WorldWideScience

Sample records for health system capacity

  1. Strengthening Health Systems Research Capacity in Mozambique ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Mozambique's health sector is dealing with system-wide challenges. ... the Ministry's work on national health accounts, resource allocation, and national health ... a combined INS-FIOCRUS program, and the master's in public health and field ...

  2. Building Capacity in Health Systems and Policy Analysis in sub ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Building Capacity in Health Systems and Policy Analysis in sub-Saharan Africa. Since 2005, the Bill and Melinda Gates Foundation has been financing the master's program in health and population at the Institut supérieure des sciences de la population (ISSP), Université de Ouagadougou, Burkina Faso. However, after ...

  3. Health policy, health systems research and analysis capacity ...

    African Journals Online (AJOL)

    Introduction: Health Policy and Systems Research and Analysis (HPSR&A) is an applied science that deals with complexity as it tries to provide lessons, tools and methods to understand and improve health systems and health policy. It is defined by the kinds of questions asked rather than a particular methodology.

  4. Health system capacity: maternal health policy implementation in the state of Gujarat, India

    Directory of Open Access Journals (Sweden)

    Linda Sanneving

    2013-03-01

    Full Text Available Introduction: The Government of Gujarat has for the past couple of decades continuously initiated several interventions to improve access to care for pregnant and delivering women within the state. Data from the last District Family Heath survey in Gujarat in 2007–2008 show that 56.4% of women had institutional deliveries and 71.5% had at least one antenatal check-up, indicating that challenges remain in increasing use of and access to maternal health care services. Objective: To explore the perceptions of high-level stakeholders on the process of implementing maternal health interventions in Gujarat. Method: Using the policy triangle framework developed by Walt and Gilson, the process of implementation was approached using in-depth interviews and qualitative content analysis. Result: Based on the analysis, three themes were developed: lack of continuity; the complexity of coordination; and lack of confidence and underutilization of the monitoring system. The findings suggest that decisions made and actions advocated and taken are more dependent on individual actors than on sustainable structures. The findings also indicate that the context in which interventions are implemented is challenged in terms of weak coordination and monitoring systems that are not used to evaluate and develop interventions on maternal health. Conclusions: The implementation of interventions on maternal health is dependent on the capacity of the health system to implement evidence-based policies. The capacity of the health system in Gujarat to facilitate implementation of maternal health interventions needs to be improved, both in terms of the role of actors and in terms of structures and processes.

  5. Lasting change – strengthening capacity to improve health systems

    International Development Research Centre (IDRC) Digital Library (Canada)

    Health workers from Bauchi and Cross River states ponder how best to respond to findings they ... these skills over the long term. An integrated ... social audits. Learning in interdiscipli- nary teams, they share their practical challenges through frequent presenta- tions and discussions. The program, which is offered at both a ...

  6. Capacity building for health inequality monitoring in Indonesia: enhancing the equity orientation of country health information system.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Nambiar, Devaki; Tawilah, Jihane; Schlotheuber, Anne; Briot, Benedicte; Bateman, Massee; Davey, Tamzyn; Kusumawardani, Nunik; Myint, Theingi; Nuryetty, Mariet Tetty; Prasetyo, Sabarinah; Suparmi; Floranita, Rustini

    Inequalities in health represent a major problem in many countries, including Indonesia. Addressing health inequality is a central component of the Sustainable Development Goals and a priority of the World Health Organization (WHO). WHO provides technical support for health inequality monitoring among its member states. Following a capacity-building workshop in the WHO South-East Asia Region in 2014, Indonesia expressed interest in incorporating health-inequality monitoring into its national health information system. This article details the capacity-building process for national health inequality monitoring in Indonesia, discusses successes and challenges, and how this process may be adapted and implemented in other countries/settings. We outline key capacity-building activities undertaken between April 2016 and December 2017 in Indonesia and present the four key outcomes of this process. The capacity-building process entailed a series of workshops, meetings, activities, and processes undertaken between April 2016 and December 2017. At each stage, a range of stakeholders with access to the relevant data and capacity for data analysis, interpretation and reporting was engaged with, under the stewardship of state agencies. Key steps to strengthening health inequality monitoring included capacity building in (1) identification of the health topics/areas of interest, (2) mapping data sources and identifying gaps, (3) conducting equity analyses using raw datasets, and (4) interpreting and reporting inequality results. As a result, Indonesia developed its first national report on the state of health inequality. A number of peer-reviewed manuscripts on various aspects of health inequality in Indonesia have also been developed. The capacity-building process undertaken in Indonesia is designed to be adaptable to other contexts. Capacity building for health inequality monitoring among countries is a critical step for strengthening equity-oriented national health

  7. Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool.

    Science.gov (United States)

    Jessani, Nasreen; Lewy, Daniela; Ekirapa-Kiracho, Elizabeth; Bennett, Sara

    2014-06-02

    Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans. Between June and November 2011, seven SPHs across the Democratic Republic of Congo, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda implemented this co-created tool. The objectives of the institutional assessments were to assess existing capacities for HSR and to develop capacity development plans to address prioritized gaps. A mixed-method approach was employed consisting of document analysis, self-assessment questionnaires, in-depth interviews, and institutional dialogues aimed at capturing individual perceptions of institutional leadership, collective HSR skills, knowledge translation, and faculty incentives to engage in HSR. Implementation strategies for the capacity assessment varied across the SPHs. This paper reports findings from semi-structured interviews with focal persons from each SPH, to reflect on the process used at each SPH to execute the institutional assessments as well as the perceived strengths and weaknesses of the assessment process. The assessment tool was robust enough to be utilized in its entirety across all seven SPHs resulting in a thorough HSR capacity assessment and a capacity development plan for each SPH. Successful implementation of the capacity assessment exercises depended on four factors: (i) support from senior leadership and collaborators, (ii) a common understanding of HSR, (iii) adequate human and financial resources for the exercise, and (iv) availability of data. Methods of extracting information from the results of the assessments, however, were tailored to the unique objectives of each SPH. This institutional HSR capacity assessment tool and the process for its utilization

  8. Developing nursing capacity for health systems and services research in Cuba, 2008-2011.

    Science.gov (United States)

    Martínez, Nelcy

    2012-07-01

    Health systems and services research by nursing personnel could inform decision-making and nursing care, providing evidence concerning quality of and patient satisfaction. Such studies are rather uncommon in Cuban research institutes, where clinical research predominates. Assess the results of a strategy implemented between 2008 and 2011 to develop nursing capacity for health systems and services research in 14 national research institutes based in Havana. The study comprised four stages: description of approaches to health systems and services research by nurses worldwide and in Cuba; analysis of current capacities for such research in Cuba; intervention design and implementation; and evaluation. Various techniques were used including: literature review, bibliometric analysis, questionnaire survey, consultation with experts, focus groups, and workshops for participant orientation and design and followup of research projects. Qualitative information reduction and quantitative information summary methods were used. Initially, 32 nursing managers participated; a further 105 nurses from the institutes were involved in research teams formed during intervention implementation. Of all published nursing research articles retrieved, 8.9% (185 of 2081) concerned health systems and services research, of which 26.5% (49 of 185) dealt with quality assessment. At baseline, 75% of Cuban nurses surveyed had poor knowledge of health systems and services research. Orientation, design and followup workshops for all institute teams developed individual and institutional capacity for health systems and services research. Post-intervention, 84.7% (27) of nurses reached good knowledge and 14.3% (5) fair; institutional research teams were formed and maintained in 9 institutes, and 13 projects designed and implemented (11 institutional, 2 addressing ministerial-level priorities) to research nursing issues at selected centers. A systematic strategy to build nursing capacity for health

  9. Skills, systems and supports: An Aboriginal Community Controlled Health Service (Apunipima) approach to building health promotion evaluation capacity of staff.

    Science.gov (United States)

    Nichols, Nina; McFarlane, Kathryn; Gibson, Priscilla; Millard, Fiona; Packer, Andrew; McDonald, Malcolm

    2018-04-01

    Building the health promotion evaluation capacity of a workforce requires more than a focus on individual skills and confidence. We must also consider the organisational systems and supports that enable staff to embed learnings into practice. This paper describes the processes used to build health promotion evaluation capacity of staff in an Aboriginal Community Controlled Health Service (ACCHS). To build health promotion evaluation capacity three approaches were used: (i) workshops and mentoring; (ii) strengthening systems to support program reporting; and (iii) recruitment of staff with skills and experience. Pre- and post-questionnaires determined levels of individual skills and confidence, updated systems were assessed for adequacy to support new health promotion practices and surveys captured the usefulness of workshops and mentoring. There was increased participant skills and confidence. Participants completed program impact evaluation reports and results were successfully presented at national conferences. The health promotion team was then able to update in-house systems to support new health promotion practices. Ongoing collaboration with experienced in-house researchers provided basic research training and professional mentoring. Building health promotion evaluation capacity of staff in an ACCHS can be achieved by providing individual skill development, strengthening organisational systems and utilising professional support. SO WHAT?: Health promotion practitioners have an ongoing professional obligation to improve the quality of routine practice and embrace new initiatives. This report outlines a process of building evaluation capacity that promotes quality reporting of program impacts and outcomes, reflects on ways to enhance program strengths, and communicates these findings internally and to outside professional bodies. This is particularly significant for ACCHSs responsible for addressing the high burden of preventable disease in Aboriginal and

  10. Bridging complexity theory and resilience to develop surge capacity in health systems.

    Science.gov (United States)

    Therrien, Marie-Christine; Normandin, Julie-Maude; Denis, Jean-Louis

    2017-03-20

    Purpose Health systems are periodically confronted by crises - think of Severe Acute Respiratory Syndrome, H1N1, and Ebola - during which they are called upon to manage exceptional situations without interrupting essential services to the population. The ability to accomplish this dual mandate is at the heart of resilience strategies, which in healthcare systems involve developing surge capacity to manage a sudden influx of patients. The paper aims to discuss these issues. Design/methodology/approach This paper relates insights from resilience research to the four "S" of surge capacity (staff, stuff, structures and systems) and proposes a framework based on complexity theory to better understand and assess resilience factors that enable the development of surge capacity in complex health systems. Findings Detailed and dynamic complexities manifest in different challenges during a crisis. Resilience factors are classified according to these types of complexity and along their temporal dimensions: proactive factors that improve preparedness to confront both usual and exceptional requirements, and passive factors that enable response to unexpected demands as they arise during a crisis. The framework is completed by further categorizing resilience factors according to their stabilizing or destabilizing impact, drawing on feedback processes described in complexity theory. Favorable order resilience factors create consistency and act as stabilizing forces in systems, while favorable disorder factors such as diversity and complementarity act as destabilizing forces. Originality/value The framework suggests a balanced and innovative process to integrate these factors in a pragmatic approach built around the fours "S" of surge capacity to increase health system resilience.

  11. Governance and Capacity to Manage Resilience of Health Systems: Towards a New Conceptual Framework

    Directory of Open Access Journals (Sweden)

    Karl Blanchet

    2017-08-01

    Full Text Available The term resilience has dominated the discourse among health systems researchers since 2014 and the onset of the Ebola outbreak in West Africa. There is wide consensus that the global community has to help build more resilient health systems. But do we really know what resilience means, and do we all have the same vision of resilience? The present paper presents a new conceptual framework on governance of resilience based on systems thinking and complexity theories. In this paper, we see resilience of a health system as its capacity to absorb, adapt and transform when exposed to a shock such as a pandemic, natural disaster or armed conflict and still retain the same control over its structure and functions.

  12. Growing organizational capacity through a systems approach: one health network's experience.

    Science.gov (United States)

    MacKenzie, Richard; Capuano, Terry; Durishin, Linda Drexinger; Stern, Glen; Burke, James B

    2008-02-01

    Hospitals are reporting unexpected surges in demand for services. Lehigh Valley Hospital challenged its clinical and administrative staff to increase capacity by at least 4% per year using an interdepartmental, systemwide initiative, Growing Organizational Capacity (GOC). Following a systemwide leadership retreat that yielded more than 1,000 ideas, the initiative's principal sponsor convened a cross-functional improvement team. During a two-year period, 17 projects were implemented. Using a complex systems approach, improvement ideas "emerged" from microsystems at the points of care. Through rigorous reporting and testing of process adaptations, need, data, and people drove innovation. Hundreds of multilevel clinical and administrative staff redesigned processes and roles to increase organizational capacity. Admissions rose by 6.1%, 5.5 %, 8.7%, 5.0%, and 3.8% in fiscal years 2003 through 2007, respectively. Process enhancements cost approximately $1 million, while increased revenues attributable to increased capacity totaled $2.5 million. Multiple, coordinated, and concurrent projects created a greater impact than that possible with a single project. GOC and its success, best explained in the context of complex adaptive systems and microsystem theories, are transferrable to throughput issues that challenge efficiency and effectiveness in other health care systems.

  13. CDMA systems capacity engineering

    CERN Document Server

    Kim, Kiseon

    2004-01-01

    This new hands-on resource tackles capacity planning and engineering issues that are crucial to optimizing wireless communication systems performance. Going beyond the system physical level and investigating CDMA system capacity at the service level, this volume is the single-source for engineering and analyzing systems capacity and resources.

  14. Institutional capacity for health systems research in East and Central Africa schools of public health: enhancing capacity to design and implement teaching programs

    Science.gov (United States)

    2014-01-01

    Background The role of health systems research (HSR) in informing and guiding national programs and policies has been increasingly recognized. Yet, many universities in sub-Saharan African countries have relatively limited capacity to teach HSR. Seven schools of public health (SPHs) in East and Central Africa undertook an HSR institutional capacity assessment, which included a review of current HSR teaching programs. This study determines the extent to which SPHs are engaged in teaching HSR-relevant courses and assessing their capacities to effectively design and implement HSR curricula whose graduates are equipped to address HSR needs while helping to strengthen public health policy. Methods This study used a cross-sectional study design employing both quantitative and qualitative approaches. An organizational profile tool was administered to senior staff across the seven SPHs to assess existing teaching programs. A self-assessment tool included nine questions relevant to teaching capacity for HSR curricula. The analysis triangulates the data, with reflections on the responses from within and across the seven SPHs. Proportions and average of values from the Likert scale are compared to determine strengths and weaknesses, while themes relevant to the objectives are identified and clustered to elicit in-depth interpretation. Results None of the SPHs offer an HSR-specific degree program; however, all seven offer courses in the Master of Public Health (MPH) degree that are relevant to HSR. The general MPH curricula partially embrace principles of competency-based education. Different strengths in curricula design and staff interest in HSR at each SPH were exhibited but a number of common constraints were identified, including out-of-date curricula, face-to-face delivery approaches, inadequate staff competencies, and limited access to materials. Opportunities to align health system priorities to teaching programs include existing networks. Conclusions Each SPH has key

  15. Institutional capacity for health systems research in East and Central African Schools of Public Health: strengthening human and financial resources

    Science.gov (United States)

    2014-01-01

    Background Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa. Methods Capacity assessment done included document analysis to establish staff numbers, qualifications and publications; self-assessment using a tool developed to capture individual perceptions on the capacity for HSR and institutional dialogues. Key informant interviews (KIIs) were held with Deans from each SPH and Ministry of Health and non-governmental officials, focusing on perceptions on capacity of SPHs to engage in HSR, access to funding, and organizational support for HSR. Results A total of 123 people participated in the self-assessment and 73 KIIs were conducted. Except for the National University of Rwanda and the University of Nairobi SPH, most respondents expressed confidence in the adequacy of staffing levels and HSR-related skills at their SPH. However, most of the researchers operate at individual level with low outputs. The average number of HSR-related publications was only capacity. This study underscores the need to form effective multidisciplinary teams to enhance research of immediate and local relevance. Capacity strengthening in the SPH needs to focus on knowledge translation and communication of findings to relevant audiences. Advocacy is needed to influence respective governments to allocate adequate funding for HSR to avoid donor dependency that distorts local research agenda. PMID:24888371

  16. Institutional capacity for health systems research in East and Central African schools of public health: knowledge translation and effective communication.

    Science.gov (United States)

    Ayah, Richard; Jessani, Nasreen; Mafuta, Eric M

    2014-06-02

    Local health systems research (HSR) provides policymakers and practitioners with contextual, evidence-based solutions to health problems. However, producers and users of HSR rarely understand the complexities of the context within which each operates, leading to the "know-do" gap. Universities are well placed to conduct knowledge translation (KT) integrating research production with uptake. The HEALTH Alliance Africa Hub, a consortium of seven schools of public health (SPHs) in East and Central Africa, was formed to build capacity in HSR. This paper presents information on the capacity of the various SPHs to conduct KT activities. In 2011, each member of the Africa Hub undertook an institutional HSR capacity assessment using a context-adapted and modified self-assessment tool. KT capacity was measured by several indicators including the presence of a KT strategy, an organizational structure to support KT activities, KT skills, and institutional links with stakeholders and media. Respondents rated their opinions on the various indicators using a 5-point Likert scale. Averages across all respondents for each school were calculated. Thereafter, each school held a results validation workshop. A total of 123 respondents from all seven SPHs participated. Only one school had a clear KT strategy; more commonly, research was disseminated at scientific conferences and workshops. While most respondents perceived their SPH as having strong institutional ties with organizations interested in HSR as well as strong institutional leadership, the organizational structures required to support KT activities were absent. Furthermore, individual researchers indicated that they had little time or skills to conduct KT. Additionally, institutional and individual links with policymakers and media were reported as weak. Few SPHs in Africa have a clear KT strategy. Strengthening the weak KT capacity of the SPHs requires working with institutional leadership to develop KT strategies designed

  17. The development and pilot testing of a rapid assessment tool to improve local public health system capacity in Australia

    Directory of Open Access Journals (Sweden)

    Lin Vivian

    2009-11-01

    Full Text Available Abstract Background To operate effectively the public health system requires infrastructure and the capacity to act. Public health's ability to attract funding for infrastructure and capacity development would be enhanced if it was able to demonstrate what level of capacity was required to ensure a high performing system. Australia's public health activities are undertaken within a complex organizational framework that involves three levels of government and a diverse range of other organizations. The question of appropriate levels of infrastructure and capacity is critical at each level. Comparatively little is known about infrastructure and capacity at the local level. Methods In-depth interviews were conducted with senior managers in two Australian states with different frameworks for health administration. They were asked to reflect on the critical components of infrastructure and capacity required at the local level. The interviews were analyzed to identify the major themes. Workshops with public health experts explored this data further. The information generated was used to develop a tool, designed to be used by groups of organizations within discrete geographical locations to assess local public health capacity. Results Local actors in these two different systems pointed to similar areas for inclusion for the development of an instrument to map public health capacity at the local level. The tool asks respondents to consider resources, programs and the cultural environment within their organization. It also asks about the policy environment - recognizing that the broader environment within which organizations operate impacts on their capacity to act. Pilot testing of the tool pointed to some of the challenges involved in such an exercise, particularly if the tool were to be adopted as policy. Conclusion This research indicates that it is possible to develop a tool for the systematic assessment of public health capacity at the local level

  18. The development and pilot testing of a rapid assessment tool to improve local public health system capacity in Australia.

    Science.gov (United States)

    Bagley, Prue; Lin, Vivian

    2009-11-15

    To operate effectively the public health system requires infrastructure and the capacity to act. Public health's ability to attract funding for infrastructure and capacity development would be enhanced if it was able to demonstrate what level of capacity was required to ensure a high performing system. Australia's public health activities are undertaken within a complex organizational framework that involves three levels of government and a diverse range of other organizations. The question of appropriate levels of infrastructure and capacity is critical at each level. Comparatively little is known about infrastructure and capacity at the local level. In-depth interviews were conducted with senior managers in two Australian states with different frameworks for health administration. They were asked to reflect on the critical components of infrastructure and capacity required at the local level. The interviews were analyzed to identify the major themes. Workshops with public health experts explored this data further. The information generated was used to develop a tool, designed to be used by groups of organizations within discrete geographical locations to assess local public health capacity. Local actors in these two different systems pointed to similar areas for inclusion for the development of an instrument to map public health capacity at the local level. The tool asks respondents to consider resources, programs and the cultural environment within their organization. It also asks about the policy environment - recognizing that the broader environment within which organizations operate impacts on their capacity to act. Pilot testing of the tool pointed to some of the challenges involved in such an exercise, particularly if the tool were to be adopted as policy. This research indicates that it is possible to develop a tool for the systematic assessment of public health capacity at the local level. Piloting the tool revealed some concerns amongst participants

  19. The challenge of benchmarking health systems: is ICT innovation capacity more systemic than organizational dependent?

    Science.gov (United States)

    Lapão, Luís Velez

    2015-01-01

    The article by Catan et al. presents a benchmarking exercise comparing Israel and Portugal on the implementation of Information and Communication Technologies in the healthcare sector. Special attention was given to e-Health and m-Health. The authors collected information via a set of interviews with key stakeholders. They compared two different cultures and societies, which have reached slightly different implementation outcomes. Although the comparison is very enlightening, it is also challenging. Benchmarking exercises present a set of challenges, such as the choice of methodologies and the assessment of the impact on organizational strategy. Precise benchmarking methodology is a valid tool for eliciting information about alternatives for improving health systems. However, many beneficial interventions, which benchmark as effective, fail to translate into meaningful healthcare outcomes across contexts. There is a relationship between results and the innovational and competitive environments. Differences in healthcare governance and financing models are well known; but little is known about their impact on Information and Communication Technology implementation. The article by Catan et al. provides interesting clues about this issue. Public systems (such as those of Portugal, UK, Sweden, Spain, etc.) present specific advantages and disadvantages concerning Information and Communication Technology development and implementation. Meanwhile, private systems based fundamentally on insurance packages, (such as Israel, Germany, Netherlands or USA) present a different set of advantages and disadvantages - especially a more open context for innovation. Challenging issues from both the Portuguese and Israeli cases will be addressed. Clearly, more research is needed on both benchmarking methodologies and on ICT implementation strategies.

  20. eLearning for health system leadership and management capacity building: a protocol for a systematic review.

    Science.gov (United States)

    Tudor Car, Lorainne; Atun, Rifat

    2017-08-21

    Health leadership and management capacity are essential for health system strengthening and for attaining universal health coverage by optimising the existing human, technological and financial resources. However, in health systems, health leadership and management training is not widely available. The use of information technology for education (ie, eLearning) could help address this training gap by enabling flexible, efficient and scalable health leadership and management training. We present a protocol for a systematic review on the effectiveness of eLearning for health leadership and management capacity building in improving health system outcomes. We will follow the Cochrane Collaboration methodology. We will search for experimental studies focused on the use of any type of eLearning modality for health management and leadership capacity building in all types of health workforce cadres. The primary outcomes of interest will be health outcomes, financial risk protection and user satisfaction. In addition, secondary outcomes of interest include the attainment of health system objectives of improved equity, efficiency, effectiveness and responsiveness. We will search relevant databases of published and grey literature as well as clinical trials registries from 1990 onwards without language restrictions. Two review authors will screen references, extract data and perform risk of bias assessment independently. Contingent on the heterogeneity of the collated literature, we will perform either a meta-analysis or a narrative synthesis of the collated data. The systematic review will aim to inform policy makers, investors, health professionals, technologists and educators about the existing evidence, potential gaps in literature and the impact of eLearning for health leadership and management capacity building on health system outcomes. We will disseminate the review findings by publishing it as a peer-reviewed journal manuscript and conference abstracts. PROSPERO CRD

  1. Women health extension workers: Capacities, opportunities and challenges to use eHealth to strengthen equitable health systems in Southern Ethiopia.

    Science.gov (United States)

    Dusabe-Richards, John N; Tesfaye, Hayley Teshome; Mekonnen, Jarso; Kea, Aschenaki; Theobald, Sally; Datiko, Daniel G

    2016-12-27

    This study assesses the feasibility of female health extension workers (HEWs) using eHealth within their core duties, supporting both the design and capacity building for an eHealth system project focussed initially on tuberculosis, maternal child health, and gender equity. Health extension workers, Health Centre Heads, District Health Officers, Zonal Health Department and Regional Health Bureau representatives in Southern Ethiopia. The study was undertaken in Southern Ethiopia with three districts in Sidama zone (population of 3.5 million) and one district in Gedeo zone (control zone with similar health service coverage and population density). Mixed method baseline data collection was undertaken, using quantitative questionnaires (n = 57) and purposively sampled qualitative face-to-face semi-structured interviews (n = 10) and focus group discussions (n = 3). Themes were identified relating to HEW commitment and role, supervision, and performance management. The Health Management Information System (HMIS) was seen as important by all participants, but with challenges of information quality, accuracy, reliability and timeliness. Participants' perceptions varied by group regarding the purpose and benefits of HMIS as well as the potential of an eHealth system. Mobile phones were used regularly by all participants. eHealth technology presents a new opportunity for the Ethiopian health system to improve data quality and community health. Front-line female HEWs are a critical bridge between communities and health systems. Empowering HEWs, supporting them and responding to the challenges they face will be an important part of ensuring the sustainability and responsiveness of eHealth strategies. Findings have informed the subsequent eHealth technology design and implementation, capacity strengthening approach, supervision, and performance management approach.

  2. Disease burden and mental health system capacity: WHO Atlas study of 117 low- and middle-income countries.

    Science.gov (United States)

    McBain, Ryan; Salhi, Carmel; Morris, Jodi E; Salomon, Joshua A; Betancourt, Theresa S

    2012-12-01

    Treatment coverage for mental disorders ranges from less than 10% to more than 90% across low- and middle-income (LAMI) countries. Studies have yet to examine whether the capacity of mental health systems might be adversely affected by the burdens of unrelated conditions such as HIV/AIDS. To examine whether the magnitude of disease burden from communicable, perinatal, maternal and nutritional conditions - commonly referred to as Group 1 diseases - is inversely associated with mental health system capacity in LAMI countries. Multiple regression analyses were undertaken using data from 117 LAMI countries included in the 2011 World Health Organization (WHO) Mental Health Atlas. Capacity was defined in terms of human resources and infrastructure. Regressions controlled for effects of political stability, government health expenditures, income inequality and neuropsychiatric disease burden. Higher Group 1 disease burden was associated with fewer psychiatrists, psychologists and nurses in the mental health sector, as well as reduced numbers of out-patient facilities and psychiatric beds in mental hospitals and general hospitals (t = -2.06 to -7.68, Pmental health system capacity in LAMI countries may be adversely affected by the magnitude of their Group 1 disease burden.

  3. Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly new approach to development?

    Directory of Open Access Journals (Sweden)

    Goldberg Jessica

    2012-07-01

    Full Text Available Abstract Background During the last decade, donor governments and international agencies have increasingly emphasized the importance of building the capacity of indigenous health care organizations as part of strengthening health systems and ensuring sustainability. In 2009, the U.S. Global Health Initiative made country ownership and capacity building keystones of U.S. health development assistance, and yet there is still a lack of consensus on how to define either of these terms, or how to implement “country owned capacity building”. Discussion Concepts around capacity building have been well developed in the for-profit business sector, but remain less well defined in the non-profit and social sectors in low and middle-income countries. Historically, capacity building in developing countries has been externally driven, related to project implementation, and often resulted in disempowerment of local organizations rather than local ownership. Despite the expenditure of millions of dollars, there is no consensus on how to conduct capacity building, nor have there been rigorous evaluations of capacity building efforts. To shift to a new paradigm of country owned capacity building, donor assistance needs to be inclusive in the planning process and create true partnerships to conduct organizational assessments, analyze challenges to organizational success, prioritize addressing challenges, and implement appropriate activities to build new capacity in overcoming challenges. Before further investments are made, a solid evidence base should be established concerning what works and what doesn’t work to build capacity. Summary Country-owned capacity building is a relatively new concept that requires further theoretical exploration. Documents such as The Paris Declaration on Aid Effectiveness detail the principles of country ownership to which partner and donor countries should commit, but do not identify the specific mechanisms to carry out these

  4. Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project

    Science.gov (United States)

    Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

    2014-01-01

    The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity ‘assets’ and ‘needs’, and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations’ resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for

  5. Assessment of management capacity to improve the value of health-care systems: a survey

    OpenAIRE

    Rebecca L Weintraub, MD; Keri Wachter, BA; Jennifer Goldsmith, MS; Marie J Teichman, BA; Eda Algur; Julie D Rosenberg, MPH

    2017-01-01

    Background: Strong management is important for high-value health-care systems if returns on global health investments are to be delivered and the Sustainable Development Goals met by 2030. Managers are responsible for care delivery systems and strategies, making sure that health services benefit the population they intend to serve. Most managers in resource-limited settings work at the district level and below, with little training in non-clinical skills. They are often health care providers ...

  6. The challenge of benchmarking health systems: is ICT innovation capacity more systemic than organizational dependent?

    OpenAIRE

    Lap?o, Lu?s Velez

    2015-01-01

    The article by Catan et al. presents a benchmarking exercise comparing Israel and Portugal on the implementation of Information and Communication Technologies in the healthcare sector. Special attention was given to e-Health and m-Health. The authors collected information via a set of interviews with key stakeholders. They compared two different cultures and societies, which have reached slightly different implementation outcomes. Although the comparison is very enlightening, it is also chall...

  7. Community Capacity Building for Health

    Directory of Open Access Journals (Sweden)

    Martha Traverso-Yepez

    2012-05-01

    Full Text Available There is a great deal of literature examining the benefits and relevance of community participation and community capacity building in health promotion and disease prevention endeavors. Academic literature embracing principles and commitment to community participation in health promotion practices often neglects the complexities involved and the flexibility required to work within this approach. This article addresses some of these challenges through a case study of two projects funded by Provincial Wellness Grants in Newfoundland and Labrador, a province in Canada with a strong tradition of community ties and support systems. In addition to addressing the unique circumstances of the community groups, this research allowed the authors to examine the situational context and power relations involved in the provision of services as well as the particular forms of subjectivity and citizenship that the institutional practices support. Recognizing this complex interdependency is an important step in creating more effective intervention practices.

  8. Improving African health research capacity

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Wallace, Samantha A; Liljestrand, Jerker

    2010-01-01

    The issue of strengthening local research capacity in Africa is again high on the health and development agenda. The latest initiative comes from the Wellcome Trust. But when it comes to capacity development, one of the chief obstacles that health sectors in the region must confront is the migrat......The issue of strengthening local research capacity in Africa is again high on the health and development agenda. The latest initiative comes from the Wellcome Trust. But when it comes to capacity development, one of the chief obstacles that health sectors in the region must confront...... is the migration of health professionals to countries that offer more lucrative opportunities, like those in western Europe. To combat this ''brain drain'', already back in 1984, the Swedish International Development Cooperation Agency (Sida) created a training programme in which healthcare professionals from...... Africa conducted the bulk of their research in their own countries. However, the model was only partly successful. Several years ago, we assessed the preconditions for the renewal of Sida support for research and research training activities in the region. Based on our work to develop a critical mass...

  9. Trends in health policy and systems research over the past decade: still too little capacity in low-income countries.

    Science.gov (United States)

    Adam, Taghreed; Ahmad, Saad; Bigdeli, Maryam; Ghaffar, Abdul; Røttingen, John-Arne

    2011-01-01

    The past decade has seen several high-level events and documents committing to strengthening the field of health policy and systems research (HPSR) as a critical input to strengthening health systems. Specifically, they called for increased production, capacity to undertake and funding for HPSR. The objective of this paper is to assess the extent to which progress has been achieved, an important feedback for stakeholders in this field. Two sources of data have been used. The first is a bibliometric analysis to assess growth in production of HPSR between 2003 and 2009. The six building blocks of the health system were used to define the scope of this search. The second is a survey of 96 research institutions undertaken in 2010 to assess the capacity and funding availability to undertake HPSR, compared with findings from the same survey undertaken in 2000 and 2008. Both analyses focus on HPSR relevant to low-income and middle-income countries (LMICs). Overall, we found an increasing trend of publications on HPSR in LMICs, although only 4% were led by authors from low-income countries (LICs). This is consistent with findings from the institutional survey, where despite improvements in infrastructure of research institutions, a minimal change has been seen in the level of experience of researchers within LIC institutions. Funding availability in LICs has increased notably to institutions in Sub-Saharan Africa; nonetheless, the overall increase has been modest in all regions. Although progress has been made in both the production and funding availability for HPSR, capacity to undertake the research locally has grown at a much slower pace, particularly in LICs where there is most need for this research. A firm commitment to dedicate a proportion of all future funding for research to building capacity may be the only solution to turn the tide.

  10. Trends in health policy and systems research over the past decade: still too little capacity in low-income countries.

    Directory of Open Access Journals (Sweden)

    Taghreed Adam

    Full Text Available BACKGROUND: The past decade has seen several high-level events and documents committing to strengthening the field of health policy and systems research (HPSR as a critical input to strengthening health systems. Specifically, they called for increased production, capacity to undertake and funding for HPSR. The objective of this paper is to assess the extent to which progress has been achieved, an important feedback for stakeholders in this field. METHODS AND FINDING: Two sources of data have been used. The first is a bibliometric analysis to assess growth in production of HPSR between 2003 and 2009. The six building blocks of the health system were used to define the scope of this search. The second is a survey of 96 research institutions undertaken in 2010 to assess the capacity and funding availability to undertake HPSR, compared with findings from the same survey undertaken in 2000 and 2008. Both analyses focus on HPSR relevant to low-income and middle-income countries (LMICs. Overall, we found an increasing trend of publications on HPSR in LMICs, although only 4% were led by authors from low-income countries (LICs. This is consistent with findings from the institutional survey, where despite improvements in infrastructure of research institutions, a minimal change has been seen in the level of experience of researchers within LIC institutions. Funding availability in LICs has increased notably to institutions in Sub-Saharan Africa; nonetheless, the overall increase has been modest in all regions. CONCLUSION: Although progress has been made in both the production and funding availability for HPSR, capacity to undertake the research locally has grown at a much slower pace, particularly in LICs where there is most need for this research. A firm commitment to dedicate a proportion of all future funding for research to building capacity may be the only solution to turn the tide.

  11. "It takes more than a fellowship program": reflections on capacity strengthening for health systems research in sub-Saharan Africa.

    Science.gov (United States)

    Izugbara, Chimaraoke O; Kabiru, Caroline W; Amendah, Djesika; Dimbuene, Zacharie Tsala; Donfouet, Hermann Pythagore Pierre; Atake, Esso-Hanam; Ingabire, Marie-Gloriose; Maluka, Stephen; Mumah, Joyce N; Mwau, Matilu; Ndinya, Mollyne; Ngure, Kenneth; Sidze, Estelle M; Sossa, Charles; Soura, Abdramane; Ezeh, Alex C

    2017-12-04

    Sub-Saharan Africa (SSA) experiences an acute dearth of well-trained and skilled researchers. This dearth constrains the region's capacity to identify and address the root causes of its poor social, health, development, and other outcomes. Building sustainable research capacity in SSA requires, among other things, locally led and run initiatives that draw on existing regional capacities as well as mutually beneficial global collaborations. This paper describes a regional research capacity strengthening initiative-the African Doctoral Dissertation Research Fellowship (ADDRF) program. This Africa-based and African-led initiative has emerged as a practical and tested platform for producing and nurturing research leaders, strengthening university-wide systems for quality research training and productivity, and building a critical mass of highly-trained African scholars and researchers. The program deploys different interventions to ensure the success of fellows. These interventions include research methods and scientific writing workshops, research and reentry support grants, post-doctoral research support and placements, as well as grants for networking and scholarly conferences attendance. Across the region, ADDRF graduates are emerging as research leaders, showing signs of becoming the next generation of world-class researchers, and supporting the transformations of their home-institutions. While the contributions of the ADDRF program to research capacity strengthening in the region are significant, the sustainability of the initiative and other research and training fellowship programs on the continent requires significant investments from local sources and, especially, governments and the private sector in Africa. The ADDRF experience demonstrates that research capacity building in Africa is possible through innovative, multifaceted interventions that support graduate students to develop different critical capacities and transferable skills and build, expand, and

  12. Assessing the Capacity of the US Health Care System to Use Additional Mechanical Ventilators During a Large-Scale Public Health Emergency.

    Science.gov (United States)

    Ajao, Adebola; Nystrom, Scott V; Koonin, Lisa M; Patel, Anita; Howell, David R; Baccam, Prasith; Lant, Tim; Malatino, Eileen; Chamberlin, Margaret; Meltzer, Martin I

    2015-12-01

    A large-scale public health emergency, such as a severe influenza pandemic, can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use. We identified key components of the health care system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (ie, conventional, contingency, and crisis), and determined the constraining key component at each capacity level. Our study results showed that US hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning. The current US health care system may have limited capacity to use additional mechanical ventilators during a large-scale public health emergency. Emergency planners need to understand their health care systems' capability to absorb additional resources and expand care. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or to identify alternatives to manage overwhelming critical care need.

  13. Health Reform Requires Policy Capacity

    Directory of Open Access Journals (Sweden)

    Pierre-Gerlier Forest

    2015-05-01

    Full Text Available Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility

  14. Aldo Leopold's land health from a resilience point of view: self-renewal capacity of social-ecological systems.

    Science.gov (United States)

    Berkes, Fikret; Doubleday, Nancy C; Cumming, Graeme S

    2012-09-01

    Health approaches to ecology have a strong basis in Aldo Leopold's thinking, and contemporary ecohealth in turn has a strong philosophical basis in Leopold. To commemorate the 125th anniversary of Leopold's birth (1887-1948), we revisit his ideas, specifically the notions of stewardship (land ethic), productive use of ecosystems (land), and ecosystem renewal. We focus on Leopold's perspective on the self-renewal capacity of the land, as understood in terms of integrity and land health, from the contemporary perspective of resilience theory and ecological theory more generally. Using a broad range of literature, we explore insights and implications of Leopold's work for today's human-environment relationships (integrated social-ecological systems), concerns for biodiversity, the development of agency with respect to stewardship, and key challenges of his time and of ours. Leopold's seminal concept of land health can be seen as a triangulation of productive use, self-renewal, and stewardship, and it can be reinterpreted through the resilience lens as the health of social-ecological systems. In contemporary language, this involves the maintenance of biodiversity and ecosystem services, and the ability to exercise agency both for conservation and for environmental justice.

  15. Improving skills and institutional capacity to strengthen adolescent immunisation programmes and health systems in African countries through HPV vaccine introduction

    Directory of Open Access Journals (Sweden)

    Carine Dochez

    2017-12-01

    Full Text Available Several African countries have recently introduced or are currently introducing the HPV vaccine, either nationwide or through demonstration projects, while some countries are planning for introduction. A collaborative project was developed to strengthen country adolescent immunisation programmes and health systems in the African Region, addressing unique public health considerations of HPV vaccination: adolescents as the primary target group, delivery platforms (e.g. school-based and facility based, socio-behavioural issues, and the opportunity to deliver other health interventions alongside HPV vaccination.Following a successful “taking-stock” meeting, a training programme was drafted to assist countries to strengthen the integration of adolescent health interventions using HPV vaccination as an entry point. Two workshops were conducted in the Eastern and Southern African Regions. All countries reported on progress made during a final joint symposium.Of the 20 countries invited to participate in either of the workshops and/or final symposium, 17 countries participated: Angola, Botswana, Ethiopia, Kenya, Malawi, Mauritius, Mozambique, Namibia, Rwanda, Seychelles, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Countries that are currently implementing HPV vaccination programmes, either nationally or through demonstration projects, reported varying degrees of integration with other adolescent health interventions. The most commonly reported adolescent health interventions alongside HPV vaccination include health education (including sexually transmitted infections, deworming and delivering of other vaccines like tetanus toxoid (TT or tetanus diphtheria (Td.The project has successfully (a established an African-based network that will advocate for incorporating the HPV vaccine into national immunisation programmes; (b created a platform for experience exchange and thereby contributed to novel ideas of

  16. Hours and Miles: Patient and Health System Implications of Transfer for Psychiatric Bed Capacity.

    Science.gov (United States)

    O'Neil, Amy M; Sadosty, Annie T; Pasupathy, Kalyan S; Russi, Christopher; Lohse, Christine M; Campbell, Ronna L

    2016-11-01

    An increasing number of behavioral health (BH) patients are presenting to the emergency department (ED) while BH resources continue to decline. This situation-may lead to more external transfers to find care. This is a retrospective cohort study of consecutive patients presenting to a tertiary care academic ED from February 1, 2013, through January 31, 2014. Patients were identified through electronic health record documentation of psychiatric consultation during ED evaluation. We reviewed electronic health records for demographic characteristics, diagnoses, payer source, ED length of stay, ED disposition, arrival method, and distance traveled to an external facility for inpatient admission. Univariable and multivariable associations with transfer to an external facility in comparison with patients admitted internally were evaluated with logistic regression models and summarized with odds ratios (OR). We identified 2,585 BH visits, of which 1,083 (41.9%) resulted in discharge. A total of 1,502 patient visits required inpatient psychiatric admission, and of these cases, 177 patients (11.8%; 95% CI = [10.2-13.5]) required transfer to an external facility. The median ED length of stay for transferred patients was 13.9 hours (interquartile range [IQR], 9.3-20.2 hours; range, 3.0-243.0 hours). The median distance for transport was 83 miles (IQR, 42-111 miles; range, 42-237 miles). In multivariable analysis, patients with suicidal or homicidal ideation had increased risk of transfer (odds ratio [OR] [95% CI], 1.93 [1.22-3.06]; P =0.005). Children younger than 18 years (OR [95% CI], 2.34 [1.60-3.40]; P< 0.001) and adults older than 65 years (OR [95% CI], 3.46 [1.93-6.19]; P <0.001) were more likely to require transfer and travel farther to access care. Patients requiring external transfer for inpatient psychiatric care were found to have prolonged ED lengths of stay. Patients with suicidal and homicidal ideation as well as children and adults older than 65 years are more

  17. Hours and Miles: Patient and Health System Implications of Transfer for Psychiatric Bed Capacity

    Directory of Open Access Journals (Sweden)

    Amy M. O’Neil

    2016-11-01

    Full Text Available Introduction: An increasing number of behavioral health (BH patients are presenting to the emergency department (ED while BH resources continue to decline. This situation may lead to more external transfers to find care. Methods: This is a retrospective cohort study of consecutive patients presenting to a tertiary care academic ED from February 1, 2013, through January 31, 2014. Patients were identified through electronic health record documentation of psychiatric consultation during ED evaluation. We reviewed electronic health records for demographic characteristics, diagnoses, payer source, ED length of stay, ED disposition, arrival method, and distance traveled to an external facility for inpatient admission. Univariable and multivariable associations with transfer to an external facility in comparison with patients admitted internally were evaluated with logistic regression models and summarized with odds ratios (OR. Results: We identified 2,585 BH visits, of which 1,083 (41.9% resulted in discharge. A total of 1,502 patient visits required inpatient psychiatric admission, and of these cases, 177 patients (11.8%; 95% CI = [10.2-13.5] required transfer to an external facility. The median ED length of stay for transferred patients was 13.9 hours (interquartile range [IQR], 9.3-20.2 hours; range, 3.0-243.0 hours. The median distance for transport was 83 miles (IQR, 42-111 miles; range, 42-237 miles. In multivariable analysis, patients with suicidal or homicidal ideation had increased risk of transfer (odds ratio [OR] [95% CI], 1.93 [1.22-3.06]; P=0.005. Children younger than 18 years (OR [95% CI], 2.34 [1.60- 3.40]; P<0.001 and adults older than 65 years (OR [95% CI], 3.46 [1.93-6.19]; P<0.001 were more likely to require transfer and travel farther to access care. Conclusion: Patients requiring external transfer for inpatient psychiatric care were found to have prolonged ED lengths of stay. Patients with suicidal and homicidal ideation as well

  18. Developing capacity-building activities for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners, and researchers.

    Science.gov (United States)

    Semrau, M; Alem, A; Abdulmalik, J; Docrat, S; Evans-Lacko, S; Gureje, O; Kigozi, F; Lempp, H; Lund, C; Petersen, I; Shidhaye, R; Thornicroft, G; Hanlon, C

    2018-02-01

    There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the 'Emerging mental health systems in low- and middle-income countries' (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.

  19. Case-resolving capacity of dental care of the Unified Health System: the perception of users in a city in the state of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Arinilson Moreira Chaves Lima

    Full Text Available Abstract The aim of this study was to learn about the users' perceptions concerning the case-resolving capacity of dental care in the Unified Health System and to analyze the associations between solving capacity and both sociodemographic characteristics and access to the service. This was a cross-sectional study with a quantitative approach, in which 461 users responded to individual interviews. The outcome variable was the case-resolving capacity of dental care, obtained through the question: “In your opinion, is the dentist of this health center managing to solve all your oral health problems (Yes/No”. Independent variables were grouped into the following: sociodemographic and related to the access to the service. Most participants reported that their oral health problems were being solved. By using the Poisson regression, the lack of case-resolving capacity was found to be associated to the patients' not considering the dental surgeon's working hours convenient; to the long time they had to wait to get an appointment in the health center; and to the long time they had to wait in the waiting room. The results showed the positive view that users have about the case-resolving capacity of public dental care, and the relationship between access to the service and the said solving capacity.

  20. Evaluating capacity-building for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners and researchers.

    Science.gov (United States)

    Hanlon, C; Semrau, M; Alem, A; Abayneh, S; Abdulmalik, J; Docrat, S; Evans-Lacko, S; Gureje, O; Jordans, M; Lempp, H; Mugisha, J; Petersen, I; Shidhaye, R; Thornicroft, G

    2018-02-01

    Efforts to support the scale-up of integrated mental health care in low- and middle-income countries (LMICs) need to focus on building human resource capacity in health system strengthening, as well as in the direct provision of mental health care. In a companion editorial, we describe a range of capacity-building activities that are being implemented by a multi-country research consortium (Emerald: Emerging mental health systems in low- and middle-income countries) for (1) service users and caregivers, (2) service planners and policy-makers and (3) researchers in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). In this paper, we focus on the methodology being used to evaluate the impact of capacity-building in these three target groups. We first review the evidence base for approaches to evaluation of capacity-building, highlighting the gaps in this area. We then describe the adaptation of best practice for the Emerald capacity-building evaluation. The resulting mixed method evaluation framework was tailored to each target group and to each country context. We identified a need to expand the evidence base on indicators of successful capacity-building across the different target groups. To address this, we developed an evaluation plan to measure the adequacy and usefulness of quantitative capacity-building indicators when compared with qualitative evaluation. We argue that evaluation needs to be an integral part of capacity-building activities and that expertise needs to be built in methods of evaluation. The Emerald evaluation provides a potential model for capacity-building evaluation across key stakeholder groups and promises to extend understanding of useful indicators of success.

  1. Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review

    Directory of Open Access Journals (Sweden)

    Roxanne Keynejad

    2016-10-01

    Full Text Available Abstract Background Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs. We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. Methods We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Results Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. Conclusions This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed

  2. Policy Capacity for Health Reform: Necessary but Insufficient: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Adams, Owen

    2015-09-04

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action. © 2016 by Kerman University of Medical Sciences.

  3. Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research.

    Science.gov (United States)

    Rockers, Peter C; Tugwell, Peter; Grimshaw, Jeremy; Oliver, Sandy; Atun, Rifat; Røttingen, John-Arne; Fretheim, Atle; Ranson, M Kent; Daniels, Karen; Luiza, Vera Lucia; Bärnighausen, Till

    2017-09-01

    Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Building system capacity for the integration of mental health at the level of primary care in Tunisia: a study protocol in global mental health.

    Science.gov (United States)

    Spagnolo, Jessica; Champagne, François; Leduc, Nicole; Piat, Myra; Melki, Wahid; Charfi, Fatma; Laporta, Marc

    2017-01-17

    In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Intervention Guide (IG), developed by the World Health Organization (WHO), aim to address this challenge by training non-specialists such as general practitioners (GPs) in mental health care. This trial aims to implement and evaluate an adapted version of the mhGAP-IG (version 1.0) offered to GPs in 2 governorates of Tunisia (i.e., Tunis and Sousse), in order to uncover important information regarding implementation process and study design before country-wide implementation and evaluation. First, a systematic review will be conducted to explore types and effectiveness of mental health training programs offered to GPs around the world, with a specific focus on programs implemented and evaluated in LMICs. Second, a cluster randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the implemented training based on the mhGAP-IG (version 1.0). Third, multiple case study design will be used to explore how contextual factors impact the successful implementation of the training and desired outcomes. In Tunisia, an important need exists to further develop proximity health services and to address the growing mental health treatment gap. One solution is to train GPs in the detection, treatment, and management of mental health problems, given their strategic role in the healthcare system. This trial thus aims to implement and evaluate an adapted version of a training based on the mhGAP-IG (version 1.0) in Tunis and Sousse before country-wide implementation and evaluation. Several contributions are envisioned: adding to the growing evidence on the mhGAP and its accompanying guide, especially in French-speaking nations; building research capacity in

  5. Public and private maternal health service capacity and patient flows in Southern Tanzania: using a geographic information system to link hospital and national census data.

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M E; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase

  6. Advancing the application of systems thinking in health: a realist evaluation of a capacity building programme for district managers in Tumkur, India.

    Science.gov (United States)

    Prashanth, Nuggehalli Srinivas; Marchal, Bruno; Devadasan, Narayanan; Kegels, Guy; Criel, Bart

    2014-08-26

    Health systems interventions, such as capacity-building of health workers, are implemented across districts in order to improve performance of healthcare organisations. However, such interventions often work in some settings and not in others. Local health systems could be visualised as complex adaptive systems that respond variously to inputs of capacity building interventions, depending on their local conditions and several individual, institutional, and environmental factors. We aim at demonstrating how the realist evaluation approach advances complex systems thinking in healthcare evaluation by applying the approach to understand organisational change within local health systems in the Tumkur district of southern India. We collected data on several input, process, and outcome measures of performance of the talukas (administrative sub-units of the district) and explore the interplay between the individual, institutional, and contextual factors in contributing to the outcomes using qualitative data (interview transcripts and observation notes) and quantitative measures of commitment, self-efficacy, and supervision style. The talukas of Tumkur district responded differently to the intervention. Their responses can be explained by the interactions between several individual, institutional, and environmental factors. In a taluka with committed staff and a positive intention to make changes, the intervention worked through aligning with existing opportunities from the decentralisation process to improve performance. However, commitment towards the organisation was neither crucial nor sufficient. Committed staff in two other talukas were unable to actualise their intentions to improve organisational performance. In yet another taluka, the leadership was able to compensate for the lack of commitment. Capacity building of local health systems could work through aligning or countering existing relationships between internal (individual and organisational) and external

  7. Seriously Implementing Health Capacity Strengthening Programs in Africa; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

    Directory of Open Access Journals (Sweden)

    Luis Velez Lapão

    2015-10-01

    Full Text Available Faced with the challenges of healthcare reform, skills and new capabilities are needed to support the reform and it is of crucial importance in Africa where shortages affects the health system resilience. Edwards et al provides a good example of the challenge of implementing a mentoring program in one province in a sub-Saharan country. From this example, various aspects of strengthening the capacity of managers in healthcare are examined based on our experience in action-training in Africa, as mentoring shares many characteristics with action-training. What practical lessons can be drawn to promote the strengthening so that managers can better intervene in complex contexts? Deeper involvement of health authorities and more rigorous approaches are seriously desirable for the proper development of health capacity strengthening programs in Africa.

