria; Cacari Stone, Lisa; Moffett, Maurice L; Nguyen, PhoungGiang; Muhammad, Michael; Bruna-Lewis, Sean; Urias-Chauvin, Rita

2014-05-01

Hypertension is a growing public health problem for U.S.-Mexico border Latinos, who commonly experience low levels of awareness, treatment, and control. We report on a process evaluation that assessed the delivery of Corazón por la Vida, a 9-week promotora de salud-led curriculum to help Latinos manage and reduce hypertension risks in two rural/frontier counties in the New Mexico border region. Ninety-six adults participated in the program, delivered in three waves and in three communities. We assessed program delivery and quality, adherence, exposure, and participant responsiveness. Participant outcome measures included self-reported eating and physical activities and assessment of community resources. Findings suggest that the program was fully delivered (99%) and that most participants (81.7%) were very satisfied with the educational sessions. The average participant attendance for educational sessions was 77.47%. We found significant differences in self-reported behavioral changes depending on the number of sessions completed: The higher the dose of sessions, the better the self-reported outcomes. These findings suggest that a promotora-led curriculum may be useful for promoting self-management of chronic disease in rural/frontier border Latino populations. Future evaluation should focus on training and implementation adaptations within evidence-based chronic disease programs for diverse Latino communities.

Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women.

PubMed

Romero, Daniela C; Sauris, Aileen; Rodriguez, Fátima; Delgado, Daniela; Reddy, Ankita; Foody, JoAnne M

2016-03-01

Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.

Intra-Provincial Inequality in Financing Compulsory Education in China: Exploring the Role of Provincial Leaders (1994-2001)

ERIC Educational Resources Information Center

Lin, Tingjin

2009-01-01

Elitism argues that the values and experiences of the political elite shape policy, while institutionalism contends that an individual's behaviour is constrained by institutional settings. This article shows that both perspectives work well overall, while offering persuasive arguments, but the former is dominated by the latter. This explains the…

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

ERIC Educational Resources Information Center

Ministry of Advanced Education, 2007

2007-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

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

ERIC Educational Resources Information Center

Alberta Office of the Ombudsman, Edmonton.

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

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

ERIC Educational Resources Information Center

Bascia, Nina

2010-01-01

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

Toward a harmonized approach to animal welfare law in Canada.

PubMed

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

2018-03-01

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

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

PubMed Central

Li, Chen; Yongbo, Lv; Chi, Chen

2015-01-01

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

Defense.gov - Special Report - On Location in Afghanistan

Science.gov Websites

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

Continued Development of the SEAMAP Data Archive

DTIC Science & Technology

2007-09-01

Acoustic Surveys 01-02 boat mammals 462 344 Baltic Porpoise Sightings 01-02 boat mammals 55 346 Cabo Verde ( Proyecto Aegina): male and "Hortensia...34 loggerheads tag turtles 2021 347 Islas Canarias ( Proyecto Aegina): juvenile loggerheads tag turtles 1187 349 Cayman Islands 2003 tag turtles 1561

Habsburg Austria: Experiments in Non-Territorial Autonomy

PubMed Central

Kuzmany, Börries

2016-01-01

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

Tu Salud ¡Sí Cuenta! Your Health Matters! A Community-wide Campaign in a Hispanic Border Community in Texas.

PubMed

Heredia, Natalia I; Lee, MinJae; Mitchell-Bennett, Lisa; Reininger, Belinda M

To evaluate a community-wide campaign, Tu Salud ¡Si Cuenta! (TSSC), in improving eating behaviors and anthropometric outcomes in Hispanic border communities. A quasi-experimental study with matched intervention and comparison communities. Cross-sectional assessments with randomly sampled adults, examined by actual exposure and site (unexposed intervention, exposed intervention, and unexposed comparison). Predominately Mexican Americans located in Brownsville, TX (intervention) and Laredo, TX (control). The TSSC campaign included television and radio segments, community health worker discussions, and newsletters delivered in Brownsville from 2005 to 2010. Healthy and unhealthy eating indices and average hip and waist circumferences. Univariable and multivariable regression models. The sample (n = 799; 400 comparison and 399 intervention) was 98% of Mexican origin; 54% had completed grade 9 or higher. Exposure to any TSSC component was associated with a lower rate of unhealthy food consumption. Compared with the unexposed intervention group, the exposed intervention for the newsletter had a higher rate of healthy eating (adjusted rate ratio = 1.18; P < .01). Compared with the unexposed intervention, the exposed intervention for the community health worker discussion had a smaller hip circumference (adjusted mean difference = -5.77 cm; P < .05) and a smaller waist circumference (adjusted mean difference = -5.25 cm; P < .05). This study provides evidence for the use of community-wide campaigns for nutrition and obesity-related outcomes in Hispanic communities. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