  8. Building Public Health Capacity through Online Global Learning

    Science.gov (United States)

    Madhok, Rajan; Frank, Erica; Heller, Richard Frederick

    2018-01-01

    Rising disease burden and health inequalities remain global concerns, highlighting the need for health systems strengthening with a sufficient and appropriately trained workforce. The current models for developing such a workforce are inadequate and newer approaches are needed. In this paper we describe a model for public health capacity building…

  9. Kenya-Malawi Health Research Capacity Strengthening Initiative ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This grant will support the creation of two task forces in Kenya and Malawi, respectively, to articulate nationally owned and strategies for an effective health research system in each country. The idea is to enhance the capacity of health research institutions to generate new scientific knowledge, and health policymaking ...

  10. [Capacity of response of the health system to the expectations of populations in zones exposed to results-based financing in Benin in 2015].

    Science.gov (United States)

    Salami, Lamidhi; Dona Ouendo, Edgard-Marius; Fayomi, Benjamin

    2017-07-10

    Introduction: The increased use of results-based financing (RBF) services was the basis for this study designed to evaluate the contribution of RBF to the capacity of response of the health system to the population’s expectations. Methods: This study, conducted in six Benin health zones randomly selected in two strata exposed to RBF (FBR_PRPSS and FBR_PASS) and one zone not exposed to RBF (Non_FBR), examined the seven dimensions of reactivity. A score, followed by weighting of their attributes, was used to calculate the index of reactivity (IR). Results: Sixty-seven health care units and 653 people were observed and interviewed. The FBR_PRPSS and FBR_PASS strata, managed by the new provisions of RBF, displayed good performances for the “rapidity of management” (70% and 80%) and “quality of the health care environment” dimensions, with a more marked improvement for the PRPSS model, which provides greater resources. Poor access to social welfare networks in the three strata led to renouncing of health care. The capacity of response to expectations was moderate and similar in the Non_FBR (IR = 0.53), FBR_PASS (IR = 0.62) and FBR_PRPSS (IR = 0.61) strata (p > 0.05). Conclusion: The FBR_PRPSS and FBR_PASS models have a non-significant effect on the capacity of response. Their success probably depends on the health system context, the combination of targeted interventions, such as universal health insurance, but also the importance and the use of the new resources that they provide.

  11. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam.

    Science.gov (United States)

    Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

    2014-01-01

    As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease

  12. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2014-12-01

    Full Text Available Background: As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective: This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design: This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results: 1 Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2 Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3 Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4 Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5 Information and research: Data that can be used for planning and management (including population and epidemiological

  13. Building Capacity For Innovation Through R&D Consortia in Health Projects: From Network Interaction to Systemic Transformation

    Directory of Open Access Journals (Sweden)

    Ria Hardiyati

    2017-12-01

    The research capacity in the area of vaccines has been long started from individual research conducted by researcher. It has been continued into organization research, and then developed into building innovation capacity through R&D consortia. However, in areas of stem cell there is still lack of evidence but it directly leaps to build innovation capacity through R&D consortia. Therefore further empirical evidence is needed to support the continuous trajectory.

  14. Simulations of floor cooling system capacity

    International Nuclear Information System (INIS)

    Odyjas, Andrzej; Górka, Andrzej

    2013-01-01

    Floor cooling system capacity depends on its physical and operative parameters. Using numerical simulations, it appears that cooling capacity of the system largely depends on the type of cooling loads occurring in the room. In the case of convective cooling loads capacity of the system is small. However, when radiation flux falls directly on the floor the system significantly increases productivity. The article describes the results of numerical simulations which allow to determine system capacity in steady thermal conditions, depending on the type of physical parameters of the system and the type of cooling load occurring in the room. Moreover, the paper sets out the limits of system capacity while maintaining a minimum temperature of the floor surface equal to 20 °C. The results are helpful for designing system capacity in different type of cooling loads and show maximum system capacity in acceptable thermal comfort condition. -- Highlights: ► We have developed numerical model for simulation of floor cooling system. ► We have described floor system capacity depending on its physical parameters. ► We have described floor system capacity depending on type of cooling loads. ► The most important in the obtained cooling capacities is the type of cooling loads. ► The paper sets out the possible maximum cooling floor system capacity

  15. Assessing the capacity of the healthcare system to use additional mechanical ventilators during a large-scale public health emergency (PHE)

    Science.gov (United States)

    Ajao, Adebola; Nystrom, Scott V.; Koonin, Lisa M.; Patel, Anita; Howell, David R.; Baccam, Prasith; Lant, Tim; Malatino, Eileen; Chamberlin, Margaret; Meltzer, Martin I.

    2015-01-01

    A large-scale Public Health Emergency (PHE), like a severe influenza pandemic can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use. We identified key components of the healthcare system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (i.e. conventional, contingency and crisis) and determined the constraining key component at each capacity level. Our study results showed that U.S. hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or identify alternatives to manage overwhelming critical care need. PMID:26450633

  16. Prepared to react? Assessing the functional capacity of the primary health care system in rural Orissa, India to respond to the devastating flood of September 2008

    Directory of Open Access Journals (Sweden)

    Michael Marx

    2012-03-01

    Full Text Available Background: Early detection of an impending flood and the availability of countermeasures to deal with it can significantly reduce its health impacts. In developing countries like India, public primary health care facilities are frontline organizations that deal with disasters particularly in rural settings. For developing robust counter reacting systems evaluating preparedness capacities within existing systems becomes necessary. Objective: The objective of the study is to assess the functional capacity of the primary health care system in Jagatsinghpur district of rural Orissa in India to respond to the devastating flood of September 2008. Methods: An onsite survey was conducted in all 29 primary and secondary facilities in five rural blocks (administrative units of Jagatsinghpur district in Orissa state. A pre-tested structured questionnaire was administered face to face in the facilities. The data was entered, processed and analyzed using STATA® 10. Results: Data from our primary survey clearly shows that the healthcare facilities are ill prepared to handle the flood despite being faced by them annually. Basic utilities like electricity backup and essential medical supplies are lacking during floods. Lack of human resources along with missing standard operating procedures; pre-identified communication and incident command systems; effective leadership; and weak financial structures are the main hindering factors in mounting an adequate response to the floods. Conclusion: The 2008 flood challenged the primary curative and preventive health care services in Jagatsinghpur. Simple steps like developing facility specific preparedness plans which detail out standard operating procedures during floods and identify clear lines of command will go a long way in strengthening the response to future floods. Performance critiques provided by the grass roots workers, like this one, should be used for institutional learning and effective preparedness

  17. Health promotion capacity building in South Africa.

    Science.gov (United States)

    Wills, Jane; Rudolph, Michael

    2010-09-01

    Health promotion in South Africa is in its early stages and while there is some institutional development and capacity building for managers, there has been relative disregard and lack of attention of the wider health promotion workforce who carry out community-based health promotion activities. This article describes one regional education and training programme for health promoters as well as the limited available evidence on the impact of the project on learners and organizations. Marked differences before and after the implementation of the training activities were reported in relation to behaviour change communication and project planning, in addition to self-reported positive change in knowledge, confidence and a high level of participant satisfaction. Investment in individual skills development needs to be accompanied by wider workforce development with organizational/institutional development and recognised competencies frameworks.

  18. Outage capacity of multicarrier systems

    KAUST Repository

    Yilmaz, Ferkan; Alouini, Mohamed-Slim

    2010-01-01

    The probability density function and the cumulative distribution function of the product of shifted Gamma variates are obtained in terms of the generalized Fox's H function. Using these new results, the exact outage capacity of multi carrier transmission through a slow Nakagami-m fading channel is presented. Moreover, it is shown that analytical and simulation results are in perfect agreement. © 2009 IEEE.

  19. Public health capacity in the provision of health care services.

    Science.gov (United States)

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.

  20. Outage capacity of multicarrier systems

    KAUST Repository

    Yilmaz, Ferkan

    2010-01-01

    The probability density function and the cumulative distribution function of the product of shifted Gamma variates are obtained in terms of the generalized Fox\\'s H function. Using these new results, the exact outage capacity of multi carrier transmission through a slow Nakagami-m fading channel is presented. Moreover, it is shown that analytical and simulation results are in perfect agreement. © 2009 IEEE.

  1. An analysis of health system resources in relation to pandemic response capacity in the Greater Mekong Subregion

    Directory of Open Access Journals (Sweden)

    Hanvoravongchai Piya

    2012-12-01

    Full Text Available Abstract Background There is increasing perception that countries cannot work in isolation to militate against the threat of pandemic influenza. In the Greater Mekong Subregion (GMS of Asia, high socio-economic diversity and fertile conditions for the emergence and spread of infectious diseases underscore the importance of transnational cooperation. Investigation of healthcare resource distribution and inequalities can help determine the need for, and inform decisions regarding, resource sharing and mobilisation. Methods We collected data on healthcare resources deemed important for responding to pandemic influenza through surveys of hospitals and district health offices across four countries of the GMS (Cambodia, Lao PDR, Thailand, Vietnam. Focusing on four key resource types (oseltamivir, hospital beds, ventilators, and health workers, we mapped and analysed resource distributions at province level to identify relative shortages, mismatches, and clustering of resources. We analysed inequalities in resource distribution using the Gini coefficient and Theil index. Results Three quarters of the Cambodian population and two thirds of the Laotian population live in relatively underserved provinces (those with resource densities in the lowest quintile across the region in relation to health workers, ventilators, and hospital beds. More than a quarter of the Thai population is relatively underserved for health workers and oseltamivir. Approximately one fifth of the Vietnamese population is underserved for beds and ventilators. All Cambodian provinces are underserved for at least one resource. In Lao PDR, 11 percent of the population is underserved by all four resource items. Of the four resources, ventilators and oseltamivir were most unequally distributed. Cambodia generally showed higher levels of inequalities in resource distribution compared to other countries. Decomposition of the Theil index suggests that inequalities result principally from

  2. Strengthening global health security capacity--Vietnam demonstration project, 2013.

    Science.gov (United States)

    Tran, Phu Dac; Vu, Long Ngoc; Nguyen, Hien Tran; Phan, Lan Trong; Lowe, Wayne; McConnell, Michelle S; Iademarco, Michael F; Partridge, Jeffrey M; Kile, James C; Do, Trang; Nadol, Patrick J; Bui, Hien; Vu, Diep; Bond, Kyle; Nelson, David B; Anderson, Lauren; Hunt, Kenneth V; Smith, Nicole; Giannone, Paul; Klena, John; Beauvais, Denise; Becknell, Kristi; Tappero, Jordan W; Dowell, Scott F; Rzeszotarski, Peter; Chu, May; Kinkade, Carl

    2014-01-31

    Over the past decade, Vietnam has successfully responded to global health security (GHS) challenges, including domestic elimination of severe acute respiratory syndrome (SARS) and rapid public health responses to human infections with influenza A(H5N1) virus. However, new threats such as Middle East respiratory syndrome coronavirus (MERS-CoV) and influenza A(H7N9) present continued challenges, reinforcing the need to improve the global capacity to prevent, detect, and respond to public health threats. In June 2012, Vietnam, along with many other nations, obtained a 2-year extension for meeting core surveillance and response requirements of the 2005 International Health Regulations (IHR). During March-September 2013, CDC and the Vietnamese Ministry of Health (MoH) collaborated on a GHS demonstration project to improve public health emergency detection and response capacity. The project aimed to demonstrate, in a short period, that enhancements to Vietnam's health system in surveillance and early detection of and response to diseases and outbreaks could contribute to meeting the IHR core capacities, consistent with the Asia Pacific Strategy for Emerging Diseases. Work focused on enhancements to three interrelated priority areas and included achievements in 1) establishing an emergency operations center (EOC) at the General Department of Preventive Medicine with training of personnel for public health emergency management; 2) improving the nationwide laboratory system, including enhanced testing capability for several priority pathogens (i.e., those in Vietnam most likely to contribute to public health emergencies of international concern); and 3) creating an emergency response information systems platform, including a demonstration of real-time reporting capability. Lessons learned included awareness that integrated functions within the health system for GHS require careful planning, stakeholder buy-in, and intradepartmental and interdepartmental coordination and

  3. Strengthening health workforce capacity through work-based training

    Directory of Open Access Journals (Sweden)

    Matovu Joseph KB

    2013-01-01

    Full Text Available Abstract Background Although much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH with funding support from the Centers for Disease Control and Prevention (CDC developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E and continuous quality improvement (CQI in health service delivery. Methods This capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement ‘projects’ meant to address work-related priority problems, working closely with mentors. Trainees’ knowledge and skills are enhanced through short courses offered at specific intervals throughout the course. Results Overall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84% from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80% were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and

  4. Investment, managerial capacity, and bias in public health preparedness.

    Science.gov (United States)

    Langabeer, James R; DelliFraine, Jami L; Tyson, Sandra; Emert, Jamie M; Herbold, John

    2009-01-01

    Nearly $7 billion has been invested through national cooperative funding since 2002 to strengthen state and local response capacity. Yet, very little outcome evidence exists to analyze funding effectiveness. The objective of this research is to analyze the relationship between investment (funding) and capacity (readiness) for public health preparedness (PHP). The aim of the authors is to use a management framework to evaluate capacity, and to explore the "immediacy bias" impact on investment stability. This study employs a longitudinal study design, incorporating survey research of the entire population of 68 health departments in the state of Texas. The authors assessed the investment-capacity relationship through several statistical methods. The authors created a structural measure of managerial capacity through principal components analysis, factorizing 10 independent variables and augment this with a perceived readiness level reported from PHP managers. The authors then employ analysis of variance, correlation analyses, and other descriptive statistics. There has been a 539 percent coefficient of variation in funding at the local level between the years 2004 and 2008, and a 63 percent reduction in total resources since the peak of funding, using paired sample data. Results suggest that investment is positively associated with readiness and managerial capacity in local health departments. The authors also find that investment was related to greater community collaboration, higher adoption of Incident Command System (ICS) structure, and more frequent operational drills and exercises. Greater investment is associated with higher levels of capacity and readiness. The authors conclude from this that investment should be stabilized and continued, and not be influenced by historical cognitive biases.

  5. BUFFER CAPACITY IN HETEROGENEOUS MULTICOMPONENT SYSTEMS. REVIEW

    Directory of Open Access Journals (Sweden)

    Oxana Spinu

    2015-12-01

    Full Text Available The quantitative basis of the theory of buffer properties for two-phase acid-base buffer systems and for multicomponent heterogeneous systems has been derived. The analytical equations with respect to all components for diverse multicomponent systems were deduced. It has been established, that the buffer capacities of components are mutually proportional.

  6. Policy Capacity Meets Politics: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Fafard, Patrick

    2015-07-22

    It is difficult to disagree with the general argument that successful health reform requires a significant degree of policy capacity or that all players in the policy game need to move beyond self-interested advocacy. However, an overly broad definition of policy capacity is a problem. More important perhaps, health reform inevitably requires not just policy capacity but political leadership and compromise. © 2015 by Kerman University of Medical Sciences.

  7. Assessing the gap between the acute trauma workload and the capacity of a single rural health district in South Africa. What are the implications for systems planning?

    Science.gov (United States)

    Clarke, D L; Aldous, C; Thomson, S R

    2014-06-01

    This study focuses on a single rural health district in South Africa, and attempts to establish the burden of disease and to review the capacity of the district hospitals to deal with this load. Ethical approval to undertake this study was obtained from both the University of Kwa-Zulu Natal and the Department of Health. The audit was performed over a 6-month period in the four district hospitals of rural Sisonke District. There were four components to this audit. 1. Information on the hospital incidence of acute trauma in Sisonke was also sourced from the epidemiology unit of the Department of Health in Pietermaritzburg 2. Each of the district hospitals was visited and the medical manager was interviewed. The medical manager was asked to complete the World Health Organization's Tool for Situational Analysis to Assess Emergency and Essential Surgical Care. (SAT). 3. The operative registers were reviewed to determine the number of index cases for trauma. This information was used to determine the unmet need of acute trauma in the district. 4. Each hospital was classified according to the Trauma Society of South Africa (TSSA) guidelines for levels of trauma care. The annual incidence of trauma in the Sisonke District is estimated to be 1,590 per 100,000 population. Although there appeared to be adequate infrastructure in the district hospitals, the SAT revealed significant deficits in terms of capacity of staff to adequately treat and triage acute trauma patients. There is a significant unmet need for trauma care in Sisonke. The four district hospitals can best be classified as Level IV centers of trauma care. There is a significant burden of trauma in the Sisonke District, yet the capacity to deal with this burden is inadequate. Although the physical infrastructure is adequate, the deficits relate to human resources. The strategic choices are between enhancing the district hospitals' capacity to deal with acute trauma, or deciding to bypass them completely and

  8. Information Processing Capacity of Dynamical Systems

    Science.gov (United States)

    Dambre, Joni; Verstraeten, David; Schrauwen, Benjamin; Massar, Serge

    2012-07-01

    Many dynamical systems, both natural and artificial, are stimulated by time dependent external signals, somehow processing the information contained therein. We demonstrate how to quantify the different modes in which information can be processed by such systems and combine them to define the computational capacity of a dynamical system. This is bounded by the number of linearly independent state variables of the dynamical system, equaling it if the system obeys the fading memory condition. It can be interpreted as the total number of linearly independent functions of its stimuli the system can compute. Our theory combines concepts from machine learning (reservoir computing), system modeling, stochastic processes, and functional analysis. We illustrate our theory by numerical simulations for the logistic map, a recurrent neural network, and a two-dimensional reaction diffusion system, uncovering universal trade-offs between the non-linearity of the computation and the system's short-term memory.

  9. Information Processing Capacity of Dynamical Systems

    Science.gov (United States)

    Dambre, Joni; Verstraeten, David; Schrauwen, Benjamin; Massar, Serge

    2012-01-01

    Many dynamical systems, both natural and artificial, are stimulated by time dependent external signals, somehow processing the information contained therein. We demonstrate how to quantify the different modes in which information can be processed by such systems and combine them to define the computational capacity of a dynamical system. This is bounded by the number of linearly independent state variables of the dynamical system, equaling it if the system obeys the fading memory condition. It can be interpreted as the total number of linearly independent functions of its stimuli the system can compute. Our theory combines concepts from machine learning (reservoir computing), system modeling, stochastic processes, and functional analysis. We illustrate our theory by numerical simulations for the logistic map, a recurrent neural network, and a two-dimensional reaction diffusion system, uncovering universal trade-offs between the non-linearity of the computation and the system's short-term memory. PMID:22816038

  10. Use of Added Sugars Instead of Total Sugars May Improve the Capacity of the Health Star Rating System to Discriminate between Core and Discretionary Foods.

    Science.gov (United States)

    Menday, Hannah; Neal, Bruce; Wu, Jason H Y; Crino, Michelle; Baines, Surinder; Petersen, Kristina S

    2017-12-01

    The Australian Government has introduced a voluntary front-of-package labeling system that includes total sugar in the calculation. Our aim was to determine the effect of substituting added sugars for total sugars when calculating Health Star Ratings (HSR) and identify whether use of added sugars improves the capacity to distinguish between core and discretionary food products. This study included packaged food and beverage products available in Australian supermarkets (n=3,610). The product categories included in the analyses were breakfast cereals (n=513), fruit (n=571), milk (n=309), non-alcoholic beverages (n=1,040), vegetables (n=787), and yogurt (n=390). Added sugar values were estimated for each product using a validated method. HSRs were then estimated for every product according to the established method using total sugar, and then by substituting added sugar for total sugar. The scoring system was not modified when added sugar was used in place of total sugar in the HSR calculation. Products were classified as core or discretionary based on the Australian Dietary Guidelines. To investigate whether use of added sugar in the HSR algorithm improved the distinction between core and discretionary products as defined by the Australian Dietary Guidelines, the proportion of core products that received an HSR of ≥3.5 stars and the proportion of discretionary products that received an HSR of added sugars were determined. There were 2,263 core and 1,347 discretionary foods; 1,684 of 3,610 (47%) products contained added sugar (median 8.4 g/100 g, interquartile range=5.0 to 12.2 g). When the HSR was calculated with added sugar instead of total sugar, an additional 166 (7.3%) core products received an HSR of ≥3.5 stars and 103 (7.6%) discretionary products received a rating of ≥3.5 stars. The odds of correctly identifying a product as core vs discretionary were increased by 61% (odds ratio 1.61, 95% CI 1.26 to 2.06; Padded compared to total sugars. In the six

  11. Testing a Web-Based, Trained-Peer Model to Build Capacity for Evidence-Based Practices in Community Mental Health Systems.

    Science.gov (United States)

    German, Ramaris E; Adler, Abby; Frankel, Sarah A; Stirman, Shannon Wiltsey; Pinedo, Paola; Evans, Arthur C; Beck, Aaron T; Creed, Torrey A

    2018-03-01

    Use of expert-led workshops plus consultation has been established as an effective strategy for training community mental health (CMH) clinicians in evidence-based practices (EBPs). Because of high rates of staff turnover, this strategy inadequately addresses the need to maintain capacity to deliver EBPs. This study examined knowledge, competency, and retention outcomes of a two-phase model developed to build capacity for an EBP in CMH programs. In the first phase, an initial training cohort in each CMH program participated in in-person workshops followed by expert-led consultation (in-person, expert-led [IPEL] phase) (N=214 clinicians). After this cohort completed training, new staff members participated in Web-based training (in place of in-person workshops), followed by peer-led consultation with the initial cohort (Web-based, trained-peer [WBTP] phase) (N=148). Tests of noninferiority assessed whether WBTP was not inferior to IPEL at increasing clinician cognitive-behavioral therapy (CBT) competency, as measured by the Cognitive Therapy Rating Scale. WBTP was not inferior to IPEL at developing clinician competency. Hierarchical linear models showed no significant differences in CBT knowledge acquisition between the two phases. Survival analyses indicated that WBTP trainees were less likely than IPEL trainees to complete training. In terms of time required from experts, WBTP required 8% of the resources of IPEL. After an initial investment to build in-house CBT expertise, CMH programs were able to use a WBTP model to broaden their own capacity for high-fidelity CBT. IPEL followed by WBTP offers an effective alternative to build EBP capacity in CMH programs, rather than reliance on external experts.

  12. Leveraging Existing Laboratory Capacity towards Universal Health ...

    African Journals Online (AJOL)

    Adequately equipped clinical laboratories should provide early warning signals of health risks. The Assessment categorized the laboratories at three levels relating to the type of facility, these being hospital, health center and health post. This study used results from the SARA to determine the ability to make timely diagnosis ...

  13. Capacity on wireless quantum cellular communication system

    Science.gov (United States)

    Zhou, Xiang-Zhen; Yu, Xu-Tao; Zhang, Zai-Chen

    2018-03-01

    Quantum technology is making excellent prospects in future communication networks. Entanglement generation and purification are two major components in quantum networks. Combining these two techniques with classical cellular mobile communication, we proposed a novel wireless quantum cellular(WQC) communication system which is possible to realize commercial mobile quantum communication. In this paper, the architecture and network topology of WQC communication system are discussed, the mathematical model of WQC system is extracted and the serving capacity, indicating the ability to serve customers, is defined and calculated under certain circumstances.

  14. Leveraging Existing Laboratory Capacity towards Universal Health ...

    African Journals Online (AJOL)

    Background: The provision of quality health care is influenced by ... Laboratory support is urgently needed to enhance service delivery in the ... Information generated through ... professionals using simple rapid technology have been adopted.

  15. African Health Economics and Policy Research Capacity Building ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    African Health Economics and Policy Research Capacity Building and Dissemination. As African countries move toward universal health coverage, it is clear there is a shortage of African experts with applied research skills in health financing such as fiscal space analysis, needs-based resource allocation methods, and ...

  16. School Mental Health: The Impact of State and Local Capacity-Building Training

    Science.gov (United States)

    Stephan, Sharon; Paternite, Carl; Grimm, Lindsey; Hurwitz, Laura

    2014-01-01

    Despite a growing number of collaborative partnerships between schools and community-based organizations to expand school mental health (SMH) service capacity in the United States, there have been relatively few systematic initiatives focused on key strategies for large-scale SMH capacity building with state and local education systems. Based on a…

  17. Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

    OpenAIRE

    Gulzar H. Shah; Bobbie Newell; Ruth E. Whitworth

    2016-01-01

    Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved em...

  18. An Assessment of Epidemiology Capacity in a One Health Team at the Provincial Level in Thailand

    Directory of Open Access Journals (Sweden)

    Soawapak Hinjoy

    2016-10-01

    Full Text Available A multi-sectoral core epidemiology capacity assessment was conducted in provinces that implemented One Health services in order to assess the efficacy of a One Health approach in Thailand. In order to conduct the assessment, four provinces were randomly selected as a study group from a total of 19 Thai provinces that are currently using a One Health approach. As a control group, four additional provinces that never implemented a One Health approach were also sampled. The provincial officers were interviewed on the epidemiologic capacity of their respective provinces. The average score of epidemiologic capacity in the provinces implementing the One Health approach was 66.45%, while the provinces that did not implement this approach earned a score of 54.61%. The epidemiologic capacity of surveillance systems in provinces that utilized the One Health approach earned higher scores in comparison to provinces that did not implement the approach (75.00% vs. 53.13%, p-value 0.13. Although none of the capacity evaluations showed significant differences between the two groups, we found evidence that provinces implementing the One Health approach gained higher scores in both surveillance and outbreak investigation capacities. This may be explained by more efficient capacity when using a One Health approach, specifically in preventing, protecting, and responding to threats in local communities.

  19. Electric distribution systems and embedded generation capacity

    International Nuclear Information System (INIS)

    Calderaro, V.; Galdi, V.; Piccolo, A.; Siano, P.

    2006-01-01

    The main policy issues of European States are sustainable energy supply promotion and liberalization of energy markets, which introduced market competition in electricity production and created support mechanisms to encourage renewable electricity production and consumption. As a result of liberalization, any generator, including small-scale and renewable energy based units, can sell electricity on the free market. In order to meet future sustainability targets, connection of a higher number of Distributed Generation (DG) units to the electrical power system is expected, requiring changes in the design and operation of distribution electricity systems, as well as changes in electricity network regulation. In order to assist distribution system operators in planning and managing DG connections and in maximizing DG penetration and renewable sources exploitation, this paper proposed a reconfiguration methodology based on a Genetic Algorithm (GA), that was tested on a 70-bus system with DG units. The simulation results confirmed that the methodology represents a suitable tool for distribution system operators when dealing with DG capacity expansion and power loss issues, providing information regarding the potential penetration network-wide and allowing maximum exploitation of renewable generation. 35 refs., 4 tabs., 6 figs

  20. Sexual Health Promotion Programme: Participants' Perspectives on Capacity Building

    Science.gov (United States)

    Keogh, Brian; Daly, Louise; Sharek, Danika; De Vries, Jan; McCann, Edward; Higgins, Agnes

    2016-01-01

    Objectives: The aim of this study was to evaluate a Health Service Executive (HSE) Foundation Programme in Sexual Health Promotion (FPSHP) with a specific emphasis on capacity building. Design: A mixed-method design using both quantitative and qualitative methods was used to collect the data. Setting: The FPSHP was delivered to staff working in…

  1. Challenges and opportunities in building health research capacity in ...

    African Journals Online (AJOL)

    Capacity building is considered a priority for health research institutions in developing countries to achieve the Millennium Development Goals by 2015. However, in many countries including Tanzania, much emphasis has been directed towards human resources for health with the total exclusion of human resources for ...

  2. Instituto Mesoamericano de Salud Pública: órgano de apoyo técnico y fortalecimiento del Sistema Mesoamericano de Salud Pública Mesoamerican Public Health Institute: Technical support and capacity strengthening arm of the Mesoamerican Public Health System

    Directory of Open Access Journals (Sweden)

    Miguel A González-Block

    2011-01-01

    Full Text Available OBJETIVO: El Instituto Mesoamericano de Salud Pública (IMSP se constituyó en 2009 como órgano técnico del Sistema Mesoamericano de Salud Pública (SMSP y la Red Virtual de Instituciones Académicas. En la primera fase se identificaron las necesidades de fortalecimiento de sistemas de salud y se evaluaron los primeros resultados de capacitación. MATERIAL Y MÉTODOS: Se realizó un análisis de contenido de los Planes Maestros del SMSP para cada prioridad y se encuestó a los integrantes del Grupo de Trabajo en Malaria y Dengue. RESULTADOS: Se identificaron los temas de capacitación requeridos por áreas de prioridad del SMSP y las necesidades de gestión de conocimiento para control y eliminación de la malaria y dengue. Se elaboró un mapeo de competencias a desarrollar con el personal estratégico, táctico y operativo. El IMSP capacitó a 91 funcionarios de ocho países en su primer año. Estas actividades se desarrollaron de julio 2009 a junio 2010, en consulta a directivos de servicios de salud de países integrantes del Sistema Mesoamericano de Salud Pública, Colombia y México. CONCLUSIONES: El IMSP está respondiendo a las necesidades de salud pública en la región mesoamericana.OBJECTIVE: The Mesoamerican Public Health Institute (IMSP was constituted in 2009 as the technical organ of the Mesoamerican Public Health System (SMSP and the Virtual Network of Academic Institutions. Health system capacity strengthening needs and preliminary training results were assessed in the first phase. MATERIAL AND METHODS: The SMSP Master Plans were content-analyzed for each priority and members of the Malaria and Dengue Working Group were surveyed. RESULTS: The training needs required for each SMSP priority area were identified and knowledge management needs for malaria and dengue analyzed. Competencies were mapped across strategic, tactical and operative personnel that will be requiring them. IMSP trained in its first year 91 persons in eight

  3. The hydraulic capacity of deteriorating sewer systems.

    Science.gov (United States)

    Pollert, J; Ugarelli, R; Saegrov, S; Schilling, W; Di Federico, V

    2005-01-01

    Sewer and wastewater systems suffer from insufficient capacity, construction flaws and pipe deterioration. Consequences are structural failures, local floods, surface erosion and pollution of receiving waters bodies. European cities spend in the order of five billion Euro per year for wastewater network rehabilitation. This amount is estimated to increase due to network ageing. The project CARE-S (Computer Aided RE-habilitation of Sewer Networks) deals with sewer and storm water networks. The final project goal is to develop integrated software, which provides the most cost-efficient system of maintenance, repair and rehabilitation of sewer networks. Decisions on investments in rehabilitation often have to be made with uncertain information about the structural condition and the hydraulic performance of a sewer system. Because of this, decision-making involves considerable risks. This paper presents the results of research focused on the study of hydraulic effects caused by failures due to temporal decline of sewer systems. Hydraulic simulations are usually carried out by running commercial models that apply, as input, default values of parameters that strongly influence results. Using CCTV inspections information as dataset to catalogue principal types of failures affecting pipes, a 3D model was used to evaluate their hydraulic consequences. The translation of failures effects in parameters values producing the same hydraulic conditions caused by failures was carried out through the comparison of laboratory experiences and 3D simulations results. Those parameters could be the input of 1D commercial models instead of the default values commonly inserted.

  4. A controlled study of funding for human immunodeficiency virus/acquired immunodeficiency syndrome as resource capacity building in the health system in Rwanda.

    Science.gov (United States)

    Shepard, Donald S; Zeng, Wu; Amico, Peter; Rwiyereka, Angelique K; Avila-Figueroa, Carlos

    2012-05-01

    Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda.

  5. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Barros, Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co−existence of a públic and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis−à−vis the private provider, under the assumption of a...

  6. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Xavier Martinez-Giralt; Barros Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co-existence of a public and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis-Ã -vis the private provider, under the assumption of ...

  7. Motivators, enablers, and barriers to building allied health research capacity

    Science.gov (United States)

    Pager, Susan; Holden, Libby; Golenko, Xanthe

    2012-01-01

    Purpose A sound, scientific base of high quality research is needed to inform service planning and decision making and enable improved policy and practice. However, some areas of health practice, particularly many of the allied health areas, are generally considered to have a low evidence base. In order to successfully build research capacity in allied health, a clearer understanding is required of what assists and encourages research as well as the barriers and challenges. Participants and methods This study used written surveys to collect data relating to motivators, enablers, and barriers to research capacity building. Respondents were asked to answer questions relating to them as individuals and other questions relating to their team. Allied health professionals were recruited from multidisciplinary primary health care teams in Queensland Health. Eighty-five participants from ten healthcare teams completed a written version of the research capacity and culture survey. Results The results of this study indicate that individual allied health professionals are more likely to report being motivated to do research by intrinsic factors such as a strong interest in research. Barriers they identified to research are more likely to be extrinsic factors such as workload and lack of time. Allied health professionals identified some additional factors that impact on their research capacity than those reported in the literature, such as a desire to keep at the “cutting edge” and a lack of exposure to research. Some of the factors influencing individuals to do research were different to those influencing teams. These results are discussed with reference to organizational behavior and theories of motivation. Conclusion Supporting already motivated allied health professional individuals and teams to conduct research by increased skills training, infrastructure, and quarantined time is likely to produce better outcomes for research capacity building investment. PMID

  8. HEALTH SYSTEMS

    International Development Research Centre (IDRC) Digital Library (Canada)

    many levels, and underscores the fact that health ... The health of mothers and their children depends on the status of women. INSIGHT ... tions find fertile ground when poverty ... Dr Gita Sen, Professor of Public Policy at the Indian Institute.

  9. Public health and health promotion capacity at national and regional level: a review of conceptual frameworks

    Directory of Open Access Journals (Sweden)

    Christoph Aluttis

    2014-04-01

    Full Text Available The concept of capacity building for public health has gained much attention during the last decade. National as well as international organizations increasingly focus their efforts on capacity building to improve performance in the health sector. During the past two decades, a variety of conceptual frameworks have been developed which describe relevant dimensions for public health capacity. Notably, these frameworks differ in design and conceptualization. This paper therefore reviews the existing conceptual frameworks and integrates them into one framework, which contains the most relevant dimensions for public health capacity at the country or regional level. A comprehensive literature search was performed to identify frameworks addressing public health capacity building at the national or regional level. We content-analysed these frameworks to identify the core dimensions of public health capacity. The dimensions were subsequently synthesized into a set of thematic areas to construct a conceptual framework which describes the most relevant dimensions for capacities at the national or regional level. The systematic review resulted in the identification of seven core domains for public health capacity: resources, organizational structures, workforce, partnerships, leadership and governance, knowledge development and country specific context. Accordingly, these dimensions were used to construct a framework, which describes these core domains more in detail. Our research shows that although there is no generally agreed upon model of public health capacity, a number of key domains for public health and health promotion capacity are consistently recurring in existing frameworks, regardless of their geographical location or thematic area. As only little work on the core concepts of public health capacities has yet taken place, this study adds value to the discourse by identifying these consistencies across existing frameworks and by synthesising

  10. Association between Organizational Capacity and Involvement in Chronic Disease Prevention Programming among Canadian Public Health Organizations

    Science.gov (United States)

    Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

    2015-01-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement…

  11. Claim Your Space: Leadership Development as a Research Capacity Building Goal in Global Health

    Science.gov (United States)

    Airhihenbuwa, Collins O.; Ogedegbe, Gbenga; Iwelunmor, Juliet; Jean-Louis, Girardin; Williams, Natasha; Zizi, Freddy; Okuyemi, Kolawole

    2016-01-01

    As the burden of noncommunicable diseases (NCDs) rises in settings with an equally high burden of infectious diseases in the Global South, a new sense of urgency has developed around research capacity building to promote more effective and sustainable public health and health care systems. In 2010, NCDs accounted for more than 2.06 million deaths…

  12. Boosting capacity for health research in Africa | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    9 mai 2013 ... Africa's progress is linked to its capacity to generate, adapt, and use scientific knowledge to meet regional health and development needs. ... opportunity for timely completion of their doctoral training; and; strengthen Fellows' research skills by providing research methodology and scientific writing training.

  13. Education, practical training and professional development for public health practitioners: a scoping review of the literature and insights for sustainable food system capacity-building.

    Science.gov (United States)

    Wegener, Jessica; Fong, Debbie; Rocha, Cecilia

    2018-06-01

    Noting the upstream positioning of sustainable food systems (SFS) to multiple global crises, the present review described examples of emerging and promising practices to support SFS-oriented education, practical training (PT) and continuing professional development (CPD) among trainees and public health practitioners (PHP). A secondary objective was to compile the evidence into practical considerations for educators, supervising practitioners and professional associations. A scoping review of the literature published between 2007 and 2017 was conducted in May 2017 using four databases: CINAHL, MEDLINE, Scopus and HSSA, along with bibliography hand-searching and expert consultation. Articles were screened for relevance and specificity by independent raters. Nineteen articles were included for analysis. Two-thirds of the articles related to dietitians and public health nutritionists. Emerging practices included curriculum-based considerations, incorporation of 'sustainability' within professional competencies and self-reflection related to SFS. Descriptions of SFS-related education, PT and CPD practices appeared largely in the literature from developed countries. Articles converged on the need for ecosystems, food systems and sustainability considerations within and across practice to support current and future practitioners. There is growing interest in SFS but guidance to support educators and preceptors is lacking. Updates to dietary guidelines to reflect issues of sustainability are a timely prompt to examine the education, training and development needs of trainees and PHP. Practical examples of emerging practices can empower PHP to promote SFS in all areas of practice. More research is needed to address identified gaps in the literature and to improve SFS-specific education, PT and CPD.

  14. Capacity Building in Open Medical Record System (OpenMRS) in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Capacity Building in Open Medical Record System (OpenMRS) in Rwanda ... Partners in Health (PIH), an international nongovernmental organization, has demonstrated the usefulness of ... Journal articles ... will fund social science, population and public health, and health systems research relevant to the emerging crisis.

  15. Building Capacity for Conducting HIV Prevention Trials in the Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Journal supplement features 10 years of West African health systems research. In the wake of the devastating Ebola virus outbreak in 2014, increased attention has been paid to West Africa's poorly functioning health systems. View moreJournal supplement features 10 years of West African health systems research ...

  16. Strengthening health systems capacity to monitor and evaluate programmes targeted at reducing abortion-related maternal mortality in Jessore district, Bangladesh.

    Science.gov (United States)

    Huda, Fauzia Akhter; Ahmed, Anisuddin; Ford, Evelyn Rebecca; Johnston, Heidi Bart

    2015-09-28

    . Notable gaps were identified in providing post-abortion contraceptive services for women treated for PAC. By systematic implementation of the SMRAC model, health systems can track and measure progress and gaps in their implementation and identify strategies for further reduction of abortion-related morbidity and mortality in Bangladesh.

  17. Global Disease Detection-Achievements in Applied Public Health Research, Capacity Building, and Public Health Diplomacy, 2001-2016.

    Science.gov (United States)

    Rao, Carol Y; Goryoka, Grace W; Henao, Olga L; Clarke, Kevin R; Salyer, Stephanie J; Montgomery, Joel M

    2017-11-01

    The Centers for Disease Control and Prevention has established 10 Global Disease Detection (GDD) Program regional centers around the world that serve as centers of excellence for public health research on emerging and reemerging infectious diseases. The core activities of the GDD Program focus on applied public health research, surveillance, laboratory, public health informatics, and technical capacity building. During 2015-2016, program staff conducted 205 discrete projects on a range of topics, including acute respiratory illnesses, health systems strengthening, infectious diseases at the human-animal interface, and emerging infectious diseases. Projects incorporated multiple core activities, with technical capacity building being most prevalent. Collaborating with host countries to implement such projects promotes public health diplomacy. The GDD Program continues to work with countries to strengthen core capacities so that emerging diseases can be detected and stopped faster and closer to the source, thereby enhancing global health security.

  18. Unpacking capacity to utilize research: A tale of the Burkina Faso public health association.

    Science.gov (United States)

    Hamel, Nadia; Schrecker, Ted

    2011-01-01

    One of the most important challenges in addressing global health is for institutions to monitor and use research in policy-making. In low- and middle-income countries (LMICs), civil society organizations such as health professional associations can be key contributors to effective national health systems. However, there is little empirical data on their capacity to use research. This case study was used to gain insight into the factors that affect the knowledge translation performance of health professional associations in LMICs by describing the organizational elements and processes constituting capacity to use research, and examining the potential determinants of this capacity. Case study methodology was chosen for its flexibility to capture the multiple and often tacit processes within organizational routines. The Burkina Faso Public Health Association (ABSP) was studied, using in-depth, semi-structured interviews and key documents review. Five key dimensions that affect the association's capacity to use research to influence health policy emerged: organizational motivation; catalysts; organizational capacity to acquire and organizational capacity to transform research findings; moderating organizational factors. Also examined were the dissemination strategies used by ABSP and its abilities to enhance its capacity through networking, to advocate for more relevant research and to develop its potential role as knowledge broker, as well as limitations due to scarce resources. We conclude that a better understanding of the organizational capacity to use research of health professional associations in LMICs is needed to assess, improve and reinforce such capacity. Increased knowledge translation potential may leverage research resources and promote knowledge-sharing. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Public health program capacity for sustainability: a new framework.

    Science.gov (United States)

    Schell, Sarah F; Luke, Douglas A; Schooley, Michael W; Elliott, Michael B; Herbers, Stephanie H; Mueller, Nancy B; Bunger, Alicia C

    2013-02-01

    Public health programs can only deliver benefits if they are able to sustain activities over time. There is a broad literature on program sustainability in public health, but it is fragmented and there is a lack of consensus on core constructs. The purpose of this paper is to present a new conceptual framework for program sustainability in public health. This developmental study uses a comprehensive literature review, input from an expert panel, and the results of concept-mapping to identify the core domains of a conceptual framework for public health program capacity for sustainability. The concept-mapping process included three types of participants (scientists, funders, and practitioners) from several public health areas (e.g., tobacco control, heart disease and stroke, physical activity and nutrition, and injury prevention). The literature review identified 85 relevant studies focusing on program sustainability in public health. Most of the papers described empirical studies of prevention-oriented programs aimed at the community level. The concept-mapping process identified nine core domains that affect a program's capacity for sustainability: Political Support, Funding Stability, Partnerships, Organizational Capacity, Program Evaluation, Program Adaptation, Communications, Public Health Impacts, and Strategic Planning. Concept-mapping participants further identified 93 items across these domains that have strong face validity-89% of the individual items composing the framework had specific support in the sustainability literature. The sustainability framework presented here suggests that a number of selected factors may be related to a program's ability to sustain its activities and benefits over time. These factors have been discussed in the literature, but this framework synthesizes and combines the factors and suggests how they may be interrelated with one another. The framework presents domains for public health decision makers to consider when developing

  20. Judicial Capacity in a Transforming Legal System

    Directory of Open Access Journals (Sweden)

    Hugh Corder

    2017-12-01

    Full Text Available Given the perennial problem of lack of access to justice; the fact that there was no shortage of superior court judges until 1994; the demands on court process which flow directly from transition to the constitutional democratic system; and the urgent and justified necessity for the demographic transformation of judicial personnel, two challenges to the capacity of the judicial system present themselves in South Africa: Enlarging the number of suitable candidates for judicial appointment to redress the former demographic imbalance; and developing the kind of skills among those appointed as judges to be able to respond with confidence across a wide range of often complex legal issues; and developing a theory of judicial deference which observes the separation of powers and preserves judicial independence. This paper explores these challenges, after setting out the socio-political context, as it impacts directly on their nature and scope, and the prospects of meeting them.Debido al constante problema de la falta de acceso a la justicia, al hecho de que no hubo escasez de jueces de tribunales superiores hasta 1994, las demandas del proceso judicial que surgen directamente de la transición al sistema democrático constitucional, y la necesidad urgente y justificada de la transformación demográfica del personal judicial, el rendimiento judicial en Sudáfrica se encuentra con dos desafíos: Aumentar el número de candidatos aptos al nombramiento judicial para compensar el anterior desequilibrio demográfico y desarrollar en los jueces nombrados aquellas habilidades que les permitan responder con confianza a asuntos jurídicos a menudo complejos; y desarrollar una teoría de deferencia judicial que respete la separación de poderes y preserve la independencia judicial. Este artículo explora estos desafíos tras explicar el contexto sociopolítico, ya que éste afecta directamente a su naturaleza y alcance, y las probabilidades de que se superen

  1. The system capacity view of aging and longevity

    Institute of Scientific and Technical Information of China (English)

    Jing-Dong J.Han; Lei Hou; Na Sun; Chi Xu; Joseph McDermott; Dan Wang

    2017-01-01

    Background:Aging is a complex systems level problem that needs a systems level solution.However,system models of aging and longevity,although urgently needed,are still lacking,largely due to the paucity of conceptual frameworks for modeling such a complex process.Results:We propose that aging can be viewed as a decline in system capacity,defined as the maximum level of output that a system produces to fulfill demands.Classical aging hallmarks and anti-aging strategies can be well-aligned to system capacity.Genetic variants responsible for lifespan variation across individuals or species can also be explained by their roles in system capacity.We further propose promising directions to develop systems approaches to modulate system capacity and thus extend both healthspan and lifespan.Conclusions:The system capacity model of aging provides an opportunity to examine aging at the systems level.This model predicts that the extent to which aging can be modulated is normally limited by the upper bound of the system capacity of a species.Within such a boundary,aging can be delayed by moderately increasing an individual's system capacity.Beyond such a boundary,increasing the upper bound is required,which is not unrealistic given the unlimited potential of regenerative medicine in the future,but it requires increasing the capacity of the whole system instead of only part of it.

  2. Organizational capacity for chronic disease prevention: a survey of Canadian public health organizations.

    Science.gov (United States)

    Hanusaik, Nancy; O'Loughlin, Jennifer L; Kishchuk, Natalie; Paradis, Gilles; Cameron, Roy

    2010-04-01

    There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.

  3. The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

    Science.gov (United States)

    Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S

    2010-11-01

    There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management

  4. Meeting the International Health Regulations (2005) surveillance core capacity requirements at the subnational level in Europe

    DEFF Research Database (Denmark)

    Ziemann, Alexandra; Rosenkötter, Nicole; Riesgo, Luis Garcia-Castrillo

    2015-01-01

    BACKGROUND: The revised World Health Organization's International Health Regulations (2005) request a timely and all-hazard approach towards surveillance, especially at the subnational level. We discuss three questions of syndromic surveillance application in the European context for assessing...... public health emergencies of international concern: (i) can syndromic surveillance support countries, especially the subnational level, to meet the International Health Regulations (2005) core surveillance capacity requirements, (ii) are European syndromic surveillance systems comparable to enable cross...... effect of different types of public health emergencies in a timely manner as required by the International Health Regulations (2005)....

  5. The creation in the French power system of a capacity mechanism and of a capacity market

    International Nuclear Information System (INIS)

    Meda, Maurice

    2014-01-01

    The key objective of the French capacity remuneration mechanism is to ensure long term security of supply and to promote peak load containment. The mechanism was set up by the NOME law of December 7, 2010 ('new organisation of the electricity market'), which has changed the organisation of the electricity market and explicitly requires a capacity obligation from suppliers, and by a decree published on December 14, 2012 'concerning the contribution of suppliers to the security of electricity supply and establishing a capacity obligation mechanism in the electricity sector'; further regulation will set up the rules for the capacity mechanism, probably during 2014. The mechanism is decentralized: every supplier has to contribute to supply security and to prove its ability to provide its clients with the capacity they need; all capacity owners in metropolitan France must have their production tools certified. Certificates can be sold and suppliers can buy them to adjust their positions. The transport System operator (TSO) calculates suppliers' obligation, checks if capacity owners fulfil their availability commitment and if suppliers have bought enough certificates. The contribution of interconnections to France's SOS is taken into account implicitly. The decree provides an additional safeguard mechanism, which is centralized: in case a critical situation is observed regarding the electricity supply and demand, the government can organize a call for tender to secure the necessary capacities; the conditions to trigger the call for tender are very restrictive, to ensure the capacity market remains the main investment provider. (author)

  6. Assessing the criminal capacity of children: a challenge to the capacity of mental health professionals.

    Science.gov (United States)

    Pillay, Anthony L; Willows, Clive

    2015-01-01

    With increasing numbers of juveniles accused of serious crimes international concern is growing around the procedural consequences for affected individuals within the context of the law and criminal justice. Issues of culpability in children and adolescents are often raised, with much deliberation and insufficient agreement among legal and child development experts. Exactly when and to what extent juveniles can be held responsible for their action is a matter requiring careful consideration to avoid substantial erring in either direction. Although some international guiding standards and principles have been established, these are rather broad and unable to provide specific prescriptions. In addition, the assessment of criminal capacity in juveniles is a complex task, and one that is not wholly without reliability and validity problems. As in the case of South Africa and a few other countries, mental health specialists are often tasked with conducting developmental assessments to provide courts with expert evidence regarding criminal capacity. This paper examines the concept of criminal capacity in the context of the theory, controversies and challenges that affect this area of psychological focus.

  7. Building policy-making capacity in the Ministry of Health: the Kazakhstan experience.

    Science.gov (United States)

    Chanturidze, Tata; Adams, Orvill; Tokezhanov, Bolat; Naylor, Mike; Richardson, Erica

    2015-01-20

    Recent economic growth in Kazakhstan has been accompanied by slower improvements in population health and this has renewed impetus for health system reform. Strengthening strategic planning and policy-making capacity in the Ministry of Health has been identified as an important priority, particularly as the Ministry of Health is leading the health system reform process. The intervention was informed by the United Nations Development Programme (UNDP) framework for capacity building which views capacity building as an ongoing process embedded in local institutions and practices. In response to local needs extra elements were included in the framework to tailor the capacity building programme according to the existing policy and budget cycles and respective competence requirements, and link it with transparent career development structures of the Ministry of Health. This aspect of the programme was informed by the institutional capability assessment model used by the United Kingdom National Health Service (NHS) which was adapted to examine the specific organizational and individual competences of the Ministry of Health in Kazakhstan. There were clear successes in building capacity for policy making and strategic planning within the Ministry of Health in Kazakhstan, including better planned, more timely and in-depth responses to policy assignments. Embedding career development as a part of this process was more challenging. This case study highlights the importance of strong political will and high level support for capacity building in ensuring the sustainability of programmes. It also shows that capacity-building programmes need to ensure full engagement with all local stakeholders, or where this is not possible, programmes need to be targeted narrowly to those stakeholders who will benefit most, for the greatest impact to be achieved. In sum, high quality tailor-made capacity development programmes should be based on thorough needs assessment of individual and

  8. Increasing Community Research Capacity to Address Health Disparities.

    Science.gov (United States)

    Komaie, Goldie; Ekenga, Christine C; Sanders Thompson, Vetta L; Goodman, Melody S

    2017-02-01

    The Community Research Fellows Training program is designed to enhance capacity for community-based participatory research; program participants completed a 15-week, Master of Public Health curriculum. We conducted qualitative, semistructured interviews with 81 participants from two cohorts to evaluate the learning environment and how the program improved participants' knowledge of public health research. Key areas that provided a conducive learning environment included the once-a-week schedule, faculty and participant diversity, and community-focused homework assignments. Participants discussed how the program enhanced their understanding of the research process and raised awareness of public health-related issues for application in their personal lives, professional occupations, and in their communities. These findings highlight key programmatic elements of a successful public health training program for community residents.

  9. Theories, models and frameworks used in capacity building interventions relevant to public health: a systematic review.

    Science.gov (United States)

    Bergeron, Kim; Abdi, Samiya; DeCorby, Kara; Mensah, Gloria; Rempel, Benjamin; Manson, Heather

    2017-11-28

    There is limited research on capacity building interventions that include theoretical foundations. The purpose of this systematic review is to identify underlying theories, models and frameworks used to support capacity building interventions relevant to public health practice. The aim is to inform and improve capacity building practices and services offered by public health organizations. Four search strategies were used: 1) electronic database searching; 2) reference lists of included papers; 3) key informant consultation; and 4) grey literature searching. Inclusion and exclusion criteria are outlined with included papers focusing on capacity building, learning plans, professional development plans in combination with tools, resources, processes, procedures, steps, model, framework, guideline, described in a public health or healthcare setting, or non-government, government, or community organizations as they relate to healthcare, and explicitly or implicitly mention a theory, model and/or framework that grounds the type of capacity building approach developed. Quality assessment were performed on all included articles. Data analysis included a process for synthesizing, analyzing and presenting descriptive summaries, categorizing theoretical foundations according to which theory, model and/or framework was used and whether or not the theory, model or framework was implied or explicitly identified. Nineteen articles were included in this review. A total of 28 theories, models and frameworks were identified. Of this number, two theories (Diffusion of Innovations and Transformational Learning), two models (Ecological and Interactive Systems Framework for Dissemination and Implementation) and one framework (Bloom's Taxonomy of Learning) were identified as the most frequently cited. This review identifies specific theories, models and frameworks to support capacity building interventions relevant to public health organizations. It provides public health practitioners

  10. Capacity analysis of spectrum sharing spatial multiplexing MIMO systems

    KAUST Repository

    Yang, Liang; Qaraqe, Khalid A.; Serpedin, Erchin; Alouini, Mohamed-Slim

    2014-01-01

    This paper considers a spectrum sharing (SS) multiple-input multiple-output (MIMO) system operating in a Rayleigh fading environment. First the capacity of a single-user SS spatial multiplexing system is investigated in two scenarios that assume

  11. Cardio-respiratory capacity as an important biomarker of health

    Directory of Open Access Journals (Sweden)

    Jaroslav Novák

    2016-12-01

    Full Text Available Background: Cardio-respiratory capacity is an important factor in human health. It's quality depends on many objective factors (such as age and gender, but it can be influenced also by others (physical activity, nutrition. Low level of cardio-respiratory capacity significantly correlates with numerous health failures. Objective: Evaluation of the cardio-respiratory capacity in athletes enables a prediction of performance. In a non-sporting population a critically low level of cardio-respiratory capacity could be a warning signal of a high risk of diseases. The Spiroergometric examination needs very sophisticated technical equipment including O2-CO2 analyzer. The aim of the study was to examine the possibility of how to replace direct measurement of oxygen consumption by the method. Methods: 2 777 protocols from the data base of examinations performed in the period of 1994 till 2015 were used. Cardio-respiratory capacity in all examinations was evaluated according to maximal oxygen uptake VO2max, physical working capacity W170 and maximal performance on the cyclo-ergometer. Step-vice increased workload on cyclo-ergometer based on procedure used in International Biological Program was applied to obtain the characteristics of cardio-respiratory capacity of each subject (2 015 men and 762 women. Results: Correlation coefficients r and regression equations of cardio-respiratory capacity characteristics (W170, W170/kg, VO2max, VO2max/kg, Wmax, Wmax/kg were calculated. The highest correlation was found between VO2max and Wmax and between VO2max/kg and Wmax/kg, both in men and women (r = .89 in men and r = .85 in women for VO2max and Wmax. The most important regression equations are: (men VO2max = 0.0095 . Wmax + 0.54 (l/min (r = .89, VO2max/kg = 8.3 . Wmax/kg + 13 (ml/min/kg (r = .83; (women VO2max = 0.0083 . Wmax + 0.67 (l/min (r = .85, VO2max/kg = 8.0 . max/kg + 13 (ml/min/kg (r = .83. Conclusions: It was proved that VO2max and VO2max/kg values

  12. Principles of capacity management, applied in the mental health context.

    Science.gov (United States)

    Zeitz, Kathryn; Watson, Darryl

    2017-06-22

    Objective The aim of the paper was to describe a suite of capacity management principles that have been applied in the mental health setting that resulted in a significant reduction in time spent in two emergency departments (ED) and improved throughput. Methods The project consisted of a multifocal change approach over three phases that included: (1) the implementation of a suite of fundamental capacity management activities led by the service and clinical director; (2) a targeted Winter Demand Plan supported by McKinsey and Co.; and (3) a sustainability of change phase. Descriptive statistics was used to analyse the performance data that was collected through-out the project. Results This capacity management project has resulted in sustained patient flow improvement. There was a reduction in the average length of stay (LOS) in the ED for consumers with mental health presentations to the ED. At the commencement of the project, in July 2014, the average LOS was 20.5h compared with 8.5h in December 2015 post the sustainability phase. In July 2014, the percentage of consumers staying longer than 24h was 26% (n=112); in November and December 2015, this had reduced to 6% and 7 5% respectively (less than one consumer per day). Conclusion Improving patient flow is multifactorial. Increased attendances in public EDs by people with mental health problems and the lengthening boarding in the ED affect the overall ED throughput. Key strategies to improve mental health consumer flow need to focus on engagement, leadership, embedding fundamentals, managing and target setting. What is known about the topic? Improving patient flow in the acute sector is an emerging topic in the health literature in response to increasing pressures of access block in EDs. What does this paper add? This paper describes the application of a suite of patient flow improvement principles that were applied in the mental health setting that significantly reduced the waiting time for consumers in two EDs

  13. Should fully autonomous artificial intelligence systems be granted legal capacity?

    OpenAIRE

    Naučius, Mindaugas

    2018-01-01

    The aim of this article is to address the issue of granting legal capacity to artificial inteligence systems. In order to approach the solution to the problem addressed, the article includes several aspects, relevant in order to achieve it. To begin with, the general concept of legal capacity is introduced. Following this aspect, the main features of both natural and juridical persons are addressed, in order to become familiar with the content of legal capacity, or in other words, to be aware...

  14. Greece: Health system review.

    Science.gov (United States)

    Economou, Charalambos

    2010-01-01

    financing and equity in access to health care services. Efficiency is in question due to the lack of incentives to improve performance in the public sector. Mechanisms for needs assessment and priority-setting are underdeveloped and, as a consequence, the regional distribution of health resources is unequal. Centralization of the system is coupled with a lack of planning and coordination, and limited managerial and administrative capacity. In addition, the oversupply of physicians, the absence of a referral system, and irrational pricing and reimbursement policies are factors encouraging under-the-table payments and the black economy. These shortcomings result in low satisfaction with the health care system expressed by citizens. The landmark in the development of the Greek health care system was the creation of the national health system (ESY) in 1983. This report describes the development of the ESY at the structural level and generally, the process of implementing reforms. The strategic targets of health reform initiatives have been to structure a unified health care sector along the lines of the original ESY proposal and to cope with current inefficiencies. However, the three reforms attempted in the 1990s were never fully implemented, while the ambitious reform project of the period 2000–2004, which provided for the regionalization of the system, new management structures, prospective reimbursement, new employment conditions for hospital doctors, modernization of public health services and reorganization of primary health care, was abolished after the elections of 2004 and a change in government. While the new strategy, launched in 2005 with the stated aims of securing the financial viability of the health care system in the short term and its sustainability in the long term, addressed specific weaknesses, it has been rather controversial: the introduction of a centralized administrative public procurement system, the development of public–private partnerships

  15. Indicators of sustainable capacity building for health research: analysis of four African case studies.

    Science.gov (United States)

    Bates, Imelda; Taegtmeyer, Miriam; Squire, S Bertel; Ansong, Daniel; Nhlema-Simwaka, Bertha; Baba, Amuda; Theobald, Sally

    2011-03-28

    Despite substantial investment in health capacity building in developing countries, evaluations of capacity building effectiveness are scarce. By analysing projects in Africa that had successfully built sustainable capacity, we aimed to identify evidence that could indicate that capacity building was likely to be sustainable. Four projects were selected as case studies using pre-determined criteria, including the achievement of sustainable capacity. By mapping the capacity building activities in each case study onto a framework previously used for evaluating health research capacity in Ghana, we were able to identify activities that were common to all projects. We used these activities to derive indicators which could be used in other projects to monitor progress towards building sustainable research capacity. Indicators of sustainable capacity building increased in complexity as projects matured and included- early engagement of stakeholders; explicit plans for scale up; strategies for influencing policies; quality assessments (awareness and experiential stages)- improved resources; institutionalisation of activities; innovation (expansion stage)- funding for core activities secured; management and decision-making led by southern partners (consolidation stage).Projects became sustainable after a median of 66 months. The main challenges to achieving sustainability were high turnover of staff and stakeholders, and difficulties in embedding new activities into existing systems, securing funding and influencing policy development. Our indicators of sustainable capacity building need to be tested prospectively in a variety of projects to assess their usefulness. For each project the evidence required to show that indicators have been achieved should evolve with the project and they should be determined prospectively in collaboration with stakeholders.

  16. The Aviation System Analysis Capability Airport Capacity and Delay Models

    Science.gov (United States)

    Lee, David A.; Nelson, Caroline; Shapiro, Gerald

    1998-01-01

    The ASAC Airport Capacity Model and the ASAC Airport Delay Model support analyses of technologies addressing airport capacity. NASA's Aviation System Analysis Capability (ASAC) Airport Capacity Model estimates the capacity of an airport as a function of weather, Federal Aviation Administration (FAA) procedures, traffic characteristics, and the level of technology available. Airport capacity is presented as a Pareto frontier of arrivals per hour versus departures per hour. The ASAC Airport Delay Model allows the user to estimate the minutes of arrival delay for an airport, given its (weather dependent) capacity. Historical weather observations and demand patterns are provided by ASAC as inputs to the delay model. The ASAC economic models can translate a reduction in delay minutes into benefit dollars.

  17. Capacity analysis of spectrum sharing spatial multiplexing MIMO systems

    KAUST Repository

    Yang, Liang

    2014-12-01

    This paper considers a spectrum sharing (SS) multiple-input multiple-output (MIMO) system operating in a Rayleigh fading environment. First the capacity of a single-user SS spatial multiplexing system is investigated in two scenarios that assume different receivers. To explicitly show the capacity scaling law of SS MIMO systems, some approximate capacity expressions for the two scenarios are derived. Next, we extend our analysis to a multiple user system with zero-forcing receivers (ZF) under spatially-independent scheduling and analyze the sum-rate. Furthermore, we provide an asymptotic sum-rate analysis to investigate the effects of different parameters on the multiuser diversity gain. Our results show that the secondary system with a smaller number of transmit antennas Nt and a larger number of receive antennas Nr can achieve higher capacity at lower interference temperature Q, but at high Q the capacity follows the scaling law of the conventional MIMO systems. However, for a ZF SS spatial multiplexing system, the secondary system with small Nt and large Nr can achieve the highest capacity throughout the entire region of Q. For a ZF SS spatial multiplexing system with scheduling, the asymptotic sum-rate scales like Ntlog2(Q(KNtNp-1)/Nt), where Np denotes the number of antennas of the primary receiver and K represents the number of secondary transmitters.

  18. School-Based Health Education Programmes, Health-Learning Capacity and Child Oral Health--related Quality of Life

    Science.gov (United States)

    Freeman, Ruth; Gibson, Barry; Humphris, Gerry; Leonard, Helen; Yuan, Siyang; Whelton, Helen

    2016-01-01

    Objective: To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health-related quality of life (COHRQoL). Setting: Primary schools, high social deprivation, Ireland/Northern Ireland. Design: Cluster…

  19. Accounting for the Assimilative Capacity of Water Systems in Scotland

    Directory of Open Access Journals (Sweden)

    Paula Novo

    2017-07-01

    Full Text Available A key methodological challenge in understanding the relationship between the economy and the underlying ecosystem base resides in how to account for the ecosystem’s degradation and the decline of associated ecosystem services. In this study, we use information on nutrients and metals concentrations from the Environmental Change Network (ECN database and the Scottish Environment Protection Agency (SEPA for the period 2000–2010 in order to assess the assimilation capacity of water systems. The research covers five upstream sites and 17 downstream sites in northeast Scotland. Our results highlight the relevance of considering a number of pollutants, and suggest that elements such as arsenic, lead and mercury can pose a threat to ecosystems’ sustainability and health. However, little research has been done in terms of their assimilation capacity and their impact on grey water footprint assessments. In addition, the results indicate that background conditions might be relevant when performing sustainability analysis at different spatial scales. The study also poses relevant questions in relation to land management approaches versus traditional ‘end-of-pipe’ water treatment approaches, and the definition of maximum and background concentrations. In this regard, further studies will be required to understand the trade-offs between different ecosystem services depending on how these concentrations are defined.

  20. A framework to evaluate research capacity building in health care

    Directory of Open Access Journals (Sweden)

    Cooke Jo

    2005-10-01

    Full Text Available Abstract Background Building research capacity in health services has been recognised internationally as important in order to produce a sound evidence base for decision-making in policy and practice. Activities to increase research capacity for, within, and by practice include initiatives to support individuals and teams, organisations and networks. Little has been discussed or concluded about how to measure the effectiveness of research capacity building (RCB Discussion This article attempts to develop the debate on measuring RCB. It highlights that traditional outcomes of publications in peer reviewed journals and successful grant applications may be important outcomes to measure, but they may not address all the relevant issues to highlight progress, especially amongst novice researchers. They do not capture factors that contribute to developing an environment to support capacity development, or on measuring the usefulness or the 'social impact' of research, or on professional outcomes. The paper suggests a framework for planning change and measuring progress, based on six principles of RCB, which have been generated through the analysis of the literature, policy documents, empirical studies, and the experience of one Research and Development Support Unit in the UK. These principles are that RCB should: develop skills and confidence, support linkages and partnerships, ensure the research is 'close to practice', develop appropriate dissemination, invest in infrastructure, and build elements of sustainability and continuity. It is suggested that each principle operates at individual, team, organisation and supra-organisational levels. Some criteria for measuring progress are also given. Summary This paper highlights the need to identify ways of measuring RCB. It points out the limitations of current measurements that exist in the literature, and proposes a framework for measuring progress, which may form the basis of comparison of RCB

  1. 1 The West Africa Initiative to Strengthen Capacities through Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Afekwo Mbonu

    2012-08-31

    ) governance and governance structures of health systems. .... Strengthened evidence base from the awarded research projects complemented by a set of ..... Canadian recipients which purchase equipment using IDRC funds ...

  2. Capacity building for global health diplomacy: Thailand’s experience of trade and health

    Science.gov (United States)

    Thaiprayoon, Suriwan; Smith, Richard

    2015-01-01

    A rapid expansion of trade liberalization in Thailand during the 1990s raised a critical question for policy transparency from various stakeholders. Particular attention was paid to a bilateral trade negotiation between Thailand and USA concerned with the impact of the ‘Trade-Related Aspects of Intellectual Rights (TRIPS) plus’ provisions on access to medicines. Other trade liberalization effects on health were also concerning health actors. In response, a number of interagency committees were established to engage with trade negotiations. In this respect, Thailand is often cited as a positive example of a country that has proactively sought, and achieved, trade and health policy coherence. This article investigates this relationship in more depth and suggests lessons for wider study and application of global health diplomacy (GHD). This study involved semi-structured interviews with 20 people involved in trade-related health negotiations, together with observation of 9 meetings concerning trade-related health issues. Capacity to engage with trade negotiations appears to have been developed by health actors through several stages; starting from the Individual (I) understanding of trade effects on health, through Nodes (N) that establish the mechanisms to enhance health interests, Networks (N) to advocate for health within these negotiations, and an Enabling environment (E) to retain health officials and further strengthen their capacities to deal with trade-related health issues. This INNE model seems to have worked well in Thailand. However, other contextual factors are also significant. This article suggests that, in building capacity in GHD, it is essential to educate both health and non-health actors on global health issues and to use a combination of formal and informal mechanisms to participate in GHD. And in developing sustainable capacity in GHD, it requires long term commitment and strong leadership from both health and non-health sectors. PMID

  3. Capacity building for global health diplomacy: Thailand's experience of trade and health.

    Science.gov (United States)

    Thaiprayoon, Suriwan; Smith, Richard

    2015-11-01

    A rapid expansion of trade liberalization in Thailand during the 1990s raised a critical question for policy transparency from various stakeholders. Particular attention was paid to a bilateral trade negotiation between Thailand and USA concerned with the impact of the 'Trade-Related Aspects of Intellectual Rights (TRIPS) plus' provisions on access to medicines. Other trade liberalization effects on health were also concerning health actors. In response, a number of interagency committees were established to engage with trade negotiations. In this respect, Thailand is often cited as a positive example of a country that has proactively sought, and achieved, trade and health policy coherence. This article investigates this relationship in more depth and suggests lessons for wider study and application of global health diplomacy (GHD). This study involved semi-structured interviews with 20 people involved in trade-related health negotiations, together with observation of 9 meetings concerning trade-related health issues. Capacity to engage with trade negotiations appears to have been developed by health actors through several stages; starting from the Individual (I) understanding of trade effects on health, through Nodes (N) that establish the mechanisms to enhance health interests, Networks (N) to advocate for health within these negotiations, and an Enabling environment (E) to retain health officials and further strengthen their capacities to deal with trade-related health issues. This INNE model seems to have worked well in Thailand. However, other contextual factors are also significant. This article suggests that, in building capacity in GHD, it is essential to educate both health and non-health actors on global health issues and to use a combination of formal and informal mechanisms to participate in GHD. And in developing sustainable capacity in GHD, it requires long term commitment and strong leadership from both health and non-health sectors. Published by

  4. Croatia: health system review.

    Science.gov (United States)

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    of the MHI scheme are broad, patients must pay towards the costs of many goods and services, and the right to free health care services has been systematically reduced since 2003, although with exemptions for vulnerable population groups. Configuration of capital and human resources in the health care sector could be improved: for example, homes for the elderly and infirm persons operate close to maximum capacity; psychiatric care in the community is not well developed; and there are shortages of certain categories of medical professionals, including geographical imbalances. Little research is available on the policy process of health care reforms in Croatia. However, it seems that reforms often lack strategic foundations and or projections that could be analysed and scrutinized by the public, and evaluation of reform outcomes is lacking. The overall performance of the health care system seems to be good, given the amount of resources available. However, there is a lack of data to assess it properly. World Health Organization 2014 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  5. From smallpox eradication to contemporary global health initiatives: enhancing human capacity towards a global public health goal.

    Science.gov (United States)

    Tarantola, Daniel; Foster, Stanley O

    2011-12-30

    The eradication of smallpox owes its success first and foremost to the thousands of lay health workers and community members who, throughout the campaign and across continents, took on the roles of advocates, educators, vaccinators, care providers and contributors to epidemic surveillance and containment. Bangladesh provides a good example where smallpox eradication and the capacity enhancement needed to achieve this goal resulted in a two-way mutually beneficial process. Smallpox-dedicated staff provided community members with information guidance, support and tools. In turn, communities not only created the enabling environment for smallpox program staff to perform their work but acquired the capacity to perform essential eradication tasks. Contemporary global health programmes can learn much from these core lessons including: the pivotal importance of supporting community aspirations, capacity and resilience; the critical need to enhance commitment, capacity and accountability across the workforce; and the high value of attentive human resources management and support. We owe to subsequent global disease control, elimination and eradication ventures recognition of the need for social and behavioural science to inform public health strategies; the essential roles that civil society organizations and public-private partnerships can play in public health discourse and action; the overall necessity of investing in broad-based health system strengthening; and the utility of applying human rights principles, norms and standards to public health policy and practice. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  6. Estimating cell capacity for multi-cell electrical energy system

    Science.gov (United States)

    Hashemi, Iman Ahari

    A Multi-Cell Electrical Energy System is a set of batteries that are connected in series. The series batteries provide the required voltage necessary for the contraption. After using the energy that is provided by the batteries, some cells within the system tend to have a lower voltage than the other cells. Also, other factors, such as the number of times a battery has been charged or discharged, how long it has been within the system and many other factors, result in some cells having a lesser capacity compared to the other cells within the system. The outcome is that it lowers the required capacity that the electrical energy system is required to provide. By having an unknown cell capacity within the system, it is unknown how much of a charge can be provided to the system so that the cells are not overcharged or undercharged. Therefore, it is necessary to know the cells capacity within the system. Hence, if we were dealing with a single cell, the capacity could be obtained by a full charge and discharge of the cell. In a series system that contains multiple cells a full charging or discharging cannot happen as it might result in deteriorating the structure of some cells within the system. Hence, to find the capacity of a single cell within an electrical energy system it is required to obtain a method that can estimate the value of each cell within the electrical energy system. To approach this method an electrical energy system is required. The electrical energy system consists of rechargeable non-equal capacity batteries to provide the required energy to the system, a battery management system (BMS) board to monitor the cells voltages, an Arduino board that provides the required communication to BMS board, and the PC, and a software that is able to deliver the required data obtained from the Arduino board to the PC. The outcome, estimating the capacity of a cell within a multi-cell system, can be used in many battery related technologies to obtain unknown

  7. Health System Measurement Project

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Health System Measurement Project tracks government data on critical U.S. health system indicators. The website presents national trend data as well as detailed...

  8. Promoting evaluation capacity building in a complex adaptive system.

    Science.gov (United States)

    Lawrenz, Frances; Kollmann, Elizabeth Kunz; King, Jean A; Bequette, Marjorie; Pattison, Scott; Nelson, Amy Grack; Cohn, Sarah; Cardiel, Christopher L B; Iacovelli, Stephanie; Eliou, Gayra Ostgaard; Goss, Juli; Causey, Lauren; Sinkey, Anne; Beyer, Marta; Francisco, Melanie

    2018-04-10

    This study provides results from an NSF funded, four year, case study about evaluation capacity building in a complex adaptive system, the Nanoscale Informal Science Education Network (NISE Net). The results of the Complex Adaptive Systems as a Model for Network Evaluations (CASNET) project indicate that complex adaptive system concepts help to explain evaluation capacity building in a network. The NISE Network was found to be a complex learning system that was supportive of evaluation capacity building through feedback loops that provided for information sharing and interaction. Participants in the system had different levels of and sources of evaluation knowledge. To be successful at building capacity, the system needed to have a balance between both centralized and decentralized control, coherence, redundancy, and diversity. Embeddedness of individuals within the system also provided support and moved the capacity of the system forward. Finally, success depended on attention being paid to the control of resources. Implications of these findings are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Good collaborative practice: reforming capacity building governance of international health research partnerships.

    Science.gov (United States)

    Ward, Claire Leonie; Shaw, David; Sprumont, Dominique; Sankoh, Osman; Tanner, Marcel; Elger, Bernice

    2018-01-08

    In line with the policy objectives of the United Nations Sustainable Development Goals, this commentary seeks to examine the extent to which provisions of international health research guidance promote capacity building and equitable partnerships in global health research. Our evaluation finds that governance of collaborative research partnerships, and in particular capacity building, in resource-constrained settings is limited but has improved with the implementation guidance of the International Ethical Guidelines for Health-related Research Involving Humans by The Council for International Organizations of Medical Sciences (CIOMS) (2016). However, more clarity is needed in national legislation, industry and ethics guidelines, and regulatory provisions to address the structural inequities and power imbalances inherent in international health research partnerships. Most notably, ethical partnership governance is not supported by the principal industry ethics guidelines - the International Conference on Harmonization Technical Requirements for Registration of Pharmaceutical for Human Use (ICH) Good Clinical Practice (ICH-GCP). Given the strategic value of ICH-GCP guidelines in defining the role and responsibility of global health research partners, we conclude that such governance should stipulate the minimal requirements for creating an equitable environment of inclusion, mutual learning, transparency and accountability. Procedurally, this can be supported by i) shared research agenda setting with local leadership, ii) capacity assessments, and iii) construction of a memorandum of understanding (MoU). Moreover, the requirement of capacity building needs to be coordinated amongst partners to support good collaborative practice and deliver on the public health goals of the research enterprise; improving local conditions of health and reducing global health inequality. In this respect, and in order to develop consistency between sources of research governance, ICH

  10. Policy Capacity for Health Reform: Necessary but Insufficient; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    Owen Adams

    2016-01-01

    Full Text Available Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government. I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a A means of “policy governance” that would promote an approach to cooperative federalism in the health arena; (b The ability to overcome the ”policy inertia” resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action.

  11. Elements for harnessing participatory action research to strengthen health managers' capacity: a critical interpretative synthesis.

    Science.gov (United States)

    Tetui, Moses; Zulu, Joseph Mumba; Hurtig, Anna-Karin; Ekirapa-Kiracho, Elizabeth; Kiwanuka, Suzanne N; Coe, Anna-Britt

    2018-04-19

    which the use of PAR can be harnessed, not only to strengthen health managers' capacity, but also to foster other health systems strengthening initiatives involving implementation research. In addition, the findings demonstrated the intricate and complex relations between the elements, which further affirms the need for a systems thinking approach to tackling health systems challenges.

  12. SE Capstone Project: Building Systems Engineering Education and Workforce Capacity

    Science.gov (United States)

    2012-04-01

    This project developed a system to improve fuel efficiency by means of regenerative braking . The team designed a simple system that allows "bolt-on...air traffic control, social networking, credit/debit cards, and anti-lock brakes are only a few functions enabled by complex systems of systems . We...Building Systems Engineering Education and Workforce Capacity SE Capstone Project APRIL 2012 Report Documentation Page Form ApprovedOMB No. 0704

  13. A simulation study of capacity utilization to predict future capacity for manufacturing system sustainability

    Science.gov (United States)

    Rimo, Tan Hauw Sen; Chai Tin, Ong

    2017-12-01

    Capacity utilization (CU) measurement is an important task in a manufacturing system, especially in make-to-order (MTO) type manufacturing system with product customization, in predicting capacity to meet future demand. A stochastic discrete-event simulation is developed using ARENA software to determine CU and capacity gap (CG) in short run production function. This study focused on machinery breakdown and product defective rate as random variables in the simulation. The study found that the manufacturing system run in 68.01% CU and 31.99% CG. It is revealed that machinery breakdown and product defective rate have a direct relationship with CU. By improving product defective rate into zero defect, manufacturing system can improve CU up to 73.56% and CG decrease to 26.44%. While improving machinery breakdown into zero breakdowns will improve CU up to 93.99% and the CG decrease to 6.01%. This study helps operation level to study CU using “what-if” analysis in order to meet future demand in more practical and easier method by using simulation approach. Further study is recommended by including other random variables that affect CU to make the simulation closer with the real-life situation for a better decision.

  14. National public health law: a role for WHO in capacity-building and promoting transparency

    Science.gov (United States)

    Tsai, Feng-jen; Anderson, Evan; Kastler, Florian; Sprumont,, Dominique; Burris, Scott

    2016-01-01

    Abstract A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries’ legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law – from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance. PMID:27429492

  15. National public health law: a role for WHO in capacity-building and promoting transparency.

    Science.gov (United States)

    Marks-Sultan, Géraldine; Tsai, Feng-Jen; Anderson, Evan; Kastler, Florian; Sprumont, Dominique; Burris, Scott

    2016-07-01

    A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries' legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law - from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance.

  16. Managing the Newsvendor Modeled Product System with Random Capacity and Capacity-Dependent Price

    Directory of Open Access Journals (Sweden)

    Qingying Li

    2015-01-01

    Full Text Available We consider a newsvendor modeled product system, where the firm provides products to the market. The supply capacity of the product is random, so the firm receives either the amount of order quantity or the realized capacity, whichever is smaller. The market price is capacity dependent. We consider two types of production cost structures: the procurement case and the in-house production case. The firm pays for the received quantity in the former case and for the ordered quantity in the latter case. We obtain the optimal order quantities for both cases. Comparing with the traditional newsvendor model, we find that the optimal order quantity in both the procurement case and the in-house production case are no greater than that in the traditional newsvendor model with a fixed selling price. We also find that the optimal order quantity for the procurement case is greater than that for the in-house production case. Numerical study is conducted to investigate the sensitivity of the optimal solution versus the distribution of the random capacity/demand.

  17. Achieving Health SDG 3 in Africa through NGO Capacity Building ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    2016-09-01

    Sep 1, 2016 ... Résumé. Comme les investisseurs mondiaux d'impact se préparent à soutenir le ... Sustainable Development Goals (SDGs) and ... innovative financing plans. .... agencies with the support of consultants. ... Centre for Health Science Training, Research and .... place consistent project management systems.

  18. Capacity analysis of automatic transport systems in an assembly factory

    NARCIS (Netherlands)

    Zijm, W.H.M.; Lenstra, J.K.; Tijms, H.C.; Volgenant, A.

    1989-01-01

    We describe a case study concerning the capacity analysis of a completely automated transport system in a flexible assembly environment. Basically, the system is modelled as a network of queues, however, due to its complex nature, product-form network theory is not applicable. Instead, we present an

  19. Capacity analysis of an automated kit transportation system

    NARCIS (Netherlands)

    Zijm, W.H.M.; Adan, I.J.B.F.; Buitenhek, R.; Houtum, van G.J.J.A.N.

    2000-01-01

    In this paper, we present a capacity analysis of an automated transportation system in a flexible assembly factory. The transportation system, together with the workstations, is modeled as a network of queues with multiple job classes. Due to its complex nature, the steadystate behavior of this

  20. Capacity and coverage of power controlled CDMA cellular systems ...

    African Journals Online (AJOL)

    Coverage and capacity are among the ambitious challenges to be met by the third generation (3G) systems for successful deployment of its services to both residential and commercial subscribers. This paper reports on the performance study of CDMA systems in relation to an optimum step-regulated SNR-based ...

  1. Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

    Science.gov (United States)

    Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

    2016-01-01

    Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high-capacity

  2. Decision Space and Capacities in the Decentralization of Health Services in FijiComment on "Decentralisation of Health Services in Fiji: A Decision Space Analysis".

    Science.gov (United States)

    Bossert, Thomas J

    2016-05-08

    The study of decentralization in Fiji shows that increasing capacities is not necessarily related to increasing decision space of local officials, which is in contrast with earlier studies in Pakistan. Future studies should address the relationship among decision space, capacities, and health system performance. © 2016 by Kerman University of Medical Sciences.

  3. Assessing Community Leadership: Understanding Community Capacity for Health Improvement.

    Science.gov (United States)

    Castle, Billie; Wendel, Monica; Kelly Pryor, Brandy N; Ingram, Monique

    The purpose of this study was to pilot a quantitative instrument to measure aspects of community leadership within an assessment framework. The instrument includes 14 Likert-type questions asking residents how they perceive leaders within 5 sectors: Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector. Louisville/Jefferson County, Kentucky, has a population of about 743 000 residents. Respondents were asked to examine leadership within West Louisville, an economically deprived area of the city made up of 9 contiguous neighborhoods. This area is predominantly African American (78% compared with 22% in Louisville Metro), with an overall poverty rate of 43% (compared with 18% in Louisville Metro), and unemployment rate of 23% (compared with 8% in Louisville Metro). Residents of West Louisville are looking to leadership to address many of the inequities. Twenty-seven participants representing 7 community sectors completed the survey, of whom 90% work in West Louisville. The instrument measured local perceptions of leadership strength, effectiveness, trust, communication, community building, and leadership development. The majority of respondents agree that strong leadership exists across the 5 sectors, with variation regarding perceptions of the quality of that leadership. City leadership within the Mayor's Office and Metro Council is largely viewed positively, while the growing tensions within the education sector were reflected in the survey results. The perception of community leadership is important to understanding local community capacity to improve health and also inclusivity of community voice in the assessment and community improvement processes. Results from such assessments can offer useful information for strengthening community capacity and sustaining relationships needed to enact progressive and equitable solutions to address local issues. Leaders in a variety of settings can utilize this instrument to

  4. Henry Ford Health Systems

    Science.gov (United States)

    Henry Ford Health Systems evolved from a hospital into a system delivering care to 2.5 million patients and includes the Cancer Epidemiology, Prevention and Control Program, which focuses on epidemiologic and public health aspects of cancer.

  5. Evaluation of capacity-building program of district health managers in India: a contextualized theoretical framework.

    Science.gov (United States)

    Prashanth, N S; Marchal, Bruno; Kegels, Guy; Criel, Bart

    2014-01-01

    Performance of local health services managers at district level is crucial to ensure that health services are of good quality and cater to the health needs of the population in the area. In many low- and middle-income countries, health services managers are poorly equipped with public health management capacities needed for planning and managing their local health system. In the south Indian Tumkur district, a consortium of five non-governmental organizations partnered with the state government to organize a capacity-building program for health managers. The program consisted of a mix of periodic contact classes, mentoring and assignments and was spread over 30 months. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organizational change. A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. In the refined program theory of the intervention, we identified various factors at individual, institutional, and environmental levels that could interact with the hypothesized mechanisms of organizational change, such as staff's perceived self-efficacy and commitment to their organizations. Based on this program theory, we formulated context-mechanism-outcome configurations that can be used to evaluate the intervention and, more specifically, to understand what worked, for whom and under what conditions. We discuss the application of program theory development in conducting a realist evaluation. Realist evaluation embraces principles of systems thinking by providing a method for understanding how elements of the system interact with one another in producing a given outcome.

  6. Network Capacity Assessment and Increase in Systems with Intermittent Water Supply

    Directory of Open Access Journals (Sweden)

    Amilkar E. Ilaya-Ayza

    2016-03-01

    Full Text Available Water supply systems have been facing many challenges in recent decades due to the potential effects of climate change and rapid population growth. Water systems need to expand because of demographic growth. Therefore, evaluating and increasing system capacity is crucial. Specifically, we analyze network capacity as one of the main features of a system. When the network capacity starts to decrease, there is a risk that continuous supply will become intermittent. This paper discusses how network expansion carried out throughout the network life span typically reduces network capacity, thus transforming a system originally designed to work with continuous supply into a system with intermittent supply. A method is proposed to expand the network capacity in an environment of economic scarcity through a greedy algorithm that enables the definition of a schedule for pipe modification stages, and thus efficiently expands the network capacity. This method is, at the same time, an important step in the process of changing a water system from intermittent back to continuous supply—an achievement that remains one of the main challenges related to water and health in developing countries.

  7. Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida.

    Science.gov (United States)

    Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi

    2009-01-01

    COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

  8. Building research and evaluation capacity in population health: the NSW Health approach.

    Science.gov (United States)

    Edwards, Barry; Stickney, Beth; Milat, Andrew; Campbell, Danielle; Thackway, Sarah

    2016-02-01

    Issue addressed An organisational culture that values and uses research and evaluation (R&E) evidence to inform policy and practice is fundamental to improving health outcomes. The 2016 NSW Government Program Evaluation Guidelines recommend investment in training and development to improve evaluation capacity. The purpose of this paper is to outline the approaches taken by the NSW Ministry of Health to develop R&E capacity and assess these against existing models of practice. Method The Ministry of Health's Centre for Epidemiology and Evidence (CEE) takes an evidence-based approach to building R&E capacity in population health. Strategies are informed by: the NSW Population Health Research Strategy, R&E communities of practice across the Ministry and health Pillar agencies and a review of the published evidence on evaluation capacity building (ECB). An internal survey is conducted biennially to monitor research activity within the Ministry's Population and Public Health Division. One representative from each of the six centres that make up the Division coordinates completion of the survey by relevant staff members for their centre. Results The review identified several ECB success factors including: implementing a tailored multifaceted approach; an organisational commitment to R&E; and offering experiential training and ongoing technical support to the workforce. The survey of research activity found that the Division funded a mix of research assets, research funding schemes, research centres and commissioned R&E projects. CEE provides technical advice and support services for staff involved in R&E and in 2015, 22 program evaluations were supported. R&E capacity building also includes a series of guides to assist policy makers, practitioners and researchers to commission, undertake and use policy-relevant R&E. Staff training includes workshops on critical appraisal, program logic and evaluation methods. From January 2013 to June 2014 divisional staff published 84

  9. Denmark: Health system review

    DEFF Research Database (Denmark)

    Juul, Annegrete; Krasnik, Allan; Rudkjøbing, Andreas

    The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery...... of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health...... system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability)....

  10. Building Capacity for Complementary and Integrative Medicine Through a Large, Cross-Agency, Acupuncture Training Program: Lessons Learned from a Military Health System and Veterans Health Administration Joint Initiative Project.

    Science.gov (United States)

    Niemtzow, Richard; Baxter, John; Gallagher, Rollin M; Pock, Arnyce; Calabria, Kathryn; Drake, David; Galloway, Kevin; Walter, Joan; Petri, Richard; Piazza, Thomas; Burns, Stephen; Hofmann, Lew; Biery, John; Buckenmaier, Chester

    2018-03-26

    Complementary and integrative medicine (CIM) use in the USA continues to expand, including within the Military Health System (MHS) and Veterans Health Administration (VHA). To mitigate the opioid crisis and provide additional non-pharmacological pain management options, a large cross-agency collaborative project sought to develop and implement a systems-wide curriculum, entitled Acupuncture Training Across Clinical Settings (ATACS). ATACS curriculum content and structure were created and refined over the course of the project in response to consultations with Subject Matter Experts and provider feedback. Course content was developed to be applicable to the MHS and VHA environments and training was open to many types of providers. Training included a 4-hr didactic and "hands on" clinical training program focused on a single auricular acupuncture protocol, Battlefield Acupuncture. Trainee learning and skills proficiency were evaluated by trainer-observation and written examination. Immediately following training, providers completed an evaluation survey on their ATACS experience. One month later, they were asked to complete another survey regarding their auricular acupuncture use and barriers to use. The present evaluation describes the ATACS curriculum, faculty and trainee characteristics, as well as trainee and program developer perspectives. Over the course of a 19-mo period, 2,712 providers completed the in-person, 4-hr didactic and hands-on clinical training session. Due to the increasing requests for training, additional ATACS faculty were trained. Overall, 113 providers were approved to be training faculty. Responses from the trainee surveys indicated high satisfaction with the ATACS training program and illuminated several challenges to using auricular acupuncture with patients. The most common reported barrier to using auricular acupuncture was the lack of obtaining privileges to administer auricular acupuncture within clinical practice. The ATACS program

  11. Dynamic Buffer Capacity in Acid-Base Systems.

    Science.gov (United States)

    Michałowska-Kaczmarczyk, Anna M; Michałowski, Tadeusz

    The generalized concept of 'dynamic' buffer capacity β V is related to electrolytic systems of different complexity where acid-base equilibria are involved. The resulting formulas are presented in a uniform and consistent form. The detailed calculations are related to two Britton-Robinson buffers, taken as examples.

  12. Dynamic Buffer Capacity in Acid?Base Systems

    OpenAIRE

    Micha?owska-Kaczmarczyk, Anna M.; Micha?owski, Tadeusz

    2015-01-01

    The generalized concept of ?dynamic? buffer capacity ? V is related to electrolytic systems of different complexity where acid?base equilibria are involved. The resulting formulas are presented in a uniform and consistent form. The detailed calculations are related to two Britton?Robinson buffers, taken as examples.

  13. A Decision Support System for Ship Maintenance Capacity Planning

    NARCIS (Netherlands)

    de Boer, R.; Schutten, Johannes M.J.; Zijm, Willem H.M.

    1997-01-01

    In this paper, the basic framework and algorithms of a decision support system are discussed, which enhance process and capacity planning at a large repair shop. The research is strongly motivated by experiences in a project carried out at a dockyard, which performs repair, overhaul and modification

  14. Classification of reserve capacity in future power systems

    NARCIS (Netherlands)

    Frunt, J.; Kling, W.L.; Myrzik, J.M.A.

    2009-01-01

    In electrical power systems must always be a balance between supply and demand. Any imbalance will result in a frequency deviation. To reduce the imbalance to zero, ancillary services for balancing are in use. Ancillary services are characterised by their deployment time and their capacity. By using

  15. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Science.gov (United States)

    Lovell, Sarah A; Gray, Andrew R; Boucher, Sara E

    2017-12-01

    Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500-2000) New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  16. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Directory of Open Access Journals (Sweden)

    Sarah A. Lovell

    2017-12-01

    Full Text Available Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500–2000 New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  17. Capacity building improve Malaysia's inspection and monitoring system for aquaculture and fishery products

    NARCIS (Netherlands)

    Gevers, G.J.M.; Zoontjes, P.W.; Essers, M.L.; Klijnstra, M.; Gerssen, A.

    2012-01-01

    The project aimed to help build a credible inspection and monitoring system that can guarantee safe quality products of Ministry of Health (MoH) and Department of Fisheries (DoF) by upgrading the analytical capacity of the laboratory staff directly involved in the analysis and detection of forbidden

  18. Ukraine: health system review.

    Science.gov (United States)

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system. World Health Organization 2015 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  19. Capacity Estimation and Near-Capacity Achieving Techniques for Digitally Modulated Communication Systems

    DEFF Research Database (Denmark)

    Yankov, Metodi Plamenov

    investigation will include linear interference channels of high dimensionality (such as multiple-input multiple-output), and the non-linear optical fiber channel, which has been gathering more and more attention from the information theory community in recent years. In both cases novel CCC estimates and lower......This thesis studies potential improvements that can be made to the current data rates of digital communication systems. The physical layer of the system will be investigated in band-limited scenarios, where high spectral efficiency is necessary in order to meet the ever-growing data rate demand....... Several issues are tackled, both with theoretical and more practical aspects. The theoretical part is mainly concerned with estimating the constellation constrained capacity (CCC) of channels with discrete input, which is an inherent property of digital communication systems. The channels under...

  20. Negative heat capacity at phase-separation in macroscopic systems

    OpenAIRE

    Gross, D. H. E.

    2005-01-01

    Systems with long-range as well with short-range interactions should necessarily have a convex entropy S(E) at proper phase transitions of first order, i.e. when a separation of phases occurs. Here the microcanonical heat capacity c(E)= -\\frac{(\\partial S/\\partial E)^2}{\\partial^2S/\\partial E^2} is negative. This should be observable even in macroscopic systems when energy fluctuations with the surrounding world can be sufficiently suppressed.

  1. Bulk power system performance issues affecting utility peaking capacity additions

    Energy Technology Data Exchange (ETDEWEB)

    Garrity, T.F. [GE Power Sytems, Schenectady, NY (United States)

    1994-12-31

    This paper presents a discussion of transmission system constraints and problems that affect the siting and rating of peaking capacity additions. Techniques for addressing and modifying these concerns are presented. Particular attention is paid to techniques that have been successfully used by utilities to improve power transfer and system loadability, while avoiding the construction of additional transmission lines. Proven techniques for dealing with thermal, short-circuit level and stability issues are presented.

  2. Farming System Evolution and Adaptive Capacity: Insights for Adaptation Support

    Directory of Open Access Journals (Sweden)

    Jami L. Dixon

    2014-02-01

    Full Text Available Studies of climate impacts on agriculture and adaptation often provide current or future assessments, ignoring the historical contexts farming systems are situated within. We investigate how historical trends have influenced farming system adaptive capacity in Uganda using data from household surveys, semi-structured interviews, focus-group discussions and observations. By comparing two farming systems, we note three major findings: (1 similar trends in farming system evolution have had differential impacts on the diversity of farming systems; (2 trends have contributed to the erosion of informal social and cultural institutions and an increasing dependence on formal institutions; and (3 trade-offs between components of adaptive capacity are made at the farm-scale, thus influencing farming system adaptive capacity. To identify the actual impacts of future climate change and variability, it is important to recognize the dynamic nature of adaptation. In practice, areas identified for further adaptation support include: shift away from one-size-fits-all approach the identification and integration of appropriate modern farming method; a greater focus on building inclusive formal and informal institutions; and a more nuanced understanding regarding the roles and decision-making processes of influential, but external, actors. More research is needed to understand farm-scale trade-offs and the resulting impacts across spatial and temporal scales.

  3. A multi-sector assessment of community organizational capacity for promotion of Chinese immigrant worker health.

    Science.gov (United States)

    Tsai, Jenny H-C; Thompson, Elaine A

    2017-12-01

    Community-based collaborative approaches have received increased attention as a means for addressing occupational health disparities. Organizational capacity, highly relevant to engaging and sustaining community partnerships, however, is rarely considered in occupational health research. To characterize community organizational capacity specifically relevant to Chinese immigrant worker health, we used a cross-sectional, descriptive design with 36 agencies from six community sectors in King County, Washington. Joint interviews, conducted with two representatives from each agency, addressed three dimensions of organizational capacity: organizational commitment, resources, and flexibility. Descriptive statistics were used to capture the patterning of these dimensions by community sector. Organizational capacity varied widely across and within sectors. Chinese and Pan-Asian service sectors indicated higher capacity for Chinese immigrant worker health than did Chinese faith-based, labor union, public, and Pan-ethnic nonprofit sectors. Variation in organizational capacity in community sectors can inform selection of collaborators for community-based, immigrant worker health interventions. © 2017 Wiley Periodicals, Inc.

  4. Building Sustainable Local Capacity for Global Health Research in West Africa.

    Science.gov (United States)

    Sam-Agudu, Nadia A; Paintsil, Elijah; Aliyu, Muktar H; Kwara, Awewura; Ogunsola, Folasade; Afrane, Yaw A; Onoka, Chima; Awandare, Gordon A; Amponsah, Gladys; Cornelius, Llewellyn J; Mendy, Gabou; Sturke, Rachel; Ghansah, Anita; Siberry, George K; Ezeanolue, Echezona E

    Global health research in resource-limited countries has been largely sponsored and led by foreign institutions. Thus, these countries' training capacity and productivity in global health research is limited. Local participation at all levels of global health knowledge generation promotes equitable access to evidence-based solutions. Additionally, leadership inclusive of competent local professionals promotes best outcomes for local contextualization and implementation of successful global health solutions. Among the sub-Saharan African regions, West Africa in particular lags in research infrastructure, productivity, and impact in global health research. In this paper, experts discuss strategies for scaling up West Africa's participation in global health evidence generation using examples from Ghana and Nigeria. We conducted an online and professional network search to identify grants awarded for global health research and research education in Ghana and Nigeria. Principal investigators, global health educators, and representatives of funding institutions were invited to add their knowledge and expertise with regard to strengthening research capacity in West Africa. While there has been some progress in obtaining foreign funding, foreign institutions still dominate local research. Local research funding opportunities in the 2 countries were found to be insufficient, disjointed, poorly sustained, and inadequately publicized, indicating weak infrastructure. As a result, research training programs produce graduates who ultimately fail to launch independent investigator careers because of lack of mentoring and poor infrastructural support. Research funding and training opportunities in Ghana and Nigeria remain inadequate. We recommend systems-level changes in mentoring, collaboration, and funding to drive the global health research agenda in these countries. Additionally, research training programs should be evaluated not only by numbers of individuals graduated but

  5. Slovenia: Health System Review.

    Science.gov (United States)

    Albreht, Tit; Pribakovic Brinovec, Radivoje; Josar, Dusan; Poldrugovac, Mircha; Kostnapfel, Tatja; Zaletel, Metka; Panteli, Dimitra; Maresso, Anna

    2016-06-01

    This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems. World Health Organization 2016 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  6. Belgium: Health system review.

    Science.gov (United States)

    Gerkens, Sophie; Merkur, Sherry

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care. World Health Organization 2010, on behalf of the European Observatory on health systems and Policies.

  7. Capacity of the legal framework of public health institutions in Mexico to support their functional integration

    Directory of Open Access Journals (Sweden)

    Ignacio Ibarra

    2013-05-01

    Full Text Available Objective. Evaluate the capacity of the federal legal framework to govern financing of health institutions in the public sector through innovative schemes –otherwise known as functional integration–, enabling them to purchase and sell health services to and from other public providers as a strategy to improve their performance. Materials and methods. Based on indicators of normative alignment with respect to functional integration across public health provider and governance institutions, content analysis was undertaken of national health programs and relevant laws and guidelines for financial coordination. Results. Significant progress was identified in the implementation of agreements for the coordination of public institutions. While the legal framework provides for a National Health System and a health sector, gaps and contradictions limit their scope. The General Register of Health is also moving forward, yet it lacks the necessary legal foundation to become a comprehensive tool for integration. The medical service exchange agreements are also moving forward based on tariffs and shared guidelines. However, there is a lack of incentives to promote the expansion of these agreements. Conclusions. It is recommended to update the legal framework for the coordination of the National Health System, ensuring a more harmonious and general focus to provide functional integration with the needed impulse.

  8. Claim Your Space: Leadership Development as a Research Capacity Building Goal in Global Health.

    Science.gov (United States)

    Airhihenbuwa, Collins O; Ogedegbe, Gbenga; Iwelunmor, Juliet; Jean-Louis, Girardin; Williams, Natasha; Zizi, Freddy; Okuyemi, Kolawole

    2016-04-01

    As the burden of noncommunicable diseases (NCDs) rises in settings with an equally high burden of infectious diseases in the Global South, a new sense of urgency has developed around research capacity building to promote more effective and sustainable public health and health care systems. In 2010, NCDs accounted for more than 2.06 million deaths in sub-Saharan Africa. Available evidence suggests that the number of people in sub-Saharan Africa with hypertension, a major risk factor for cardiovascular diseases, will increase by 68% from 75 million in 2008 to 126 million in 2025. Furthermore, about 27.5 million people currently live with diabetes in Africa, and it is estimated that 49.7 million people living with diabetes will reside in Africa by 2030. It is therefore necessary to centralize leadership as a key aspect of research capacity building and strengthening in the Global South in ways that enables researchers to claim their spaces in their own locations. We believe that building capacity for transformative leadership in research will lead to the development of effective and appropriate responses to the multiple burdens of NCDs that coexist with infectious diseases in Africa and the rest of the Global South. © 2016 Society for Public Health Education.