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

DTIC Science & Technology

1983-06-10

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

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

PubMed

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

2017-01-01

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

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

PubMed

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

2017-05-01

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

Mujeres Fuertes y Corazones Saludables: adaptation of the StrongWomen -healthy hearts program for rural Latinas using an intervention mapping approach.

PubMed

Perry, Cynthia K; McCalmont, Jean C; Ward, Judy P; Menelas, Hannah-Dulya K; Jackson, Christie; De Witz, Jazmyne R; Solanki, Emma; Seguin, Rebecca A

2017-12-28

To describe our use of intervention mapping as a systematic method to adapt an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas. An intervention mapping process involving six steps guided the adaptation of an evidence based physical activity and nutrition program, using a community-based participatory research approach. We partnered with a community advisory board of rural Latinas throughout the adaptation process. A needs assessment and logic models were used to ascertain which program was the best fit for adaptation. Once identified, we collaborated with one of the developers of the original program (StrongWomen - Healthy Hearts) during the adaptation process. First, essential theoretical methods and program elements were identified, and additional elements were added or adapted. Next, we reviewed and made changes to reflect the community and cultural context of the practical applications, intervention strategies, program curriculum, materials, and participant information. Finally, we planned for the implementation and evaluation of the adapted program, Mujeres Fuertes y Corazones Saludables, within the context of the rural community. A pilot study will be conducted with overweight, sedentary, middle-aged, Spanish-speaking Latinas. Outcome measures will assess change in weight, physical fitness, physical activity, and nutrition behavior. The intervention mapping process was feasible and provided a systematic approach to balance fit and fidelity in the adaptation of an evidence-based program. Collaboration with community members ensured that the components of the curriculum that were adapted were culturally appropriate and relevant within the local community context.

Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective.

PubMed

Nigenda, Gustavo; González-Robledo, Luz María; Juárez-Ramírez, Clara; Adam, Taghreed

2016-05-13

In 2003, Mexico's Seguro Popular de Salud (SPS), was launched as an innovative financial mechanism implemented to channel new funds to provide health insurance to 50 million Mexicans and to reduce systemic financial inequities. The objective of this article is to understand the complexity and dynamics that contributed to the adaptation of the policy in the implementation stage, how these changes occurred, and why, from a complex and adaptive systems perspective. A complex adaptive systems (CAS) framework was used to carry out a secondary analysis of data obtained from four SPS's implementation evaluations. We first identified key actors, their roles, incentives and power, and their responses to the policy and guidelines. We then developed a causal loop diagram to disentangle the feedback dynamics associated with the modifications of the policy implementation which we then analyzed using a CAS perspective. Implementation variations were identified in seven core design features during the first 10 years of implementation period, and in each case, the SPS's central coordination introduced modifications in response to the reactions of the different actors. We identified several CAS phenomena associated with these changes including phase transitions, network emergence, resistance to change, history dependence, and feedback loops. Our findings generate valuable lessons to policy implementation processes, especially those involving a monetary component, where the emergence of coping mechanisms and other CAS phenomena inevitably lead to modifications of policies and their interpretation by those who implement them. These include the difficulty of implementing strategies that aim to pool funds through solidarity among beneficiaries where the rich support the poor when there are no incentives for the rich to do so. Also, how resistance to change and history dependence can pose significant challenges to implementing changes, where the local actors use their significant power

Gestational Weight Gain, Body Mass Index, and Risk of Hypertensive Disorders of Pregnancy in a Predominantly Puerto Rican Population.