  9. Management capacity to promote nurse workplace health and safety.

    Science.gov (United States)

    Fang, Yaxuan; McDonald, Tracey

    2018-04-01

    To investigate regarding workplace health and safety factors, and to identify strategies to preserve and promote a healthy nursing workplace. Data collected using the Delphi technique with input from 41 key informants across four participant categories drawn from a Chinese university and four hospitals were thematically analysed. Most respondents agreed on the importance of nurses' health and safety, and that nurse managers should act to protect nurses, but not enough on workplace safety. Hospital policies, staff disempowerment, workload and workplace conflicts are major obstacles. The reality of Chinese nurses' workplaces is that health and safety risks abound and relate to socio-cultural expectations of women. Self-management of risks is neccessary, gaps exist in understanding of workplace risks among different nursing groups and their perceptions of the professional status, and the value of nurses' contribution to ongoing risks in the hospital workplace. The Chinese hospital system must make these changes to produce a safer working environment for nurses. This research, based in China, presents an instructive tale for all countries that need support on the types and amounts of management for nurses working at the clinical interface, and on the consequences of management neglect of relevant policies and procedures. © 2017 John Wiley & Sons Ltd.

  10. Health research capacity building in Georgia: a case-based needs assessment.

    Science.gov (United States)

    Squires, A; Chitashvili, T; Djibuti, M; Ridge, L; Chyun, D

    2017-06-01

    Research capacity building in the health sciences in low- and middle-income countries (LMICs) has typically focused on bench-science capacity, but research examining health service delivery and health workforce is equally necessary to determine the best ways to deliver care. The Republic of Georgia, formerly a part of the Soviet Union, has multiple issues within its healthcare system that would benefit from expended research capacity, but the current research environment needs to be explored prior to examining research-focused activities. The purpose of this project was to conduct a needs assessment focused on developing research capacity in the Republic of Georgia with an emphasis on workforce and network development. A case study approach guided by a needs assessment format. We conducted in-country, informal, semi-structured interviews in English with key informants and focus groups with faculty, students, and representatives of local non-governmental organizations. Purposive and snowball sampling approaches were used to recruit participants, with key informant interviews scheduled prior to arrival in country. Documents relevant to research capacity building were also included. Interview results were coded via content analysis. Final results were organized into a SWOT (strengths, weaknesses, opportunities, threat) analysis format, with the report shared with participants. There is widespread interest among students and faculty in Georgia around building research capacity. Lack of funding was identified by many informants as a barrier to research. Many critical research skills, such as proposal development, qualitative research skills, and statistical analysis, were reported as very limited. Participants expressed concerns about the ethics of research, with some suggesting that research is undertaken to punish or 'expose' subjects. However, students and faculty are highly motivated to improve their skills, are open to a variety of learning modalities, and have

  11. Approaches to developing the capacity of health policy analysis institutes: a comparative case study

    Directory of Open Access Journals (Sweden)

    Bennett Sara

    2012-03-01

    Full Text Available Abstract Objectives To review and assess (i the factors that facilitate the development of sustainable health policy analysis institutes in low and middle income countries and (ii the nature of external support for capacity development provided to such institutes. Methods Comparative case studies of six health policy analysis institutes (3 from Asia and 3 from Africa were conducted. In each region an NGO institute, an institute linked to government and a university based institute were included. Data collection comprised document review, semi-structured interviews with stakeholders and discussion of preliminary findings with institute staff. Findings The findings are organized around four key themes: (i Financial resources: three of the institutes had received substantial external grants at start-up, however two of these institutes subsequently collapsed. At all but one institute, reliance upon short term, donor funding, created high administrative costs and unpredictability. (ii Human resources: the retention of skilled human resources was perceived to be key to institute success but was problematic at all but one institute. In particular staff often moved to better paid positions elsewhere once having acquired necessary skills and experience, leaving remaining senior staff with heavy workloads. (iii Governance and management: board structures and roles varied according to the nature of institute ownership. Boards made important contributions to organizational capacity through promoting continuity, independence and fund raising. Routine management systems were typically perceived to be strong. (iv Networks: linkages to policy makers helped promote policy influences. External networks with other research organizations, particularly where these were longer term institutional collaborations helped promote capacity. Conclusions The development of strong in-country analytical and research capacity to guide health policy development is critical, yet

  12. France: Health System Review.

    Science.gov (United States)

    Chevreul, Karine; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Hernandez-Quevedo, Cristina

    2015-01-01

    This analysis of the French health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The French population has a good level of health, with the second highest life expectancy in the world for women. It has a high level of choice of providers, and a high level of satisfaction with the health system. However, unhealthy habits such as smoking and harmful alcohol consumption remain significant causes of avoidable mortality. Combined with the significant burden of chronic diseases, this has underscored the need for prevention and integration of services, although these have not historically been strengths of the French system. Although the French health care system is a social insurance system, it has historically had a stronger role for the state than other Bismarckian social insurance systems. Public financing of health care expenditure is among the highest in Europe and out-of-pocket spending among the lowest. Public insurance is compulsory and covers the resident population; it is financed by employee and employer contributions as well as increasingly through taxation. Complementary insurance plays a significant role in ensuring equity in access. Provision is mixed; providers of outpatient care are largely private, and hospital beds are predominantly public or private non-profit-making. Despite health outcomes being among the best in the European Union, social and geographical health inequities remain. Inequality in the distribution of health care professionals is a considerable barrier to equity. The rising cost of health care and the increasing demand for long-term care are also of concern. Reforms are ongoing to address these issues, while striving for equity in financial access; a long-term care reform including public coverage of long-term care is still pending. World Health Organization 2015 (acting as the host organization for, and secretariat of, the

  13. Qualitative study to develop processes and tools for the assessment and tracking of African institutions' capacity for operational health research.

    Science.gov (United States)

    Wallis, Selina; Cole, Donald C; Gaye, Oumar; Mmbaga, Blandina T; Mwapasa, Victor; Tagbor, Harry; Bates, Imelda

    2017-09-05

    Research is key to achieving global development goals. Our objectives were to develop and test an evidence-informed process for assessing health research management and support systems (RMSS) in four African universities and for tracking interventions to address capacity gaps. Four African universities. 83 university staff and students from 11 cadres. A literature-informed 'benchmark' was developed and used to itemise all components of a university's health RMSS. Data on all components were collected during site visits to four African universities using interview guides, document reviews and facilities observation guides. Gaps in RMSS capacity were identified against the benchmark and institutional action plans developed to remedy gaps. Progress against indicators was tracked over 15 months and common challenges and successes identified. Common gaps in operational health research capacity included no accessible research strategy, a lack of research e-tracking capability and inadequate quality checks for proposal submissions and contracts. Feedback indicated that the capacity assessment was comprehensive and generated practical actions, several of which were no-cost. Regular follow-up helped to maintain focus on activities to strengthen health research capacity in the face of challenges. Identification of each institutions' strengths and weaknesses against an evidence-informed benchmark enabled them to identify gaps in in their operational health research systems, to develop prioritised action plans, to justify resource requests to fulfil the plans and to track progress in strengthening RMSS. Use of a standard benchmark, approach and tools enabled comparisons across institutions which has accelerated production of evidence about the science of research capacity strengthening. The tools could be used by institutions seeking to understand their strengths and to address gaps in research capacity. Research capacity gaps that were common to several institutions could be

  14. Air conditioning system with supplemental ice storing and cooling capacity

    Science.gov (United States)

    Weng, Kuo-Lianq; Weng, Kuo-Liang

    1998-01-01

    The present air conditioning system with ice storing and cooling capacity can generate and store ice in its pipe assembly or in an ice storage tank particularly equipped for the system, depending on the type of the air conditioning system. The system is characterized in particular in that ice can be produced and stored in the air conditioning system whereby the time of supplying cooled air can be effectively extended with the merit that the operation cycle of the on and off of the compressor can be prolonged, extending the operation lifespan of the compressor in one aspect. In another aspect, ice production and storage in great amount can be performed in an off-peak period of the electrical power consumption and the stored ice can be utilized in the peak period of the power consumption so as to provide supplemental cooling capacity for the compressor of the air conditioning system whereby the shift of peak and off-peak power consumption can be effected with ease. The present air conditioning system can lower the installation expense for an ice-storing air conditioning system and can also be applied to an old conventional air conditioning system.

  15. Malta: Health system review.

    Science.gov (United States)

    Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

    2014-01-01

    This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community. World Health Organization 2014 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  16. Austria: health system review.

    Science.gov (United States)

    Hofmarcher, Maria M; Quentin, Wilm

    2013-01-01

    This analysis of the Austrian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health-system performance. The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. Free choice of providers and unrestricted access to all care levels (general practitioners, specialist physicians and hospitals) are characteristic features of the system. Unsurprisingly, population satisfaction is well above EU average. Income-related inequality in health has increased since 2005, although it is still relatively low compared to other countries. The health-care system has been shaped by both the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. On the one hand, this enables decentralized planning and governance, adjusted to local norms and preferences. On the other hand, it also leads to fragmentation of responsibilities and frequently results in inadequate coordination. For this reason, efforts have been made for several years to achieve more joint planning, governance and financing of the health-care system at the federal and regional level. As in any health system, a number of challenges remain. The costs of the health-care system are well above the EU15 average, both in absolute terms and as a percentage of GDP. There are important structural imbalances in healthcare provision, with an oversized hospital sector and insufficient resources available for ambulatory care and preventive medicine. This is coupled with stark regional differences in utilization, both in curative services (hospital beds and specialist physicians) and preventative services such as preventive health check-ups, outpatient rehabilitation, psychosocial and psychotherapeutic care and nursing. There are clear social inequalities in the use of medical services, such as preventive health check-ups, immunization or dentistry

  17. Strengthening public health laboratory capacity in Thailand for International Health Regulations (IHR) (2005).

    Science.gov (United States)

    Peruski, Anne Harwood; Birmingham, Maureen; Tantinimitkul, Chawalit; Chungsamanukool, Ladawan; Chungsamanukool, Preecha; Guntapong, Ratigorn; Pulsrikarn, Chaiwat; Saengklai, Ladapan; Supawat, Krongkaew; Thattiyaphong, Aree; Wongsommart, Duangdao; Wootta, Wattanapong; Nikiema, Abdoulaye; Pierson, Antoine; Peruski, Leonard F; Liu, Xin; Rayfield, Mark A

    2014-07-01

    Thailand conducted a national laboratory assessment of core capacities related to the International Health Regulations (IHR) (2005), and thereby established a baseline to measure future progress. The assessment was limited to public laboratories found within the Thai Bureau of Quality and Safety of Food, National Institute of Health and regional medical science centres. The World Health Organization (WHO) laboratory assessment tool was adapted to Thailand through a participatory approach. This adapted version employed a specific scoring matrix and comprised 16 modules with a quantitative output. Two teams jointly performed the on-site assessments in December 2010 over a two-week period, in 17 public health laboratories in Thailand. The assessment focused on the capacity to identify and accurately detect pathogens mentioned in Annex 2 of the IHR (2005) in a timely manner, as well as other public health priority pathogens for Thailand. Performance of quality management, budget and finance, data management and communications was considered strong (>90%); premises quality, specimen collection, biosafety, public health functions, supplies management and equipment availability were judged as very good (>70% but ≤90%); while microbiological capacity, staffing, training and supervision, and information technology needed improvement (>60% but ≤70%). This assessment is a major step in Thailand towards development of an optimized and standardized national laboratory network for the detection and reporting of infectious disease that would be compliant with IHR (2005). The participatory strategy employed to adapt an international tool to the Thai context can also serve as a model for use by other countries in the Region. The participatory approach probably ensured better quality and ownership of the results, while providing critical information to help decision-makers determine where best to invest finite resources.

  18. A practical and systematic approach to organisational capacity strengthening for research in the health sector in Africa.

    Science.gov (United States)

    Bates, Imelda; Boyd, Alan; Smith, Helen; Cole, Donald C

    2014-03-03

    Despite increasing investment in health research capacity strengthening efforts in low and middle income countries, published evidence to guide the systematic design and monitoring of such interventions is very limited. Systematic processes are important to underpin capacity strengthening interventions because they provide stepwise guidance and allow for continual improvement. Our objective here was to use evidence to inform the design of a replicable but flexible process to guide health research capacity strengthening that could be customized for different contexts, and to provide a framework for planning, collecting information, making decisions, and improving performance. We used peer-reviewed and grey literature to develop a five-step pathway for designing and evaluating health research capacity strengthening programmes, tested in a variety of contexts in Africa. The five steps are: i) defining the goal of the capacity strengthening effort, ii) describing the optimal capacity needed to achieve the goal, iii) determining the existing capacity gaps compared to the optimum, iv) devising an action plan to fill the gaps and associated indicators of change, and v) adapting the plan and indicators as the programme matures. Our paper describes three contrasting case studies of organisational research capacity strengthening to illustrate how our five-step approach works in practice. Our five-step pathway starts with a clear goal and objectives, making explicit the capacity required to achieve the goal. Strategies for promoting sustainability are agreed with partners and incorporated from the outset. Our pathway for designing capacity strengthening programmes focuses not only on technical, managerial, and financial processes within organisations, but also on the individuals within organisations and the wider system within which organisations are coordinated, financed, and managed. Our five-step approach is flexible enough to generate and utilise ongoing learning. We have

  19. Organizational capacity for change in health care: Development and validation of a scale.

    Science.gov (United States)

    Spaulding, Aaron; Kash, Bita A; Johnson, Christopher E; Gamm, Larry

    We do not have a strong understanding of a health care organization's capacity for attempting and completing multiple and sometimes competing change initiatives. Capacity for change implementation is a critical success factor as the health care industry is faced with ongoing demands for change and transformation because of technological advances, market forces, and regulatory environment. The aim of this study was to develop and validate a tool to measure health care organizations' capacity to change by building upon previous conceptualizations of absorptive capacity and organizational readiness for change. A multistep process was used to develop the organizational capacity for change survey. The survey was sent to two populations requesting answers to questions about the organization's leadership, culture, and technologies in use throughout the organization. Exploratory and confirmatory factor analyses were conducted to validate the survey as a measurement tool for organizational capacity for change in the health care setting. The resulting organizational capacity for change measurement tool proves to be a valid and reliable method of evaluating a hospital's capacity for change through the measurement of the population's perceptions related to leadership, culture, and organizational technologies. The organizational capacity for change measurement tool can help health care managers and leaders evaluate the capacity of employees, departments, and teams for change before large-scale implementation.

  20. Policy Capacity Meets Politics; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    Patrick Fafard

    2015-10-01

    Full Text Available It is difficult to disagree with the general argument that successful health reform requires a significant degree of policy capacity or that all players in the policy game need to move beyond self-interested advocacy. However, an overly broad definition of policy capacity is a problem. More important perhaps, health reform inevitably requires not just policy capacity but political leadership and compromise.

  1. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  2. It Systems Supporting the Management of Production Capacity

    Science.gov (United States)

    Milewska, Elżbieta

    2017-03-01

    The paper presents the problem of manufacturing process flexibility in view of a company's material and information flow stream management. The author of the article has described the functions of a production process control system and presented the characteristics of production capacity intensive and extensive reserves. The MRP II/ERP, MES and APS class IT tools supporting the process of production planning, organization and control have also been discussed.

  3. IT SYSTEMS SUPPORTING THE MANAGEMENT OF PRODUCTION CAPACITY

    Directory of Open Access Journals (Sweden)

    Elżbieta MILEWSKA

    2017-01-01

    Full Text Available The paper presents the problem of manufacturing process flexibility in view of a company’s material and information flow stream management. The author of the article has described the functions of a production process control system and presented the characteristics of production capacity intensive and extensive reserves. The MRP II/ERP, MES and APS class IT tools supporting the process of production planning, organization and control have also been discussed.

  4. IT SYSTEMS SUPPORTING THE MANAGEMENT OF PRODUCTION CAPACITY

    OpenAIRE

    Elżbieta MILEWSKA

    2017-01-01

    The paper presents the problem of manufacturing process flexibility in view of a company’s material and information flow stream management. The author of the article has described the functions of a production process control system and presented the characteristics of production capacity intensive and extensive reserves. The MRP II/ERP, MES and APS class IT tools supporting the process of production planning, organization and control have also been discussed.

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

    Science.gov (United States)

    Asante, Augustine; Roberts, Graham; Hall, John

    2012-04-01

    and to Ministry of Finance and Public Service Division regulations. The delineation of central and provincial health authorities' responsibilities requires guidelines in a changing system, where both population-based and targeted vertical programs are implemented at local levels. NUMBER AND DISTRIBUTION OF MANAGERS: Nine of the 10 positions of Provincial Health Director have experienced high turnover, which reportedly occurs without adequate handover to incoming appointees, most of whom are recent clinical graduates. Health services in the Honiara urban area are provided through the Honiara City Council. Church health services are staffed by government employees. COMPETENCE OF DISTRICT HEALTH MANAGERS: Management skills are reportedly weak at the provincial level. The Regional Assistance Mission to Solomon Islands provides governance training inputs to provincial government staff. Provincial health departments have limited financial and human resource management capacity. They also have clinical backgrounds and no training in public health planning or health services management, other than that provided by donors, the Regional Assistance Mission itself and the MHMS. MANAGEMENT WORKING ENVIRONMENT: Provincial health directors have limited control over health staff. Little supportive supervision in management is provided to new provincial health directors. No performance management systems are in place to ensure that staff are properly assessed and supported to do their best Large numbers of non-government organisations working at the provincial level in youth and women's programs require coordination by Provincial health directors to avoid duplication or implementation of programs that will require ongoing funding, but this is not done. FUNCTIONING OF MANAGEMENT SUPPORT SYSTEMS: Management support systems for budgeting and finance, management information and procurement and supply do not function adequately to support provincial health directors to manage effectively

  6. Switzerland: Health System Review.

    Science.gov (United States)

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  7. Organizational capacity for community development in regional health authorities: a conceptual model.

    Science.gov (United States)

    Germann, Kathy; Wilson, Doug

    2004-09-01

    The value of community development (CD) practices is well documented in the health promotion literature; it is a foundational strategy outlined in the Ottawa Charter for Health Promotion. Despite the importance of collaborative action with communities to enhance individual and community health and well-being, there exists a major gap between the evidence for CD and the actual extent to which CD is carried out by health organizations. In this paper it is argued that the gap exists because we have failed to turn the evaluative gaze inward-to examine the capacity of health organizations themselves to facilitate CD processes. This study was designed to explicate key elements that contribute to organizational capacity for community development (OC-CD). Twenty-two front-line CD workers and managers responsible for CD initiatives from five regional health authorities in Alberta, Canada, were interviewed. Based on the study findings, a multidimensional model for conceptualizing OC-CD is presented. Central to the model are four inter-related dimensions: (i) organizational commitment to CD, rooted in particular values and beliefs, leadership and shared understanding of CD; (ii) supportive structures and systems, such as job design, flexible planning processes, evaluation mechanisms and collaborative processes; (iii) allocation of resources for CD; and (iv) working relationships and processes that model CD within the health organization. These four dimensions contribute to successful CD practice in numerous ways, but perhaps most importantly by supporting the empowerment and autonomy of the pivotal organizational player in health promotion practice: the front-line worker.

  8. Estonia: health system review.

    Science.gov (United States)

    Lai, Taavi; Habicht, Triin; Kahur, Kristiina; Reinap, Marge; Kiivet, Raul; van Ginneken, Ewout

    2013-01-01

    This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. Without doubt, the main issue has been the 2008 financial crisis. Although Estonia has managed the downturn quite successfully and overall satisfaction with the system remains high, it is hard to predict the longer-term effects of the austerity package. The latter included some cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialized care. In terms of health outcomes, important progress was made in life expectancy, which is nearing the European Union (EU) average, and infant mortality. Improvements are necessary in smoking and alcohol consumption, which are linked to the majority of avoidable diseases. Although the health behaviour of the population is improving, large disparities between groups exist and obesity rates, particularly among young people, are increasing. In health care, the burden of out-of-pocket payments is still distributed towards vulnerable groups. Furthermore, the number of hospitals, hospital beds and average length of stay has decreased to the EU average level, yet bed occupancy rates are still below EU averages and efficiency advances could be made. Going forwards, a number of pre-crisis challenges remain. These include ensuring sustainability of health care financing, guaranteeing a sufficient level of human resources, prioritizing patient-centred health care, integrating health and social care services, implementing intersectoral action to promote healthy behaviour, safeguarding access to health care for lower socioeconomic groups, and, lastly, improving evaluation and monitoring tools across the health system. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  9. Poland health system review.

    Science.gov (United States)

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  10. Strengthening core public health capacity based on the implementation of the International Health Regulations (IHR) (2005): Chinese lessons

    Science.gov (United States)

    Liu, Bin; Sun, Yan; Dong, Qian; Zhang, Zongjiu; Zhang, Liang

    2015-01-01

    As an international legal instrument, the International Health Regulations (IHR) is internationally binding in 196 countries, especially in all the member states of the World Health Organization (WHO). The IHR aims to prevent, protect against, control, and respond to the international spread of disease and aims to cut out unnecessary interruptions to traffic and trade. To meet IHR requirements, countries need to improve capacity construction by developing, strengthening, and maintaining core response capacities for public health risk and Public Health Emergency of International Concern (PHEIC). In addition, all the related core capacity requirements should be met before June 15, 2012. If not, then the deadline can be extended until 2016 upon request by countries. China has promoted the implementation of the IHR comprehensively, continuingly strengthening the core public health capacity and advancing in core public health emergency capacity building, points of entry capacity building, as well as risk prevention and control of biological events (infectious diseases, zoonotic diseases, and food safety), radiological, nuclear, and chemical events, and other catastrophic events. With significant progress in core capacity building, China has dealt with many public health emergencies successfully, ensuring that its core public health capacity has met the IHR requirements, which was reported to WHO in June 2014. This article describes the steps, measures, and related experiences in the implementation of IHR in China. PMID:26029897

  11. Strengthening Core Public Health Capacity Based on the Implementation of the International Health Regulations (IHR (2005: Chinese Lessons

    Directory of Open Access Journals (Sweden)

    Bin Liu

    2015-06-01

    Full Text Available As an international legal instrument, the International Health Regulations (IHR is internationally binding in 196 countries, especially in all the member states of the World Health Organization (WHO. The IHR aims to prevent, protect against, control, and respond to the international spread of disease and aims to cut out unnecessary interruptions to traffic and trade. To meet IHR requirements, countries need to improve capacity construction by developing, strengthening, and maintaining core response capacities for public health risk and Public Health Emergency of International Concern (PHEIC. In addition, all the related core capacity requirements should be met before June 15, 2012. If not, then the deadline can be extended until 2016 upon request by countries. China has promoted the implementation of the IHR comprehensively, continuingly strengthening the core public health capacity and advancing in core public health emergency capacity building, points of entry capacity building, as well as risk prevention and control of biological events (infectious diseases, zoonotic diseases, and food safety, radiological, nuclear, and chemical events, and other catastrophic events. With significant progress in core capacity building, China has dealt with many public health emergencies successfully, ensuring that its core public health capacity has met the IHR requirements, which was reported to WHO in June 2014. This article describes the steps, measures, and related experiences in the implementation of IHR in China.

  12. Mapping health research capacity in 17 countries of the former Soviet Union and south-eastern Europe: an exploratory study.

    Science.gov (United States)

    Santoro, Alessio; Glonti, Ketevan; Bertollini, Roberto; Ricciardi, Walter; McKee, Martin

    2016-04-01

    Policies to improve health status, tackle disease and ensure equitable access to healthcare should be informed by evidence derived from high-quality research. However, health research capacity is unevenly distributed across countries, as revealed by mapping exercises that have been undertaken to provide a basis for concerted action to strengthen capacity. This study systematically describes capacity to undertake health research in the countries of the former Soviet Union and south-eastern Europe and identifies the elements required to create a national health research system. The mapping exercise comprised two elements: a survey of key informants in the respective countries and a bibliometric analysis of scientific publications in the field of public health. Our results confirm that health research remains a low priority in some countries of the WHO European Region. In these countries, most of the literature was produced by researchers outside the country, often to inform international donors. This study provides important information for countries seeking to initiate action to strengthen their research capacity. There is a need for a comprehensive strategy with sustained investment in training and career development of researchers. There is also a need to create new funding systems to provide financial support to those undertaking policy-relevant research. International collaboration and investment in mechanisms to bridge the gap between research and policy are urgently required. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  13. Assessing capacity for sustainability of effective programs and policies in local health departments

    Science.gov (United States)

    Tabak, Rachel G.; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C.

    2015-01-01

    Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High

  14. Bulgaria health system review.

    Science.gov (United States)

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  15. On finite capacity queueing systems with a general vacation policy

    Directory of Open Access Journals (Sweden)

    Jacqueline Loris-Teghem

    2000-01-01

    Full Text Available We consider a Poisson arrival queueing system with finite capacity and a general vacation policy as described in Loris-Teghem [Queueing Systems 3 (1988, 41-52]. From our previous results regarding the stationary queue length distributions immediately after a departure and at an arbitrary epoch, we derive a relation between both distributions which extends a result given in Frey and Takahashi [Operations Research Letters 21 (1997, 95-100] for the particular case of an exhaustive service multiple vacation policy.

  16. Impact of Cyclic Prefix length on OFDM system Capacity

    DEFF Research Database (Denmark)

    Rom, Christian; Sørensen, Troels Bundgaard; Mogensen, Preben Elgaard

    2005-01-01

    This paper is a study on the impact of the Cyclic Prefix (CP) length on the downlink Capacity in a base-band synchronized SISO-OFDM context. To measure this impact, the capacity, measured in bits per second per hertz, is chosen as quality parameter. The study shows how the lengthening of the CP......) the useful OFDM symbol duration, 2) the Signal to Noise Ratio (SNR) at the receiver and 3) the channel Power Delay Profile (PDP). Depending on the values of these parameters different optimum CP lengths are obtained. For a system using only one value of CP length we suggest an optimum value to be 4us...... for an OFDM symbol length of 40us and 6us for an OFDM symbol length of 80us....

  17. Building capacity to develop an African teaching platform on health workforce development: a collaborative initiative of universities from four sub Saharan countries

    OpenAIRE

    Amde, Woldekidan Kifle; Sanders, David; Lehmann, Uta

    2014-01-01

    Introduction Health systems in many low-income countries remain fragile, and the record of human resource planning and management in Ministries of Health very uneven. Public health training institutions face the dual challenge of building human resources capacity in ministries and health services while alleviating and improving their own capacity constraints. This paper reports on an initiative aimed at addressing this dual challenge through the development and implementation of a joint Maste...

  18. Circumpolar Inuit health systems.

    Science.gov (United States)

    Ellsworth, Leanna; O'Keeffe, Annmaree

    2013-01-01

    The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic - Canada, Greenland, USA (Alaska) and Russia (Chukotka). In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska) and Russia (Chukotka) and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Literature review. It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems' effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of comparison in terms of methodology and timing of the available data

  19. Dynamic simulation of variable capacity refrigeration systems under abnormal conditions

    International Nuclear Information System (INIS)

    Liang Nan; Shao Shuangquan; Tian Changqing; Yan Yuying

    2010-01-01

    There are often abnormal working conditions at evaporator outlet of a refrigeration system, such as two-phase state in transient process, and it is essential to investigate such transient behaviours for system design and control strategy. In this paper, a dynamic lumped parameter model is developed to simulate the transient behaviours of refrigeration system with variable capacity in both normal and abnormal working conditions. The appropriate discriminant method is adopted to switch the normal and abnormal conditions smoothly and to eliminate the simulated data oscillation. In order to verify the dynamic model, we built a test system with variable frequency compressor, water-cooling condenser, evaporator and electronic expansion valve. Calculated values from the mathematical model show reasonable agreement with the experimental data. The simulation results show that the transient behaviours of the variable capacity refrigeration system in the abnormal working conditions can be calculated reliably with the dynamic model when the compressor rotary speed or the opening of electronic expansion valve changes abruptly.

  20. Increasing the capacity of health surveillance assistants in ...

    African Journals Online (AJOL)

    stigma and discrimination. The focus of ... behaviour and stigma, including holding alternative ... with mental health problems avoid seeking help from health services. This is .... issues of risk of harm to self or others by providing HSAs with the ...

  1. Developing Social Marketing Capacity to Address Health Issues

    Science.gov (United States)

    Whitelaw, S.; Smart, E.; Kopela, J.; Gibson, T.; King, V.

    2011-01-01

    Purpose: Social marketing is increasingly being seen as a potentially effective means of pursuing health education practice generally and within various specific areas such as mental health and wellbeing and more broadly in tackling health inequalities. This paper aims to report and reflect on the authors' experiences of undertaking a health…

  2. Circumpolar Inuit health systems

    Directory of Open Access Journals (Sweden)

    Leanna Ellsworth

    2013-08-01

    Full Text Available Background . The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska and Russia (Chukotka. In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective . To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska and Russia (Chukotka and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design . Literature review. Results . It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of

  3. Building capacity for public and population health research in Africa: the consortium for advanced research training in Africa (CARTA) model

    Science.gov (United States)

    Ezeh, Alex C.; Izugbara, Chimaraoke O.; Kabiru, Caroline W.; Fonn, Sharon; Kahn, Kathleen; Manderson, Lenore; Undieh, Ashiwel S.; Omigbodun, Akinyinka; Thorogood, Margaret

    2010-01-01

    Background Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region's socio-economic and health problems. Objective and program overview We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTA's program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions CARTA's focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiative's goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems. PMID:21085517

  4. Building capacity for public and population health research in Africa: the consortium for advanced research training in Africa (CARTA model

    Directory of Open Access Journals (Sweden)

    Alex C. Ezeh

    2010-11-01

    Full Text Available Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region's socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA, which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTA's program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions: CARTA's focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiative's goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems.

  5. Separate Poles Mode for Large-Capacity HVDC System

    Science.gov (United States)

    Zhu, Lin; Gao, Qin

    2017-05-01

    This paper proposes a novel connection mode, separate poles mode (SPM), for large-capacity HVDC systems. The proposed mode focuses on the core issues of HVDC connection in interconnected power grids and principally aims at increasing effective electric distance between poles, which helps to mitigate the interaction problems between AC system and DC system. Receiving end of bipolar HVDC has been divided into different inverter stations under the mode, and thus significantly alleviates difficulties in power transmission and consumption of receiving-end AC grids. By investigating the changes of multi-feed short-circuit ratio (MISCR), finding that HVDC with SPM shows critical impacts upon itself and other HVDC systems with conventional connection mode, which demonstrates that SPM can make balance between MISCR increase and short-circuit current limit.

  6. An “All Teach, All Learn” Approach to Research Capacity Strengthening in Indigenous Primary Health Care Continuous Quality Improvement

    Science.gov (United States)

    McPhail-Bell, Karen; Matthews, Veronica; Bainbridge, Roxanne; Redman-MacLaren, Michelle Louise; Askew, Deborah; Ramanathan, Shanthi; Bailie, Jodie; Bailie, Ross; Matthews, Veronica

    2018-01-01

    In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators—all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous primary health care, to the benefit of Indigenous people. This paper describes the collaborative development of, and principles underpinning, a research capacity strengthening (RCS) model in a national Indigenous primary health care CQI research network. The development process identified the need to address power imbalances, cultural contexts, relationships, systems requirements and existing knowledge, skills, and experience of all parties. Taking a strengths-based perspective, we harnessed existing knowledge, skills and experiences; hence our emphasis on capacity “strengthening”. New insights are provided into the complex processes of RCS within the context of CQI in Indigenous primary health care. PMID:29761095

  7. Strengthening health promotion in hospitals with capacity building: a Taiwanese case study.

    Science.gov (United States)

    Lee, Chiachi Bonnie; Chen, Michael S; Chien, Sou-Hsin; Pelikan, Jürgen M; Wang, Ying Wei; Chu, Cordia Ming-Yeuk

    2015-09-01

    Organizational capacity building for health promotion (HP) is beneficial to the effective implementation of HP in organizational settings. The World Health Organization (WHO) Health Promoting Hospitals' (HPHs) initiative encourages hospitals to promote the health of their stakeholders by developing organizational capacity. This study analyzes an application case of one hospital of the HPH initiative in Taiwan, characterizes actions aiming at building organizational support to strengthen health gains and identifies facilitators of and barriers to the implementation of the HP in this hospital. Case study methodology was used with a triangulation of various sources; thematic analysis was used to analyze qualitative information. This study found a positive impact of the HPH initiative on the case hospital, such as more support from leadership, a fine-tuned HP mission and strategy, cultivated pro-HP habits of physical activities, a supportive intramural structure, an HP-inclusive system, improved management practices and enhanced staff participation. Transformational and transactional enablers are of equal importance in implementing HPH. However, it was also found that the case hospital encountered more transactional barriers than transformational ones. This hospital was hindered by insufficient support from external environments, leadership with limited autonomy and authority, a preference for ideals over professionalism, insufficient participation by physicians, a lack of manpower and time, a merit system with limited stimulating effect, ineffective management practices in weak central project management, a lack of integration, insufficient communication and an inability to inculcate the staff on the importance of HP, and inadequate staff participation. Several implications for other hospitals are suggested. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. On the Capacity of Underlay Cognitive Radio Systems

    KAUST Repository

    Sboui, Lokman

    2013-05-05

    Due to the scarcity of frequency spectrum in view of the evolution of wireless communication technologies, the cognitive radio (CR) concept has been introduced to efficiently exploit the available spectrum. This concept consists in introducing unlicensed/secondary users (SU’s) in existing networks to share the spectrum of licensed/primary users (PU’s) without harming primary communications hence the name of “spectrum sharing” technique. We study in this dissertation, the capacity and the achievable rate of the secondary user within various communication settings. We, firstly, investigate the capacity of the (SU’s) at low power regime for Nakagami fading channels and present closed form of the capacity under various types of interference and/or power constraints. We explicitly characterize two regimes where either the interference constraint or the power constraint dictates the optimal power profile. Our framework also highlights the effects of different fading parameters on the secondary link ergodic capacity. Interestingly, we show that the low power regime analysis provides a specific insight on the capacity behavior of CR that has not been reported by previous studies. Next, we determine the spectral efficiency gain of an uplink CR Multi-Input Multi- Output (MIMO) system in which the SU is allowed to share the spectrum with the PU using a specific precoding scheme to communicate with a common receiver. Applied to Rayleigh fading channels, we show, through numerical results, that our proposed scheme enhances considerably the cognitive achievable rate. For instance, in case of a perfect detection of the PU signal, after applying Successive Interference Cancellation (SIC), the CR rate remains non-zero for high Signal to Noise Ratio (SNR) which is usually impossible when we only use space alignment technique. In addition, we show that the rate gain is proportional to the allowed interference threshold by providing a fixed rate even in the high SNR range

  9. Building capacity without disrupting health services: public health education for Africa through distance learning

    Directory of Open Access Journals (Sweden)

    Igumbor Ehi

    2009-04-01

    Full Text Available Abstract The human resources crisis in Africa is especially acute in the public health field. Through distance education, the School of Public Health of the University of the Western Cape, South Africa, has provided access to master's level public health education for health professionals from more than 20 African countries while they remain in post. Since 2000, interest has increased overwhelmingly to a point where four times more applications are received than can be accommodated. This home-grown programme remains sensitive to the needs of the target learners while engaging them in high-quality learning applied in their own work contexts. This brief paper describes the innovative aspects of the programme, offering some evaluative indications of its impact, and reviews how the delivery of text-led distance learning has facilitated the realization of the objectives of public health training. Strategies are proposed for scaling up such a programme to meet the growing need in this essential area of health human resource capacity development in Africa.

  10. Health Information Systems

    International Development Research Centre (IDRC) Digital Library (Canada)

    the technology and expertise to process and share ... services. GEHS supports efforts that reach beyond healthcare institutions to capture evidence ... Health information systems are a foundation for quality care, and can increase accountability ...

  11. Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy.

    Science.gov (United States)

    Sabo, Samantha; Flores, Melissa; Wennerstrom, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia

    2017-12-01

    Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.

  12. Legal and regulatory capacity to support the global health security agenda.

    Science.gov (United States)

    Morhard, Ryan; Katz, Rebecca

    2014-01-01

    On February 13, 2014, 27 nations, along with 3 international organizations, launched the Global Health Security Agenda (GHSA). The intent of GHSA is to accelerate progress in enabling countries around the world to prevent, detect, and respond to public health emergencies-capacities to be achieved through 9 core objectives. Building national, regional, and international capacity includes creating strong legal and regulatory regimes to support national and international capacities to prevent, detect, and respond to public health emergencies. Accordingly, establishing and reinforcing international and national-level legal preparedness is central to advancing elements of each of the 9 objectives of the GHSA.

  13. The role of schools of public health in capacity building.

    Science.gov (United States)

    Tulchinsky, Theodore H; Goodman, Julien

    2012-08-01

    Public health has been an enormously effective instrument for improving life expectancy and quality of life. Historically a sphere of governmental activity led by physicians and staffed by sanitarians and nurses, public health has evolved to become a multi-facetted field of societal activity. It engages many agencies and community action in reducing infectious and non-communicable diseases as well as many aspects of lifestyle and health equity. Education for an adequate professional workforce is one of its key functions. Schools of public health have fulfilled this role only partly even in developed countries, but in countries in transition and in low-income countries the problem is much more acute. We discuss the role of mentoring of new schools calling for strong public and private donor support for this as a key issue in global health.

  14. Enhancing employee capacity to prioritize health insurance benefits.

    Science.gov (United States)

    Danis, Marion; Goold, Susan Dorr; Parise, Carol; Ginsburg, Marjorie

    2007-09-01

    To demonstrate that employees can gain understanding of the financial constraints involved in designing health insurance benefits. While employees who receive their health insurance through the workplace have much at stake as the cost of health insurance rises, they are not necessarily prepared to constructively participate in prioritizing their health insurance benefits in order to limit cost. Structured group exercises. Employees of 41 public and private organizations in Northern California. Administration of the CHAT (Choosing Healthplans All Together) exercise in which participants engage in deliberation to design health insurance benefits under financial constraints. Change in priorities and attitudes about the need to exercise insurance cost constraints. Participants (N = 744) became significantly more cognizant of the need to limit insurance benefits for the sake of affordability and capable of prioritizing benefit options. Those agreeing that it is reasonable to limit health insurance coverage given the cost increased from 47% to 72%. It is both possible and valuable to involve employees in priority setting regarding health insurance benefits through the use of structured decision tools.

  15. Comparative Study Between Internal Ohmic Resistance and Capacity for Battery State of Health Estimation

    Directory of Open Access Journals (Sweden)

    M. Nisvo Ramadan

    2015-12-01

    Full Text Available In order to avoid battery failure, a battery management system (BMS is necessary. Battery state of charge (SOC and state of health (SOH are part of information provided by a BMS. This research analyzes methods to estimate SOH based lithium polymer battery on change of its internal resistance and its capacity. Recursive least square (RLS algorithm was used to estimate internal ohmic resistance while coloumb counting was used to predict the change in the battery capacity. For the estimation algorithm, the battery terminal voltage and current are set as the input variables. Some tests including static capacity test, pulse test, pulse variation test and before charge-discharge test have been conducted to obtain the required data. After comparing the two methods, the obtained results show that SOH estimation based on coloumb counting provides better accuracy than SOH estimation based on internal ohmic resistance. However, the SOH estimation based on internal ohmic resistance is faster and more reliable for real application

  16. Harnessing the sun: Developing capacity to sustain local solar energy systems

    Science.gov (United States)

    Olarewaju, Olufemi

    2011-12-01

    Use of solar photovoltaic (PV) and other renewable sources to meet rising electricity demand by a growing world population has gained traction in many countries in recent years. In rural Sub-Saharan Africa, where 86 percent of the populace has no access to electricity, solar energy systems represent partial solutions to demand, especially in support of rural development initiatives to supply potable water, health care services and education. Unfortunately, development of human and organizational capacity to maintain solar technology has not kept pace with the rate of installation, causing many to fall into disrepair and disuse. This has stimulated interest in capacity development processes required to make solar systems sustainable. To cast light on the practical meanings and challenges of capacity development for solar energy, this study compares the experiences of two rural projects, one in Lagos State (Nigeria) that disregarded the importance of capacity development, and the other in Texas (United States) that, in contrast, made such development the centerpiece of its operations. Based largely on interviews with 60 key actors, findings underscore the crucial importance of sustained investment in capacity development to assurance of durable power supply from renewable sources.

  17. Boosting capacity for health research in Africa | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-09

    Jun 9, 2016 ... But Africa's institutions of higher learning that are mandated to foster this ... in developing and implementing the ADDRF offers invaluable lessons to ... was recognized for its efforts to improve health service provision and the ...

  18. System health monitoring

    International Nuclear Information System (INIS)

    Reneke, J.A.; Fryer, M.O.

    1995-01-01

    Well designed large systems include many instrument taking data. These data are used in a variety of ways. They are used to control the system and its components, to monitor system and component health, and often for historical or financial purposes. This paper discusses a new method of using data from low level instrumentation to monitor system and component health. The method uses the covariance of instrument outputs to calculate a measure of system change. The method involves no complicated modeling since it is not a parameter estimation algorithm. The method is iterative and can be implemented on a computer in real time. Examples are presented for a metal lathe and a high efficiency particulate air (HEPA) filter. It is shown that the proposed method is quite sensitive to system changes such as wear out and failure. The method is useful for low level system diagnostics and fault detection

  19. One Health/EcoHealth capacity building programs in South and South East Asia: a mixed method rapid systematic review.

    Science.gov (United States)

    Chatterjee, Pranab; Chauhan, Abhimanyu Singh; Joseph, Jessy; Kakkar, Manish

    2017-09-29

    Although One Health (OH) or EcoHealth (EH) have been acknowledged to provide comprehensive and holistic approaches to study complex problems, like zoonoses and emerging infectious diseases, there remains multiple challenges in implementing them in a problem-solving paradigm. One of the most commonly encountered barriers, especially in low- and middle-income countries, is limited capacity to undertake OH/EH inquiries. A rapid review was undertaken to conduct a situation analysis of the existing OH/EH capacity building programs, with a focused analysis of those programs with extensive OH engagement, to help map the current efforts in this area. A listing of the OH/EH projects/initiatives implemented in South Asia (SA) and South East Asia (SEA) was done, followed by analysis of documents related to the projects, available from peer-reviewed or grey literature sources. Quantitative data was extracted using a data extraction format, and a free listing of qualitative themes was undertaken. In SEA, 13 unique OH/EH projects, with 37 capacity building programs, were identified. In contrast, in SA, the numbers were 8 and 11 respectively. In SA, programs were oriented to develop careers in program management, whereas, in SEA, the emphasis was on research. Two thirds of the programs in SEA had extensive OH engagement, whereas only one third of those in SA did. The target for the SEA programs was wider, including a population more representative of OH stakes. SEA program themes reveal utilization of multiple approaches, usually in shorter terms, and are growing towards integration with the traditional curricula. Such convergence of themes was lacking in SA programs. In both regions, the programs were driven by external donor agencies, with minimal local buy-in. There is limited investment in research capacity building in both SA and SEA. The situation appears to be more stark in SA, whilst SEA has been able to use the systematic investment and support to develop the OH

  20. Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review.

    Science.gov (United States)

    Barakat, Suzette; Boehmer, Kasey; Abdelrahim, Marwan; Ahn, Sangwoo; Al-Khateeb, Abdulrahman A; Villalobos, Neri Álvarez; Prokop, Larry; Erwin, Patricia J; Fleming, Kirsten; Serrano, Valentina; Spencer-Bonilla, Gabriela; Murad, Mohammad Hassan

    2018-02-01

    Interventions that grow patient capacity to do the work of health care and life are needed to support the health of cancer survivors. Health coaching may grow capacity. This systematic review of health coaching interventions explored coaching's ability to grow capacity of cancer survivors. The authors included randomized trials or quasi-experimental studies comparing coaching to alternative interventions, and adhered to PRISMA reporting guidelines. Data were analyzed using the Theory of Patient Capacity (BREWS: Capacity is affected by factors that influence ability to reframe Biography ["B"], mobilize or recruit Resources ["R"], interact with the Environment of care ["E"], accomplish Work ["W"]), and function Socially ["S"]). The authors reviewed 2210 references and selected 12 studies (6 randomized trials and 6 pre-post). These studies included 1038 cancer survivors, mean age 57.2 years, with various type of cancers: breast, colorectal, prostate, and lung. Health coaching was associated with improved quality of life, mood, and physical activity but not self-efficacy. Classified by potential to support growth in patient capacity, 67% of included studies reported statistically significant outcomes that support "B" (quality of life, acceptance, spirituality), 75% "R" (decreased fatigue, pain), 67% "W" (increased physical activity), and 33% "S" (social deprivation index). None addressed changing the patient's environment of care. In cancer survivors, health coaching improved quality of life and supported patient capacity by several mechanisms, suggesting an important role for "Capacity Coaching." Future interventions that improve self-efficacy and patients' environments of care are needed. Capacity Coaching may improve health and quality of life of cancer survivors.

  1. A survey of the governance capacity of national public health associations to enhance population health.

    Science.gov (United States)

    Chauvin, James; Shukla, Mahesh; Rice, James; Rispel, Laetitia

    2016-03-11

    National public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public's health. Governance and organizational capacity are among the key determinants of a PHA's effectiveness as an advocate for appropriate public health policies and practice. During 2014, the World Federation of Public Health Associations (WFPHA) conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA's leaders (77 %) and the competence of people serving on the PHA's governing body (76 %). The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %). The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health leaders. National PHA have a responsibility to put into place

  2. A survey of the governance capacity of national public health associations to enhance population health

    Directory of Open Access Journals (Sweden)

    James Chauvin

    2016-03-01

    Full Text Available Abstract Background National public health associations (PHAs are key partners with governments and communities to improve, protect and promote the public’s health. Governance and organizational capacity are among the key determinants of a PHA’s effectiveness as an advocate for appropriate public health policies and practice. Methods During 2014, the World Federation of Public Health Associations (WFPHA conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis Results Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA’s leaders (77 % and the competence of people serving on the PHA’s governing body (76 %. The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %. The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health

  3. Building capacity in health facility management: guiding principles for skills transfer in Liberia.

    Science.gov (United States)

    Rowe, Laura A; Brillant, Sister Barbara; Cleveland, Emily; Dahn, Bernice T; Ramanadhan, Shoba; Podesta, Mae; Bradley, Elizabeth H

    2010-03-18

    Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership) delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Respondents (n=93, response rate 95.9%) reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1) use a short-course format focusing on four key skill areas with practical tools; 2) include didactic training, on-site projects, and on-site mentoring; 3

  4. Building capacity in health facility management: guiding principles for skills transfer in Liberia

    Directory of Open Access Journals (Sweden)

    Dahn Bernice T

    2010-03-01

    Full Text Available Abstract Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9% reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1 use a short-course format focusing on four key skill areas with practical tools; 2 include

  5. CAPACITY BUILDING PROCESS IN ENVIRONMENTAL AND HEALTH IMPACT ASSESSMENT FOR A THAI COMMUNITY.

    Science.gov (United States)

    Chaithui, Suthat; Sithisarankul, Pornchai; Hengpraprom, Sarunya

    2017-03-01

    This research aimed at exploring the development of the capacitybuilding process in environmental and health impact assessment, including the consideration of subsequent, capacity-building achievements. Data were gathered through questionnaires, participatory observations, in-depth interviews, focus group discussions, and capacity building checklist forms. These data were analyzed using content analysis, descriptive statistics, and inferential statistics. Our study used the components of the final draft for capacity-building processes consisting of ten steps that were formulated by synthesis from each respective process. Additionally, the evaluation of capacity building levels was performed using 10-item evaluation criteria for nine communities. The results indicated that the communities performed well under these criteria. Finally, exploration of the factors influencing capacity building in environmental and health impact assessment indicated that the learning of community members by knowledge exchange via activities and study visits were the most influential factors of the capacity building processes in environmental and health impact assessment. The final revised version of capacitybuilding process in environmental and health impact assessment could serve as a basis for the consideration of interventions in similar areas, so that they increased capacity in environmental and health impact assessments.

  6. One Health capacity building in sub-Saharan Africa.

    Science.gov (United States)

    Rwego, Innocent B; Babalobi, Olutayo Olajide; Musotsi, Protus; Nzietchueng, Serge; Tiambo, Christian Keambo; Kabasa, John David; Naigaga, Irene; Kalema-Zikusoka, Gladys; Pelican, Katherine

    2016-01-01

    Africa of late has been faced with challenges that require a multidisciplinary and multisectoral approach to address them, and academic and non-academic institutions have played a key role in training and conducting research that would promote the One Health approach. The objective of this review was to document networks and organizations conducting One Health training, research, and outreach in Africa, as one of a series of articles around the world. Data for this review were collected from organizations through key contacts of the authors and their knowledge of networks they have worked with. Web searches were conducted using One Health, training, and research as key words for work done in Africa. Africa has major networks involved in One Health training, research, and outreach, with participation of both academic and non-academic institutions. This review highlights an effort in Africa to form networks to conduct multidisciplinary training and research. The main networks include Afrique One, Southern African Centre for Infectious Disease Surveillance (SACIDS), and One Health Central and Eastern Africa (OHCEA). Both academic and non-academic institutions and organizations have shown an interest to conduct multidisciplinary training and research in Africa for managing challenges that Africa is facing currently, especially the outbreak of infectious diseases.

  7. Health policies and federative gaps in Brazil: an analysis of regional capacity of services delivery.

    Science.gov (United States)

    Ribeiro, José Mendes; Moreira, Marcelo Rasga; Ouverney, Assis Mafort; Silva, Cosme Marcelo Furtado Passos da

    2017-04-01

    This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.

  8. The West Africa Initiative to Strengthen Capacities through Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    West Africa has many of the lowest development indicators in the world - 10 of the 15 member states of the West African Community number among the world's 35 low-income countries. The World Health Organization reports that 14 of the member states have a high maternal mortality ratio, defined as 300 or more maternal ...

  9. Attention capacity in European adolescents: role of different health-related factors. The HELENA study.

    Science.gov (United States)

    Esteban-Cornejo, Irene; Cadenas-Sanchez, Cristina; Vanhelst, Jérémy; Michels, Nathalie; Lambrinou, Christina-Paulina; González-Gross, Marcela; Widhalm, Kurt; Kersting, Mathilde; de la O Puerta, Alejandro; Kafatos, Anthony; Moreno, Luis A; Ortega, Francisco B

    2017-10-01

    We compared the level of attention capacity between adolescents from the center and south of Europe. The study included 627 European adolescents (54% girls), aged 12.5-17.5 years, who participated in the HELENA Study. The d2 Test of Attention was administered to assess attention capacity. The main results showed that adolescents from the south of Europe had significantly higher score in attention capacity compared with adolescents from central Europe (score + 8.1; 95%CI, 2.44-13.61) after adjustment for age, sex, socioeconomic indicators, body mass index, cardiorespiratory fitness and diet quality index (p = 0.012). Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from central Europe independently of sociodemographic and health-related factors. These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student's capacities. What is Known? • Attention is a crucial capacity during adolescence. • Several health-related factors (i.e., physical activity, fitness or fatness) may influence attention capacity in adolescents. What is New? • Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from the center, after accounting for socioeconomic factors, fitness, fatness and quality of diet. • These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student's capacities.

  10. Canada: Health system review.

    Science.gov (United States)

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and

  11. Building policy capacities: an interactive approach for linking knowledge to action in health promotion.

    Science.gov (United States)

    Rütten, Alfred; Gelius, Peter

    2014-09-01

    This article outlines a theoretical framework for an interactive, research-driven approach to building policy capacities in health promotion. First, it illustrates how two important issues in the recent public health debate, capacity building and linking scientific knowledge to policy action, are connected to each other theoretically. It then introduces an international study on an interactive approach to capacity building in health promotion policy. The approach combines the ADEPT model of policy capacities with a co-operative planning process to foster the exchange of knowledge between policy-makers and researchers, thus improving intra- and inter-organizational capacities. A regional-level physical activity promotion project involving governmental and public-law institutions, NGOs and university researchers serves as a case study to illustrate the potential of the approach for capacity building. Analysis and comparison with a similar local-level project indicate that the approach provides an effective means of linking scientific knowledge to policy action and to planning concrete measures for capacity building in health promotion, but that it requires sufficiently long timelines and adequate resources to achieve adequate implementation and sustainability. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Research capacity and culture of the Victorian public health allied health workforce is influenced by key research support staff and location.

    Science.gov (United States)

    Williams, Cylie; Miyazaki, Koki; Borkowski, Donna; McKinstry, Carol; Cotchet, Matthew; Haines, Terry

    2015-06-01

    The aim of the present study was to identify and understand the self-rated research capacity and culture of the allied health workforce. METHODS. The present study was a cross-sectional survey. The Research Capacity and Culture tool was disseminated to all Victorian public health allied health departments. General demographic data were also collected, including the presence of an organisational allied health research lead. Five hundred and twenty fully completed surveys were returned by participants; all allied health disciplines and all grades were represented. One hundred and eighty-six participants had an organisational allied health research lead and 432 were located in a metropolitan-based health service. There were significant differences (P workforce identifies as a group that is ready to build the evidence to support clinical practice yet requires a whole-systems approach to do so. The results of the present study suggest that the development of key people to build capacity at a higher organisational level has a flow-down effect on research capacity and culture.

  13. Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

    Science.gov (United States)

    Guyon, Ak'ingabe; Perreault, Robert

    2016-10-20

    Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

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

    Science.gov (United States)

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

    2012-09-01

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

  15. Impact of community capacity on the health status of residents: understanding with the contextual multilevel model.

    Science.gov (United States)

    Jung, Minsoo; Choi, Mankyu

    2013-01-01

    There has been little conceptual understanding as to how community capacity works, although it allows for an important, population-based health promotional strategy. In this study, the mechanism of community capacity was studied through literature reviews to suggest a comprehensive conceptual model. The research results found that the key to community capacity prevailed in how actively the capacities of individuals and their communities are able to interact with one another. Under active interactions, community-based organizations, which are a type of voluntary association, were created within the community, and cohesion among residents was enhanced. In addition, people were more willing to address community issues. During the process, many services were initiated to meet the people's health needs and strengthen their social and psychological ties. The characteristics of community capacity were named as the contextual multilevel effects. Because an increase in community capacity contributes to a boosted health status, encourages health behaviors, and eventually leads to the overall prosperity of the community, more public health-related attention is required.

  16. Capacity of Commune Health Stations in Chi Linh District, Hai Duong Province, for Prevention and Control of Noncommunicable Diseases.

    Science.gov (United States)

    Thi Thuy Nga, Nguyen; Thi My Anh, Bui; Nguyen Ngoc, Nguyen; Minh Diem, Dang; Duy Kien, Vu; Bich Phuong, Tran; Quynh Anh, Tran; Van Minh, Hoang

    2017-07-01

    The primary health care system in Vietnam has been playing an important role in prevention and control of diseases. This study aimed to describe the capacity of commune health stations in Chi Linh district, Hai Duong province for prevention and control of noncommunicable diseases (NCDs). A mixed-methods (quantitative and qualitative approaches) approach was applied to collect data in 20 commune health stations. The participants, including health workers, stakeholders, and patients with NCDs, were selected for the study. The findings reported that the main activities of prevention and control of NCDs at commune health stations (CHSs) still focused on information-education-community (IECs), unqualified for providing screening, diagnosis, and treatments of NCDs. The capacity for prevention and control of NCDs in CHSs was inadequate to provide health care services related to prevention and control of NCDs and unmet with the community's demands. In order to ensure the role and implementation of primary care level, there is an urgent need to improve the capacity of CHSs for prevention and control of NCDs, particularly a national budget for NCDs prevention and control, the essential equipment and medicines recommended by the World Health Organization should be provided and available at the CHSs.

  17. Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview.

    Science.gov (United States)

    Grant, Kiran L; Simmons, Magenta Bender; Davey, Christopher G

    2018-01-16

    To provide evidence for wider use of peer workers and other nonprofessionals, the authors examined three approaches to mental health service provision-peer support worker (PSW) programs, task shifting, and mental health first-aid and community advocacy organizations-summarizing their effectiveness, identifying similarities and differences, and highlighting opportunities for integration. Relevant articles obtained from PubMed, MEDLINE, and Google Scholar searches are discussed. Studies indicate that PSWs can achieve outcomes equal to or better than those achieved by nonpeer mental health professionals. PSWs can be particularly effective in reducing hospital admissions and inpatient days and engaging severely ill patients. When certain care tasks are given to individuals with less training than professionals (task shifting), these staff members can provide psychoeducation, engage service users in treatment, and help them achieve symptom reduction and manage risk of relapse. Mental health first-aid and community organizations can reduce stigma, increase awareness of mental health issues, and encourage help seeking. Most PSW programs have reported implementation challenges, whereas such challenges are fewer in task-shifting programs and minimal in mental health first-aid. Despite challenges in scaling and integrating these approaches into larger systems, they hold promise for improving access to and quality of care. Research is needed on how these approaches can be combined to expand a community's capacity to provide care. Because of the serious shortage of mental health providers globally and the rising prevalence of mental illness, utilizing nontraditional providers may be the only solution in both low- and high-resource settings, at least in the short term.

  18. Organizational capacities for health promotion implementation: results from an international hospital study.

    Science.gov (United States)

    Röthlin, Florian; Schmied, Hermann; Dietscher, Christina

    2015-06-01

    In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health.

    Science.gov (United States)

    Andze, Gervais Ondobo; Namsenmo, Abel; Illunga, Benoit Kebella; Kazambu, Ditu; Delissaint, Dieula; Kuaban, Christopher; Mbopi-Kéou, Francois-Xavier; Gabsa, Wilfred; Mulumba, Leopold; Bangamingo, Jean Pierre; Ngulefac, John; Dahlke, Melissa; Mukanga, David; Nsubuga, Peter

    2011-01-01

    The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries.

  20. Activation of zero-error classical capacity in low-dimensional quantum systems

    Science.gov (United States)

    Park, Jeonghoon; Heo, Jun

    2018-06-01

    Channel capacities of quantum channels can be nonadditive even if one of two quantum channels has no channel capacity. We call this phenomenon activation of the channel capacity. In this paper, we show that when we use a quantum channel on a qubit system, only a noiseless qubit channel can generate the activation of the zero-error classical capacity. In particular, we show that the zero-error classical capacity of two quantum channels on qubit systems cannot be activated. Furthermore, we present a class of examples showing the activation of the zero-error classical capacity in low-dimensional systems.

  1. Measuring name system health

    NARCIS (Netherlands)

    Casalicchio, Emiliano; Caselli, Marco; Coletta, Alessio; Di Blasi, Salvatore; Fovino, Igor Nai; Butts, Jonathan; Shenoi, Sujeet

    2012-01-01

    Modern critical infrastructure assets are exposed to security threats arising from their use of IP networks and the Domain Name System (DNS). This paper focuses on the health of DNS. Indeed, due to the increased reliance on the Internet, the degradation of DNS could have significant consequences for

  2. Health system reform.

    Science.gov (United States)

    Ortolon, Ken

    2009-06-01

    A vote on reforming the nation's health care system seems likely this summer as President Obama makes good on a campaign pledge. Although the Democratic leadership in Congress appears ready to push through reform legislation before the next election, TMA and AMA leaders say very little is known about what that "reform" likely will look like.

  3. Assessing Capacity of Faith-Based Organizations for Health Promotion Activities.

    Science.gov (United States)

    Tagai, Erin Kelly; Scheirer, Mary Ann; Santos, Sherie Lou Z; Haider, Muhiuddin; Bowie, Janice; Slade, Jimmie; Whitehead, Tony L; Wang, Min Qi; Holt, Cheryl L

    2017-10-01

    Faith-based organizations (FBOs) are important venues for health promotion, particularly in medically underserved communities. These organizations vary considerably in their structural capacities, which may be linked to variability in implementation success for health promotion initiatives. Lacking an existing validated assessment of organizational capacity specific to FBOs, an initial prototype assessment was developed. The Faith-Based Organization Capacity Inventory (FBO-CI) assesses three structural areas of capacity: Staffing and Space, Health Promotion Experience, and External Collaboration. The multidisciplinary team, including FBO leaders, codeveloped the initial instrument. The initial reliability from a convenience sample of 34 African American churches including descriptions of FBOs representing three capacity levels is reported. The FBO-CI demonstrated feasibility of administration using an in-person interview format, and the three subscales had acceptable internal reliability (α ~ .70). Most churches had an established health ministry (n = 23) and had conducted activities across an average of seven health areas in the previous 2 years. This initial FBO-CI prototype is promising, and future work should consider validation with a larger sample of churches and domain expansion based on the conceptual model. The FBO-CI has a number of potential uses for researchers, FBO leaders, and practitioners working with FBOs in health promotion initiatives.

  4. Feeling hindered by health problems and functional capacity at 60 years and above.

    Science.gov (United States)

    Fagerström, Cecilia; Holst, Göran; Hallberg, Ingalill R

    2007-01-01

    It is common to use activities of daily living (ADL) rating scales to identify the impact of health problems such as diseases, impaired eyesight or hearing on daily life. However, for various reasons people with health problems might feel hindered in daily life before limitations in ability to perform ADL have occurred. In addition, there is sparse knowledge of what makes people feel hindered by health problems in relation to their ADL capacity. The aim was to investigate feeling hindered by health problems among 1297 people aged 60-89 living at home in relation to ADL capacity, health problems, life satisfaction, self-esteem, and social and financial resources, using a self-reported questionnaire, including questions from Older Americans' Resources and Services schedule (OARS), Rosenberg's self-esteem and Life Satisfaction Index Z (LSIZ). People feeling greatly hindered by health problems rarely had anyone who could help when they needed support, had lower life satisfaction and self-esteem than those not feeling hindered. Feeling hindered by health problems appeared to take on a different meaning depending on ADL capacity, knowledge that seems essential to include when accomplishing health promotion and rehabilitation interventions, especially at the early stages of reduced ADL capacity.

  5. A national survey on health department capacity for community engagement in emergency preparedness.

    Science.gov (United States)

    Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

    2015-01-01

    Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and

  6. Reorienting health services with capacity building: a case study of the Core Skills in Health Promotion Project.

    Science.gov (United States)

    Yeatman, H R; Nove, T

    2002-12-01

    This paper presents a case study of the application of a framework for capacity building [Hawe, P., King, L., Noort, M., Jordens, C. and Lloyd, B. (2000) Indicators to Help with Capacity Building in Health Promotion. NSW Health, Sydney] to describe actions aimed at building organizational support for health promotion within an area health service in New South Wales, Australia. The Core Skills in Health Promotion Project (CSHPP) arose from an investigation which reported that participants of a health promotion training course had increased health promotion skills but that they lacked the support to apply their skills in the workplace. The project was action-research based. It investigated and facilitated the implementation of a range of initiatives to support community health staff to apply a more preventive approach in their practice and it contributed to the establishment of new organizational structures for health promotion. An evaluation was undertaken 4 years after the CSHPP was established, and 2 years after it had submitted its final report. Interviews with senior managers, document analysis of written reports, and focus groups with middle managers and service delivery staff were undertaken. Change was achieved in the three dimensions of health infrastructure, program maintenance and problem solving capacity of the organization. It was identified that the critically important elements in achieving the aims of the project-partnership, leadership and commitment-were also key elements of the capacity building framework. This case study provides a practical example of the usefulness of the capacity building framework in orienting health services to be supportive of health promotion.

  7. Research capacity and culture in podiatry: early observations within Queensland Health

    Science.gov (United States)

    2013-01-01

    Background Research is a major driver of health care improvement and evidence-based practice is becoming the foundation of health care delivery. For health professions to develop within emerging models of health care delivery, it would seem imperative to develop and monitor the research capacity and evidence-based literacy of the health care workforce. This observational paper aims to report the research capacity levels of statewide populations of public-sector podiatrists at two different time points twelve-months apart. Methods The Research Capacity & Culture (RCC) survey was electronically distributed to all Queensland Health (Australia) employed podiatrists in January 2011 (n = 58) and January 2012 (n = 60). The RCC is a validated tool designed to measure indicators of research skill in health professionals. Participants rate skill levels against each individual, team and organisation statement on a 10-point scale (one = lowest, ten = highest). Chi-squared and Mann Whitney U tests were used to determine any differences between the results of the two survey samples. A minimum significance of p  6). Whereas, most reported their organisation’s skills to perform and support research at much higher levels (Median > 6). The 2012 survey respondents reported significantly higher skill ratings compared to the 2011 survey in individuals’ ability to secure research funding, submit ethics applications, and provide research advice, plus, in their organisation’s skills to support, fund, monitor, mentor and engage universities to partner their research (p < 0.05). Conclusions This study appears to report the research capacity levels of the largest populations of podiatrists published. The 2011 survey findings indicate podiatrists have similarly low research capacity skill levels to those reported in the allied health literature. The 2012 survey, compared to the 2011 survey, suggests podiatrists perceived higher skills and support to initiate

  8. Improving public health training and research capacity in Africa: a replicable model for linking training to health and socio-demographic surveillance data

    Directory of Open Access Journals (Sweden)

    Jill R. Williams

    2010-08-01

    Full Text Available Background: Research training for public health professionals is key to the future of public health and policy in Africa. A growing number of schools of public health are connected to health and socio-demographic surveillance system field sites in developing countries, in Africa and Asia in particular. Linking training programs with these sites provides important opportunities to improve training, build local research capacity, foreground local health priorities, and increase the relevance of research to local health policy. Objective: To increase research training capacity in public health programs by providing targeted training to students and increasing the accessibility of existing data. Design: This report is a case study of an approach to linking public health research and training at the University of the Witwatersrand. We discuss the development of a sample training database from the Agincourt Health and Socio-demographic Surveillance System in South Africa and outline a concordant transnational intensive short course on longitudinal data analysis offered by the University of the Witwatersrand and the University of Colorado-Boulder. This case study highlights ways common barriers to linking research and training can be overcome. Results and Conclusions: This collaborative effort demonstrates that linking training to ongoing data collection can improve student research, accelerate student training, and connect students to an international network of scholars. Importantly, the approach can be adapted to other partnerships between schools of public health and longitudinal research sites.

  9. PROLOGUE : Health Information System

    OpenAIRE

    Tomar, Shivanjali

    2013-01-01

    Prologue is a health information system developed for underserved communities in Bihar, India. It is aimed at helping people living in poverty and with low literacy to take the right steps to manage their and their family’s health. Bihar suffers from one of the worst healthcare records in the country. This is as much due to the lack of access to the right information as it is due to the economic condition of the region. The inaccessibility of information is aggravated by the complex social se...

  10. [Evaluation of the capacity of elderly patients to make decisions about their health].

    Science.gov (United States)

    Atienza-Martín, F J; Garrido-Lozano, M; Losada-Ruiz, C; Rodríguez-Fernández, L M; Revuelta-Pérez, F; Marín-Andrés, G

    2013-09-01

    To assess the decision-making capacity and variables related to this, in elderly patients in a home care program. A cross-sectional study was conducted on 130 patients assigned to home care program or in social welfare residences of an urban health centre. Demographic variables, as well as comorbidities, social support, institutionalisation, number of drugs used, degree of dependence (Barthel Index), cognitive function (Pfeiffer) were collected. The primary endpoint was the capacity for decision-making about their health assessed using the Aid to Capacity Evaluation (ACE) tool. There was a prevalence of 58.5% capacity. There was an association between ability and independence for activities of daily living (odds ratio (OR): 12.214; Confidence interval 95% (95% CI): 3.90 to 32.29, P de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. Overcoming Barriers to Rural Children's Mental Health: An Interconnected Systems Public Health Model

    Science.gov (United States)

    Huber, Brenda J.; Austen, Julie M.; Tobin, Renée M.; Meyers, Adena B.; Shelvin, Kristal H.; Wells, Michael

    2016-01-01

    A large, Midwestern county implemented a four-tiered public health model of children's mental health with an interconnected systems approach involving education, health care, juvenile justice and community mental health sectors. The community sought to promote protective factors in the lives of all youth, while improving the capacity,…

  12. System of Health Accounts and Health Satellite Accounts : Application in Low- and Middle-Income Countries

    NARCIS (Netherlands)

    Nakhimovsky, S.; Hernandez-Peña, P.; van Mosseveld, C.; Palacios, A.

    2014-01-01

    Health accounting data that show economic and financial resource flows within a health system are critical to informing health and economic policy – at both national and international levels. However, countries vary widely in their health accounting histories as well as the demand for and capacity

  13. Quantitative safety assessment of air traffic control systems through system control capacity

    Science.gov (United States)

    Guo, Jingjing

    Quantitative Safety Assessments (QSA) are essential to safety benefit verification and regulations of developmental changes in safety critical systems like the Air Traffic Control (ATC) systems. Effectiveness of the assessments is particularly desirable today in the safe implementations of revolutionary ATC overhauls like NextGen and SESAR. QSA of ATC systems are however challenged by system complexity and lack of accident data. Extending from the idea "safety is a control problem" in the literature, this research proposes to assess system safety from the control perspective, through quantifying a system's "control capacity". A system's safety performance correlates to this "control capacity" in the control of "safety critical processes". To examine this idea in QSA of the ATC systems, a Control-capacity Based Safety Assessment Framework (CBSAF) is developed which includes two control capacity metrics and a procedural method. The two metrics are Probabilistic System Control-capacity (PSC) and Temporal System Control-capacity (TSC); each addresses an aspect of a system's control capacity. And the procedural method consists three general stages: I) identification of safety critical processes, II) development of system control models and III) evaluation of system control capacity. The CBSAF was tested in two case studies. The first one assesses an en-route collision avoidance scenario and compares three hypothetical configurations. The CBSAF was able to capture the uncoordinated behavior between two means of control, as was observed in a historic midair collision accident. The second case study compares CBSAF with an existing risk based QSA method in assessing the safety benefits of introducing a runway incursion alert system. Similar conclusions are reached between the two methods, while the CBSAF has the advantage of simplicity and provides a new control-based perspective and interpretation to the assessments. The case studies are intended to investigate the

  14. Understanding Absorptive Capacities is an "Innovation Systems" Context

    DEFF Research Database (Denmark)

    Narula, Rajneesh

    2004-01-01

    This paper seeks to broaden our understanding of the concept underlying absorptive capacity atthe macro -level, paying particular attention to the growth and development perspectives. Weprovide definitions of absorptive and technological capacity, external technology flows,productivity growth....... We also undertake to explain how the nature ofabsorptive capacity changes with stages of economic development, and the importance of thedifferent aspects of absorptive capability at different stages. The relationship is not a linear one:the benefits that accrue from marginal increases in absorptive...... capability change over time.Finally, we provide a tentative and preliminary conceptual argument of how the different stagesof absorptive capacity are related to productivity growth, economic growth and employmentcreation.Key words: New economy, absorptive capacity, knowledge...

  15. Putting Chronic Disease on the Map: Building GIS Capacity in State and Local Health Departments

    Science.gov (United States)

    Casper, Michele; Tootoo, Joshua; Schieb, Linda

    2013-01-01

    Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants’ experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments. PMID:23786907

  16. Putting chronic disease on the map: building GIS capacity in state and local health departments.

    Science.gov (United States)

    Miranda, Marie Lynn; Casper, Michele; Tootoo, Joshua; Schieb, Linda

    2013-06-20

    Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants' experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments.

  17. The Use of National Systems of Innovation Models to Develop Indicators of Innovation and Technological Capacity

    OpenAIRE

    Holbrook, J. A.

    1997-01-01

    This paper addresses various models that can be used to assess indicators of innovation and technical capacity. It stresses the importance of looking at the national system of innovation (NSI) to gain a complete understanding of industry capacity.

  18. Enhancing public health practice through a capacity-building educational programme: an evaluation.

    Science.gov (United States)

    Negandhi, Preeti; Negandhi, Himanshu; Sharma, Kavya; Wild, Sarah; Zodpey, Sanjay

    2015-05-13

    The Post-Graduate Diploma in Public Health Management, launched by the Govt. of India under the aegis of the National Rural Health Mission in 2008, aims to enhance the managerial capabilities of public health professionals to improve the public health system. The Govt. of India invested enormous resources into this programme and requested an evaluation to understand the current processes, assess the graduates' work performance and identify areas for improvement. Quantitative telephone surveys as well as qualitative in-depth interviews were used. Graduates from the first three batches, their supervisors, peers and subordinates and faculty members were interviewed. Quantitative data were analysed using proportions, means and interpretative descriptions. Qualitative analyses involved transcription, translation, sorting, coding and filing into domains. Of the 363 graduates whose contact details were available, 138 could not be contacted. Two hundred twenty-three (223) graduates (61.43% of eligible participants) were interviewed by telephone; 52 in-depth interviews were conducted. Of the graduates who joined, 63.8% graduates were motivated to join the programme for career advancement and gaining public health knowledge. The content was theoretically good, informative and well-designed. Graduates expressed need for more practical and group work. After graduating, they reported being equipped with some new skills to implement programmes effectively. They reported that attitudes and healthcare delivery practices had improved; they had better self-esteem, increased confidence, better communication skills and implementation capacity. While they were able to apply some skills, they encountered some barriers, such as governance, placements, lack of support from the system and community, inadequate implementation authority and lack of planning by the state government. Incentives (both monetary and non-monetary) played a major role in motivating them to deliver public health

  19. A participatory action research approach to strengthening health managers' capacity at district level in Eastern Uganda.

    Science.gov (United States)

    Tetui, Moses; Coe, Anna-Britt; Hurtig, Anna-Karin; Bennett, Sara; Kiwanuka, Suzanne N; George, Asha; Kiracho, Elizabeth Ekirapa

    2017-12-28

    Many approaches to improving health managers' capacity in poor countries, particularly those pursued by external agencies, employ non-participatory approaches and often seek to circumvent (rather than strengthen) weak public management structures. This limits opportunities for strengthening local health managers' capacity, improving resource utilisation and enhancing service delivery. This study explored the contribution of a participatory action research approach to strengthening health managers' capacity in Eastern Uganda. This was a qualitative study that used open-ended key informant interviews, combined with review of meeting minutes and observations to collect data. Both inductive and deductive thematic analysis was undertaken. The Competing Values Framework of organisational management functions guided the deductive process of analysis and the interpretation of the findings. The framework builds on four earlier models of management and regards them as complementary rather than conflicting, and identifies four managers' capacities (collaborate, create, compete and control) by categorising them along two axes, one contrasting flexibility versus control and the other internal versus external organisational focus. The findings indicate that the participatory action research approach enhanced health managers' capacity to collaborate with others, be creative, attain goals and review progress. The enablers included expanded interaction spaces, encouragement of flexibility, empowerment of local managers, and the promotion of reflection and accountability. Tension and conflict across different management functions was apparent; for example, while there was a need to collaborate, maintaining control over processes was also needed. These tensions meant that managers needed to learn to simultaneously draw upon and use different capacities as reflected by the Competing Values Framework in order to maximise their effectiveness. Improved health manager capacity is

  20. Health Information Systems.

    Science.gov (United States)

    Sirintrapun, S Joseph; Artz, David R

    2015-06-01

    This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Does community capacity influence self-rated health? Multilevel contextual effects in Seoul, Korea.

    Science.gov (United States)

    Jung, Minsoo; Viswanath, K

    2013-01-01

    This study examined the relationship between community-level contextual effects and self-rated health (SRH) based on the perspective of community capacity rather than social capital. Community capacity for mobilization is broad cooperation for networking among indigenous social agents and grassroots organizations that may serve as potential resources. The idea of community capacity is rooted in the philosophy that a community not only faces problems but also possesses the necessary resources to solve its problems. We used nationally representative data from South Korea, 2010, drawing on 14,228 residents in 404 communities. Community capacity was measured at two levels: an individual-level indicator of community satisfaction, and community-level indicators of participation rate in community organizations, number of community-based organizations (CBOs), and number of volunteer work camps (VWCs). The outcome variable was SRH, which was categorized into two groups: the low-SRH and high-SRH groups. Confounders included gender, age, and income at the individual level, and aggregate length of residency, financial independence ratio, and aggregate income at the community level. We estimated the effects of community capacity on SRH using hierarchical generalized linear models. The likelihood of belonging to the group having low-SRH is significantly high among those respondents living in places with lower community capacity at the community level, that report lower community satisfaction, and that have lower income at the individual level. After controlling for socio-economic confounders, the odds ratios were attenuated but remained significant in the final model, which included the gender-specific model. This study revealed that SRH is related to the level of community capacity for mobilization. It is probably because CBOs and VWCs not only provide necessary information and complementary services but also play an active role in identifying and resolving health problems

  2. The Healthy Aging Research Network: Resources for Building Capacity for Public Health and Aging Practice

    Science.gov (United States)

    Wilcox, Sara; Altpeter, Mary; Anderson, Lynda A.; Belza, Basia; Bryant, Lucinda; Jones, Dina L.; Leith, Katherine H.; Phelan, Elizabeth A.; Satariano, William A.

    2015-01-01

    There is an urgent need to translate science into practice and help enhance the capacity of professionals to deliver evidence-based programming. We describe contributions of the Healthy Aging Research Network in building professional capacity through online modules, issue briefs, monographs, and tools focused on health promotion practice, physical activity, mental health, and environment and policy. We also describe practice partnerships and research activities that helped inform product development and ways these products have been incorporated into real-world practice to illustrate possibilities for future applications. Our work aims to bridge the research-to-practice gap to meet the demands of an aging population. PMID:24000962

  3. Capacity-building for health research in developing countries: a manager's approach

    Directory of Open Access Journals (Sweden)

    Franklin White

    2002-09-01

    Full Text Available Research may be viewed as rigorous inquiry to advance knowledge and improve practices. An international commission has argued that strengthening research capacity is one of the most powerful, cost-effective, and sustainable means of advancing health and development. However, the global effort to promote research in developing countries has been mostly policy driven, and largely at the initiative of donor agencies based in developed countries. This policy approach, although essential, both contrasts with and is complementary to that of research managers, who must build capacity "from the ground up" in a variety of health service settings within countries and with differing mandates, resources, and constraints. In health organizations the concept of research is broad, and practices vary widely. However, building research capacity is not altogether different from building other kinds of organizational capacity, and it involves two major dimensions: strategic and operational. In organizations in the health field, if reference to research is not in the mission statement, then developing a relevant research capacity is made vastly more difficult. Research capacities that take years to develop can be easily damaged through inadequate support, poor management, or other negative influences associated with both internal and external environments. This paper draws from key international research policy documents and observations on the behavior of research and donor agencies in relation to developing countries. It examines capacity-building primarily as a challenge for research managers, realities underlying operational effectiveness and efficiency, approaches to resource mobilization, and the need for marketing the research enterprise. Selected examples from South Asia and Latin America and the Caribbean are presented.

  4. Network Capacity Assessment and Increase in Systems with Intermittent Water Supply

    OpenAIRE

    Ilaya-Ayza, Amilkar Ernesto; Campbell-Gonzalez, Enrique; Pérez García, Rafael; Izquierdo Sebastián, Joaquín

    2016-01-01

    [EN] Water supply systems have been facing many challenges in recent decades due to the potential effects of climate change and rapid population growth. Water systems need to expand because of demographic growth. Therefore, evaluating and increasing system capacity is crucial. Specifically, we analyze network capacity as one of the main features of a system. When the network capacity starts to decrease, there is a risk that continuous supply will become intermittent. This paper discusses how...

  5. The development of ORACLe: a measure of an organisation's capacity to engage in evidence-informed health policy.

    Science.gov (United States)

    Makkar, Steve R; Turner, Tari; Williamson, Anna; Louviere, Jordan; Redman, Sally; Haynes, Abby; Green, Sally; Brennan, Sue

    2016-01-14

    Evidence-informed policymaking is more likely if organisations have cultures that promote research use and invest in resources that facilitate staff engagement with research. Measures of organisations' research use culture and capacity are needed to assess current capacity, identify opportunities for improvement, and examine the impact of capacity-building interventions. The aim of the current study was to develop a comprehensive system to measure and score organisations' capacity to engage with and use research in policymaking, which we entitled ORACLe (Organisational Research Access, Culture, and Leadership). We used a multifaceted approach to develop ORACLe. Firstly, we reviewed the available literature to identify key domains of organisational tools and systems that may facilitate research use by staff. We interviewed senior health policymakers to verify the relevance and applicability of these domains. This information was used to generate an interview schedule that focused on seven key domains of organisational capacity. The interview was pilot-tested within four Australian policy agencies. A discrete choice experiment (DCE) was then undertaken using an expert sample to establish the relative importance of these domains. This data was used to produce a scoring system for ORACLe. The ORACLe interview was developed, comprised of 23 questions addressing seven domains of organisational capacity and tools that support research use, including (1) documented processes for policymaking; (2) leadership training; (3) staff training; (4) research resources (e.g. database access); and systems to (5) generate new research, (6) undertake evaluations, and (7) strengthen relationships with researchers. From the DCE data, a conditional logit model was estimated to calculate total scores that took into account the relative importance of the seven domains. The model indicated that our expert sample placed the greatest importance on domains (2), (3) and (4). We utilised

  6. Reorienting health services in the Northern Territory of Australia: a conceptual model for building health promotion capacity in the workforce.

    Science.gov (United States)

    Judd, Jenni; Keleher, Helen

    2013-06-01

    Reorienting work practices to include health promotion and prevention is complex and requires specific strategies and interventions. This paper presents original research that used 'real-world' practice to demonstrate that knowledge gathered from practice is relevant for the development of practice-based evidence. The paper shows how practitioners can inform and influence improvements in health promotion practice. Practitioner-informed evidence necessarily incorporates qualitative research to capture the richness of their reflective experiences. Using a participatory action research (PAR) approach, the research question asked 'what are the core dimensions of building health promotion capacity in a primary health care workforce in a real-world setting?' PAR is a method in which the researcher operates in full collaboration with members of the organisation being studied for the purposes of achieving some kind of change, in this case to increase the amount of health promotion and prevention practice within this community health setting. The PAR process involved six reflection and action cycles over two years. Data collection processes included: survey; in-depth interviews; a training intervention; observations of practice; workplace diaries; and two nominal groups. The listen/reflect/act process enabled lessons from practice to inform future capacity-building processes. This research strengthened and supported the development of health promotion to inform 'better health' practices through respectful change processes based on research, practitioner-informed evidence, and capacity-building strategies. A conceptual model for building health promotion capacity in the primary health care workforce was informed by the PAR processes and recognised the importance of the determinants approach. Practitioner-informed evidence is the missing link in the evidence debate and provides the links between evidence and its translation to practice. New models of health promotion service

  7. Framework for assessing the capacity of a health ministry to conduct health policy processes--a case study from Tajikistan.

    Science.gov (United States)

    Mirzoev, Tolib N; Green, Andrew; Van Kalliecharan, Ricky

    2015-01-01

    An adequate capacity of ministries of health (MOH) to develop and implement policies is essential. However, no frameworks were found assessing MOH capacity to conduct health policy processes within developing countries. This paper presents a conceptual framework for assessing MOH capacity to conduct policy processes based on a study from Tajikistan, a former Soviet republic where independence highlighted capacity challenges. The data collection for this qualitative study included in-depth interviews, document reviews and observations of policy events. Framework approach for analysis was used. The conceptual framework was informed by existing literature, guided the data collection and analysis, and was subsequently refined following insights from the study. The Tajik MOH capacity, while gradually improving, remains weak. There is poor recognition of wider contextual influences, ineffective leadership and governance as reflected in centralised decision-making, limited use of evidence, inadequate actors' participation and ineffective use of resources to conduct policy processes. However, the question is whether this is a reflection of lack of MOH ability or evidence of constraining environment or both. The conceptual framework identifies five determinants of robust policy processes, each with specific capacity needs: policy context, MOH leadership and governance, involvement of policy actors, the role of evidence and effective resource use for policy processes. Three underlying considerations are important for applying the capacity to policy processes: the need for clear focus, recognition of capacity levels and elements, and both ability and enabling environment. The proposed framework can be used in assessing and strengthening of the capacity of different policy actors. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Research culture and capacity in community health services: results of a structured survey of staff.

    Science.gov (United States)

    Friesen, Emma L; Comino, Elizabeth J

    2017-05-01

    Developing research capacity is recognised as an important endeavour. However, little is known about the current research culture, capacity and supports for staff working in community-based health settings. A structured survey of Division of Community Health staff was conducted using the research capacity tool. The survey was disseminated by email and in paper format. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. In total, 109 usable responses were received, giving a response rate of 26%. Respondents were predominately nurses (n=71, 65.7%), with ~50% reporting post-graduate vocational qualifications. The highest levels of skills or organisational success were in using evidence to plan, promote and guide clinical practice. Most participants were unsure of organisational and team level skills and success at generating research. Few reported recent experience in research-generating activities. Barriers to undertaking research included lack of skills, time and access to external support and funding. Lack of skills and success in accessing external funding and resources to protect research time or to 'buy-in' technical expertise appeared to exacerbate these barriers. Community health staff have limited capacity to generate research with current levels of skill, funding and time. Strategies to increase research capacity should be informed by knowledge of clinicians' research experience and interests, and target development of skills to generate research. Resources and funding are needed at the organisational and team levels to overcome the significant barriers to research generation reported.

  9. On the High Altitude Platform (HAP W-CDMA System Capacity

    Directory of Open Access Journals (Sweden)

    L. de Haro-Ariet

    2004-06-01

    Full Text Available The performance of a downlink power control model, based on a n-thpower distance law, is evaluated for high altitude platform station(HAPS W-CDMA systems. The downlink capacity using this model iscompared with the uplink capacity. It is shown that the uplink capacityis higher than the downlink capacity.

  10. Health care administrators' perspectives on the role of absorptive capacity for strategic change initiatives: a qualitative study.

    Science.gov (United States)

    Kash, Bita A; Spaulding, Aaron; Gamm, Larry; Johnson, Christopher E

    2013-01-01

    The dimensions of absorptive capacity (ACAP) are defined, and the importance of ACAP is established in the management literature, but the concept has not been applied to health care organizations attempting to implement multiple strategic initiatives. The aim of this study was to test the utility of ACAP by analyzing health care administrators' experiences with multiple strategic initiatives within two health systems. Results are drawn from administrators' assessments of multiple initiatives within two health systems using in-depth personal interviews with a total of 61 health care administrators. Data analysis was performed following deductive qualitative analysis guidelines. Interview transcripts were coded based on the four dimensions of ACAP: acquiring, assimilating, internalizing/transforming, and exploiting knowledge. Furthermore, we link results related to utilization of management resources, including number of key personnel involved and time consumption, to dimensions of ACAP. Participants' description of multiple strategic change initiatives confirmed the importance of the four ACAP dimensions. ACAP can be a useful framework to assess organizational capacity with respect to the organization's ability to concurrently implement multiple strategic initiatives. This capacity specifically revolves around human capital requirements from upper management based on the initiatives' location or stage within the ACAP framework. Strategic change initiatives in health care can be usefully viewed from an ACAP perspective. There is a tendency for those strategic initiatives ranking higher in priority and time consumption to reflect more advanced dimensions of ACAP (assimilate and transform), whereas few initiatives were identified in the ACAP "exploit" dimension. This may suggest that health care leaders tend to no longer identify as strategic initiatives those innovations that have moved to the exploitation stage or that less attention is given to the exploitation

  11. Multi-dimensional knowledge translation: enabling health informatics capacity audits using patient journey models.

    Science.gov (United States)

    Catley, Christina; McGregor, Carolyn; Percival, Jennifer; Curry, Joanne; James, Andrew

    2008-01-01

    This paper presents a multi-dimensional approach to knowledge translation, enabling results obtained from a survey evaluating the uptake of Information Technology within Neonatal Intensive Care Units to be translated into knowledge, in the form of health informatics capacity audits. Survey data, having multiple roles, patient care scenarios, levels, and hospitals, is translated using a structured data modeling approach, into patient journey models. The data model is defined such that users can develop queries to generate patient journey models based on a pre-defined Patient Journey Model architecture (PaJMa). PaJMa models are then analyzed to build capacity audits. Capacity audits offer a sophisticated view of health informatics usage, providing not only details of what IT solutions a hospital utilizes, but also answering the questions: when, how and why, by determining when the IT solutions are integrated into the patient journey, how they support the patient information flow, and why they improve the patient journey.

  12. [Comparison of mental health state and psychological capacities between college students with and without siblings].

    Science.gov (United States)

    Zhang, Xiao-yuan; Yu, Shou-yi; Zhao, Jiu-bo; Li, Jian-ming; Xiao, Rong

    2007-04-01

    To compare the differences in mental health state and psychological capacities between Chinese college students with and without siblings. The psychological status and capacities were evaluated with SCL-90, the Self-Esteem Scale, Spheres of Control Scale, Security Questionnaire and Cattell 16-PF Questionnaire in 427 college students, and among the students who presented valid responses, 139 with and 139 without siblings were selected for this comparative study. The total score and average score of SCL-90 in college students without siblings were significantly lower than those in students with siblings (Psiblings (Pmental health state and some of the psychological capacities are generally better in college students with siblings than in those without siblings.

  13. Interference and memory capacity effects in memristive systems

    Science.gov (United States)

    Hermiz, John; Chang, Ting; Du, Chao; Lu, Wei

    2013-02-01

    Short-term memory implies the existence of a capacity limit beyond which memory cannot be securely formed and retained. The underlying mechanisms are believed to be two primary factors: decay and interference. Here, we demonstrate through both simulation and experiment that the memory capacity effect can be implemented in a parallel memristor circuit, where decay and interference are achieved by the inherent ion diffusion in the device and the competition for current supply in the circuit, respectively. This study suggests it is possible to emulate high-level biological behaviors with memristor circuits and will stimulate continued studies on memristor-based neuromorphic circuits.

  14. Building evaluation capacity in Ontario's public health units: promising practices and strategies.

    Science.gov (United States)

    Bourgeois, I; Simmons, L; Buetti, D

    2018-03-26

    This article presents the findings of a project focusing on building evaluation capacity in 10 Ontario public health units. The study sought to identify effective strategies that lead to increased evaluation capacity in the participating organizations. This study used a qualitative, multiple case research design. An action research methodology was used to design customized evaluation capacity building (ECB) strategies for each participating organization, based on its specific context and needs. This methodological approach also enabled monitoring and assessment of each strategy, based on a common set of reporting templates. A multiple case study was used to analyze the findings from the 10 participating organizations and derive higher level findings. The main findings of the study show that most of the strategies used to increase evaluation capacity in public health units are promising, especially those focusing on developing the knowledge, skills, and attitudes of health unit staff and managers. Facilitators to ECB strategies were the engagement of all staff members, the support of leadership, and the existence of organizational tools and infrastructure to support evaluation. It is also essential to recognize that ECB takes time and resources to be successful. The design and implementation of ECB strategies should be based on organizational needs. These can be assessed using a standardized instrument, as well as interviews and staff surveys. The implementation of a multicomponent approach (i.e. several strategies implemented simultaneously) is also linked to better ECB outcomes in organizations. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Impact of health research capacity strengthening in low- and middle-income countries: the case of WHO/TDR programmes.

    Science.gov (United States)

    Minja, Happiness; Nsanzabana, Christian; Maure, Christine; Hoffmann, Axel; Rumisha, Susan; Ogundahunsi, Olumide; Zicker, Fabio; Tanner, Marcel; Launois, Pascal

    2011-10-01

    Measuring the impact of capacity strengthening support is a priority for the international development community. Several frameworks exist for monitoring and evaluating funding results and modalities. Based on its long history of support, we report on the impact of individual and institutional capacity strengthening programmes conducted by the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and on the factors that influenced the outcome of its Research Capacity Strengthening (RCS) activities. A mix of qualitative and quantitative methods (questionnaires and in-depth interviews) was applied to a selected group of 128 individual and 20 institutional capacity development grant recipients that completed their training/projects between 2000 and 2008. A semi-structured interview was also conducted on site with scientists from four institutions. Most of the grantees, both individual and institutional, reported beneficial results from the grant. However, glaring inequities stemming from gender imbalances and a language bias towards English were identified. The study showed that skills improvement through training contributed to better formulation of research proposals, but not necessarily to improved project implementation or communication of results. Appreciation of the institutional grants' impact varied among recipient countries. The least developed countries saw the programmes as essential for supporting basic infrastructure and activities. Advanced developing countries perceived the research grants as complementary to available resources, and particularly suitable for junior researchers who were not yet able to compete for major international grants. The study highlights the need for a more equitable process to improve the effectiveness of health research capacity strengthening activities. Support should be tailored to the existing research capacity in disease endemic countries and should focus on strengthening

  16. Impact of health research capacity strengthening in low- and middle-income countries: the case of WHO/TDR programmes.

    Directory of Open Access Journals (Sweden)

    Happiness Minja

    2011-10-01

    capacity in disease endemic countries and should focus on strengthening national health research systems, particularly in the least developing countries. The engagement of stakeholders at country level would facilitate the design of more specific and comprehensive strategies based on local needs.

  17. Building and Evaluating Research Capacity in Healthcare Systems ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-29

    Jun 29, 2016 ... Research capacity is considered an essential foundation for a ... of the world, including Sub-Saharan Africa, the Caribbean, Latin America, and Asia. ... Nancy Edwards is a nurse epidemiologist and a professor in the School of ...

  18. Model study on steady heat capacity in driven stochastic systems

    Czech Academy of Sciences Publication Activity Database

    Pešek, Jiří; Boksenbojm, E.; Netočný, Karel

    2012-01-01

    Roč. 10, č. 3 (2012), 692-701 ISSN 1895-1082 Institutional research plan: CEZ:AV0Z10100520 Keywords : nonequilibrium steady state * quasistatic process * heat capacity Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 0.905, year: 2012

  19. Reaching consensus: a review on sexual health training modules for professional capacity building

    Directory of Open Access Journals (Sweden)

    Zahra Karimian

    2018-01-01

    Full Text Available Background: Professional capacity building (PCB is the focus point in health-related subjects.The present study was conducted to systematically review the existing sexual health training modules for health care providers.Methods: The following keywords were used to search: training, education, professional capacity, practitioner, sexual health, skill education, module, course, package and curriculum.The term MESH is referred to Medical Subject Headings and the following databases were investigated: MEDLINE, EMBASE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL, The Cochrane Library and Web of Science, Scopus, Google Scholar, SID,Magiran, and Iranmedex. All articles from 1980 to 2015 were extracted. Online modules were excluded. Considering that lesson plan was the basis of instruction, the modules were selected based on the characteristics of the lesson plans.Results: A total number of 38 published training modules in the field of sexuality we redetermined. In total, more than half of the modules (58% were designed for medical doctor sand allied health professionals and the remaining (42% were for nurses and midwives. Almost all the modules (97% were introduced and utilized in developed countries, and only 3% were disseminated in developing countries.Conclusion: There are invaluable modules to build professional capacity in the field of sexual health. As a number of modules have been designed for nurses and midwifes, as the first-line health care providers, the use of these groups in sexual counseling and empowerment for sexual health is essential. No sexual health training program was designed in Iran. Therefore, designing such modules according to Iranian culture is strongly recommended.

  20. Reaching consensus: a review on sexual health training modules for professional capacity building.

    Science.gov (United States)

    Karimian, Zahra; Azin, Seied Ali; Javid, Nasrin; Araban, Marzieh; Maasoumi, Raziyeh; Aghayan, Shahrokh; Merghati Khoie, Effat

    2018-01-01

    Background: Professional capacity building (PCB) is the focus point in health-related subjects.The present study was conducted to systematically review the existing sexual health training modules for health care providers. Methods: The following keywords were used to search: training, education, professional capacity, practitioner, sexual health, skill education, module, course, package and curriculum.The term MESH is referred to Medical Subject Headings and the following databases were investigated: MEDLINE, EMBASE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library and Web of Science, Scopus, Google Scholar, SID,Magiran, and Iranmedex. All articles from 1980 to 2015 were extracted. Online modules were excluded. Considering that lesson plan was the basis of instruction, the modules were selected based on the characteristics of the lesson plans. Results: A total number of 38 published training modules in the field of sexuality we redetermined. In total, more than half of the modules (58%) were designed for medical doctor sand allied health professionals and the remaining (42%) were for nurses and midwives. Almost all the modules (97%) were introduced and utilized in developed countries, and only 3% were disseminated in developing countries. Conclusion: There are invaluable modules to build professional capacity in the field of sexual health. As a number of modules have been designed for nurses and midwifes, as the first-line health care providers, the use of these groups in sexual counseling and empowerment for sexual health is essential. No sexual health training program was designed in Iran. Therefore, designing such modules according to Iranian culture is strongly recommended.

  1. Research capacity and culture in podiatry: early observations within Queensland Health

    Directory of Open Access Journals (Sweden)

    Lazzarini Peter A

    2013-01-01

    Full Text Available Abstract Background Research is a major driver of health care improvement and evidence-based practice is becoming the foundation of health care delivery. For health professions to develop within emerging models of health care delivery, it would seem imperative to develop and monitor the research capacity and evidence-based literacy of the health care workforce. This observational paper aims to report the research capacity levels of statewide populations of public-sector podiatrists at two different time points twelve-months apart. Methods The Research Capacity & Culture (RCC survey was electronically distributed to all Queensland Health (Australia employed podiatrists in January 2011 (n = 58 and January 2012 (n = 60. The RCC is a validated tool designed to measure indicators of research skill in health professionals. Participants rate skill levels against each individual, team and organisation statement on a 10-point scale (one = lowest, ten = highest. Chi-squared and Mann Whitney U tests were used to determine any differences between the results of the two survey samples. A minimum significance of p  Results Thirty-seven (64% podiatrists responded to the 2011 survey and 33 (55% the 2012 survey. The 2011 survey respondents reported low skill levels (Median  6. Whereas, most reported their organisation’s skills to perform and support research at much higher levels (Median > 6. The 2012 survey respondents reported significantly higher skill ratings compared to the 2011 survey in individuals’ ability to secure research funding, submit ethics applications, and provide research advice, plus, in their organisation’s skills to support, fund, monitor, mentor and engage universities to partner their research (p  Conclusions This study appears to report the research capacity levels of the largest populations of podiatrists published. The 2011 survey findings indicate podiatrists have similarly low research capacity skill

  2. Building district-level capacity for continuous improvement in maternal and newborn health.

    Science.gov (United States)

    Stover, Kim Ethier; Tesfaye, Solomon; Frew, Aynalem Hailemichael; Mohammed, Hajira; Barry, Danika; Alamineh, Lamesgin; Teshome, Abebe; Hepburn, Kenneth; Sibley, Lynn M

    2014-01-01

    The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) adapted a collaborative improvement strategy to develop woreda (district) leadership capacity to support and facilitate continuous improvement of community maternal and neonatal health (CMNH) and to provide a model for other woredas, dubbed "lead" woredas. Community-level quality improvement (QI) teams tested solutions to improve CMNH care supported by monthly coaching and regular meetings to share experiences. This study examines the extent of the capacity built to support continuous improvement in CMNH care. Surveys and in-depth interviews assessed the extent to which MaNHEP developed improvement capacity. A survey questionnaire evaluated woreda culture, leadership support, motivation, and capacity for improvement activities. Interviews focused on respondents' understanding and perceived value of the MaNHEP improvement approach. Bivariate analyses and multivariate linear regression models were used to analyze the survey data. Interview transcripts were organized by region, cadre, and key themes. Respondents reported significant positive changes in many areas of woreda culture and leadership, including involving a cross-section of community stakeholders (increased from 3.0 to 4.6 on 5-point Likert scale), using improvement data for decision making (2.8-4.4), using locally developed and tested solutions to improve CMNH care (2.5-4.3), demonstrating a commitment to improve the health of women and newborns (2.6-4.2), and creating a supportive environment for coaches and QI teams to improve CMNH (2.6-4.0). The mean scores for capacity were 3.7 and higher, reflecting respondents' agreement that they had gained capacity in improvement skills. Interview respondents universally recognized the capacity built in the woredas. The themes of community empowerment and focused improvement emerged strongly from the interviews. MaNHEP was able to build capacity for continuous improvement and develop lead woredas. The

  3. Developing Workforce Capacity in Public Health Informatics: Core Competencies and Curriculum Design

    Directory of Open Access Journals (Sweden)

    Douglas R. Wholey

    2018-05-01

    Full Text Available We describe a master’s level public health informatics (PHI curriculum to support workforce development. Public health decision-making requires intensive information management to organize responses to health threats and develop effective health education and promotion. PHI competencies prepare the public health workforce to design and implement these information systems. The objective for a Master’s and Certificate in PHI is to prepare public health informaticians with the competencies to work collaboratively with colleagues in public health and other health professions to design and develop information systems that support population health improvement. The PHI competencies are drawn from computer, information, and organizational sciences. A curriculum is proposed to deliver the competencies and result of a pilot PHI program is presented. Since the public health workforce needs to use information technology effectively to improve population health, it is essential for public health academic institutions to develop and implement PHI workforce training programs.