PubMed

Chasan-Taber, Lisa; Silveira, Marushka; Waring, Molly E; Pekow, Penelope; Braun, Barry; Manson, JoAnn E; Solomon, Caren G; Markenson, Glenn

2016-09-01

Objectives To prospectively evaluate the association between gestational weight gain (GWG), prepregnancy body mass index (BMI), and hypertensive disorders of pregnancy using the revised Institute of Medicine (IOM) Guidelines. Methods We examined these associations among 1359 participants in Proyecto Buena Salud, a prospective cohort study conducted from 2006 to 2011 among women from the Caribbean Islands. Information on prepregnancy BMI, GWG, and incident diagnoses of hypertension in pregnancy were based on medical record abstraction. Results Four percent (n = 54) of women were diagnosed with hypertension in pregnancy, including 2.6 % (n = 36) with preeclampsia. As compared to women who gained within IOM GWG guidelines (22.8 %), those who gained above guidelines (52.5 %) had an odds ratio of 3.82 for hypertensive disorders (95 % CI 1.46-10.00; ptrend = 0.003) and an odds ratio of 2.94 for preeclampsia (95 % CI 1.00-8.71, ptrend = 0.03) after adjusting for important risk factors. Each one standard deviation (0.45 lbs/week) increase in rate of GWG was associated with a 1.74 odds of total hypertensive disorders (95 % CI 1.34-2.27) and 1.86 odds of preeclampsia (95 % CI 1.37-2.52). Conclusions for Practice Findings from this prospective study suggest that excessive GWG is associated with hypertension in pregnancy and could be a potentially modifiable risk factor in this high-risk ethnic group.

Physical activity, sedentary behavior and risk of hypertensive disorders of pregnancy in Hispanic women.

PubMed

Chasan-Taber, Lisa; Silveira, Marushka; Pekow, Penelope; Braun, Barry; Manson, JoAnn E; Solomon, Caren G; Markenson, Glenn

2015-02-01

Prior studies of the association between physical activity and hypertensive disorders of pregnancy have been conflicting; the majority focused on leisure-time activity only, did not use physical activity questionnaires validated for pregnancy, and were conducted in primarily non-Hispanic white populations. We prospectively evaluated this association among 1240 Hispanic women in Proyecto Buena Salud. The Pregnancy Physical Activity Questionnaire, validated for use in pregnancy, was used to assess pre- and early pregnancy sports/exercise, household/caregiving, occupational and transportation activity. Diagnoses of hypertensive disorders of pregnancy were based on medical record abstraction and confirmed by the study obstetrician. A total of 49 women (4.0%) were diagnosed with a hypertensive disorder of pregnancy, including 32 women (2.6%) with pre-eclampsia. In age-adjusted analyses, high levels of early pregnancy household/caregiving activity were associated with reduced risk of total hypertensive disorders (OR = 0.4, 95% CI 0.1-0.9) and pre-eclampsia (OR = 0.3, 95% CI 0.1-0.9) relative to low levels; however, these findings were no longer statistically significant in multivariable models. Pre-pregnancy activity and pattern of activity from pre- to early-pregnancy were not significantly associated with risk. Finally, sedentary behavior was not significantly associated with hypertensive disorders. Findings from this prospective study of Hispanic women were consistent with those of prior prospective cohorts indicating that physical activity prior to and during early pregnancy does not significantly reduce risk of hypertensive disorders of pregnancy.

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

PubMed

Turner, Leigh

2012-05-01

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

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

PubMed Central

Turner, Leigh

2012-01-01

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

Guidelines for Management Information Systems in Canadian Health Care Facilities

PubMed Central

Thompson, Larry E.

1987-01-01

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

Una búsqueda de la identidad regional em Astrometria

NASA Astrophysics Data System (ADS)

Abad, C.

2003-11-01

La idea sobre una reunión latino-americana que congregara a las personas que desarrollan su trabajo en el área de la astrometría, se gestó a partir de una de las reuniones que el proyecto QUEST realizaba anualmente en Mérida (Venezuela). El proyecto QUEST (Quasars Equatorial Survey Team) celebraba su IV Reunión Anual, en la cual se hacía una revisón de la marcha del proyecto durante el último año. Además, se exponían los logros científicos y técnicos alcanzados hasta el momento y se planificaba el futuro del mismo para el período anual siguiente.

[Not Available].