  4. Developing Workforce Capacity in Public Health Informatics: Core Competencies and Curriculum Design

    Science.gov (United States)

    Wholey, Douglas R.; LaVenture, Martin; Rajamani, Sripriya; Kreiger, Rob; Hedberg, Craig; Kenyon, Cynthia

    2018-01-01

    We describe a master’s level public health informatics (PHI) curriculum to support workforce development. Public health decision-making requires intensive information management to organize responses to health threats and develop effective health education and promotion. PHI competencies prepare the public health workforce to design and implement these information systems. The objective for a Master’s and Certificate in PHI is to prepare public health informaticians with the competencies to work collaboratively with colleagues in public health and other health professions to design and develop information systems that support population health improvement. The PHI competencies are drawn from computer, information, and organizational sciences. A curriculum is proposed to deliver the competencies and result of a pilot PHI program is presented. Since the public health workforce needs to use information technology effectively to improve population health, it is essential for public health academic institutions to develop and implement PHI workforce training programs. PMID:29770321

  5. Capacity building to improve the Malaysian inspection and monitoring systems for aquaculture and fisheries products

    NARCIS (Netherlands)

    Berendsen, B.; Wegh, R.S.; Zaaijer, S.; Dijk, van J.P.; Gevers, G.J.M.

    2013-01-01

    This report describes the content, the approach used and lessons learned during the implementation of a capacity development programme to build the analytical capacity of laboratory staff of the Department of Fisheries (DoF) and the Ministry of Health (MoH) who are directly involved in the analysis

  6. Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania.

    Science.gov (United States)

    Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

    2017-12-01

    Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn-related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential

  7. Determination of SMES capacity to enhance the dynamic stability of power system

    International Nuclear Information System (INIS)

    Shi, J.; Tang, Y.; Dai, T.; Ren, L.; Li, J.; Cheng, S.

    2010-01-01

    This paper proposes the principle of SMES capacity determination for power system stable operation. Adopting the energy function method, the mechanism of SMES damping power oscillation in the classical single-machine infinite-bus (SMIB) system is analyzed. The released kinetic energy during disturbance is the original of power system oscillation, which is taken as the principle of SMES capacity determination. Then, the influence of fault type, fault position, and fault clearing time on the SMES capacity determination are discussed. Using MATLAB simulation, the principle of SMES capacity determination is evaluated.

  8. A socioecological analysis of the determinants of national public health nutrition work force capacity: Australia as a case study.

    Science.gov (United States)

    Hughes, Roger

    2006-01-01

    This article uses a socioecological analytical approach to assess the capacity of the public health nutrition work force in Australia as a prelude to work force development strategy planning. It demonstrates how the socioecological model can be used to assess and inform the development of the infrastructure required for effective public health nutrition effort. An interpretive case study method was used involving triangular analysis of quantitative and qualitative data from multiple sources including semistructured interviews with advanced-level practitioners, literature review, a cross-sectional national work force survey, and position description audit and consensus development using a Delphi study. The findings of this analysis indicate that the Australian public health nutrition work force's capacity to effectively address priority nutrition issues is limited by determinants that can be categorized as relating to human resource infrastructure, organizational and policy environments, intelligence access and use, practice improvement and learning systems, and work force preparation. This socioecological analysis supports an intelligence-based focus for work force development effort in Australia and a conceptual framework for work force capacity assessment with potential applications in other countries.

  9. Results of the Community Health Applied Research Network (CHARN) National Research Capacity Survey of Community Health Centers.

    Science.gov (United States)

    Song, Hui; Li, Vivian; Gillespie, Suzanne; Laws, Reesa; Massimino, Stefan; Nelson, Christine; Singal, Robbie; Wagaw, Fikirte; Jester, Michelle; Weir, Rosy Chang

    2015-01-01

    The mission of the Community Health Applied Research Network (CHARN) is to build capacity to carry out Patient-Centered Outcomes Research at community health centers (CHCs), with the ultimate goal to improve health care for vulnerable populations. The CHARN Needs Assessment Staff Survey investigates CHCs' involvement in research, as well as their need for research training and resources. Results will be used to guide future training. The survey was developed and implemented in partnership with CHARN CHCs. Data were collected across CHARN CHCs. Data analysis and reports were conducted by the CHARN data coordinating center (DCC). Survey results highlighted gaps in staff research training, and these gaps varied by staff role. There is considerable variation in research involvement, partnerships, and focus both within and across CHCs. Development of training programs to increase research capacity should be tailored to address the specific needs and roles of staff involved in research.

  10. Health care capacity and allocations among South Africa's provinces: infrastructure-inequality traps after the end of apartheid.

    Science.gov (United States)

    Stuckler, David; Basu, Sanjay; McKee, Martin

    2011-01-01

    We assessed the determinants of health care funding allocations among South Africa's provinces and their effects on health care from 1996 through 2007. We performed multivariate regression of funding allocation data against measures of disease burden and health system infrastructure by province. Disease burden was increasingly negatively correlated with funding allocations and explained less than one quarter of the variation in allocations among provinces. Nearly three quarters of the variation in allocations was explained by preexisting hospital infrastructure and health care workers. The density of private hospitals in the preceding year was associated with greater government allocations (b(private) = 0.12; 95% confidence interval [CI] = 0.08, 0.15), but public hospital density in the preceding year was not (b(public) = 0.05; 95% CI = -0.02, 0.11). Greater allocations were associated with a higher number of doctors (b = 0.54; 95% CI = 0.34, 0.75) but fewer nurses (b = -0.37; 95% CI = -0.72,-0.25) in the same year. Regions with a greater capacity to spend funds received more funding and created more infrastructure than those with greater health needs. Historical infrastructure inequalities may have created an infrastructure-inequality trap, in which the distribution of funds to those with greater "absorptive capacity" exacerbates inequalities.

  11. Mutual research capacity strengthening: a qualitative study of two-way partnerships in public health research

    Directory of Open Access Journals (Sweden)

    Redman-MacLaren Michelle

    2012-12-01

    Full Text Available Abstract Introduction Capacity building has been employed in international health and development sectors to describe the process of ‘experts’ from more resourced countries training people in less resourced countries. Hence the concept has an implicit power imbalance based on ‘expert’ knowledge. In 2011, a health research strengthening workshop was undertaken at Atoifi Adventist Hospital, Solomon Islands to further strengthen research skills of the Hospital and College of Nursing staff and East Kwaio community leaders through partnering in practical research projects. The workshop was based on participatory research frameworks underpinned by decolonising methodologies, which sought to challenge historical power imbalances and inequities. Our research question was, “Is research capacity strengthening a two-way process?” Methods In this qualitative study, five Solomon Islanders and five Australians each responded to four open-ended questions about their experience of the research capacity strengthening workshop and activities: five chose face to face interview, five chose to provide written responses. Written responses and interview transcripts were inductively analysed in NVivo 9. Results Six major themes emerged. These were: Respectful relationships; Increased knowledge and experience with research process; Participation at all stages in the research process; Contribution to public health action; Support and sustain research opportunities; and Managing challenges of capacity strengthening. All researchers identified benefits for themselves, their institution and/or community, regardless of their role or country of origin, indicating that the capacity strengthening had been a two-way process. Conclusions The flexible and responsive process we used to strengthen research capacity was identified as mutually beneficial. Using community-based participatory frameworks underpinned by decolonising methodologies is assisting to redress

  12. Capacity of a dual enrollment system with two keys based on an SRAM-PUF

    NARCIS (Netherlands)

    Kusters, L.; Willems, F.M.J.

    2018-01-01

    We investigate the capacity of an SRAM-PUF based secrecy system that produces two secret keys during two consecutive enrollments. We determined the region of secret-key rates that are achievable and show that the total secret-key capacity is larger than for a single enrollment system. In our

  13. The Netherlands: health system review

    NARCIS (Netherlands)

    Schäfer, W.; Kroneman, M.; Boerma, W.; van den Berg, M.; Westert, G.; Devillé, W.; van Ginneken, E.

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of

  14. Physical capacity and risk for long-term sickness absence: a prospective cohort study among 8664 female health care workers.

    Science.gov (United States)

    Rasmussen, Charlotte Diana Nørregaard; Andersen, Lars Louis; Clausen, Thomas; Strøyer, Jesper; Jørgensen, Marie Birk; Holtermann, Andreas

    2015-05-01

    To assess the prospective associations between self-reported physical capacity and risk of long-term sickness absence among female health care workers. Female health care workers answered a questionnaire about physical capacity and were followed in a national register of sickness absence lasting for two or more consecutive weeks during 1-year follow-up. Using Cox regression hazard ratio analyses adjusted for age, smoking, body mass index, physical workload, job seniority, psychosocial work conditions, and previous sickness absence, we modeled risk estimates for sickness absence from low and medium physical capacity. Low and medium aerobic fitness, low muscle strength, low flexibility, and low overall physical capacity significantly increased the risk for sickness absence with 20% to 34% compared with health care workers with high capacity. Low physical capacity increases the risk of long-term sickness absence among female health care workers.

  15. Four centuries on from Bacon: progress in building health research systems to improve health systems?

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2014-09-23

    In 1627, Francis Bacon's New Atlantis described a utopian society in which an embryonic research system contributed to meeting the needs of the society. In this editorial, we use some of the aspirations described in New Atlantis to provide a context within which to consider recent progress in building health research systems to improve health systems and population health. In particular, we reflect on efforts to build research capacity, link research to policy, identify the wider impacts made by the science, and generally build fully functioning research systems to address the needs identified. In 2014, Health Research Policy and Systems has continued to publish one-off papers and article collections covering a range of these issues in both high income countries and low- and middle-income countries. Analysis of these contributions, in the context of some earlier ones, is brought together to identify achievements, challenges and possible ways forward. We show how 2014 is likely to be a pivotal year in the development of ways to assess the impact of health research on policies, practice, health systems, population health, and economic benefits.We demonstrate how the increasing focus on health research systems will contribute to realising the hopes expressed in the World Health Report, 2013, namely that all nations would take a systematic approach to evaluating the outputs and applications resulting from their research investment.

  16. TRICARE, Military Health System

    Science.gov (United States)

    ... Claim Get Proof of TRICARE Coverage View My Military Health Record Less TRICARE Enrollment Freeze Starting Dec. ... Disaster Information Download a Form Go Paperless My Military Health Records Multimedia Center Plan Information Kits Recoupment ...

  17. Impact of termogidroprocedure to the physical health and functional capacity of student's organism

    Directory of Open Access Journals (Sweden)

    Agoshkov V.V.

    2012-11-01

    Full Text Available The aspects of the use are considered athletic-health-improvement technologies of termogidrotrenings for the increase of functional possibilities and somatic health of students. 12 boys and 16 girls took part in research. Testing of physical development, functional trained, physical preparedness and somatic health of students is conducted. The health swimming was used in combination with the dosed contrasting shower. Also bath-house procedures with dousing cold water. The increase of level of general physical capacity of students is set. It is marked that the use of technology of termogidrotrenings is instrumental in the increase of level of adaptation possibilities of organism of students. The optimum variant of the use of technology is recommended: 32 planned employment after a physical culture with the health swimming; 16 additional bath-house procedures with dousing; 16 independent employments.

  18. Institution-to-Institution Mentoring to Build Capacity in 24 Local US Health Departments: Best Practices and Lessons Learned

    OpenAIRE

    Veatch, Maggie; Goldstein, Gail P.; Sacks, Rachel; Lent, Megan; Van Wye, Gretchen

    2014-01-01

    Introduction Institutional mentoring may be a useful capacity-building model to support local health departments facing public health challenges. The New York City Department of Health and Mental Hygiene conducted a qualitative evaluation of an institutional mentoring program designed to increase capacity of health departments seeking to address chronic disease prevention. The mentoring program included 2 program models, a one-to-one model and a collaborative model, developed and implemented ...

  19. Health system challenges of NCDs in Tunisia.

    Science.gov (United States)

    Ben Romdhane, Habiba; Tlili, Faten; Skhiri, Afef; Zaman, Shahaduz; Phillimore, Peter

    2015-01-01

    The objective of this study was to present a qualitative 'situation analysis' of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs). Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilson's framework (1994) for policy analysis was used: content, actors, context, and process. Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void. This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.

  20. Building Capacity for Workplace Health Promotion: Findings From the Work@Health® Train-the-Trainer Program

    Science.gov (United States)

    Lang, Jason; Cluff, Laurie; Rineer, Jennifer; Brown, Darigg; Jones-Jack, Nkenge

    2017-01-01

    Small- and mid-sized employers are less likely to have expertise, capacity, or resources to implement workplace health promotion programs, compared with large employers. In response, the Centers for Disease Control and Prevention developed the Work@Health® employer training program to determine the best way to deliver skill-based training to employers of all sizes. The core curriculum was designed to increase employers’ knowledge of the design, implementation, and evaluation of workplace health strategies. The first arm of the program was direct employer training. In this article, we describe the results of the second arm—the program’s train-the-trainer (T3) component, which was designed to prepare new certified trainers to provide core workplace health training to other employers. Of the 103 participants who began the T3 program, 87 fully completed it and delivered the Work@Health core training to 233 other employers. Key indicators of T3 participants’ knowledge and attitudes significantly improved after training. The curriculum delivered through the T3 model has the potential to increase the health promotion capacity of employers across the nation, as well as organizations that work with employers, such as health departments and business coalitions. PMID:28829622

  1. Building capacity for evidence informed decision making in public health: a case study of organizational change

    Directory of Open Access Journals (Sweden)

    Peirson Leslea

    2012-02-01

    Full Text Available Abstract Background Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM. However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. Methods This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27 with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. Results The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services, fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. Conclusion With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.

  2. Building capacity for evidence informed decision making in public health: a case study of organizational change.

    Science.gov (United States)

    Peirson, Leslea; Ciliska, Donna; Dobbins, Maureen; Mowat, David

    2012-02-20

    Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM). However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.

  3. [The health system of Ecuador].

    Science.gov (United States)

    Lucio, Ruth; Villacrés, Nilhda; Henríquez, Rodrigo

    2011-01-01

    This paper describes the health conditions in Ecuador and, in more detail, the characteristics of the Ecuadorian health system, including its structure and coverage, its financial sources, the physical, material and human resources available, and the stewardship activities developed by the Ministry of Public Health. It also describes the structure and content of its health information system, and the participation of citizens in the operation and evaluation of the health system. The paper ends with a discussion of the most recent policy innovations implemented in the Ecuadorian system, including the incorporation of a chapter on health into the new Constitution which recognizes the protection of health as a human right, and the construction of the Comprehensive Public Health Network.

  4. A survey tool for measuring evidence-based decision making capacity in public health agencies

    Directory of Open Access Journals (Sweden)

    Jacobs Julie A

    2012-03-01

    Full Text Available Abstract Background While increasing attention is placed on using evidence-based decision making (EBDM to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. Methods Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. Results In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. Conclusions The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence

  5. Organizational capacity for service integration in community-based addiction health services.

    Science.gov (United States)

    Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A

    2014-04-01

    We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.

  6. Strengthening global health security by embedding the International Health Regulations requirements into national health systems.

    Science.gov (United States)

    Kluge, Hans; Martín-Moreno, Jose Maria; Emiroglu, Nedret; Rodier, Guenael; Kelley, Edward; Vujnovic, Melitta; Permanand, Govin

    2018-01-01

    The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.

  7. Self-Assessment of Physical Activity and Health Capacity of Students

    OpenAIRE

    Plavina Liana; Dulevska Ilva; Karklina Helena

    2017-01-01

    The compulsory part of the individual life is physical activity. The physical activity is important for maintenance health capacity. Physical activity includes various kinds of components: physical activity during the leisure time (during the week days and weekend days), physical activity at home and in working place and physical activity during the transference from home to other place. Intensity of the physical activity could also be various from low to moderate and till high. Respondent of...

  8. Optimal Capacity Proportion and Distribution Planning of Wind, Photovoltaic and Hydro Power in Bundled Transmission System

    Science.gov (United States)

    Ye, X.; Tang, Q.; Li, T.; Wang, Y. L.; Zhang, X.; Ye, S. Y.

    2017-05-01

    The wind, photovoltaic and hydro power bundled transmission system attends to become common in Northwest and Southwest of China. To make better use of the power complementary characteristic of different power sources, the installed capacity proportion of wind, photovoltaic and hydro power, and their capacity distribution for each integration node is a significant issue to be solved in power system planning stage. An optimal capacity proportion and capacity distribution model for wind, photovoltaic and hydro power bundled transmission system is proposed here, which considers the power out characteristic of power resources with different type and in different area based on real operation data. The transmission capacity limit of power grid is also considered in this paper. Simulation cases are tested referring to one real regional system in Southwest China for planning level year 2020. The results verify the effectiveness of the model in this paper.

  9. Smoking and Early COPD as Independent Predictors of Body Composition, Exercise Capacity, and Health Status.

    Science.gov (United States)

    Caram, Laura Miranda de Oliveira; Ferrari, Renata; Bertani, André Luís; Garcia, Thaís; Mesquita, Carolina Bonfanti; Knaut, Caroline; Tanni, Suzana Erico; Godoy, Irma

    2016-01-01

    The effects of tobacco smoke, mild/moderate COPD disease and their combined effect on health status (HS), body composition (BC), and exercise capacity (EC) impairment are still unclear. We hypothesized that smoking and early COPD have a joint negative influence on these outcomes. We evaluated 32 smokers (smoking history >10 pack/years), 32 mild/moderate COPD (current smokers or former smokers), and 32 never smokers. All individuals underwent medical and smoking status evaluations, pre and post-bronchodilator spirometry, BC [fat-free mass (FFM) and FFM index (FFMI)], EC [six-minute walk distance (6MWD)] and HS [Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)]. FFM (p = 0.02) and FFMI (p = 0.008) were lower in COPD than never smokers. 6MWT, as a percentage of reference values for the Brazilian population, was lower in COPD and smokers than never smokers (p = 0.01). Smokers showed worse SF-36 score for functional capacity than never smokers (psmoking were inversely associated with FFMI, 6MWD and HS. Smoking and early COPD have a joint negative influence on body composition, exercise capacity and health status.

  10. Pilgrimage to Wellness: An Exploratory Report of Rural African American Clergy Perceptions of Church Health Promotion Capacity

    Science.gov (United States)

    Carter-Edwards, Lori; Hooten, Elizabeth Gerken; Bruce, Marino A.; Toms, Forrest; Lloyd, Cheryl LeMay; Ellison, Calvin

    2013-01-01

    Churches serve a vital role in African American communities and may be effective vehicles for health promotion in rural areas where disease burden is disproportionately greater and healthcare access is more limited than other communities. Endorsement by church leadership is often necessary for the approval of programs and activities within churches; however, little is known about how church leaders perceive their respective churches as health promotion organizations. The purpose of this exploratory pilot was to report perceptions of church capacity to promote health among African American clergy leaders of predominantly African American rural churches. The analysis sample included 27 pastors of churches in Eastern NC who completed a survey on church health promotion capacity and perceived impact on their own health. Capacities assessed included perceived need and impact of health promotion activities, church preparedness to promote health, health promotion actions to take, and the existence and importance of health ministry attributes. The results from this pilot study indicated a perceived need to increase the capacity of their churches to promote health. Conducting health programs, displaying health information, collaborations within the church (i.e., kitchen committee working with the health ministry), partnerships outside of the church, and funding were most commonly reported needed capacities. Findings from this exploratory work lay the foundation for the development of future, larger observational studies that can specify some of the key factors associated with organizational change and ultimately health promotion in these rural church settings. PMID:22694157

  11. Medicaid Expansion And Grant Funding Increases Helped Improve Community Health Center Capacity.

    Science.gov (United States)

    Han, Xinxin; Luo, Qian; Ku, Leighton

    2017-01-01

    Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states. Increases in federal grant funding levels were associated with increases in numbers of patients and of overall, medical, and preventive service visits. If federal grant levels are not sustained after 2017, there could be marked reductions in health center capacity in both expansion and nonexpansion states. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research.

    Science.gov (United States)

    Brownson, Ross C; Fielding, Jonathan E; Green, Lawrence W

    2018-04-01

    Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and its application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan, deliver, and evaluate the preventive dose of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. Although there is general agreement among practitioners and scientists on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when, and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity building will foster more effective public health practice.

  13. Building allied health workforce capacity: a strategic approach to workforce innovation.

    Science.gov (United States)

    Somerville, Lisa; Davis, Annette; Elliott, Andrea L; Terrill, Desiree; Austin, Nicole; Philip, Kathleen

    2015-06-01

    The aim of the present study was to identify areas where allied health assistants (AHAs) are not working to their full scope of practice in order to improve the effectiveness of the allied health workforce. Qualitative data collected via focus groups identified suitable AHA tasks and a quantitative survey with allied health professionals (AHPs) measured the magnitude of work the current AHP workforce spends undertaking these tasks. Quantification survey results indicate that Victoria's AHP workforce spends up to 17% of time undertaking tasks that could be delegated to an AHA who has relevant training and adequate supervision. Over half this time is spent on clinical tasks. The skills of AHAs are not being optimally utilised. Significant opportunity exists to reform the current allied health workforce. Such reform should result in increased capacity of the workforce to meet future demands.

  14. New degradation call admission control for increasing WCDMA system capacity

    Institute of Scientific and Technical Information of China (English)

    Liu Ningqing; Lu Zhi; Gu Xuemai

    2006-01-01

    Propose a new degradation call admission control(DCAC)scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call's access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls' blocking probability and increase the total number of the on-line users.

  15. Improving capacity in ethnicity and health research: report of a tailored programme for NHS Public Health practitioners

    OpenAIRE

    Salway, Sarah; Piercy, Hilary; Chowbey, Punita; Brewins, Louise; Dhoot, Permjeet

    2012-01-01

    Aim: To determine whether an intervention designed to enhance research capacity among commissioners in the area of ethnicity and health was feasible and impactful, and to identify programme elements that might usefully be replicated elsewhere.\\ud Background: How healthcare commissioners should be equipped to understand and address multiethnic needs has received little attention to-date. Being able to mobilise and apply evidence is a central element of the commissioning process that requires d...

  16. Extrapulmonary features of bronchiectasis: muscle function, exercise capacity, fatigue, and health status

    Directory of Open Access Journals (Sweden)

    Ozalp Ozge

    2012-06-01

    Full Text Available Abstract Background There are limited number of studies investigating extrapulmonary manifestations of bronchiectasis. The purpose of this study was to compare peripheral muscle function, exercise capacity, fatigue, and health status between patients with bronchiectasis and healthy subjects in order to provide documented differences in these characteristics for individuals with and without bronchiectasis. Methods Twenty patients with bronchiectasis (43.5 ± 14.1 years and 20 healthy subjects (43.0 ± 10.9 years participated in the study. Pulmonary function, respiratory muscle strength (maximal expiratory pressure – MIP - and maximal expiratory pressure - MEP, and dyspnea perception using the Modified Medical Research Council Dyspnea Scale (MMRC were determined. A six-minute walk test (6MWT was performed. Quadriceps muscle, shoulder abductor, and hand grip strength (QMS, SAS, and HGS, respectively using a hand held dynamometer and peripheral muscle endurance by a squat test were measured. Fatigue perception and health status were determined using the Fatigue Severity Scale (FSS and the Leicester Cough Questionnaire (LCQ, respectively. Results Number of squats, 6MWT distance, and LCQ scores as well as lung function testing values and respiratory muscle strength were significantly lower and MMRC and FSS scores were significantly higher in patients with bronchiectasis than those of healthy subjects (p p p p p  Conclusions Peripheral muscle endurance, exercise capacity, fatigue and health status were adversely affected by the presence of bronchiectasis. Fatigue was associated with dyspnea and health status. Respiratory muscle strength was related to peripheral muscle strength and health status, but not to fatigue, peripheral muscle endurance or exercise capacity. These findings may provide insight for outcome measures for pulmonary rehabilitation programs for patients with bronchiectasis.

  17. Tax levy financing for local public health: fiscal allocation, effort, and capacity.

    Science.gov (United States)

    Riley, William J; Gearin, Kimberly J; Parrotta, Carmen D; Briggs, Jill; Gyllstrom, M Elizabeth

    2013-12-01

    Local health departments (LHDs) rely on a wide variety of funding sources, and the level of financing is associated with both LHD performance in essential public health services and population health outcomes. Although it has been shown that funding sources vary across LHDs, there is no evidence regarding the relationship between fiscal allocation (local tax levy); fiscal effort (tax capacity); and fiscal capacity (community wealth). The purpose of this study is to analyze local tax levy support for LHD funding. Three research questions are addressed: (1) What are tax levy trends in LHD fiscal allocation? (2) What is the role of tax levy in overall LHD financing? and (3) How do local community fiscal capacity and fiscal effort relate to LHD tax levy fiscal allocation? This study focuses on 74 LHDs eligible for local tax levy funding in Minnesota. Funding and expenditure data for 5 years (2006 to 2010) were compiled from four governmental databases, including the Minnesota Department of Health, the State Auditor, the State Demographer, and the Metropolitan Council. Trends in various funding sources and expenditures are described for the time frame of interest. Data were analyzed in 2012. During the 2006-2010 time period, total average LHD per capita expenditures increased 13%, from $50.98 to $57.63. Although the overall tax levy increase in Minnesota was 25%, the local tax levy for public health increased 5.6% during the same period. There is a direct relationship between fiscal effort and LHD expenditures. Local funding reflects LHD community priorities and the relative importance in comparison to funding other local programs with tax dollars. In Minnesota, local tax levy support for local public health services is not keeping pace with local tax support for other local government services. These results raise important questions about the relationship between tax levy resource effort, resource allocation, and fiscal capacity as they relate to public health

  18. Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research.

    Science.gov (United States)

    Li, Ryan; Ruiz, Francis; Culyer, Anthony J; Chalkidou, Kalipso; Hofman, Karen J

    2017-01-01

    Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders - not only the technical capacity to "do" research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE) framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values); academics need to understand and respond to decision-makers' needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England's National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand) and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country) to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to their own capacity

  19. Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Ryan Li

    2017-03-01

    Full Text Available Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders – not only the technical capacity to “do” research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values; academics need to understand and respond to decision-makers’ needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England’s National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to

  20. Heat capacity for systems with excited-state quantum phase transitions

    Energy Technology Data Exchange (ETDEWEB)

    Cejnar, Pavel; Stránský, Pavel, E-mail: stransky@ipnp.troja.mff.cuni.cz

    2017-03-18

    Heat capacities of model systems with finite numbers of effective degrees of freedom are evaluated using canonical and microcanonical thermodynamics. Discrepancies between both approaches, which are observed even in the infinite-size limit, are particularly large in systems that exhibit an excited-state quantum phase transition. The corresponding irregularity of the spectrum generates a singularity in the microcanonical heat capacity and affects smoothly the canonical heat capacity. - Highlights: • Thermodynamics of systems with excited-state quantum phase transitions • ESQPT-generated singularities of the microcanonical heat capacity • Non-monotonous dependences of the canonical heat capacity • Discord between canonical and microcanonical pictures in the infinite-size limit.

  1. Review on the Evaluation System of Public Safety Carrying Capacity about Small Town Community

    Institute of Scientific and Technical Information of China (English)

    Ming; SUN; Tianyu; ZHU

    2014-01-01

    Recently,small town community public safety problem has been increasingly highlighted,but its research is short on public safety carrying capacity. Through the investigation and study of community public safety carrying capacity,this paper analyzes the problem of community public safety in our country,to construct index evaluation system of public safety carrying capacity in small town community. DEA method is used to evaluate public safety carrying capacity in small town community,to provide scientific basis for the design of support and standardization theory about small town community in public safety planning.

  2. Entanglement Capacity of Two-Qubit Unitary Operator with the Help of Auxiliary System

    International Nuclear Information System (INIS)

    Hu Baolin; Di Yaomin

    2007-01-01

    The entanglement capacity of general two-qubit unitary operators is studied when auxiliary systems are allowed, and the analytical results based on linear entropy when input states are disentangled are given. From the results the condition for perfect entangler, α 1 = α 2 = π/4, is obtained. Contrary to the case without auxiliary system, the parameter α 3 may play active role to the entanglement capacity when auxiliary systems are allowed.

  3. The Experimental Research on Seismic Capacity of the Envelope Systems with Steel Frame

    Science.gov (United States)

    Li, Jiuyang; Wang, Bingbing; Li, Hengxu

    2017-09-01

    In this paper, according to the present application situation of the external envelope systems steel frame in the severe cold region, the stuffed composite wall panels are improved, the flexible connection with the steel frame is designed, the reduced scale specimens are made, the seismic capacity test is made and some indexes of the envelope systems such as bearing capacity, energy consumption and ductility, etc. are compared, which provide reference for the development and application of the steel frame envelope systems.

  4. Ontario's intertie capacity and electricity trade in the interconnected system

    International Nuclear Information System (INIS)

    Dorey, S.

    2002-01-01

    Hydro One's capacity of existing interconnections were described. The Ontario utility is within reach of about 320 GW electricity markets in neighbouring Quebec, New York, Michigan, Minnesota, and Manitoba. It is also within reach of 50 million customers, and 30 per cent of total U.S. energy consumption. The author emphasized the need for expanded interties and new interconnections. The status of new interconnections was described along with the rules regarding electric power import, export and wheeling. It was noted that compared to the United States, Canada has a higher proportion of clean hydro and nuclear power plants in its mix of power generation. Markets across North America are adopting electricity restructuring and open competition. However, the transmission grids were not designed to support market-driven electricity trading. Most transmission grids were built when utilities were tightly regulated and provided service only within their assigned regions. The current energy infrastructure is not equipped for large-scale swapping of power in competitive markets. It was also noted that growth in US power flows is outpacing transmission investment. This paper addressed the issue of license requirements, transmitter proposals for regulated investments, and non-rate base transmitter investments. It was concluded that while market rules are flexible enough to encourage inter-jurisdictional trade, the rules have to facilitate and encourage transmission investment. 8 figs

  5. Bursaries, writing grants and fellowships: a strategy to develop research capacity in primary health care

    Directory of Open Access Journals (Sweden)

    Farmer Elizabeth A

    2007-04-01

    Full Text Available Abstract Background General practitioners and other primary health care professionals are often the first point of contact for patients requiring health care. Identifying, understanding and linking current evidence to best practice can be challenging and requires at least a basic understanding of research principles and methodologies. However, not all primary health care professionals are trained in research or have research experience. With the aim of enhancing research skills and developing a research culture in primary health care, University Departments of General Practice and Rural Health have been supported since 2000 by the Australian Government funded 'Primary Health Care Research Evaluation and Development (PHCRED Strategy'. A small grant funding scheme to support primary health care practitioners was implemented through the PHCRED program at Flinders University in South Australia between 2002 and 2005. The scheme incorporated academic mentors and three types of funding support: bursaries, writing grants and research fellowships. This article describes outcomes of the funding scheme and contributes to the debate surrounding the effectiveness of funding schemes as a means of building research capacity. Methods Funding recipients who had completed their research were invited to participate in a semi-structured 40-minute telephone interview. Feedback was sought on acquisition of research skills, publication outcomes, development of research capacity, confidence and interest in research, and perception of research. Data were also collected on demographics, research topics, and time needed to complete planned activities. Results The funding scheme supported 24 bursaries, 11 writing grants, and three research fellows. Nearly half (47% of all grant recipients were allied health professionals, followed by general practitioners (21%. The majority (70% were novice and early career researchers. Eighty-nine percent of the grant recipients were

  6. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

    Directory of Open Access Journals (Sweden)

    Elizabeth H. Bradley

    2015-07-01

    Full Text Available Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved

  7. Multicore fibers for high-capacity submarine transmission systems

    DEFF Research Database (Denmark)

    Nooruzzaman, Md.; Morioka, Toshio

    2018-01-01

    Applications of multicore fibers (MCFs) in undersea transmission systems are investigated, and various potential architectures of branching units for MCF-based undersea transmission systems are presented. Some MCF-based submarine network architectures based on the amount of data traffic are also...

  8. Optimum capacity determination of stand-alone hybrid generation system considering cost and reliability

    International Nuclear Information System (INIS)

    Chen, Hung-Cheng

    2013-01-01

    Highlights: ► This paper presents a methodology for the installation capacity optimization. ► Hybrid generation system is optimized by application of adaptive genetic algorithm. ► A cost investigation is made under various conditions and component characteristics. ► The optimization scheme is validated to meet the annual power load demand. -- Abstract: The aim of this work is to present an optimization methodology for the installation capacity of a stand-alone hybrid generation system, taking into consideration the cost and reliability. Firstly, on the basis of derived steady state models of a wind generator (WG), a photovoltaic array (PV), a battery and an inverter, the hybrid generation system is modeled for the purpose of capacity optimization. Secondly, the power system is analyzed for determining both the system structure and the operation control strategy. Thirdly, according to hourly weather database of wind speed, temperature and solar irradiation, annual power generation capacity is estimated for the system match design in order that an annual power load demand can be met. The capacity determination of a hybrid generation system becomes complicated as a result of the uncertainty in the renewable energy together with load demand and the nonlinearity of system components. Aimed at the power system reliability and the cost minimization, the capacity of a hybrid generation system is optimized by application of an adaptive genetic algorithm (AGA) to individual power generation units. A total cost investigation is made under various conditions, such as wind generator power curves, battery discharge depth and the loss of load probability (LOLP). At the end of this work, the capacity of a hybrid generation system is optimized at two installation sites, namely the offshore Orchid Island and Wuchi in Taiwan. The optimization scheme is validated to optimize power capacities of a photovoltaic array, a battery and a wind turbine generator with a relative

  9. Fixing Health Systems

    International Development Research Centre (IDRC) Digital Library (Canada)

    In Africa, health care has been in a state of crisis for several decades. ..... Instead, think about them as representations of real people — people with families that ...... blood screening; patient care, counseling, and social support; palliative care.

  10. A theory-informed approach to mental health care capacity building for pharmacists.

    Science.gov (United States)

    Murphy, Andrea L; Gardner, David M; Kutcher, Stan P; Martin-Misener, Ruth

    2014-01-01

    Pharmacists are knowledgeable, accessible health care professionals who can provide services that improve outcomes in mental health care. Various challenges and opportunities can exist in pharmacy practice to hinder or support pharmacists' efforts. We used a theory-informed approach to development and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. Theories and frameworks including the Consolidated Framework for Implementation Research, the Theoretical Domains Framework, and the Behaviour Change Wheel were used to inform the conceptualization, development, and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. The More Than Meds program was developed and implemented through an iterative process. The main program components included: an education and training day; use of a train-the-trainer approach from partnerships with pharmacists and people with lived experience of mental illness; development of a community of practice through email communications, a website, and a newsletter; and use of educational outreach delivered by pharmacists. Theories and frameworks used throughout the program's development and implementation facilitated a means to conceptualize the component parts of the program as well as its overall presence as a whole from inception through evolution in implementation. Using theoretical foundations for the program enabled critical consideration and understanding of issues related to trialability and adaptability of the program. Theory was essential to the underlying development and implementation of a capacity-building program for enhancing services by pharmacists for people with lived experience of mental illness. Lessons learned from the development and implementation of this program are informing current research and evolution of the program.

  11. Building capacity in workplace health promotion: the case of the Healthy Together e-learning project.

    Science.gov (United States)

    Hodgins, Margaret; Battel-Kirk, Barbara; Asgeirsdottir, Asa G

    2010-03-01

    The current global economic crisis poses major challenges for workplace health promotion (WHP). Activities that are not perceived to obviously and directly contribute to profits could be sacrificed. This paper argues that WHP must remain centre-stage because of the rights of workers to a healthy, safe working environment but also because of WHP's beneficial financial implications for enterprises. Capacity building for WHP can be developed even within a recessionary environment, particularly if the focus is on the wider workforce, described here as people for whom workplace health promotion may not be their primary function but who have an important role to play in health improvement in workplaces. There is a strong case for the development of the wider workforce based both on the lack of suitably qualified specialists and on the practicalities of having WHP implemented within organizations, particularly for small and medium-sized enterprises (SMEs). SMEs make up a very significant proportion of the global economy and are identified as a priority area for action internationally. An example of an e-learning course, the Healthy Together programme, developed by a partnership of three countries, is discussed as an approach that has potential to develop capacity for WHP in the current climate. The findings of the evaluation of the Healthy Together programme indicate that there is a real potential in developing e-learning materials for training those with a brief for promoting workplace health and safety in SMEs. Although modifications in some aspects of delivery identified in the evaluation of the pilot course need to be considered, the course was well received, and was reported to be relevant to the learning needs of students, to their workplaces and specifically to small businesses in rural areas. Specific features of the e-learning approach increase its potential to address capacity building for WHP.

  12. Optimization of MIMO Systems Capacity Using Large Random Matrix Methods

    Directory of Open Access Journals (Sweden)

    Philippe Loubaton

    2012-11-01

    Full Text Available This paper provides a comprehensive introduction of large random matrix methods for input covariance matrix optimization of mutual information of MIMO systems. It is first recalled informally how large system approximations of mutual information can be derived. Then, the optimization of the approximations is discussed, and important methodological points that are not necessarily covered by the existing literature are addressed, including the strict concavity of the approximation, the structure of the argument of its maximum, the accuracy of the large system approach with regard to the number of antennas, or the justification of iterative water-filling optimization algorithms. While the existing papers have developed methods adapted to a specific model, this contribution tries to provide a unified view of the large system approximation approach.

  13. Large capacity, high-speed multiparameter multichannel analysis system

    International Nuclear Information System (INIS)

    Hendricks, R.W.; Seeger, P.A.; Scheer, J.W.; Suehiro, S.

    1980-01-01

    A data acquisition system for recording multiparameter digital data into a large memory array at over 2.5 MHz is described. The system consists of a MOSTEK MK8600 2048K x 24-bit memory system, I/O ports to various external devices including the CAMAC dataway, a memory incrementer/adder and a daisy-chain of experiment-specific modules which calculate the memory address which is to be incremented. The design of the daisy-chain permits multiple modules and provides for easy modification as experimental needs change. The system has been designed for use in multiparameter, multichannel analysis of high-speed data gathered by position-sensitive detectors at conventional and synchrotron x-ray sources as well as for fixed energy and time-of-flight diffraction at continuous and pulsed neutron sources

  14. THE E-HEALTH SYSTEMS IN POLAND

    Directory of Open Access Journals (Sweden)

    Zdzisław PÓLKOWSKI

    2013-11-01

    Full Text Available Information Technologies are disruptive technologies that have caused major changes in health system in Poland. Current digital economy is driven by modern information and new IT tools, which offer hospitals, doctors and patient access to any type of information, regardless of its form of existence, storage type or geographical location. These tools encourage the development of new activities, health services. The purpose of this article is to analyze the the current state of development of e-services in Poland in the context of nowadays health system. In the first part of the paper, the authors present various programmes, which enable the access to the medical services and patients’ data online. The next part of the paper is devoted to examining the technical aspects of the said programmes and presenting their advantages as well as the areas which might be improved.The last part of the work will be focused on the websites of the selected health institutions. According to the authors, WWW services provide much information on how the process of computer systems are being implemented, what data the services include and the capacity of the equipment as well as the software, human resources and the knowledge in this sphere. Moreover this section highlights the latest trends in e-health with particular emphasis on aspects such as the use of private and public cloud computer and t heir integration with web sites of health institutions. This study brings its contribution to the understanding of the change of health system in Poland behavior by using a new perspective e-health systems and IT tools above by doctors, officers and patients.

  15. On the Capacity of a Cellular CDMA System Reverse Channel

    National Research Council Canada - National Science Library

    Klitorakis, Petros

    2002-01-01

    .... The performance of the system is examined under several values of the standard deviation of lognormal shadowing and the power control error for various numbers of users and values of the Nakagami-m variable by using simulations. Finally, a barrage noise jammer will be introduced and its effect seen in the performance of the cellular communication system for a specific value of E(sub b)/N(sub o).

  16. Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Adamsen, Lis; Midtgaard, Julie; Rorth, Mikael

    2003-01-01

    Cancer patients frequently experience considerable loss of physical capacity and general wellbeing when diagnosed and treated for their disease. The aim of this study was to evaluate the feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients...... during advanced stages of disease who are undergoing adjuvant or high-dose chemotherapy. The supervised program included high- and low-intensity activities (physical exercise, relaxation, massage, and body-awareness training). A total of 23 patients between 18 and 65 years of age (median 40 years...... significance. It is concluded that an exercise program, which combines high- and low-intensity physical activities, may be used to prevent and/or minimize physical inactivity, fatigue, muscle wasting and energy loss in cancer patients undergoing chemotherapy....

  17. Improving Power System Modeling. A Tool to Link Capacity Expansion and Production Cost Models

    Energy Technology Data Exchange (ETDEWEB)

    Diakov, Victor [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cole, Wesley [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sullivan, Patrick [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brinkman, Gregory [National Renewable Energy Lab. (NREL), Golden, CO (United States); Margolis, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-11-01

    Capacity expansion models (CEM) provide a high-level long-term view at the prospects of the evolving power system. In simulating the possibilities of long-term capacity expansion, it is important to maintain the viability of power system operation in the short-term (daily, hourly and sub-hourly) scales. Production-cost models (PCM) simulate routine power system operation on these shorter time scales using detailed load, transmission and generation fleet data by minimizing production costs and following reliability requirements. When based on CEM 'predictions' about generating unit retirements and buildup, PCM provide more detailed simulation for the short-term system operation and, consequently, may confirm the validity of capacity expansion predictions. Further, production cost model simulations of a system that is based on capacity expansion model solution are 'evolutionary' sound: the generator mix is the result of logical sequence of unit retirement and buildup resulting from policy and incentives. The above has motivated us to bridge CEM with PCM by building a capacity expansion - to - production cost model Linking Tool (CEPCoLT). The Linking Tool is built to onset capacity expansion model prescriptions onto production cost model inputs. NREL's ReEDS and Energy Examplar's PLEXOS are the capacity expansion and the production cost models, respectively. Via the Linking Tool, PLEXOS provides details of operation for the regionally-defined ReEDS scenarios.

  18. Power system health analysis

    International Nuclear Information System (INIS)

    Billinton, Roy; Fotuhi-Firuzabad, Mahmud; Aboreshaid, Saleh

    1997-01-01

    This paper presents a technique which combines both probabilistic indices and deterministic criteria to reflect the well-being of a power system. This technique permits power system planners, engineers and operators to maximize the probability of healthy operation as well as minimizing the probability of risky operation. The concept of system well-being is illustrated in this paper by application to the areas of operating reserve assessment and composite power system security evaluation

  19. Training responsibly to improve global surgical and anaesthesia capacity through institutional health partnerships: a case study.

    Science.gov (United States)

    Macpherson, Laura; Collins, Maggie

    2017-01-01

    Urgent investment in human resources for surgical and anaesthesia care is needed globally. Responsible training and education is required to ensure healthcare providers are confident and skilled in the delivery of this care in both the rural and the urban setting. The Tropical Health and Education Trust (THET), a UK-based specialist global health organisation, is working with health training institutions, health professionals, Ministries of Health and Health Partnerships or 'links' between healthcare institutions in the UK and low- or middle-income country (LMIC) counterparts. These institutions may be hospitals, professional associations or universities whose primary focus is delivery of health services or the training and education of health workers. Since 2011, THET has been delivering the Health Partnership Scheme (HPS), a UK government-funded programme that provides grants and guidance to health partnerships and promotes the voluntary engagement of UK health professionals overseas. To date, the £30 million Scheme has supported peer-to-peer collaborations involving more than 200 UK and overseas hospitals, universities and professional associations across 25 countries in Africa, Asia and the Middle East. In this paper, we focus on four partnerships that are undertaking training initiatives focused on building capacity for surgery and anaesthesia. In order to do so, we discuss their role as a responsible and effective approach to harnessing the expertise available in the UK in order to increase surgical and anaesthesia capacity in LMICs. Specifically, how well they: (1) respond to locally identified needs; (2) are appropriate to the local context and are of high quality; and (3) have an overarching goal of making a sustainable contribution to the development of the health workforce through education and training. The HPS has now supported 24 training initiatives focused on building capacity for surgery and anaesthesia in 16 countries across sub-Saharan Africa

  20. Microwave photonics technologies supporting high capacity and flexible wireless communications systems

    DEFF Research Database (Denmark)

    Lu, Xiaofeng; Tatarczak, Anna; Rommel, Simon

    2015-01-01

    Emerging 5G wireless systems require technologies for increased capacity, guarantee robustness, low latency and flexibility. We review a number of approaches to provide the above based on microwave photonics and hybrid optical fiber-wireless communication techniques....

  1. Achievable capacity of a spectrum sharing system over hyper fading channels

    KAUST Repository

    Ekin, Sabit; Yilmaz, Ferkan; Ç elebi, Hasari Burak; Qaraqe, Khalid A.; Alouini, Mohamed-Slim; Serpedin, Erchin

    2009-01-01

    Cognitive radio with spectrum sharing feature is a promising technique to address the spectrum under-utilization problem in dynamically changing environments. In this paper, achievable capacity gain of spectrum sharing systems over dynamic fading

  2. On the average capacity and bit error probability of wireless communication systems

    KAUST Repository

    Yilmaz, Ferkan; Alouini, Mohamed-Slim

    2011-01-01

    Analysis of the average binary error probabilities and average capacity of wireless communications systems over generalized fading channels have been considered separately in the past. This paper introduces a novel moment generating function

  3. The Analysis and the Performance Simulation of the Capacity of Bit-interleaved Coded Modulation System

    Directory of Open Access Journals (Sweden)

    Hongwei ZHAO

    2014-09-01

    Full Text Available In this paper, the capacity of the BICM system over AWGN channels is first analyzed; the curves of BICM capacity versus SNR are also got by the Monte-Carlo simulations===?=== and compared with the curves of the CM capacity. Based on the analysis results, we simulate the error performances of BICM system with LDPC codes. Simulation results show that the capacity of BICM system with LDPC codes is enormously influenced by the mapping methods. Given a certain modulation method, the BICM system can obtain about 2-3 dB gain with Gray mapping compared with Non-Gray mapping. Meanwhile, the simulation results also demonstrate the correctness of the theory analysis.

  4. Higher order capacity statistics of multi-hop transmission systems over Rayleigh fading channels

    KAUST Repository

    Yilmaz, Ferkan; Tabassum, Hina; Alouini, Mohamed-Slim

    2012-01-01

    In this paper, we present an exact analytical expression to evaluate the higher order statistics of the channel capacity for amplify and forward (AF) multihop transmission systems operating over Rayleigh fading channels. Furthermore, we present

  5. Developing capacities of community health workers in sexual and reproductive, maternal, newborn, child, and adolescent health: a mapping and review of training resources.

    Science.gov (United States)

    Tran, Nguyen Toan; Portela, Anayda; de Bernis, Luc; Beek, Kristen

    2014-01-01

    Given country demands for support in the training of community health workers (CHWs) to accelerate progress towards reaching the Millennium Development Goals in sexual and reproductive health and maternal, newborn, child, and adolescent health (SR/MNCAH), the United Nations Health Agencies conducted a synthesis of existing training resource packages for CHWs in different components of SR/MNCAH to identify gaps and opportunities and inform efforts to harmonize approaches to developing the capacity of CHWs. A mapping of training resource packages for CHWs was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation. We identified 31 relevant packages. They covered different components of the SR/MNCAH continuum in varying breadth (integrated packages) and depth (focused packages), including family planning, antenatal and childbirth care (mainly postpartum haemorrhage), newborn care, and childhood care, and HIV. There is no or limited coverage of interventions related to safe abortion, adolescent health, and gender-based violence. There is no training package addressing the range of evidence-based interventions that can be delivered by CHWs as per World Health Organization guidance. Gaps include weakness in the assessment of competencies of trainees, in supportive supervision, and in impact assessment of packages. Many packages represent individual programme efforts rather than national programme materials, which could reflect weak integration into national health systems. There is a wealth of training packages on SR/MNCAH for CHWs which reflects interest in strengthening the capacity of CHWs. This offers an opportunity for governments and partners to mount a synergistic response to address the gaps and ensure an evidence-based comprehensive package of interventions to be delivered by CHWs. Packages with defined

  6. A large capacity, high-speed multiparameter multichannel analysis system

    International Nuclear Information System (INIS)

    Hendricks, R.W.; Suehiro, S.; Seeger, P.A.; Scheer, J.W.

    1982-01-01

    A data acquisition system for recording multiparameter digital data into a large memory array at over 2.5 MHz is described. The system consists of a MOSTEK MK 8600 2048 K x 24-bit memory system, I/O ports to various external devices including the CAMAC dataway, a memory incrementer/adder and a daisy-chain of experiment-specific modules which calculate the memory address which is to be incremented. The design of the daisy-chain permits multiple modules and provides for easy modification as experimental needs change. The system has been designed for use in multiparameter, multichannel analysis of high-speed data gathered by position-sensitive detectors at conventional and synchrotron X-ray sources as well as for fixed energy and time-of-flight diffraction at continuous and pulsed neutron sources. Modules which have been developed to date include a buffer for two-dimensional position-sensitive detectors, a mapper for high-speed coordinate transformations, a buffered time-of-flight clock, a time-correlator for synchronized diffraction experiments, and a display unit for data bus diagnostics. (orig.)

  7. Optimised battery capacity utilisation within battery management systems

    NARCIS (Netherlands)

    Wilkins, S.; Rosca, B. (Bogdan); Jacob, J.; Hoedmaekers, E.

    2015-01-01

    Battery Management Systems (BMSs) play a key role in the performance of both hybrid and fully electric vehicles. Typically, the role of the BMS is to help maintain safety, performance, and overall efficiency of the battery pack. One important aspect of its operation is the estimation of the state of

  8. Capacity Building of a District Education System: Insights from Kenya

    Science.gov (United States)

    Datta, Dipankar; Phillip, Serene; Verma, Prashant Kumar

    2009-01-01

    Both (a) in-school factors such as over-focus on academic performance, absence of uniform, and corporal punishment, and (b) out-of school factors such as caring for ailing parents, child labor, etc., hinder participation of orphan and vulnerable children (PVC) in Free Primary Education (FOE) system in Nyasa Province, Kenya. In this context Concern…

  9. Strengthening and expanding the capacity of health worker education in Zambia.

    Science.gov (United States)

    Michelo, Charles; Zulu, Joseph Mumba; Simuyemba, Moses; Andrews, Benjamin; Katubulushi, Max; Chi, Benjamin; Njelesani, Evariste; Vwalika, Bellington; Bowa, Kasonde; Maimbolwa, Margaret; Chipeta, James; Goma, Fastone; Nzala, Selestine; Banda, Sekelani; Mudenda, John; Ahmed, Yusuf; Hachambwa, Lotti; Wilson, Craig; Vermund, Sten; Mulla, Yakub

    2017-01-01

    Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia. Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach. The MEPI program triggered the development of new postgraduate programs thereby increasing student enrollment. This was achieved by leveraging of existing and new partnerships with other universities and differentiating the old Master in Public Health into specialized curriculum. Furthermore, the MEPI program improved the capacity and quality of training by facilitating installation and integration of new technology such as the eGranary digital library, E-learning methods and clinical skills laboratory into the Schools. This technology enabled easy access to relevant data or information, quicker turn around of experiments and enhanced data recording, display and analysis features for experiments. The program also facilitated transforming of the academic environment into a more conducive work place through strengthening the Staff Development program and support towards research activities. These activities stimulated work motivation and interest in research by faculty. Meanwhile, these processes were inhibited by the inability to upload all courses on to Moodle as well as inadequate operating procedures and feedback mechanisms for the Moodle. Expansion and improvement in training processes for health care workers requires targeted investment within medical institutions and strengthening local and international partnerships.