PubMed

Vio, Fernando; Lera, Lydia; Salinas, Judith

2016-07-19

Objetivo: mediante la técnica de consenso Delphi, conocer la opinión de un grupo de expertos en nutrición, educación y gastronomía para buscar consenso sobre metodologías educativas en alimentación saludable, alumnos de tercero a quinto año básico, sus familias y profesores.Métodos: con los resultados de encuestas y grupos focales realizados previamente a niños, padres y profesores, se elaboró un cuestionario que fue enviado a 51 expertos en nutrición, educación y gastronomía en una primera ronda. Los resultados fueron analizados y reenviados en una segunda ronda con las preguntas no consensuadas, obteniendo 38 respuestas.Resultados: hubo consenso en que se pueden cambiar hábitos en escuelas mediante talleres de cocina con chefs o monitores, educación activo-participativa y huertos escolares. Padres y profesores deben tener habilidades culinarias saludables para educar a los niños. Estos deben hacer uso racional del dinero en la escuela. Para ello es necesario cambiar la oferta del kiosko hacia alimentos saludables, o suprimirlo si no es saludable. Los profesores deben capacitarse con talleres de autocuidado y vida sana para educar en alimentación saludable a los niños en horarios de clase con material educativo, talleres de cocina con recetas y aprovechar horarios de desayuno y almuerzo para actividades educativas. Los padres deben participar en talleres para escoger alimentos saludables en lugares de venta y preparar menús saludables. Los niños deben aprender habilidades culinarias simples, preparando y degustando alimentos saludables. Conclusiones: estos resultados son fundamentales para diseñar materiales educativos en alimentación saludable que cambien los malos hábitos alimentarios actuales.

Iniciativas escolares y deportivas lideradas desde la Fédération Internationale de Football Association (FIFA): revisión sistemática.

PubMed

Correa, Jorge E; Meneses-Echávez, José F; Barengo, Noël C; Tovar, Gustavo; Ruiz-Castellanos, Erika; Lobelo, Felipe; Ramírez-Vélez, Robinson

2015-09-01

Introducción: Los programas iniciados por la Fédération Internationale de Football Association (FIFA) consisten en la difusión de mensajes relacionados con el cuidado de la salud y como estrategia de prevención de lesiones deportivas entre los niños y jóvenes. El objetivo de esta revisión sistemática fue resumir los resultados de la implementación de los programas "FIFA 11 para la salud" y "FIFA 11+". Métodos: Se realizó una búsqueda sistemática en las bases de datos electrónicos de MEDLINE, EMBASE y Scopus, identificando los estudios que evaluaran la implementación de los programas "FIFA 11 para la salud" y "FIFA 11+", durante los últimos 10 años (1 enero 2003 a 1 diciembre 2013). Resultados: Incluimos 17 estudios. Dos estudios evaluaron la implementación del programa "FIFA 11 para la salud" y encontraron un aumento significativo en el conocimiento de los mensajes de promoción de la salud; 15 estudios evaluaron los efectos del programa "FIFA 11+", reportando una reducción en el riesgo de lesiones deportivas y mejorías en el rendimiento deportivo. Discusión: Los programas "FIFA 11 para la salud" y "FIFA 11+" han demostrado resultados positivos para la salud, en el ámbito escolar y deportivo. Conclusiones: Dichos programas del FIFA representan una oportunidad para crear hábitos protectores y fomentar modos de vida saludables en niños y jóvenes.

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

DTIC Science & Technology

2015-01-01

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

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

DTIC Science & Technology

2012-04-30

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

Acute care hospitals' accountability to provincial funders.

PubMed

Kromm, Seija K; Ross Baker, G; Wodchis, Walter P; Deber, Raisa B

2014-09-01

Ontario's acute care hospitals are subject to a number of tools, including legislation and performance measurement for fiscal accountability and accountability for quality. Examination of accountability documents used in Ontario at the government, regional and acute care hospital levels reveals three trends: (a) the number of performance measures being used in the acute care hospital sector has increased significantly; (b) the focus of the health system has expanded from accountability for funding and service volumes to include accountability for quality and patient safety; and (c) the accountability requirements are misaligned at the different levels. These trends may affect the success of the accountability approach currently being used. Copyright © 2014 Longwoods Publishing.