  10. Empowerment and the ecological determinants of health: three critical capacities for practitioners.

    Science.gov (United States)

    Williams, Lewis

    2017-08-01

    Human agency or the expression of intentionality towards some form of betterment has long occupied human imagination and creativity. The ways in which we express such aspirations are fundamentally informed by our beliefs about the nature of reality, meanings of human well-being and progress, and the ways in which our social locations shape our interests. Within Western health-promoting discourse and practice, such processes have largely been expressed through the construct of empowerment. To date, like health, much empowerment practice has been implicitly rooted in Cartesianism, has tended towards anthropocentrism and in cases where it has engaged with environmental issues, has mirrored environmentalism's focus on externalities and objectivity. These tendencies coupled with the increasing complexity of global, ecological, human well-being issues call empowerment practitioners to integrate new kinds of capacities more suited to addressing the ecological determinants of health. Drawing in part on the author's empowerment research over more than a decade, this article distinguishes between a range of epistemological perspectives underlying contemporary empowerment practices while fore-grounding the concepts of place-based agency and social-ecological resilience. These constructs in turn form the basis for three capacities considered critical for practitioners addressing human-ecological well-being. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Building capacity to develop an African teaching platform on health workforce development: a collaborative initiative of universities from four sub Saharan countries.

    Science.gov (United States)

    Amde, Woldekidan Kifle; Sanders, David; Lehmann, Uta

    2014-05-30

    Health systems in many low-income countries remain fragile, and the record of human resource planning and management in Ministries of Health very uneven. Public health training institutions face the dual challenge of building human resources capacity in ministries and health services while alleviating and improving their own capacity constraints. This paper reports on an initiative aimed at addressing this dual challenge through the development and implementation of a joint Masters in Public Health (MPH) programme with a focus on health workforce development by four academic institutions from East and Southern Africa and the building of a joint teaching platform. Data were obtained through interviews and group discussions with stakeholders, direct and participant observations, and reviews of publications and project documents. Data were analysed using thematic analysis. The institutions developed and collaboratively implemented a 'Masters Degree programme with a focus on health workforce development'. It was geared towards strengthening the leadership capacity of Health ministries to develop expertise in health human resources (HRH) planning and management, and simultaneously build capacity of faculty in curriculum development and innovative educational practices to teach health workforce development. The initiative was configured to facilitate sharing of experience and resources. The implementation of this initiative has been complex, straddling multiple and changing contexts, actors and agendas. Some of these are common to postgraduate programmes with working learners, while others are unique to this particular partnership, such as weak institutional capacity to champion and embed new programmes and approaches to teaching. The partnership, despite significant inherent challenges, has potential for providing real opportunities for building the field and community of practice, and strengthening the staff and organizational capacity of participant institutions. Key

  12. Higher order capacity statistics of multi-hop transmission systems over Rayleigh fading channels

    KAUST Repository

    Yilmaz, Ferkan

    2012-03-01

    In this paper, we present an exact analytical expression to evaluate the higher order statistics of the channel capacity for amplify and forward (AF) multihop transmission systems operating over Rayleigh fading channels. Furthermore, we present simple and efficient closed-form expression to the higher order moments of the channel capacity of dual hop transmission system with Rayleigh fading channels. In order to analyze the behavior of the higher order capacity statistics and investigate the usefulness of the mathematical analysis, some selected numerical and simulation results are presented. Our results are found to be in perfect agreement. © 2012 IEEE.

  13. Capital investment strategies in health care systems.

    Science.gov (United States)

    Reiter, K L; Smith, D G; Wheeler, J R; Rivenson, H L

    2000-01-01

    Capital investment decisions are among the most important decisions made by firms. They determine the firm's capacity for providing services and commit the firm's cash for an extended period of time. Interviews with chief financial officers of leading health care systems reveal capital investment strategies that generally follow the recommendations of modern finance theory. Still, there is substantial variation in capital budgeting techniques, methods of risk adjustment, and the importance of qualitative considerations in investment decision making. There is also variation in delegation of investment decision making to operating units and methods of performance evaluation. Health care systems face the same challenges as other organizations in developing and implementing capital investment strategies that use consistent methods for evaluation of projects that have inconsistent aims and outcomes.

  14. Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health risk.

    Science.gov (United States)

    McCraty, Rollin; Shaffer, Fred

    2015-01-01

    Heart rate variability, the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operates on different time scales to adapt to environmental and psychological challenges. This article briefly reviews neural regulation of the heart and offers some new perspectives on mechanisms underlying the very low frequency rhythm of heart rate variability. Interpretation of heart rate variability rhythms in the context of health risk and physiological and psychological self-regulatory capacity assessment is discussed. The cardiovascular regulatory centers in the spinal cord and medulla integrate inputs from higher brain centers with afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. We also discuss the intrinsic cardiac nervous system and the heart-brain connection pathways, through which afferent information can influence activity in the subcortical, frontocortical, and motor cortex areas. In addition, the use of real-time HRV feedback to increase self-regulatory capacity is reviewed. We conclude that the heart's rhythms are characterized by both complexity and stability over longer time scales that reflect both physiological and psychological functional status of these internal self-regulatory systems.

  15. The Health Equity Leadership Institute (HELI): Developing workforce capacity for health disparities research.

    Science.gov (United States)

    Butler, James; Fryer, Craig S; Ward, Earlise; Westaby, Katelyn; Adams, Alexandra; Esmond, Sarah L; Garza, Mary A; Hogle, Janice A; Scholl, Linda M; Quinn, Sandra C; Thomas, Stephen B; Sorkness, Christine A

    2017-06-01

    Efforts to address health disparities and achieve health equity are critically dependent on the development of a diverse research workforce. However, many researchers from underrepresented backgrounds face challenges in advancing their careers, securing independent funding, and finding the mentorship needed to expand their research. Faculty from the University of Maryland at College Park and the University of Wisconsin-Madison developed and evaluated an intensive week-long research and career-development institute-the Health Equity Leadership Institute (HELI)-with the goal of increasing the number of underrepresented scholars who can sustain their ongoing commitment to health equity research. In 2010-2016, HELI brought 145 diverse scholars (78% from an underrepresented background; 81% female) together to engage with each other and learn from supportive faculty. Overall, scholar feedback was highly positive on all survey items, with average agreement ratings of 4.45-4.84 based on a 5-point Likert scale. Eighty-five percent of scholars remain in academic positions. In the first three cohorts, 73% of HELI participants have been promoted and 23% have secured independent federal funding. HELI includes an evidence-based curriculum to develop a diverse workforce for health equity research. For those institutions interested in implementing such an institute to develop and support underrepresented early stage investigators, a resource toolbox is provided.

  16. Building capacity in Australian interprofessional health education: perspectives from key health and higher education stakeholders.

    Science.gov (United States)

    Matthews, Lynda R; Pockett, Rosalie B; Nisbet, Gillian; Thistlethwaite, Jill E; Dunston, Roger; Lee, Alison; White, Jill F

    2011-05-01

    A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.

  17. Hawaii's public mental health system.

    Science.gov (United States)

    VanderVoort, Debra J

    2005-03-01

    The following article addresses the nature of and problems with the public mental health system in Hawaii. It includes a brief history of Hawaii's public mental health system, a description and analysis of this system, economic factors affecting mental health, as well as a needs assessment of the elderly, individuals with severe mental illness, children and adolescents, and ethnically diverse individuals. In addition to having the potential to increase suicide rates and unnecessarily prolong personal suffering, problems in the public mental health system such as inadequate services contribute to an increase in social problems including, but not limited to, an increase in crime rates (e.g., domestic violence, child abuse), divorce rates, school failure, and behavioral problems in children. The population in need of mental health services in Hawaii is under served, with this inadequacy of services due to economic limitations and a variety of other factors.

  18. Integrated Systems Health Management for Intelligent Systems

    Science.gov (United States)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  19. Building capacity for health promotion--a case study from China.

    Science.gov (United States)

    Tang, Kwok-Cho; Nutbeam, Don; Kong, Lingzhi; Wang, Ruotao; Yan, Jun

    2005-09-01

    During the period 1997-2000 a technical assistance project to build capacity for community-based health promotion was implemented in seven cities and one province in China. The technical assistance project formed part of a much larger World Bank supported program to improve disease prevention capabilities in China, commonly known as Health VII. The technical assistance project was funded by the Australian Agency for International Development. It was designed to develop capacity within the Ministry of Health (MOH) and the cities and province in the management of community-based health promotion projects, as well as supporting institutional development and public health policy reform. There are some relatively unique features of this technical assistance which helped shape its implementation and impact. It sought to provide the Chinese MOH and the cities and province with an introduction to comprehensive health promotion strategies, in contrast to the more limited information, education and communication strategies. The project was provided on a continuing basis over 3 years through a single institution, rather than as a series of ad hoc consultancies by individuals. Teaching and learning processes were developmental, leading progressively to a greater degree of local Chinese input and management to ensure sustainability and maintenance of technical support for the project. Based on this experience, this paper presents a model for capacity building projects of this type. It describes the education, training and planning activities that were the key inputs to the project, as well as the limited available evidence on the impact of the project. It describes how the project evolved over time to meet the changing needs of the participants, specifically how the content of the project shifted from a risk-factor orientation to a settings-based focus, and the delivery of the project moved from an expert-led approach to a more participatory, problem based learning approach. In

  20. A Disability and Health Institutional Research Capacity Building and Infrastructure Model Evaluation: A Tribal College-Based Case Study

    Science.gov (United States)

    Moore, Corey L.; Manyibe, Edward O.; Sanders, Perry; Aref, Fariborz; Washington, Andre L.; Robertson, Cherjuan Y.

    2017-01-01

    Purpose: The purpose of this multimethod study was to evaluate the institutional research capacity building and infrastructure model (IRCBIM), an emerging innovative and integrated approach designed to build, strengthen, and sustain adequate disability and health research capacity (i.e., research infrastructure and investigators' research skills)…

  1. Strengthening capacity for local evidence to inform local responders to HIV in a remote Solomon Island health service

    Directory of Open Access Journals (Sweden)

    David MacLaren

    2015-04-01

    Full Text Available Background: Documenting specific knowledge and attitudes about HIV in the culturally diverse nation of Solomon Islands is essential to inform locally targeted public health responses. As part of a large capacity-strengthening project at Atoifi Adventist Hospital in East Kwaio, Solomon Islands, researchers, using a ‘learn-by-doing’ process, worked with participants in public health research methods. Methods: Overall, 43 people attended research capacity building workshops in 2011; eight joined the HIV study group. A cross-sectional survey including semi-structured interviews on HIV was conducted by the group. In February 2014, a hospital administrator was interviewed about how the 2011 study informed local HIV responses. Results: Of the 53 survey participants, 64% self-assessed as having little or no HIV knowledge, but 90% knew HIV could be transmitted between men and women during sex. Less than 50% knew HIV could be transmitted between two men having sex, 45% thought HIV could be transmitted by mosquitoes and 55% agreed condoms help protect from HIV. Most participants reported negative attitudes towards people with HIV. Three years later the health administrator reported ad hoc responses to HIV because of low HIV prevalence, increasing noncommunicable diseases, staff turnover and resource shortages. Discussion: This HIV study was used to strengthen research skills in local health professionals and community members in Solomon Islands. It showed that community members require accurate information about HIV transmission and that entrenched stigma is an issue. Although results provided local evidence for local response, ongoing health system challenges and little local HIV transmission meant HIV services remain rudimentary.

  2. SDH-NET: a South-North-South collaboration to build sustainable research capacities on social determinants of health in low- and middle-income countries.

    Science.gov (United States)

    Cash-Gibson, Lucinda; Guerra, German; Salgado-de-Snyder, V Nelly

    2015-10-22

    It is desirable that health researchers have the ability to conduct research on health equity and contribute to the development of their national health system and policymaking processes. However, in low- and middle-income countries (LMICs), there is a limited capacity to conduct this type of research due to reasons mostly associated with the status of national (health) research systems. Building sustainable research capacity in LMICs through the triangulation of South-North-South (S-N-S) collaborative networks seems to be an effective way to maximize limited national resources to strengthen these capacities. This article describes how a collaborative project (SDH-Net), funded by the European Commission, has successfully designed a study protocol and a S-N-S collaborative network to effectively support research capacity building in LMICs, specifically in the area of social determinants of health (SDH); this project seeks to elaborate on the vital role of global collaborative networks in strengthening this practice. The implementation of SDH-Net comprised diverse activities developed in three phases. Phase 1: national level mapping exercises were conducted to assess the needs for SDH capacity building or strengthening in local research systems. Four strategic areas were defined, namely research implementation and system performance, social appropriation of knowledge, institutional and national research infrastructure, and research skills and training/networks. Phase 2: development of tools to address the identified capacity building needs, as well as knowledge management and network strengthening activities. Phase 3: identifying lessons learned in terms of research ethics, and how policies can support the capacity building process in SDH research. The implementation of the protocol has led the network to design innovative tools for strengthening SDH research capacities, under a successful S-N-S collaboration that included national mapping reports, a global open

  3. Polarized Uniform Linear Array System: Beam Radiation Pattern, Beamforming Diversity Order, and Channel Capacity

    Directory of Open Access Journals (Sweden)

    Xin Su

    2015-01-01

    Full Text Available There have been many studies regarding antenna polarization; however, there have been few publications on the analysis of the channel capacity for polarized antenna systems using the beamforming technique. According to Chung et al., the channel capacity is determined by the density of scatterers and the transmission power, which is obtained based on the assumption that scatterers are uniformly distributed on a 3D spherical scattering model. However, it contradicts the practical scenario, where scatterers may not be uniformly distributed under outdoor environment, and lacks the consideration of fading channel gain. In this study, we derive the channel capacity of polarized uniform linear array (PULA systems using the beamforming technique in a practical scattering environment. The results show that, for PULA systems, the channel capacity, which is boosted by beamforming diversity, can be determined using the channel gain, beam radiation pattern, and beamforming diversity order (BDO, where the BDO is dependent on the antenna characteristics and array configurations.

  4. Qualification of the adaptive capacities of livestock farming systems

    Directory of Open Access Journals (Sweden)

    Benoît Dedieu

    2009-07-01

    Full Text Available This paper aims at exploring what is covered by « adapting to last » with a farming systems approach. Long term dynamics can be analysed as adaptive cycles, the system being permanently exposed to disturbances and shocks. Mobilizing the concept of resilience, we analyse the factors that differentiate the principles for long term action the livestock farmers have, principles which give consistency to the family - farms trajectories. With the concept of operational flexibilty, we qualify the sources of flexibility the livestock farmers maintain to cope with hazards. They are internal, related to the production process regulation properties, to the technical (adaptive or rigid specifications, to the sales policies, or external related to the information and commercial networks. Understanding the production process regulation properties require livestock farming systems models (i.e. combining decisional and biological sub-systems that can simulate how herd dynamics operate under fluctuant rules or productive parameters. It also require to evaluate the room for manoeuvre the work organization let to the farmer. All these aspects are illsutrated with on farm studies in herbivore systems (sheep, dairy, beef.Este artigo busca explorar "adaptações a mudanças" sob a ótica de sistemas de produção animal. Dinâmicas de longo prazo podem ser analisadas como ciclos adaptativos, sendo o sistema permanentemente exposto a distúrbios e choques. Utilizando o conceito de resiliência, analisam-se os fatores que diferenciam os princípios para ações de longo prazo tomadas por produtores rurais, princípios estes que dão consistência à família - trajetórias da propriedade rural. Com o conceito de flexibilidade operacional, qualificam-se as fontes de flexibilidade que os produtores mantêm para lidar com riscos. Eles são internos, relacionados a propriedades de regulação do processo produtivo, a especificações técnicas (adaptáveis ou rígidas, a

  5. Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study.

    Directory of Open Access Journals (Sweden)

    Nguyen-Toan Tran

    Full Text Available Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS, yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS.Descriptive study using an online questionnaire tool.Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%, but was also embraced by development organizations (25% and institutions with dual humanitarian and development mandates (50%. Agencies reported working with refugees (81%, internally-displaced (87% and stateless persons (20%, in camp-based settings (78%, and in urban (83% and rural settings (78%. Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR, emergency management and coordination, delivery of the Minimum Initial Services Package (MISP for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections

  6. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

    Science.gov (United States)

    Missoni, Eduardo

    2013-01-01

    In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Health-care professionals' knowledge, attitudes and behaviours relating to patient capacity to consent to treatment: an integrative review.

    Science.gov (United States)

    Lamont, Scott; Jeon, Yun-Hee; Chiarella, Mary

    2013-09-01

    This integrative review aims to provide a synthesis of research findings of health-care professionals' knowledge, attitudes and behaviours relating to patient capacity to consent to or refuse treatment within the general hospital setting. Search strategies included relevant health databases, hand searching of key journals, 'snowballing' and expert recommendations. The review identified various knowledge gaps and attitudinal dispositions of health-care professionals, which influence their behaviours and decision-making in relation to capacity to consent processes. The findings suggest that there is tension between legal, ethical and professional standards relating to the assessment of capacity and consent within health care. Legislation and policy guidance concerning capacity assessment processes are lacking, and this may contribute to inconsistencies in practice.

  8. Building capacity for Health Impact Assessment: Training outcomes from the United States

    Energy Technology Data Exchange (ETDEWEB)

    Schuchter, Joseph [Berkeley, CA (United States); Rutt, Candace, E-mail: awr8@cdc.gov [Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, 4770 Buford Highway MS/F-77, Atlanta, GA 30341 (United States); Satariano, William A. [University of California Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, CA (United States); Seto, Edmund [University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA (United States)

    2015-01-15

    Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building.

  9. Building capacity for Health Impact Assessment: Training outcomes from the United States

    International Nuclear Information System (INIS)

    Schuchter, Joseph; Rutt, Candace; Satariano, William A.; Seto, Edmund

    2015-01-01

    Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building

  10. e-Health Research and Capacity Building in Latin America and the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project will therefore investigate a range of locally relevant, affordable and ... awareness of free and open source software (FOSS) in health informatics, with a ... for decision-makers, practitioners and developers of health information systems. ... IWRA/IDRC webinar on climate change and adaptive water management.

  11. Developing capacity in health informatics in a resource poor setting: lessons from Peru.

    Science.gov (United States)

    Kimball, Ann Marie; Curioso, Walter H; Arima, Yuzo; Fuller, Sherrilynne; Garcia, Patricia J; Segovia-Juarez, Jose; Castagnetto, Jesus M; Leon-Velarde, Fabiola; Holmes, King K

    2009-10-27

    The public sectors of developing countries require strengthened capacity in health informatics. In Peru, where formal university graduate degrees in biomedical and health informatics were lacking until recently, the AMAUTA Global Informatics Research and Training Program has provided research and training for health professionals in the region since 1999. The Fogarty International Center supports the program as a collaborative partnership between Universidad Peruana Cayetano Heredia in Peru and the University of Washington in the United States of America. The program aims to train core professionals in health informatics and to strengthen the health information resource capabilities and accessibility in Peru. The program has achieved considerable success in the development and institutionalization of informatics research and training programs in Peru. Projects supported by this program are leading to the development of sustainable training opportunities for informatics and eight of ten Peruvian fellows trained at the University of Washington are now developing informatics programs and an information infrastructure in Peru. In 2007, Universidad Peruana Cayetano Heredia started offering the first graduate diploma program in biomedical informatics in Peru.

  12. System capacity and economic modeling computer tool for satellite mobile communications systems

    Science.gov (United States)

    Wiedeman, Robert A.; Wen, Doong; Mccracken, Albert G.

    1988-01-01

    A unique computer modeling tool that combines an engineering tool with a financial analysis program is described. The resulting combination yields a flexible economic model that can predict the cost effectiveness of various mobile systems. Cost modeling is necessary in order to ascertain if a given system with a finite satellite resource is capable of supporting itself financially and to determine what services can be supported. Personal computer techniques using Lotus 123 are used for the model in order to provide as universal an application as possible such that the model can be used and modified to fit many situations and conditions. The output of the engineering portion of the model consists of a channel capacity analysis and link calculations for several qualities of service using up to 16 types of earth terminal configurations. The outputs of the financial model are a revenue analysis, an income statement, and a cost model validation section.

  13. Building Partner Health Capacity with U.S. Military Forces: Enhancing AFSOC Health Engagement Missions

    Science.gov (United States)

    2012-01-01

    footprint in the partner nation • expertise working with partner SOFs • advanced language and transcultural skills • inculcation of a “BPC mindset” in...these relationships have led to critical support for U.S. opera- tions during times of crisis or conflict. Details of these instances are not...United States with access and support in times of crisis and conflict.21 AFSOC health advisors could likewise enable the United States to benefit in

  14. North-south collaboration and capacity development in global health research in low- and middle-income countries - the ARCADE projects.

    Science.gov (United States)

    Atkins, Salla; Marsden, Sophie; Diwan, Vishal; Zwarenstein, Merrick

    2016-01-01

    Research capacity enhancement is needed in low- and middle-income countries (LMICs) for improved health, wellbeing, and health systems' development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE) in Health Systems and Services Research (HSSR) and Research on Social Determinants of Health (RSDH), implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level). We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research environment in Africa, Asia, and Europe.

  15. Estimation of energy storage capacity in power system in japan under future demand and supply factors

    International Nuclear Information System (INIS)

    Kurihara, Ikuo; Tanaka, Toshikatsu

    1996-01-01

    The desirable capacity of future energy storage facility in power system in Japan is discussed in this paper, putting emphasis on future new electric demand/supply factors such as CO 2 emission problems and social structure change. The two fundamental demand scenarios are considered; one is base case scenario which extrapolates the trend until now and the other is social structure change scenario. The desirable capacity of the energy storage facility is obtained from the result of optimum generation mix which minimizes the yearly expenses of the target year (2030 and 2050). The result shows that the optimum capacity of energy storage facility is about 10 to 15%. The social structure change and demand side energy storage have great influences on the optimum capacity of supply side storage. The former increases storage capacity. The latter reduces it and also contributes to the reduction of generation cost. Suppression of CO 2 emission basically affects to reduce the storage capacity. The load following operation of nuclear plant also reduces the optimum storage capacity in the case it produces surplus energy at night. Though there exist many factors which increase or decrease the capacity of energy storage facility, as a whole, it is concluded that the development of new energy storage technology is necessary for future. (author)

  16. The Guatemala-Penn Partners: An Innovative Inter-Institutional Model for Scientific Capacity-Building, Healthcare Education, and Public Health

    Science.gov (United States)

    Paniagua-Avila, Maria Alejandra; Messenger, Elizabeth; Nelson, Caroline A.; Calgua, Erwin; Barg, Frances K.; Bream, Kent W.; Compher, Charlene; Dean, Anthony J.; Martinez-Siekavizza, Sergio; Puac-Polanco, Victor; Richmond, Therese S.; Roth, Rudolf R.; Branas, Charles C.

    2017-01-01

    Population health outcomes are directly related to robust public health programs, access to basic health services, and a well-trained health-care workforce. Effective health services need to systematically identify solutions, scientifically test these solutions, and share generated knowledge. The World Health Organization (WHO)’s Global Healthcare Workforce Alliance states that the capacity to perform research is an essential factor for well-functioning public health systems. Low- and middle-income countries have greater health-care worker shortages and lower research capacity than higher-income countries. International global health partnerships between higher-income countries and low-middle-income countries aim to directly address such inequalities through capacity building, a process by which human and institutional resources are strengthened and developed, allowing them to perform high-level functions, solve complex problems, and achieve important objectives. The Guatemala–Penn Partners (GPP) is a collaboration among academic centers in Guatemala and the University of Pennsylvania (Penn), in Philadelphia, Pennsylvania that echoes the vision of the WHO’s Global Healthcare Workforce Alliance. This article describes the historical development and present organization of the GPP according to its three guiding principles: university-to-university connections, dual autonomies with locally led capacity building, and mutually beneficial exchanges. It describes the GPP activities within the domains of science, health-care education, and public health, emphasizing implementation factors, such as sustainability and scalability, in relation to the guiding principles. Successes and limitations of this innovative model are also analyzed in the hope that the lessons learned may be applied to similar partnerships across the globe. PMID:28443274

  17. Building Capacity in Health Systems and Policy Analysis in sub ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1 avr. 2010 ... L'Initiative des conseils subventionnaires de la recherche scientifique en Afrique subsaharienne remporte le prix de la diplomatie scientifique. L'Initiative des conseils subventionnaires de la recherche scientifique en Afrique subsaharienne a reçu un prix de la diplomatie scientifique de la part du ...

  18. A globally networked hybrid approach to public health capacity training for maternal health professionals in low and middle income countries.

    Science.gov (United States)

    McIntosh, Scott; Pérez-Ramos, José G; David, Tamala; Demment, Margaret M; Avendaño, Esteban; Ossip, Deborah J; De Ver Dye, Timothy

    2017-01-01

    MundoComm is a current NIH-funded project for sustainable public health capacity building in community engagement and technological advances aimed at improving maternal health issues. Two to four teams are selected annually, each consisting of three healthcare professionals and one technical person from specific low and middle income countries (LMICs) including Costa Rica, Dominican Republic, Honduras, and other LMICs. MundoComm is a course with three parts: in-person workshops, online modules, and mentored community engagement development. Two annual 1-week on-site "short courses" convened in Costa Rica are supplemented with six monthly online training modules using the Moodle® online platform for e-learning, and mentored project development. The year-long course comprises over 20 topics divided into the six modules - each module further segmented into 4 week-long assignments, with readings and assigned tasks covering different aspects of community-engaged interventions. The content is peer reviewed by experts in the respective fields from University of Rochester, UCIMED in Costa Rica, and faculty from Costa Rica and the Dominican Republic who maintain regular contact with the trainees to mentor learning and project progress. The purpose of this paper is to report the first year results of the MundoComm project. Both quantitative and qualitative feedback (using online data capturing forms) assess baseline and post-training knowledge and skills in public health project strategies. The course currently has one team each in Costa Rica, the Dominican Republic, and Honduras for a total of 12 trainees. The course and modules include best practices in information and communication technologies (ICTs), ethical reviews, community engagement, evidence-based community interventions, and e-Health strategies. To maximize successful and culturally appropriate training approaches, the multi-media didactic presentations, flexible distance learning strategies, and the use of

  19. Global health education in Germany: an analysis of current capacity, needs and barriers.

    Science.gov (United States)

    Kaffes, Ioannis; Moser, Fabian; Pham, Miriam; Oetjen, Aenne; Fehling, Maya

    2016-11-25

    In times of increasing global challenges to health, it is crucial to create a workforce capable of tackling these complex issues. Even though a lack of GHE in Germany is perceived by multiple stakeholders, no systematic analysis of the current landscape exists. The aim of this study is to provide an analysis of the global health education (GHE) capacity in Germany as well as to identify gaps, barriers and future strategies. An online search in combination with information provided by student representatives, course coordinators and lecturers was used to create an overview of the current GHE landscape in Germany. Additionally, a semi-structured questionnaire was sent to GHE educators and students engaged in global health (GH) to assess the capacity of German GHE, its barriers and suggested strategies for the future. A total of 33 GHE activities were identified at 18 German universities. Even though medical schools are the main provider of GHE (42%), out of 38 medical schools, only 13 (34%) offer any kind of GHE. Modules offered for students of other health-related professions constitute 27% of all activities. Most survey respondents (92%, n = 48) consider current GHE activities in Germany insufficient. Suggested formats were GHE as part of medical curricula (82%, n = 45) and dual degree MD/MPH or PhD programs. Most important barriers mentioned were low priority of GH at faculties and academic management levels (n = 41, 75%) as well as lack of necessary institutional structures (n = 33, 60%). Despite some innovative academic approaches, there is clearly a need for more systematic GHE in Germany. GHE educators and students can take an important role advocating for more awareness at university management level and suggesting ways to institutionalize GHE to overcome barriers. This study provides key evidence, relevant perceptions and suggestions to strengthen GHE in Germany.

  20. Mobile health systems and emergence

    NARCIS (Netherlands)

    Jones, Valerie M.; Graziosi, Barbara

    2015-01-01

    Changes in the age distribution of the population and increased prevalence of chronic illnesses, together with a shortage of health professionals and other resources, will increasingly challenge the ability of national healthcare systems to meet rising demand for services. Large-scale use of eHealth

  1. Czechoslovakia's changing health care system.

    Science.gov (United States)

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.

  2. An assessment of Makerere University College of Health Sciences: optimizing health research capacity to meet Uganda’s priorities

    Directory of Open Access Journals (Sweden)

    Groves Sara

    2011-03-01

    Full Text Available Abstract Background Health research is critical to the institutional mission of the Makerere College of Health Sciences (MakCHS. Optimizing the alignment of health research capacity at MakCHS with the health needs and priorities of Uganda, as outlined in the country’s Health Sector Strategic Plan (HSSP, is a deliberate priority, a responsibility, and a significant opportunity for research. To guide this strategic direction, an assessment of MakCHS’s research grants and publication portfolio was conducted. Methods A survey of all new and ongoing grants, as well as all publications, between January 2005 and December 2009 was conducted. Research, training, and education grants awarded to MakCHS’ constituent faculties and departments, were looked for through financial records at the college or by contact with funding organizations. Published manuscripts registered with PubMed, that included MakCHS faculty authors, were also analyzed. Results A total of 58 active grants were identified, of which 18 had been initiated prior to 2005 and there were an average of about eight new grants per year. Most grants funded basic and applied research, with major focus areas being HIV/AIDS (44%, malaria (19%, maternal and child health (14%, tuberculosis (11%, mental health (3%, and others (8%. MakCHS faculty were identified as Principal Investigators (PIs in only 22 (38% active grants. Grant funding details were only available for one third of the active grants at MakCHS. A total of 837 publications were identified, with an average of 167 publications per year, most of which (66% addressed the country’s priority health areas, and 58% had MakCHS faculty or students as first authors. Conclusions The research grants and publications at MakCHS are generally well-aligned with the Ugandan Health Ministry priorities. Greater efforts to establish centralized and efficient grants management procedures are needed. In addition, greater efforts are needed to expand

  3. Breast Health Belief Systems Study

    National Research Council Canada - National Science Library

    Williams, Mary

    1999-01-01

    .... The hypothesis underlying this research is that a breast health promotion approach that is based in specific belief systems among three disparate African American rural populations of low socioeconomic status (SES...

  4. On the Asymptotic Capacity of Dual-Aperture FSO Systems with a Generalized Pointing Error Model

    KAUST Repository

    Al-Quwaiee, Hessa

    2016-06-28

    Free-space optical (FSO) communication systems are negatively affected by two physical phenomenon, namely, scintillation due to atmospheric turbulence and pointing errors. To quantify the effect of these two factors on FSO system performance, we need an effective mathematical model for them. In this paper, we propose and study a generalized pointing error model based on the Beckmann distribution. We then derive a generic expression of the asymptotic capacity of FSO systems under the joint impact of turbulence and generalized pointing error impairments. Finally, the asymptotic channel capacity formula are extended to quantify the FSO systems performance with selection and switched-and-stay diversity.

  5. Thermal performance analysis of reciprocating compressor with stepless capacity control system

    International Nuclear Information System (INIS)

    Bin, Tang; Yuanyang, Zhao; Liansheng, Li; Guangbin, Liu; Le, Wang; Qichao, Yang; Haiping, Xu; Feng, Zhu; Wenhui, Meng

    2013-01-01

    On the basic principle of stepless capacity control system for large reciprocating compressor, the thermal cycle was analyzed. The equations for the process of suction, reverse flow, compression, discharge and expansion of clearance gas were established. According to these equations, p–V diagrams at various situations were simulated. An experimental platform was setup and the compressor with designed stepless capacity control system run well. The experimental results show that the capacity of compressor can be regulated steplessly, and the motor power is reduced proportionally with respect to the reduction of capacity. During the suction process, both the flow resistance of valve and the pressure fluctuation in cylinder can be reduced by opening the suction valves with the actuators. The simulated and experimental results showed good coincidence. The clearance volume and valve clearance Mach number had a negative influence on the thermal performance of compressor with stepless capacity control system. -- Highlights: ► Flow resistance of valve can be reduced and pressure fluctuation can be reduced. ► Equivalent Mach number of reverse flow is much higher than that of suction process. ► Response of stepless capacity control system is important for regulation accuracy. ► Clearance and valve clearance Mach number have influence on thermal performance

  6. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  7. Health Systems Strengthening

    DEFF Research Database (Denmark)

    Hanlin, Rebecca; Andersen, Margrethe Holm

    The Global Network for the Economics of Learning, Innovation, and Competence Building Systems (Globelics) is an open and diverse community of scholars working on innovation and competence building in the context of economic development. The major purpose of the network is to contribute to buildin...

  8. Intelligent Integrated System Health Management

    Science.gov (United States)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  9. The effects of changes to estuarine hydrology on system phosphorous retention capacity: The Mondego estuary, Portugal

    DEFF Research Database (Denmark)

    Lillebo, A. I.; Otero, M.; Coelho, J. P.

    2012-01-01

    with the highest PO4-P adsorption capacity (Q* = 657 mu g P g(-1) wwt), thus the PO4-P availability in the water column was mostly dependent on the mineralization processes, which is in agreement with previous findings; ii) After 1998, the water residence time diminished from moderate (weeks) to short (days......). This change coincided with a diversion of the water to an area with a much lower PO4-P adsorption capacity (Q* = 410 mu g P g(-1) wwt), which represented a decrease in 7.3% of the system adsorption capacity. This means that sediments were not able to adsorb much of the PO4-P and a higher equilibrium...... in the estuary, we framed the hypothesis that the significant increase of DIP could be related to different sorption capacities of the sediments. The results highlighted two scenarios: i) Before 1998 the nutrient-rich freshwater input from the upstream cultivated lands entered the system through the area...

  10. Impact of Operating Rules on Planning Capacity Expansion of Urban Water Supply Systems

    Science.gov (United States)

    de Neufville, R.; Galelli, S.; Tian, X.

    2017-12-01

    This study addresses the impact of operating rules on capacity planning of urban water supply systems. The continuous growth of metropolitan areas represents a major challenge for water utilities, which often rely on industrial water supply (e.g., desalination, reclaimed water) to complement natural resources (e.g., reservoirs). These additional sources increase the reliability of supply, equipping operators with additional means to hedge against droughts. How do their rules for using industrial water supply impact the performance of water supply system? How might it affect long-term plans for capacity expansion? Possibly significantly, as demonstrated by the analysis of the operations and planning of a water supply system inspired by Singapore. Our analysis explores the system dynamics under multiple inflow and management scenarios to understand the extent to which alternative operating rules for the use of industrial water supply affect system performance. Results first show that these operating rules can have significant impact on the variability in system performance (e.g., reliability, energy use) comparable to that of hydro-climatological conditions. Further analyses of several capacity expansion exercises—based on our original hydrological and management scenarios—show that operating rules significantly affect the timing and magnitude of critical decisions, such as the construction of new desalination plants. These results have two implications: Capacity expansion analysis should consider the effect of a priori uncertainty about operating rules; and operators should consider how their flexibility in operating rules can affect their perceived need for capacity.

  11. Experimental study of a novel capacity control algorithm for a multi-evaporator air conditioning system

    International Nuclear Information System (INIS)

    Xu Xiangguo; Pan Yan; Deng Shiming; Xia Liang; Chan Mingyin

    2013-01-01

    The use of a multi-evaporator air conditioning (MEAC) system is advantageous in terms of installation convenience, high design flexibility, being easy to maintain and commission, better indoor thermal comfort control and higher energy efficiency. While MEAC units worth billions of dollars are sold worldwide, the detailed accounts on compressor capacity control and refrigeration flow distribution amongst evaporators remain unavailable in public domain, mainly due to commercial confidentiality. Limited control algorithms for MEAC systems have been developed based on system simulation, and no experimental-based capacity controller developments and their controllability tests may be identified in open literature. In the study reported in this paper, a novel capacity control algorithm, which imitated On–Off control of a single evaporator air conditioning (A/C) system in each indoor unit of a MEAC system by using variable speed compressor and electronic expansion valves (EEVs), was developed. Controllability tests under various settings for experimentally validating the novel capacity control algorithm were carried out and the control algorithm was further improved based on the experimental results. - Highlights: ► A capacity control algorithm for a multi-evaporator air conditioning system was developed. ► Experimental controllability tests under various settings were carried out. ► The control algorithm was further improved based on the experimental results.

  12. Switching the poles in sexual and reproductive health research: implementing a research capacity-strengthening network in West and North Africa.

    Science.gov (United States)

    Dossou, Jean-Paul; Assarag, Bouchra; Delamou, Alexandre; Van der Veken, Karen; Belaid, Loubna; Ouédraogo, Moctar; Khalfallah, Sonia; Aouras, Hayet; Diadhiou, Mohamed; Fassassi, Raïmi; Delvaux, Thérèse

    2016-08-08

    Health research capacities have been improved in Africa but still remain weak as compared to other regions of the World. To strengthen these research capacities, international collaboration and networking for knowledge and capacity transfer are needed. In this commentary, we present the Network for Scientific Support in the field of Sexual and Reproductive Health in West and North Africa, its priority research topics and discuss its implementation process. Established in January 2014, the Network aims at generating human rights and gender-based research fully carried out and driven by South based institutions. It is composed of 12 institutions including the Institute of Tropical Medicine of Antwerp (Belgium) and 11 institutions from eight Francophone West and North African countries. The key areas of interest of this network are health policies analysis and health system research in family planning, HIV prevention among vulnerable groups, quality of care and breast cancers. Since it started, seventeen research proposals based on locally relevant research questions have been developed. Among the seventeen proposals, eleven have been implemented. Several research institutions enhanced linkages with local representations of international partners such as UNFPA. The network is committed to strengthening methodological research capacities and soft skills such as fundraising, advocacy and leadership. Such competencies are strongly needed for developing an effective South-based leadership in Sexual and Reproductive Health research, and for achieving the Sustainable Development Goals.

  13. A thematic analysis of the role of the organisation in building allied health research capacity: a senior managers' perspective.

    Science.gov (United States)

    Golenko, Xanthe; Pager, Susan; Holden, Libby

    2012-08-27

    Evidence-based practice aims to achieve better health outcomes in the community. It relies on high quality research to inform policy and practice; however research in primary health care continues to lag behind that of other medical professions. The literature suggests that research capacity building (RCB) functions across four levels; individual, team, organisation and external environment. Many RCB interventions are aimed at an individual or team level, yet evidence indicates that many barriers to RCB occur at an organisational or external environment level. This study asks senior managers from a large healthcare organisation to identify the barriers and enablers to RCB. The paper then describes strategies for building allied health (AH) research capacity at an organisational level from a senior managers' perspective. This qualitative study is part of a larger collaborative RCB project. Semi-structured in-depth interviews were conducted with nine allied health senior managers. Recorded interviews were transcribed and NVivo was used to analyse findings and emergent themes were defined. The dominant themes indicate that the organisation plays an integral role in building AH research capacity and is the critical link in creating synergy across the four levels of RCB. The organisation can achieve this by incorporating research into its core business with a whole of organisation approach including its mission, vision and strategic planning. Critical success factors include: developing a co-ordinated and multidisciplinary approach to attain critical mass of research-active AH and enhance learning and development; support from senior managers demonstrated through structures, processes and systems designed to facilitate research; forming partnerships to increase collaboration and sharing of resources and knowledge; and establishing in internal framework to promote recognition for research and career path opportunities. This study identifies four key themes: whole of

  14. [The health system of Guatemala].

    Science.gov (United States)

    Becerril-Montekio, Víctor; López-Dávila, Luis

    2011-01-01

    This paper describes the health conditions in Guatemala and, in more detail, the characteristics of the Guatemalan health system, including its structure en coverage, its financial sources, the stewardship functions developed by the Ministry of Health, as well as the generation of health information and the development of research activities. It also discusses the recent efforts to extend coverage of essential health services, mostly to poor rural areas.The most recent innovations also discussed in this paper include the Program for the Expansion of Coverage of Essential Services, the Program to Expand Access to Essential Drugs and the agreements between the Ministry of Health and several non-governmental organizations to provide essential services in rural settings.

  15. Strengthening Governance in Health Systems for Reproductive ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Home · What we do ... As a result, Pakistan's health system has suffered and health service delivery has worsened. ... This four-year project aims to strengthen health systems governance for reproductive health and rights in Pakistan.

  16. Building Capacity in the Sikh Asian Indian Community to Lead Participatory Oral Health Projects.

    Science.gov (United States)

    Kavathe, Rucha; Islam, Nadia; Zanowiak, Jennifer; Wyatt, Laura; Singh, Hardayal; Northridge, Mary E

    2018-01-01

    Lack of access to oral health care is a significant burden for disadvantaged populations, yet rarely draws the attention of policymakers or community leaders. To understand how UNITED SIKHS identified oral health care as a priority need through its involvement in community-based participatory research (CBPR) initiatives and local data collection, thereby building its capacity to lead participatory oral health projects. The foundation for the partnership between UNITED SIKHS and the New York University (NYU) Prevention Research Center (PRC) was the joint implementation of a CBPR project to prevent diabetes in the Sikh Asian Indian community. Project partners also included a community coalition composed of religious leaders, health providers, members of the media, and dental students and faculty at the NYU College of Dentistry (NYU Dentistry). A community needs and resources assessment survey was jointly developed and conducted in 2010 to better understand health needs in the Sikh community. Fewer than one-half of the Sikh participants (43.0%) reported ever receiving a check-up or screening by a dentist, and of those who did, only one-half (50.0%) reported that it occurred in the past 12 months. Upon clinical assessment, more than one-half of Sikh adults (58.2%) had untreated dental decay. The collection and analysis of local data motivated UNITED SIKHS to develop new priorities based upon the findings. UNITED SIKHS applied for and received external funding to lead a CBPR project that developed, implemented, evaluated, and disseminated a culturally tailored oral health and healthy living curriculum for the Sikh Asian Indian community.

  17. SOLUTION OF THE PROBLEM OF INCREASING THE CAPACITY OF POWER SYSTEM BY USING THE MATLAB MODELING

    International Nuclear Information System (INIS)

    Mshvidobadze, T.

    2008-01-01

    A mathematical model of power system was constructed. It included eight types of electric power plants essential for covering a deficit and bringing the generating capacities of the power system to the level which would provide its normal operation. The restrictions were stated in terms of inequalities, the efficiency function was chosen and the corresponding problem was solved by using the Matlab system. The obtained values of variables represented the values of generated capacities of appropriate power plants providing the minimum value of the efficiency function. (author)

  18. Individual capacity-building approaches in a global pharmaceutical systems strengthening program: a selected review.

    Science.gov (United States)

    Konduri, Niranjan; Rauscher, Megan; Wang, Shiou-Chu Judy; Malpica-Llanos, Tanya

    2017-01-01

    Medicines use related challenges such as inadequate adherence, high levels of antimicrobial resistance and preventable adverse drug reactions have underscored the need to incorporate pharmaceutical services to help achieve desired treatment outcomes, and protect patients from inappropriate use of medicines. This situation is further constrained by insufficient numbers of pharmaceutical personnel and inappropriate skill mix. Studies have addressed individual capacity building approaches of logistics, supply chain or disease specific interventions but few have documented those involving such pharmacy assistants/professionals, or health workers/professionals charged with improving access and provision of pharmaceutical services. We examined how different training modalities have been employed and adapted to meet country-specific context and needs by a global pharmaceutical systems strengthening program in collaboration with a country's Ministry of Health and local stakeholders. Structured, content analysis of training approaches from twelve selected countries and a survey among conveniently selected trainees in Bangladesh and Ethiopia. Case-based learning, practice and feedback, and repetitive interventions such as post-training action plan, supportive supervision and mentoring approaches are effective, evidence-based training techniques. In Ethiopia and Bangladesh, over 94% of respondents indicated that they have improved or developed skills or competencies as a result of the program's training activities. Supportive supervision structures and mentorship have been institutionalized with appropriate management structures. National authorities have been sensitized to secure funding from domestic resources or from the global fund grants for post-training follow-up initiatives. The Pharmaceutical Leadership Development Program is an effective, case-based training modality that motivates staff to develop quality-improvement interventions and solve specific challenges

  19. Reverse Link CDMA System Capacity Evaluation for Stratospheric Platform Mobile Communications

    Directory of Open Access Journals (Sweden)

    Iskandar Iskandar

    2010-10-01

    Full Text Available We propose an analysis of reverse link CDMA multispot beam stratospheric platforms (SPF in this paper. The SPF is currently proposed as a novel wireless technology for the development of the next generation fixed and mobile communications. The geometry of this technology is different from that of the terrestrial but rather similar to the satellite based cellular system. However, evaluation on the CDMA system capacity of this technology has not been much reported. This paper addresses all possible multiple access interference analyses including the effects of channel fading and shadowing in order to evaluate the system capacity. Single SPF and multiple SPF model are evaluated under perfect power control and imperfect power control. The results indicate that in SPF systems the reverse link CDMA capacity is significantly reduced because of the power control imperfections. Moreover, in multiple SPF model the interference caused by the users in overlapped region is not trivial. We found that because of this problem the capacity is reduced for both speech and real-time data applications compared with the single SPF model even though the assumption of perfect power control can be made. In order to improve the system capacity we proposed two methods, first is to increase the minimum elevation angle definition for each platform and the second is to employ an adaptive antenna.

  20. Inactivation of transferrin iron binding capacity by the neutrophil myeloperoxidase system

    International Nuclear Information System (INIS)

    Clark, R.A.; Pearson, D.W.

    1989-01-01

    Human serum apotransferrin was exposed to the isolated myeloperoxidase-H2O2-halide system or to phorbol ester-activated human neutrophils. Such treatment resulted in a marked loss in transferrin iron binding capacity as well as concomitant iodination of transferrin. Each component of the cell-free system (myeloperoxidase, H2O2, iodide) or neutrophil system (neutrophils, phorbol ester, iodide) was required in order to observe these changes. In the cell-free system, the H2O2 requirement was fulfilled by either reagent H2O2 or the peroxide-generating system glucose oxidase plus glucose. Both loss of iron binding capacity and transferrin iodination by either the myeloperoxidase system or activated neutrophils were blocked by azide or catalase. The isolated peroxidase system had an acidic pH optimum, whereas the intact cell system was more efficient at neutral pH. The kinetics of changes in iron binding capacity and iodination closely paralleled one another, exhibiting t1/2 values of less than 1 min for the myeloperoxidase-H2O2 system, 3-4 min for the myeloperoxidase-glucose oxidase system, and 8 min for the neutrophil system. That the occupied binding site is protected from the myeloperoxidase system was suggested by (1) a failure to mobilize iron from iron-loaded transferrin, (2) an inverse correlation between initial iron saturation and myeloperoxidase-mediated loss of iron binding capacity, and (3) decreased myeloperoxidase-mediated iodination of iron-loaded versus apotransferrin. Since as little as 1 atom of iodide bound per molecule of transferrin was associated with substantial losses in iron binding capacity, there appears to be a high specificity of myeloperoxidase-catalyzed iodination for residues at or near the iron binding sites. Amino acid analysis of iodinated transferrin (approximately 2 atoms/molecule) demonstrated that iodotyrosine was the predominant iodinated species

  1. North–south collaboration and capacity development in global health research in low- and middle-income countries – the ARCADE projects

    Directory of Open Access Journals (Sweden)

    Salla Atkins

    2016-10-01

    Full Text Available Background: Research capacity enhancement is needed in low- and middle-income countries (LMICs for improved health, wellbeing, and health systems’ development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE in Health Systems and Services Research (HSSR and Research on Social Determinants of Health (RSDH, implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level. Design: We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Results: Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. Discussion: ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research

  2. Research on Overconfidence in Decision-Making for the Capacity Recovery of Damaged Power Systems

    Directory of Open Access Journals (Sweden)

    Xing Bao

    2014-01-01

    Full Text Available This paper studies the influence of two types of overconfident behavior, overestimation and overprecision, on decision of capacity recovery when power system’s critical capacity is seriously damaged. A newsvendor model is used to prove that increasing regulatory punishment for electricity shortage and providing subsidy for capacity recovery are conducive measures to calibrate insufficient service level caused by an overconfident manager. The research also finds that the manager’s overprecision behavior both negatively and positively influences the decision of capacity recovery, and a calibration method could motivate manager to recover more capacity by tuning up the ratio of punishment and subsidy. However, the effectiveness of the calibration mentioned above is inevitably weakened due to the less capacity recovery given by an overestimated manager. This research also indicates that the manager should pay close attention to the random disturbance whose distribution peak is left skewed, and correspondingly more capacity recovery should be given to improve the service level of power system during the disruption.

  3. Health system resilience: Lebanon and the Syrian refugee crisis

    Science.gov (United States)

    Ammar, Walid; Kdouh, Ola; Hammoud, Rawan; Hamadeh, Randa; Harb, Hilda; Ammar, Zeina; Atun, Rifat; Christiani, David; Zalloua, Pierre A

    2016-01-01

    Background Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. Methods We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. Results In studying the case of Lebanon we used input–process–output–outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Conclusion Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved. PMID:28154758

  4. Mobile health information system: a mobile app. to aid health ...

    African Journals Online (AJOL)

    Mobile health information system: a mobile app. to aid health workers relate health information. ... Global Journal of Mathematical Sciences ... phones in delivering vital health information and effective fieldwork reporting is of significance.

  5. Integrating ICTs within health systems | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-10

    Jun 10, 2016 ... ... to help improve service delivery, build local capacity for primary health care, and address the ... There is limited evidence on how electronic health (eHealth) technologies can be ... The world is now home to the greatest num.

  6. Health systems research in the time of health system reform in India: a review.

    Science.gov (United States)

    Rao, Krishna D; Arora, Radhika; Ghaffar, Abdul

    2014-08-09

    Research on health systems is an important contributor to improving health system performance. Importantly, research on program and policy implementation can also create a culture of public accountability. In the last decade, significant health system reforms have been implemented in India. These include strengthening the public sector health system through the National Rural Health Mission (NRHM), and expansion of government-sponsored insurance schemes for the poor. This paper provides a situation analysis of health systems research during the reform period. We reviewed 9,477 publications between 2005 and 2013 in two online databases, PubMed and IndMED. Articles were classified according to the WHO classification of health systems building blocks. Our findings indicate the number of publications on health systems progressively increased every year from 92 in 2006 to 314 in 2012. The majority of papers were on service delivery (40%), with fewer on information (16%), medical technology and vaccines (15%), human resources (11%), governance (5%), and financing (8%). Around 70% of articles were lead by an author based in India, the majority by authors located in only four states. Several states, particularly in eastern and northeastern India, did not have a single paper published by a lead author located in a local institution. Moreover, many of these states were not the subject of a single published paper. Further, a few select institutions produced the bulk of research. Of the foreign author lead papers, 77% came from five countries (USA, UK, Canada, Australia, and Switzerland). The growth of published research during the reform period in India is a positive development. However, bulk of this research is produced in a few states and by a few select institutions Further strengthening health systems research requires attention to neglected health systems domains like human resources, financing, and governance. Importantly, research capacity needs to be strengthened in

  7. Governance of Health Systems Comment on “A Network Based Theory of Health Systems and Cycles of Well-Being”

    OpenAIRE

    Blanchet, Karl

    2013-01-01

    Health systems research aims to understand the governance of health systems (i.e. how health systems function and perform and how their actors interact with each other). This can be achieved by applying innovative methodologies and concepts that are going to capture the complexity and dynamics of health systems when they are affected by shocks. The capacity of health systems to adapt to shocks (i.e. the resilience of health systems) is a new area of investigation. Social network analysis is a...

  8. Introduction on health recommender systems.

    Science.gov (United States)

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  9. Liquid heat capacity of the solvent system (piperazine + n-methyldiethanolamine + water)

    International Nuclear Information System (INIS)

    Chen, Y.-R.; Caparanga, Alvin R.; Soriano, Allan N.; Li, M.-H.

    2010-01-01

    A new set of values for the heat capacity of aqueous mixtures of piperazine (PZ) and n-methyldiethanolamine (MDEA) at different concentrations and temperatures are reported in this paper. The differential scanning calorimetry technique was used to measure the property over the range T = 303.2 K to T = 353.2 K for mixtures containing 0.60 to 0.90 mole fraction water with 15 different concentrations of the system (PZ + MDEA + H 2 O). Heat capacity for four concentrations of the binary system (PZ + MDEA) was also measured. A Redlich-Kister-type equation was adopted to estimate the excess molar heat capacity, which was used to predict the value of the molar heat capacity at a particular concentration and temperature, which would then be compared against the measured value. A total of 165 data points fit into the model resulted in a low overall average absolute deviation of 4.6% and 0.3% for the excess molar heat capacity and molar heat capacity, respectively. Thus, the results presented here are of acceptable accuracy for use in engineering process design.

  10. Research Equity: A Capacity Building Workshop of Research Methodology for Medical Health Professionals

    Directory of Open Access Journals (Sweden)

    Ashok Kumar Bhardwaj

    2013-01-01

    Full Text Available Research is a cornerstone for knowledge generation, which in turns requires capacity building for its tools and techniques. Despite having a vast infrastructure in India the research in medical science has been carried out in limited and focused institutions. In order to build the capacity in carrying out research activities a five-day planning workshop was conducted at state run medical college. Total 22 medical faculty members participated in the workshop with average public health experience of 12 years (range: 5–25 years. The knowledge was assessed objectively by multiple-choice questionnaire. The mean score increased from 6.7 to 7.9 from pre- to posttest. About seventy-percent participants showed improvement, whereas 21.0% showed deterioration in the knowledge and the rest showed the same score. Apart from knowledge skills also showed improvement as total 12 research projects were generated and eight were approved for funding by the Indian Council of Medical Research (ICMR, New Delhi. It can be concluded that a supportive environment for research can be built with the technical assistance.

  11. Capacity of spectrum sharing Cognitive Radio systems over Nakagami fading channels at low SNR

    KAUST Repository

    Sboui, Lokman

    2013-06-01

    In this paper, we study the ergodic capacity of Cognitive Radio (CR) spectrum sharing systems at low power regime. We focus on Nakagami fading channels. We formally define the low power regime and present closed form expressions of the capacity in the low power regime under various types of interference and/or power constraints, depending on the available channel state information (CSI) of the cross link (CL) between the secondary user transmitter and the primary user receiver. We explicitly characterize two regimes where either the interference constraint or the power constraint dictates the optimal power profile. Our framework also highlights the effects of different fading parameters on the secondary link ergodic capacity. Interestingly, we show that the low power regime analysis provides a specific insight on the capacity behavior of CR that has not been reported by previous studies. © 2013 IEEE.

  12. Improving capacity in ethnicity and health research: report of a tailored programme for NHS Public Health practitioners.

    Science.gov (United States)

    Salway, Sarah; Piercy, Hilary; Chowbey, Punita; Brewins, Louise; Dhoot, Permjeet

    2013-10-01

    To determine whether an intervention designed to enhance research capacity among commissioners in the area of ethnicity and health was feasible and impactful, and to identify programme elements that might usefully be replicated elsewhere. How healthcare commissioners should be equipped to understand and address multiethnic needs has received little attention to-date. Being able to mobilise and apply evidence is a central element of the commissioning process that requires development. Researching ethnicity and health is widely recognised as challenging and several prior interventions have aimed to enhance competence in this area. These have, however, predominantly taken place in North America and have not been evaluated in detail. An innovative research capacity development programme was delivered to public health staff within a large healthcare commissioning organisation in England. Evaluation methodology drew on 'pluralistic' evaluation principles and included formative and summative elements. Participant evaluation forms gave immediate feedback during the programme. Participants also provided feedback at two weeks and 12 months after the programme ended. In addition, one participant and one facilitator provided reflective accounts of the programme's strengths and weaknesses, and programme impact was traced through ongoing partnership work. The programme was well received and had a tangible impact on knowledge, confidence and practice for most participants. Factors important to success included: embedding learning within the participants' work context; ensuring a balance between theory and practical tips to enhance confidence; and having sustained interaction between trainers and participants. Despite positive signs, the challenging nature of the topic was highlighted, as were wider structural and cultural factors that impede progress in this area. Although it is unrealistic to expect such programmes to have a major impact on commissioning practices, they may well

  13. Building Capacity to Use Earth Observations in Decision Making for Climate, Health, Agriculture and Natural Disasters

    Science.gov (United States)

    Robertson, A. W.; Ceccato, P.

    2015-12-01

    In order to fill the gaps existing in climate and public health, agriculture, natural disasters knowledge and practices, the International Research Institute for Climate and Society (IRI) has developed a Curriculum for Best Practices in Climate Information. This Curriculum builds on the experience of 10 years courses on 'Climate Information' and captures lessons and experiences from different tailored trainings that have been implemented in many countries in Africa, Asia and Latin America. In this presentation, we will provide examples of training activities we have developed to bring remote sensing products to monitor climatic and environmental information into decision processes that benefited users such as the World Health Organization, Ministries of Health, Ministries of Agriculture, Universities, Research Centers such as CIFOR and FIOCRUZ. The framework developed by IRI to provide capacity building is based on the IDEAS framework: Innovation (research) Around climate impacts, evaluation of interventions, and the value of climate information in reducing risks and maximizing opportunities Demonstration E.g. in-country GFCS projects in Tanzania and Malawi - or El Nino work in Ethiopia Education Academic and professional training efforts Advocacy This might focus on communication of variability and change? We are WHO collaborating center so are engaged through RBM/Global Malaria Programme Service ENACTS and Data library key to this. Country data better quality than NASA as incorporates all relevant station data and NASA products. This presentation will demonstrate how the IDEAS framework has been implemented and lessons learned.

  14. On the BER and capacity analysis of MIMO MRC systems with channel estimation error

    KAUST Repository

    Yang, Liang

    2011-10-01

    In this paper, we investigate the effect of channel estimation error on the capacity and bit-error rate (BER) of a multiple-input multiple-output (MIMO) transmit maximal ratio transmission (MRT) and receive maximal ratio combining (MRC) systems over uncorrelated Rayleigh fading channels. We first derive the ergodic (average) capacity expressions for such systems when power adaptation is applied at the transmitter. The exact capacity expression for the uniform power allocation case is also presented. Furthermore, to investigate the diversity order of MIMO MRT-MRC scheme, we derive the BER performance under a uniform power allocation policy. We also present an asymptotic BER performance analysis for the MIMO MRT-MRC system with multiuser diversity. The numerical results are given to illustrate the sensitivity of the main performance to the channel estimation error and the tightness of the approximate cutoff value. © 2011 IEEE.

  15. Achievable capacity of a spectrum sharing system over hyper fading channels

    KAUST Repository

    Ekin, Sabit

    2009-11-01

    Cognitive radio with spectrum sharing feature is a promising technique to address the spectrum under-utilization problem in dynamically changing environments. In this paper, achievable capacity gain of spectrum sharing systems over dynamic fading environments is studied. For the analysis, a theoretical fading model called hyper fading model that is suitable to the dynamic nature of cognitive radio channel is proposed. Closed-form expression of probability density function (PDF) and cumulative density function (CDF) of the signal-to-noise ratio (SNR) for secondary users in spectrum sharing systems are derived. In addition, the capacity gains achievable with spectrum sharing systems in high and low power regions are obtained. Numerical simulations are performed to study the effects of different fading figures, average powers, interference temperature, and number of secondary users on the achievable capacity.

  16. Adaptive Capacity: An Evolutionary Neuroscience Model Linking Exercise, Cognition, and Brain Health.

    Science.gov (United States)

    Raichlen, David A; Alexander, Gene E

    2017-07-01

    The field of cognitive neuroscience was transformed by the discovery that exercise induces neurogenesis in the adult brain, with the potential to improve brain health and stave off the effects of neurodegenerative disease. However, the basic mechanisms underlying exercise-brain connections are not well understood. We use an evolutionary neuroscience approach to develop the adaptive capacity model (ACM), detailing how and why physical activity improves brain function based on an energy-minimizing strategy. Building on studies showing a combined benefit of exercise and cognitive challenge to enhance neuroplasticity, our ACM addresses two fundamental questions: (i) what are the proximate and ultimate mechanisms underlying age-related brain atrophy, and (ii) how do lifestyle changes influence the trajectory of healthy and pathological aging? Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. What Factors Influence States' Capacity to Report Children's Health Care Quality Measures? A Multiple-Case Study.

    Science.gov (United States)

    Christensen, Anna L; Petersen, Dana M; Burton, Rachel A; Forsberg, Vanessa C; Devers, Kelly J

    2017-01-01

    Objectives The objective of this study was to describe factors that influence the ability of state Medicaid agencies to report the Centers for Medicare & Medicaid Services' (CMS) core set of children's health care quality measures (Child Core Set). Methods We conducted a multiple-case study of four high-performing states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program: Illinois, Maine, Pennsylvania, and Oregon. Cases were purposively selected for their diverse measurement approaches and used data from 2010 to 2015, including 154 interviews, semiannual grant progress reports, and annual public reports on Child Core Set measures. We followed Yin's multiple-case study methodology to describe how and why each state increased the number of measures reported to CMS. Results All four states increased the number of Child Core Set measures reported to CMS during the grant period. Each took a different approach to reporting, depending on the available technical, organizational, and behavioral inputs in the state. Reporting capacity was influenced by a state's Medicaid data availability, ability to link to other state data systems, past experience with quality measurement, staff time and technical expertise, and demand for the measures. These factors were enhanced by CHIPRA Quality Demonstration grant funding and other federal capacity building activities, as hypothesized in our conceptual framework. These and other states have made progress reporting the Child Core Set since 2010. Conclusion With financial support and investment in state data systems and organizational factors, states can overcome challenges to reporting most of the Child Core Set measures.

  18. Physical capacity and the motor tests relative for the health promotion in children and adolescents

    Directory of Open Access Journals (Sweden)

    Roberto Jerônimo dos Santos Silva

    2003-06-01

    Full Text Available This article discusses physical capacity and health-promotion-oriented motor tests in children and adolescents, in order to provide a foundation for future studies that intend to debate this topic. The idea of evaluating physical activity levels in a population is aimed to determine the level of physical fi tness, and to verify that this is in line with criteria for good health. From a functional point of view, .good health is defined by the following components: body composition (not considered in this article, strength, muscular endurance capacity and fl exibility. These components are measured by test batteries that are intended to measure the health of individuals and/or populations. The starting point for this debate is the published reference literature that classifi es motor tests as either norm-referenced or criterion-referenced standards. RESUMO Este artigo discute as capacidades físicas e os testes motores voltados à promoção da saúde em crianças e adolescentes, de forma a subsidiar trabalhos em que este tema esteja em voga. A idéia de avaliar a atividade física em uma população é baseada no desejo de determinar o estado de atividade atual da mesma, e verifi car se ela está de acordo com os critérios apropriados para uma boa saúde. Do ponto de vista morfofuncional, uma boa “saúde relatada” é defi nida a partir dos componentes: composição corporal (não abordado neste trabalho, força e resistência muscular e fl exibilidade, componentes estes que são verifi cados a partir da aplicação de testes ou baterias de testes que pretendem medir e verifi car os níveis individuais e/ou populacionais de saúde relatada. A literatura de referência, que classifi ca os testes motores como referenciados a partir de normas ou critérios é o ponto de partida para esse debate.

  19. MIMO channel capacity versus mutual coupling in multi antenna element system

    DEFF Research Database (Denmark)

    Thaysen, Jesper; Jakobsen, Kaj Bjarne

    2004-01-01

    In this paper the influence of mutual coupling on the capacity of a multiple-input multiple-output (MIMO) antenna system is demonstrated. No direct relation between the envelope correlation and the actual location and orientation of the antennas is found. Even though being essential for high MIMO...... capacity, configurations with the lowest envelope correlations are not necessarily the most suitable for a MIMO system. A certain bandwidth is required as well. Three planar inverted F-antennas (PIFA) located on the same 40 mm x 100 mm ground plane. The antennas that haves a resonant frequency of 1.8 GHz...

  20. Portable Health Algorithms Test System

    Science.gov (United States)

    Melcher, Kevin J.; Wong, Edmond; Fulton, Christopher E.; Sowers, Thomas S.; Maul, William A.

    2010-01-01

    A document discusses the Portable Health Algorithms Test (PHALT) System, which has been designed as a means for evolving the maturity and credibility of algorithms developed to assess the health of aerospace systems. Comprising an integrated hardware-software environment, the PHALT system allows systems health management algorithms to be developed in a graphical programming environment, to be tested and refined using system simulation or test data playback, and to be evaluated in a real-time hardware-in-the-loop mode with a live test article. The integrated hardware and software development environment provides a seamless transition from algorithm development to real-time implementation. The portability of the hardware makes it quick and easy to transport between test facilities. This hard ware/software architecture is flexible enough to support a variety of diagnostic applications and test hardware, and the GUI-based rapid prototyping capability is sufficient to support development execution, and testing of custom diagnostic algorithms. The PHALT operating system supports execution of diagnostic algorithms under real-time constraints. PHALT can perform real-time capture and playback of test rig data with the ability to augment/ modify the data stream (e.g. inject simulated faults). It performs algorithm testing using a variety of data input sources, including real-time data acquisition, test data playback, and system simulations, and also provides system feedback to evaluate closed-loop diagnostic response and mitigation control.

  1. Considerations for transient stability, fault capacity and power flow study of offsite power system

    Energy Technology Data Exchange (ETDEWEB)

    Shin, M C; Kim, C W; Gwon, M H; Park, C W; Lee, K W; Kim, H M; Lee, G Y; Joe, P H [Sungkyunkwan Univ., Seoul (Korea, Republic of)

    1994-04-15

    By study of power flow calculation, fault capacity calculation and stability analysis according to connection of two units YGN 3 and 4 to KEPCO power system, we have conclusions as follows. As the result of power flow calculation, at peak load, the voltage change of each bus is very small when YGN 3 and 4 is connected with KEPCO power system. At base load, installation of phase modifing equipment is necessary in Seoul, Kyungki province where load is concentrated because bus voltage rises by increasing of charge capacity caused installation of underground cables. As the result of fault capacity calculation, fault capacity is increased because fault current increases when two units YGN 3 and 4 is connected with KEPCO power system. But it is enough to operate with presenting circuits breaker rated capacity. Transient stability studies have been conducted on the YK N/P generators 3 and 4 using a digital computer program. Three phase short faults have been simulated at the YK N/P 345[KV] bus with the resulting outage of transmission circuits. Several fault clearing times are applied: 6 cycles, 12 cycles, 15 cycles. The study results demonstrate that the transient stability of YK N/P is adequate to maintain stable for three phase short faults cleared within 12 cycles. The study results also demonstrate that the transient stability of YK N/P is stable for machine removals except 4-machine removal. In addition, the study shows that the transient stability analysis is implemented for the case of load.

  2. Workplace health promotion implementation, readiness, and capacity among midsize employers in low-wage industries: a national survey.

    Science.gov (United States)

    Hannon, Peggy A; Garson, Gayle; Harris, Jeffrey R; Hammerback, Kristen; Sopher, Carrie J; Clegg-Thorp, Catherine

    2012-11-01

    To describe workplace health promotion (WHP) implementation, readiness, and capacity among midsize employers in low-wage industries in the United States. A cross-sectional survey of a national sample of midsize employers (100 to 4999 employees) representing five low-wage industries. Employers' WHP implementation for both employees and employees' spouses and partners was low. Readiness scales showed that employers believe WHP would benefit their employees and their companies, but they were less likely to believe that WHP was feasible for their companies. Employers' capacity to implement WHP was very low; nearly half the sample reported no capacity. Midsize employers in low-wage industries implement few WHP programs; their responses to readiness and capacity measures indicate that low capacity may be one of the principal barriers to WHP implementation.

  3. Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations.

    Science.gov (United States)

    Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K; Mukose, Aggrey; Van Geertruyden, Jean-Pierre; Nuwaha, Fred

    2015-01-01

    The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5, 1.9%) indicated that they

  4. Absorptive capacity, technological innovation, and product life cycle: a system dynamics model.

    Science.gov (United States)

    Zou, Bo; Guo, Feng; Guo, Jinyu

    2016-01-01

    While past research has recognized the importance of the dynamic nature of absorptive capacity, there is limited knowledge on how to generate a fair and comprehensive analytical framework. Based on interviews with 24 Chinese firms, this study develops a system-dynamics model that incorporates an important feedback loop among absorptive capacity, technological innovation, and product life cycle (PLC). The simulation results reveal that (1) PLC affects the dynamic process of absorptive capacity; (2) the absorptive capacity of a firm peaks in the growth stage of PLC, and (3) the market demand at different PLC stages is the main driving force in firms' technological innovations. This study also explores a sensitivity simulation using the variables of (1) time spent in founding an external knowledge network, (2) research and development period, and (3) knowledge diversity. The sensitivity simulation results show that the changes of these three variables have a greater impact on absorptive capacity and technological innovation during growth and maturity stages than in the introduction and declining stages of PLC. We provide suggestions on how firms can adjust management policies to improve their absorptive capacity and technological innovation performance during different PLC stages.

  5. Radiologic total lung capacity measurement. Development and evaluation of a computer-based system

    Energy Technology Data Exchange (ETDEWEB)

    Seeley, G.W.; Mazzeo, J.; Borgstrom, M.; Hunter, T.B.; Newell, J.D.; Bjelland, J.C.

    1986-11-01

    The development of a computer-based radiologic total lung capacity (TLC) measurement system designed to be used by non-physician personnel is detailed. Four operators tested the reliability and validity of the system by measuring inspiratory PA and lateral pediatric chest radiographs with a Graf spark pen interfaced to a DEC VAX 11/780 computer. First results suggest that the ultimate goal of developing an accurate and easy to use TLC measurement system for non-physician personnel is attainable.

  6. Late-life functional capacity and health among Finnish war veterans:Veteran Project 1992 and 2004 surveys

    OpenAIRE

    Leskinen, R. (Riitta)

    2015-01-01

    Abstract Becoming involved in war is an experience that has the potential to shape later-life health. The aim of the present study was to explore Finnish Second World War veterans’ health status and the determinants of self-rated health (SRH) and functional capacity, especially the ability to walk, and to identify risk factors and their combinations that predict late-life mortality among veterans. The study population comprised Finnish Second World War veterans who participated in the ...

  7. [The health system of Brazil].

    Science.gov (United States)

    Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

    2011-01-01

    This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

  8. Improvement of tuberculosis laboratory capacity on Pemba Island, Zanzibar: a health cooperation project.

    Directory of Open Access Journals (Sweden)

    Maria G Paglia

    Full Text Available Low-income countries with high Tuberculosis burden have few reference laboratories able to perform TB culture. In 2006, the Zanzibar National TB Control Programme planned to decentralize TB diagnostics. The Italian Cooperation Agency with the scientific support of the "L. Spallanzani" National Institute for Infectious Diseases sustained the project through the implementation of a TB reference laboratory in a low-income country with a high prevalence of TB. The implementation steps were: 1 TB laboratory design according to the WHO standards; 2 laboratory equipment and reagent supplies for microscopy, cultures, and identification; 3 on-the-job training of the local staff; 4 web- and telemedicine-based supervision. From April 2007 to December 2010, 921 sputum samples were received from 40 peripheral laboratories: 120 TB cases were diagnosed. Of all the smear-positive cases, 74.2% were culture-positive. During the year 2010, the smear positive to culture positive rate increased up to 100%. In March 20, 2010 the Ministry of Health and Social Welfare of Zanzibar officially recognized the Public Health Laboratory- Ivo de Carneri as the National TB Reference Laboratory for the Zanzibar Archipelago. An advanced TB laboratory can represent a low cost solution to strengthen the TB diagnosis, to provide capacity building and mid-term sustainability.

  9. Pursuing minimally disruptive medicine: disruption from illness and health care-related demands is correlated with patient capacity.

    Science.gov (United States)

    Boehmer, Kasey R; Shippee, Nathan D; Beebe, Timothy J; Montori, Victor M

    2016-06-01

    Chronic conditions burden patients with illness and treatments. We know little about the disruption of life by the work of dialysis in relation to the resources patients can mobilize, that is, their capacity, to deal with such demands. We sought to determine the disruption of life by dialysis and its relation to patient capacity to cope. We administered a survey to 137 patients on dialysis at an academic medical center. We captured disruption from illness and treatment, and physical, mental, personal, social, financial, and environmental aspects of patient capacity using validated scales. Covariates included number of prescriptions, hours spent on health care, existence of dependents, age, sex, and income level. On average, patients reported levels of capacity and disruption comparable to published levels. In multivariate regression models, limited physical, financial, and mental capacity were significantly associated with greater disruption. Patients in the top quartile of disruption had lower-than-expected physical, financial, and mental capacity. Our sample generally had capacity comparable to other populations and may be able to meet the demands imposed by treatment. Those with reduced physical, financial, and mental capacity reported higher disruption and represent a vulnerable group that may benefit from innovations in minimally disruptive medicine. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  10. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...

  11. The Economics of Public Health: Missing Pieces to the Puzzle of Health System Reform.

    Science.gov (United States)

    Mays, Glen P; Atherly, Adam J; Zaslavsky, Alan M

    2017-12-01

    The United States continues to experiment with health care delivery and financing innovations, but relatively little attention is given to the public health system and its capacity for improving health status in the U.S. population at large. The public health system operates as a multisector enterprise in which government agencies work in conjunction with private and voluntary organizations to identify health risks in the population and to mobilize community-wide actions that prevent and contain these risks. The Affordable Care Act and related health reform initiatives are generating new interest in the question of how best to expand and integrate public health approaches into the larger U.S. health system. The research articles featured in this issue of Health Services Research cluster around two broad topics: how public health agencies can deliver services efficiently and how public health agencies can interact productively with other elements of the health system. The results suggest promising avenues for aligning medical care and public health practices. © Health Research and Educational Trust.

  12. A strategic approach to public health workforce development and capacity building.

    Science.gov (United States)

    Dean, Hazel D; Myles, Ranell L; Spears-Jones, Crystal; Bishop-Cline, Audriene; Fenton, Kevin A

    2014-11-01

    In February 2010, CDC's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease (STD), and Tuberculosis (TB) Prevention (NCHHSTP) formally institutionalized workforce development and capacity building (WDCB) as one of six overarching goals in its 2010-2015 Strategic Plan. Annually, workforce team members finalize an action plan that lays the foundation for programs to be implemented for NCHHSTP's workforce that year. This paper describes selected WDCB programs implemented by NCHHSTP during the last 4 years in the three strategic goal areas: (1) attracting, recruiting, and retaining a diverse and sustainable workforce; (2) providing staff with development opportunities to ensure the effective and innovative delivery of NCHHSTP programs; and (3) continuously recognizing performance and achievements of staff and creating an atmosphere that promotes a healthy work-life balance. Programs have included but are not limited to an Ambassador Program for new hires, career development training for all staff, leadership and coaching for mid-level managers, and a Laboratory Workforce Development Initiative for laboratory scientists. Additionally, the paper discusses three overarching areas-employee communication, evaluation and continuous review to guide program development, and the implementation of key organizational and leadership structures to ensure accountability and continuity of programs. Since 2010, many lessons have been learned regarding strategic approaches to scaling up organization-wide public health workforce development and capacity building. Perhaps the most important is the value of ensuring the high-level strategic prioritization of this issue, demonstrating to staff and partners the importance of this imperative in achieving NCHHSTP's mission. Published by Elsevier Inc.

  13. Capacity of waters in the Magela Creek system, Northern Territory, to complex copper and cadmium

    International Nuclear Information System (INIS)

    Hart, B.T.; Davies, S.H.R.

    1984-08-01

    Two methods were used to determine the concentrations of copper-binding ligand (complexing capacity) and conditional formation constants for waters collected from the Magela Creek system, Northern Territory. These data are particularly important in estimating the concentrations of toxic forms of copper that may result from particular effluent discharge strategies from the Ranger uranium operation

  14. Curtailment in a Highly Renewable Power System and Its Effect on Capacity Factors

    Directory of Open Access Journals (Sweden)

    Alexander Kies

    2016-06-01

    Full Text Available The capacity factor of a power plant is the ratio of generation over its potential generation. It is an important measure to describe wind and solar resources. However, the fluctuating nature of renewable power generation makes it difficult to integrate all generation at times. Whenever generation exceeds the load, curtailment or storage of energy is required. With increasing renewable shares in the power system, the level of curtailment will further increase. In this work, the influence of the curtailment on the capacity factors for a highly renewable German power system is studied. An effective capacity factor is introduced, and the implications for the distribution of renewable power plants are discussed. Three years of highly-resolved weather data were used to model wind and solar power generation. Together with historical load data and a transmission model, a possible future German power system was simulated. It is shown that effective capacity factors for unlimited transmission are strongly reduced by up to 60% (wind and 70% (photovoltaics and therefore of limited value in a highly renewable power system. Furthermore, the results demonstrate that wind power benefits more strongly from a reinforced transmission grid than photovoltaics (PV does.

  15. On the BER and capacity analysis of MIMO MRC systems with channel estimation error

    KAUST Repository

    Yang, Liang; Alouini, Mohamed-Slim

    2011-01-01

    In this paper, we investigate the effect of channel estimation error on the capacity and bit-error rate (BER) of a multiple-input multiple-output (MIMO) transmit maximal ratio transmission (MRT) and receive maximal ratio combining (MRC) systems over

  16. Hydrophobic interaction chromatography in dual salt system increases protein binding capacity.

    Science.gov (United States)

    Senczuk, Anna M; Klinke, Ralph; Arakawa, Tsutomu; Vedantham, Ganesh; Yigzaw, Yinges

    2009-08-01

    Hydrophobic interaction chromatography (HIC) uses weakly hydrophobic resins and requires a salting-out salt to promote protein-resin interaction. The salting-out effects increase with protein and salt concentration. Dynamic binding capacity (DBC) is dependent on the binding constant, as well as on the flow characteristics during sample loading. DBC increases with the salt concentration but decreases with increasing flow rate. Dynamic and operational binding capacity have a major raw material cost/processing time impact on commercial scale production of monoclonal antibodies. In order to maximize DBC the highest salt concentration without causing precipitation is used. We report here a novel method to maintain protein solubility while increasing the DBC by using a combination of two salting-out salts (referred to as dual salt). In a series of experiments, we explored the dynamic capacity of a HIC resin (TosoBioscience Butyl 650M) with combinations of salts. Using a model antibody, we developed a system allowing us to increase the dynamic capacity up to twofold using the dual salt system over traditional, single salt system. We also investigated the application of this novel approach to several other proteins and salt combinations, and noted a similar protein solubility and DBC increase. The observed increase in DBC in the dual salt system was maintained at different linear flow rates and did not impact selectivity.

  17. Capacities and overlap indexes with an application in fuzzy rule-based classification systems

    Czech Academy of Sciences Publication Activity Database

    Paternain, D.; Bustince, H.; Pagola, M.; Sussner, P.; Kolesárová, A.; Mesiar, Radko

    2016-01-01

    Roč. 305, č. 1 (2016), s. 70-94 ISSN 0165-0114 Institutional support: RVO:67985556 Keywords : Capacity * Overlap index * Overlap function * Choquet integral * Fuzzy rule-based classification systems Subject RIV: BA - General Mathematics Impact factor: 2.718, year: 2016 http://library.utia.cas.cz/separaty/2016/E/mesiar-0465739.pdf

  18. Test-retest reliability of the isernhagen work systems functional capacity evaluation in healthy adults

    NARCIS (Netherlands)

    Reneman, MF; Brouwer, S; Meinema, A; Dijkstra, PU; Geertzen, JHB; Groothoff, JW

    2004-01-01

    Aim of this study was to investigate test-retest reliability of the Isernhagen Work System Functional Capacity Evaluation (IWS FCE) in healthy subjects. The IWS FCE consists of 28 tests that reflect work-related activities such as lifting, carrying, bending, etc. A convenience sample of 26 healthy

  19. Gaps and strategies in developing health research capacity: experience from the Nigeria Implementation Science Alliance.

    Science.gov (United States)

    Ezeanolue, Echezona E; Menson, William Nii Ayitey; Patel, Dina; Aarons, Gregory; Olutola, Ayodotun; Obiefune, Michael; Dakum, Patrick; Okonkwo, Prosper; Gobir, Bola; Akinmurele, Timothy; Nwandu, Anthea; Khamofu, Hadiza; Oyeledun, Bolanle; Aina, Muyiwa; Eyo, Andy; Oleribe, Obinna; Ibanga, Ikoedem; Oko, John; Anyaike, Chukwuma; Idoko, John; Aliyu, Muktar H; Sturke, Rachel

    2018-02-12

    Despite being disproportionately burdened by preventable diseases than more advanced countries, low- and middle-income countries (LMICs) continue to trail behind other parts of the world in the number, quality and impact of scholarly activities by their health researchers. Our strategy at the Nigerian Implementation Science Alliance (NISA) is to utilise innovative platforms that catalyse collaboration, enhance communication between different stakeholders, and promote the uptake of evidence-based interventions in improving healthcare delivery. This article reports on findings from a structured group exercise conducted at the 2016 NISA Conference to identify (1) gaps in developing research capacity and (2) potential strategies to address these gaps. A 1-hour structured group exercise was conducted with 15 groups of 2-9 individuals (n = 94) to brainstorm gaps for implementation, strategies to address gaps and to rank their top 3 in each category. Qualitative thematic analysis was used. First, duplicate responses were merged and analyses identified emerging themes. Each of the gaps and strategies identified were categorised as falling into the purview of policy-makers, researchers, implementing partners or multiple groups. Participating stakeholders identified 98 gaps and 91 strategies related to increasing research capacity in Nigeria. A total of 45 gaps and an equal number of strategies were ranked; 39 gaps and 43 strategies were then analysed, from which 8 recurring themes emerged for gaps (lack of sufficient funding, poor research focus in education, inadequate mentorship and training, inadequate research infrastructure, lack of collaboration between researchers, research-policy dissonance, lack of motivation for research, lack of leadership buy-in for research) and 7 themes emerged for strategies (increased funding for research, improved research education, improved mentorship and training, improved infrastructure for research, increased collaboration between

  20. Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

    Science.gov (United States)

    Fusheini, Adam; Eyles, John

    2016-10-07

    Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

  1. African Health Systems Initiative (AHSI) | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The African Health Systems Initiative (AHSI) is a 10-year Canadian International ... for strengthening African-led health systems and human resources for health. ... IDRC congratulates first cohort of Women in Climate Change Science Fellows.

  2. Influence of genotype, cultivation system and irrigation regime on antioxidant capacity and selected phenolics of blueberries (Vaccinium corymbosum L.).

    Science.gov (United States)

    Cardeñosa, Vanessa; Girones-Vilaplana, Amadeo; Muriel, José Luis; Moreno, Diego A; Moreno-Rojas, José M

    2016-07-01

    Demand for and availability of blueberries has increased substantially over recent years, driven in part by their health-promoting properties. Three blueberry varieties ('Rocío', V2, and V3) were grown under two cultivation systems (open-field and plastic tunnels) and subjected to two irrigations regimes (100% and 80% of crop evapotranspiration) in two consecutive years (2011-2012). They were evaluated for their phytochemical composition and antioxidant capacity. Genotype influenced the antioxidant capacity and the content of the three groups of phenolics in the blueberries. The antioxidant activity and total flavonols content increased when the blueberries were grown under open-field conditions. Deficit irrigation conditions led to additional positive effects on their phenolics (delphinidn-3-acetilhexoside content was increased under plastic tunnel with deficit irrigation). In conclusion, the amount of phenolic compounds and the antioxidant capacity of blueberries were not negatively affected by water restriction; Moreover, several changes were recorded due to growing system and genotype. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  4. On the average capacity and bit error probability of wireless communication systems

    KAUST Repository

    Yilmaz, Ferkan

    2011-12-01

    Analysis of the average binary error probabilities and average capacity of wireless communications systems over generalized fading channels have been considered separately in the past. This paper introduces a novel moment generating function-based unified expression for both average binary error probabilities and average capacity of single and multiple link communication with maximal ratio combining. It is a matter to note that the generic unified expression offered in this paper can be easily calculated and that is applicable to a wide variety of fading scenarios, and the mathematical formalism is illustrated with the generalized Gamma fading distribution in order to validate the correctness of our newly derived results. © 2011 IEEE.

  5. [Specialty specific reference values in linen use in public health and social service as a basis for determining laundry capacities].

    Science.gov (United States)

    Rietdorf, M; Häse, I

    1990-01-01

    The use of linen in health and social care should primarily be seen from a hygienic angle. Disproportions between the use of linen in the various fields of health care and the available laundry capacities have a negative hygienic and economic effect. Laundry capacities should, therefore, be calculated on the basis of specialty-specific guidevalues. The authors propose indicators suitable to this aim and present the results of a comprehensive analysis for the inpatient departments of internal medicine, surgery, urology, ophthalmology and otorhinolaryngology.

  6. Estimation of Parameters Obtained by Electrochemical Impedance Spectroscopy on Systems Containing High Capacities

    Directory of Open Access Journals (Sweden)

    Mirjana Rajčić Vujasinović

    2009-09-01

    Full Text Available Electrochemical systems with high capacities demand devices for electrochemical impedance spectroscopy (EIS with ultra-low frequencies (in order of mHz, that are almost impossible to accomplish with analogue techniques, but this becomes possible by using a computer technique and accompanying digital equipment. Recently, an original software and hardware for electrochemical measurements, intended for electrochemical systems exhibiting high capacities, such as supercapacitors, has been developed. One of the included methods is EIS. In this paper, the method of calculation of circuit parameters from an EIS curve is described. The results of testing on a physical model of an electrochemical system, constructed of known elements (including a 1.6 F capacitor in a defined arrangement, proved the validity of the system and the method.

  7. Measuring the Capacity and Transaction Time of Cash and Electronic Toll Collection Systems

    Directory of Open Access Journals (Sweden)

    Rudy Hermawan Karsaman

    2014-07-01

    Full Text Available A long queue can occur at tollgates due to the amount of transaction time required to perform ticket payment and toll fee collection. This problem can be addressed by the use of an electronic toll collection (ETC system. A case study conducted on the Jakarta Intra Urban, Cikupa-Merak, and Cawang Pluit Toll Roads suggests that the queueing at the tollgates when modelled followed a Poisson distribution. The average cash transaction time was approximately 5 to 6 seconds, while the ETC transaction time was only 4 seconds. Furthermore, the capacity of the cash system gate was 550 to 620 vehicles/hour (which is above the minimum service standard of 450 vehicles/hour,whereas the electronic gate capacity was 770 to 870 vehicles/hour. This study demonstrates that the ETC system is more effective than the cash system in terms of reducing the number of queueing vehicles.

  8. Performance and capacity analysis of Poisson photon-counting based Iter-PIC OCDMA systems.

    Science.gov (United States)

    Li, Lingbin; Zhou, Xiaolin; Zhang, Rong; Zhang, Dingchen; Hanzo, Lajos

    2013-11-04

    In this paper, an iterative parallel interference cancellation (Iter-PIC) technique is developed for optical code-division multiple-access (OCDMA) systems relying on shot-noise limited Poisson photon-counting reception. The novel semi-analytical tool of extrinsic information transfer (EXIT) charts is used for analysing both the bit error rate (BER) performance as well as the channel capacity of these systems and the results are verified by Monte Carlo simulations. The proposed Iter-PIC OCDMA system is capable of achieving two orders of magnitude BER improvements and a 0.1 nats of capacity improvement over the conventional chip-level OCDMA systems at a coding rate of 1/10.

  9. A CATASTROPHIC-CUM-RESTORATIVE QUEUING SYSTEM WITH CORRELATED BATCH ARRIVALS AND VARIABLE CAPACITY

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar

    2008-07-01

    Full Text Available In this paper, we study a catastrophic-cum-restorative queuing system with correlated batch arrivals and service in batches of variable sizes. We perform the transient analysis of the queuing model. We obtain the Laplace Transform of the probability generating function of system size. Finally, some particular cases of the model have been derived and discussed. Keywords: Queue length, Catastrophes, Correlated batch arrivals, Broadband services, Variable service capacity, and Restoration.

  10. Capacity of fully correlated MIMO system using character expansion of groups

    Directory of Open Access Journals (Sweden)

    Ejaz Khan

    2005-09-01

    Full Text Available It is well known that the use of antenna arrays at both sides of communication link can result in high channel capacities provided that the propagation medium is rich scattering. In most previous works presented on MIMO wireless structures, Rayleigh fading conditions were considered. In this work, the capacity of MIMO systems under fully correlated (i.e., correlations between rows and columns of channel matrix fading is considered. We use replica method and character expansions to calculate the capacity of correlated MIMO channel in closed form. In our calculations, it is assumed that the receiver has perfect channel state information (CSI but no such information is available at the transmitter.

  11. Phosphorus Sorption Capacity of Gray Forest Soil as Dependent on Fertilization System

    Science.gov (United States)

    Rogova, O. B.; Kolobova, N. A.; Ivanov, A. L.

    2018-05-01

    In this paper, the results of the study of changes in the phosphorus sorption capacity of gray forest soils of Vladimir opolie under the impact of different fertilization systems are discussed. The quantitative parameters of the potential buffer capacity of soils for phosphorus (PBCP) and Langmuir sorption isotherms have been calculated. It is shown that the application of organic fertilizers results in a stronger decrease in PBCP than the application of mineral fertilizers. The portion of phosphorus of mineral compounds considerably increases, and the high content of available phosphates is maintained. In the variants with application of mineral phosphorus in combination with manure, the portions of organic and mineral phosphorus are at the level typical of unfertilized soils. The energy of phosphate bonds with the soil is minimal upon the application of a double rate of mineral phosphorus at the maximum capacity in relation to phosphate ions.

  12. Antioxidant and chelating capacity of Maillard reaction products in amino acid-sugar model systems: applications for food processing.

    Science.gov (United States)

    Mondaca-Navarro, Blanca A; Ávila-Villa, Luz A; González-Córdova, Aarón F; López-Cervantes, Jaime; Sánchez-Machado, Dalia I; Campas-Baypoli, Olga N; Rodríguez-Ramírez, Roberto

    2017-08-01

    Maillard reaction products (MRP) have gained increasing interest owing to their both positive and negative effects on human health. Aqueous amino acid-sugar model systems were studied in order to evaluate the antioxidant and chelating activity of MRP under conditions similar to those of food processing. Amino acids (cysteine, glycine, isoleucine and lysine) combined with different sugars (fructose or glucose) were heated to 100 and 130 °C for 30, 60 and 90 min. Antioxidant capacity was evaluated via ABTS and DPPH free radical scavenging assays, in addition to Fe 2+ and Cu 2+ ion chelating capacity. In the ABTS assay, the cysteine-fructose model system presented the highest antioxidant activity at 7.05 µmol mL -1 (130 °C, 60 min), expressed in Trolox equivalents. In the DPPH assay, the cysteine-glucose system presented the highest antioxidant activity at 3.79 µmol mL -1 (100 °C, 90 min). The maximum rate of chelation of Fe 2+ and Cu 2+ was 96.31 and 59.44% respectively in the lysine-fructose and cysteine-glucose systems (100 °C, 30 min). The model systems presented antioxidant and chelating activity under the analyzed temperatures and heating times, which are similar to the processing conditions of some foods. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  13. Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study.

    Science.gov (United States)

    Lennquist Montán, K; Riddez, L; Lennquist, S; Olsberg, A C; Lindberg, H; Gryth, D; Örtenwall, P

    2017-08-01

    The aim of this study was to use a simulation model developed for the scientific evaluation of methodology in disaster medicine to test surge capacity (SC) in a major hospital responding to a simulated major incident with a scenario copied from a real incident. The tested hospital was illustrated on a system of magnetic boards, where available resources, staff, and patients treated in the hospital at the time of the test were illustrated. Casualties were illustrated with simulation cards supplying all data required to determine procedures for diagnosis and treatment, which all were connected to real consumption of time and resources. The first capacity-limiting factor was the number of resuscitation teams that could work parallel in the emergency department (ED). This made it necessary to refer severely injured to other hospitals. At this time, surgery (OR) and intensive care (ICU) had considerable remaining capacity. Thus, the reception of casualties could be restarted when the ED had been cleared. The next limiting factor was lack of ventilators in the ICU, which permanently set the limit for SC. At this time, there was still residual OR capacity. With access to more ventilators, the full surgical capacity of the hospital could have been utilized. The tested model was evaluated as an accurate tool to determine SC. The results illustrate that SC cannot be determined by testing one single function in the hospital, since all functions interact with each other and different functions can be identified as limiting factors at different times during the response.

  14. Self-Assessment of Physical Activity and Health Capacity of Students

    Directory of Open Access Journals (Sweden)

    Plavina Liana

    2017-12-01

    Full Text Available The compulsory part of the individual life is physical activity. The physical activity is important for maintenance health capacity. Physical activity includes various kinds of components: physical activity during the leisure time (during the week days and weekend days, physical activity at home and in working place and physical activity during the transference from home to other place. Intensity of the physical activity could also be various from low to moderate and till high. Respondent of study groups were partly time students from Riga Medical College (RMC, n = 41, and from Riga Teacher Training and Education Management Academy (RTTEMA, n = 37. Respondents were students of both genders aged from 19 years till 53 years. We have provided the assessment of the principal anthropometric characteristics (height and body mass as well the anthropometric indices (body mass index (BMI and physical activity level questionnaire for students. Analysis of the data of physical activity questionnaire revealed that the average physical activity for students from RMC corresponded to low level of physical activity. The respondents from RRTEMA have moderate level of physical activity.

  15. Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine L.; Berg, Selina K.; Rasmussen, Trine B.

    2016-01-01

    Objective: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart......-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36. Results: 76% were men, mean age 62 years......, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0...

  16. Influence of capacity- and time-constrained intermediate storage in two-stage food production systems

    DEFF Research Database (Denmark)

    Akkerman, Renzo; van Donk, Dirk Pieter; Gaalman, Gerard

    2007-01-01

    In food processing, two-stage production systems with a batch processor in the first stage and packaging lines in the second stage are common and mostly separated by capacity- and time-constrained intermediate storage. This combination of constraints is common in practice, but the literature hardly...... of systems like this. Contrary to the common sense in operations management, the LPT rule is able to maximize the total production volume per day. Furthermore, we show that adding one tank has considerable effects. Finally, we conclude that the optimal setup frequency for batches in the first stage...... pays any attention to this. In this paper, we show how various capacity and time constraints influence the performance of a specific two-stage system. We study the effects of several basic scheduling and sequencing rules in the presence of these constraints in order to learn the characteristics...

  17. Simplified inelastic seismic response analysis of piping system using improved capacity spectrum method

    International Nuclear Information System (INIS)

    Iijima, Tadashi

    2005-01-01

    We applied improved capacity spectrum method (ICSM) to a piping system with an asymmetric load-deformation relationship in a piping elbow. The capacity spectrum method can predict an inelastic response by balancing the structural capacity obtained from the load-deformation relationship with the seismic demand defined by an acceleration-displacement response spectrum. The ICSM employs (1) effective damping ratio and period that are based on a statistical methodology, (2) practical procedures necessary to obtain a balance between the structural capacity and the seismic demand. The effective damping ratio and period are defined so as to maximize the probability that predicted response errors lie inside the -10 to 20% range. However, without taking asymmetry into consideration the displacement calculated by using the load-deformation relationship on the stiffer side was 39% larger than that of a time history analysis by a direct integral method. On the other hand, when asymmetry was taken into account, the calculated displacement was only 14% larger than that of a time history analysis. Thus, we verified that the ICSM could predict the inelastic response with errors lying within the -10 to 20% range, by taking into account the asymmetric load-deformation relationship of the piping system. (author)

  18. Guided preparedness planning with lay communities: enhancing capacity of rural emergency response through a systems-based partnership.

    Science.gov (United States)

    McCabe, O Lee; Perry, Charlene; Azur, Melissa; Taylor, Henry G; Gwon, Howard; Mosley, Adrian; Semon, Natalie; Links, Jonathan M

    2013-02-01

    Community disaster preparedness plans, particularly those with content that would mitigate the effects of psychological trauma on vulnerable rural populations, are often nonexistent or underdeveloped. The purpose of the study was to develop and evaluate a model of disaster mental health preparedness planning involving a partnership among three, key stakeholders in the public health system. A one-group, post-test, quasi-experimental design was used to assess outcomes as a function of an intervention designated Guided Preparedness Planning (GPP). The setting was the eastern-, northern-, and mid-shore region of the state of Maryland. Partner participants were four local health departments (LHDs), 100 faith-based organizations (FBOs), and one academic health center (AHC)-the latter, collaborating entities of the Johns Hopkins University and the Johns Hopkins Health System. Individual participants were 178 community residents recruited from counties of the above-referenced geographic area. Effectiveness of GPP was based on post-intervention assessments of trainee knowledge, skills, and attitudes supportive of community disaster mental health planning. Inferences about the practicability (feasibility) of the model were drawn from pre-defined criteria for partner readiness, willingness, and ability to participate in the project. Additional aims of the study were to determine if LHD leaders would be willing and able to generate post-project strategies to perpetuate project-initiated government/faith planning alliances (sustainability), and to develop portable methods and materials to enhance model application and impact in other health jurisdictions (scalability). The majority (95%) of the 178 lay citizens receiving the GPP intervention and submitting complete evaluations reported that planning-supportive objectives had been achieved. Moreover, all criteria for inferring model feasibility, sustainability, and scalability were met. Within the span of a six-month period

  19. Preliminary Findings of the South Africa Power System Capacity Expansion and Operational Modelling Study: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Reber, Timothy J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Chartan, Erol Kevin [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Brinkman, Gregory L [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-01-01

    Wind and solar power contract prices have recently become cheaper than many conventional new-build alternatives in South Africa and trends suggest a continued increase in the share of variable renewable energy (vRE) on South Africa's power system with coal technology seeing the greatest reduction in capacity, see 'Figure 6: Percentage share by Installed Capacity (MW)' in [1]. Hence it is essential to perform a state-of-the-art grid integration study examining the effects of these high penetrations of vRE on South Africa's power system. Under the 21st Century Power Partnership (21CPP), funded by the U.S. Department of Energy, the National Renewable Energy Laboratory (NREL) has significantly augmented existing models of the South African power system to investigate future vRE scenarios. NREL, in collaboration with Eskom's Planning Department, further developed, tested and ran a combined capacity expansion and operational model of the South African power system including spatially disaggregated detail and geographical representation of system resources. New software to visualize and interpret modelling outputs has been developed, and scenario analysis of stepwise vRE build targets reveals new insight into associated planning and operational impacts and costs. The model, built using PLEXOS, is split into two components, firstly a capacity expansion model and secondly a unit commitment and economic dispatch model. The capacity expansion model optimizes new generation decisions to achieve the lowest cost, with a full understanding of capital cost and an approximated understanding of operational costs. The operational model has a greater set of detailed operational constraints and is run at daily resolutions. Both are run from 2017 through 2050. This investigation suggests that running both models in tandem may be the most effective means to plan the least cost South African power system as build plans seen to be more expensive than optimal by the

  20. Energy Systems and Population Health

    Energy Technology Data Exchange (ETDEWEB)

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    It is well-documented that energy and energy systems have a central role in social and economic development and human welfare at all scales, from household and community to regional and national (41). Among its various welfare effects, energy is closely linked with people s health. Some of the effects of energy on health and welfare are direct. With abundant energy, more food or more frequent meals can be prepared; food can be refrigerated, increasing the types of food items that are consumed and reducing food contamination; water pumps can provide more water and eliminate the need for water storage leading to contamination or increased exposure to disease vectors such as mosquitoes or snails; water can be disinfected by boiling or using other technologies such as radiation. Other effects of energy on public health are mediated through more proximal determinants of health and disease. Abundant energy can lead to increased irrigation, agricultural productivity, and access to food and nutrition; access to energy can also increase small-scale income generation such as processing of agricultural commodities (e.g., producing refined oil from oil seeds, roasting coffee, drying and preserving fruits and meats) and production of crafts; ability to control lighting and heating allows education or economic activities to be shielded from daily or seasonal environmental constraints such as light, temperature, rainfall, or wind; time and other economic resources spent on collecting and/or transporting fuels can be used for other household needs if access to energy is facilitated; energy availability for transportation increases access to health and education facilities and allow increased economic activity by facilitating the transportation of goods and services to and from markets; energy for telecommunication technology (radio, television, telephone, or internet) provides increased access to information useful for health, education, or economic purposes; provision of energy

  1. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

    Science.gov (United States)

    Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

    2013-01-01

    Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health surve