JPRS Report, China, Provincial Government Work Reports.

DTIC Science & Technology

1992-06-19

with the law , and be determined to curb the rising momentum of ferocious criminal cases. We must control various social trends in good time...public security took a favorable turn. A number of cases involving violation of discipline and law were cracked and dealt with, and new results... law , be conscious in abiding by state laws and regulations, and subject themselves to the supervision of the people’s congresses and their standing

Achievement Test Provincial Report, June 1987 Administration.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Student Evaluation and Records Branch.

This document summarizes results of province-wide achievement tests given in Alberta, Canada in June 1987. These tests evaluated student achievement in third grade science, sixth grade mathematics, and ninth grade social studies. The test questions for each subject area reflected Alberta's curriculum specifications for that subject. The grade 3…

Increasing Effectiveness of Interagency Provincial Reconstruction Teams

DTIC Science & Technology

2007-03-29

harmony.30 During this phase the team’s ability to perform is developed and enhance by a sense of what the noted psychologist Albert Bandura of...perform…specific task[s].”31 Bandura goes on to state that these “efficacy beliefs contribute significantly to the level of motivation and performance

[Reflections and recommendations from Quebec mental health university institutes on the working paper of the provincial forum for the 2014-2020 Mental Health Action Plan].

PubMed

Fortin, Denise; McVey, Lynne; Racine, Simon; Luyet, André J; Israël, Mimi; Villeneuve, Evens; Trudel, Jean-François; Fortier, Linda

2014-01-01

Quebec's three mental health university institutes (DMHUI, IUSMM and the IUSMQ) and the Centre hospitalier universitaire de Sherbrooke submitted a statement to the provincial consultation forum on the 2014-2020 Mental Health Action Plan (MHAP), which was held in January 2014 and organized by the Ministère de la Santé et des Services sociaux (MSSS). This article presents these institutes' main recommendations. Mental health university institutes deliver a wide and diverse range of services. They know about the challenges of organizing mental health services and are aware of national and international trends in the delivery of the best organizational and clinical practices in mental health. It is therefore as key stakeholders in the mental health care network that they commented on each component in the working paper. The proposed orientations are consistent with the 2005-2010 MHAP. The presented themes clearly reflect current issues, although the guidelines must be more explicit regarding the vision of how services will be organized in coming years. These institutes therefore suggest that the following principles be included: the full exercise of citizenship rights, the organization of services within integrated networks, performance, continuous improvement and innovation, as well as a global and integrated vision of health. The complexity of today's problems requires flexibility, complementarity and continuity of services, particularly for youth, aboriginals, and people with concomitant disorders. These institutions therefore stress the importance of prevention, early intervention programs, and increased support for first-line general practitioners and health care professionals. They also emphasized that specialized inpatient and outpatient services should not be neglected. Community services must also be structured around various levels of support, such as ICM and ACT, as well as around specialized programs available in hospital outpatient clinics. The

[Occupational health in the Autonomous Community of the Basque Country. OSALAN-Instituto Vasco de Seguridad y Salud Laborales].

PubMed

Martínez Castillo, A; Achutegui Basagoiti, G

1996-01-01

O.S.A.L.A.N.-Instituto Vasco de Seguridad y Salud Laborales is an autonomous administrative body depending on the Basque Government, ascribed to the Dept. of Justice, Economy, Work and Social Security, which is in charge of managing the general occupational health policies in the Autonomous Community of the Basque Country. Its objectives are: To promote an ongoing improvement in safety and occupational health for all the workers in the Basque Autonomous Region, through the management of programmes in matters affecting safety, hygiene, the environment and occupational health. To co-ordinate and concentrate the different activities related to occupational health, unifying and giving coherence to the functions which were previously the jurisdiction of different departments. Making companies aware of national and E.U. regulations, taking the measures that are set out by the European Directives and the Prevention of Occupational Hazards Act and the rest of the employment regulations, establishing the training and information channels required for promoting and applying these in the companies. It acts: from an overall perspective as regards the prevention of occupational hazards, thanks to co-ordination with all the disciplines involved, applying a multi-disciplinary treatment to the study of each and every one of the occupational hazard factors, which is aimed at the prevention of risks at their source. Providing companies with the ideal means for managing the safety and health of their workers. Promoting the implementation of systems which guarantee an ongoing improvement in occupational safety and health in the companies of the Basque Autonomous Region. Providing the technical and research support that makes it possible to tackle prevention efficiently. The provision established in the Creation Act (O.S.A.L.A.N.) should also be mentioned, as regards its application in public administration and the field of social economy, which was later endorsed and ratified through

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

PubMed

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

2008-05-01

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

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

PubMed

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

2007-01-01

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

[History of the Montpellier Society of Biology].

PubMed

Bali, Jean-Pierre

2017-01-01

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

Assessing the effectiveness of a patient-centred computer-based clinic intervention, Health-E You/Salud iTu, to reduce health disparities in unintended pregnancies among Hispanic adolescents: study protocol for a cluster randomised control trial.

PubMed

Tebb, Kathleen P; Rodriguez, Felicia; Pollack, Lance M; Trieu, Sang Leng; Hwang, Loris; Puffer, Maryjane; Adams, Sally; Ozer, Elizabeth M; Brindis, Claire D

2018-01-10

Teen pregnancy rates in the USA remain higher than any other industrialised nation, and pregnancies among Hispanic adolescents are disproportionately high. Computer-based interventions represent a promising approach to address sexual health and contraceptive use disparities. Preliminary findings have demonstrated that the Health-E You/Salud iTu, computer application (app) is feasible to implement, acceptable to Latina adolescents and improves sexual health knowledge and interest in selecting an effective contraceptive method when used in conjunction with a healthcare visit. The app is now ready for efficacy testing. The purpose of this manuscript is to describe patient-centred approaches used both in developing and testing the Health-E You app and to present the research methods used to evaluate its effectiveness in improving intentions to use an effective method of contraception as well as actual contraceptive use. This study is designed to assess the effectiveness of a patient-centred computer-based clinic intervention, Health-E You/Salud  iTu, on its ability to reduce health disparities in unintended pregnancies among Latina adolescent girls. This study uses a cluster randomised control trial design in which 18 school-based health centers from the Los Angeles Unified School District were randomly assigned, at equal chance, to either the intervention ( Health-E You app) or control group. Analyses will examine differences between the control and intervention group's knowledge of and attitudes towards contraceptive use, receipt of contraception at the clinic visit and self-reported use of contraception at 3-month and 6-month follow-ups. The study began enrolling participants in August 2016, and a total of 1400 participants (700 per treatment group) are expected to be enrolled by March 2018. Ethics approval was obtained through the University of California, San Francisco Institutional Review Board. Results of this trial will be submitted for publication in peer

Alternatives Impact in Combatant-Ship Design

DTIC Science & Technology

2011-09-01

2010. [3] E. Romero and J. Carreño, “ Proyecto de diseño y construcción en Colombia por COTECMAR en Colombia de una clase de buque de superficie que...replace the actual Colombian’s navy light frigates,”], Working PaperNo. 0.1.2008, Cartagena, 2008. [4] E. Romero and J.E. Carreño, “ Proyecto de

Un Corazón Saludable: factors influencing outcomes of an exercise program designed to impact cardiac and metabolic risks among urban Latinas.

PubMed

Harralson, Tina L; Emig, Julie Cousler; Polansky, Marcia; Walker, Renee E; Cruz, Joanna Otero; Garcia-Leeds, Claudia

2007-12-01

A high prevalence of physical inactivity, metabolic risk factors, and depression place Latinas in peril of developing cardiovascular disease. "Un Corazón Saludable: A Healthy Heart" was developed to engage urban Latinas in physical activity and increase awareness of cardiac and metabolic risk factors. Two hundred and twenty-five Latinas enrolled in the program that included salsa aerobics and culturally sensitive health education modules. Cardiac and metabolic risk factors measured in this study were body mass index (BMI), waist-to-hip ratio, abdominal obesity, and blood pressure. Psychosocial risk factors measured included depressive symptoms and perceived social support. Fifty-two percent of the enrollees completed the program. Results indicated decreases in BMI, abdominal obesity, and symptoms of depression among Latinas who completed the program. Those who did not complete the program were younger, had greater depressive symptomatology, reported poorer social support, and they tended to be caregivers and U.S. born. Focus groups of program participants ascertained that caregiving and family obligations were major barriers to exercise while social support was a major facilitator of exercise. This research indicates that programs developed to recognize and address cultural barriers can impact physical and psychosocial risk factors among urban Latinas who are able to attend. Program retention may improve if future exercise programs conducted through community-base organizations offered support to Latinas regarding issues that interfere with self-care and health promotion. Future programs should consider including mental health and social service case management as part of comprehensive exercise/educational programs.

Proyecto multidisciplinar `Marte nos visita'

NASA Astrophysics Data System (ADS)

Merlo, D.; Merlo, N.; Parodi, B.; Garis, A.; Peralta, G.; Rovessi, V.; Urrutia, S.; Calderón, J.; Bustos Fierro, I.; Melia, R.

The planets Earth and Mars reached in August 2003 the most approximation in the last 58,000 years. In order to that we carried out a transversal study of red planet, joining the knowledges from several subjects of second school year of unified basic cycle (eighth basic general education) at I.P.E.M. No 249 "Nicolás Copérnico" (a public secondary institution from Córdoba, Argentine). In this study, activities in accordance with current contents has been proposed by common consents of each teacher. Besides, students visited Córdoba Astronomical Observatory in order to search informations and received a multimedia exposition about of astronomical event and a performance of the "Carl Sagan" Moveable Planetary. Finally, each student carried out practical works and wrote an integrative report, which one has been evaluated and exposed at ExpoIPEM 2003, an annual exhibition of several specialities that Institution offers in its specialization cycle (10-12 grade), where the annual students' activities are exhibited too (workshops, school projects, etc.).

Proyecto Leer Bulletin, Number 10.

ERIC Educational Resources Information Center

Benson, Susan Shattuck

This guide to instructional materials for teachers of Spanish contains references to commercially-prepared works in several classified areas. The works listed are intended for use in grades ranging from kindergarten through senior high school and also include materials for adult education. The 10 categories cover: (1) audiovisual materials, (2)…

Proyecto Leer Bulletin, Number 12.

ERIC Educational Resources Information Center

Tome, Martha V., Ed.

This bulletin is designed to serve the Spanish-speaking population of the United States. This issue contains a list of popular magazines in Spanish for children and adults. Another section provides the names of comics for children. Titles to be found under "Publications in Series and Collections" are the popular type of romantic, western, or…

Proyecto Leer Bulletin, Number 8.

ERIC Educational Resources Information Center

Benson, Susan Shattuck

This bulletin lists educational materials for the Spanish speaking. Several hundred documents are listed in three main sections: (1) organizations, programs, laws, and news related to the Spanish speaking; (2) a list of books selected; and (3) a list of publishers and distributors with their addresses. Several bibliographies are included. Entries…

Proyecto Leer Bulletin, Number 11.

ERIC Educational Resources Information Center

Tome, Martha V., Ed.

Educational materials for students of Spanish and the Spanish speaking are listed in this bulletin. A general information section lists reference materials on bilingual children, the blind and physically handicapped, comics, consumer education, employment, health, heritage of the Spanish speaking, Mexican American biography, Mexican American film…

Proyecto Leer Bulletin, Number 9.

ERIC Educational Resources Information Center

Benson, Susan Shattuck

This bulletin lists addresses of publishers and distributors of audiovisual instructional materials in Spanish in the United States and Latin America. Sources are listed in four categories: (1) federal sources of materials, information on materials, names of resource people, programs, and proposal guidelines concerning the Spanish speaking; (2)…

Taxation and regulation of uranium mining in Canada

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

NONE

1990-11-01

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

Sistema de Vigilancia de Influenza de Puerto Rico |

Science.gov Websites

Rico VIH Publicaciones sobre la Salud Otras Publicaciones Registros Suicidio Tuberculosis Centro de Suicidio Tuberculosis Recent Ávisos Públicos Reglamentación Informe de Casos del Síndrome de Guillain Departamento de Salud de Puerto Rico Departamento de Salud Search... Search It looks like your

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

PubMed

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

2018-01-01

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

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

PubMed Central

Zhu, Bin; Fu, Yang; Liu, Jinlin

2018-01-01

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

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

DTIC Science & Technology

1932-06-01

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