WorldWideScience

Sample records for subnational health authorities

  1. The European Union and the autonomy of sub-national authorities: Towards an analysis of constraints and opportunities in sub-national decision-making

    NARCIS (Netherlands)

    Fleurke, F.; Willemse, R.

    2006-01-01

    This paper explores what is known about the actual impact of the EU on sub-national (local and regional) government. Existing research on the impact of the EU on sub-national authorities appears to have a strong emphasis on the positive effects or the opportunities that emanate from the EU. By

  2. 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 pu...

  3. Sub-national health care financing reforms in Indonesia.

    Science.gov (United States)

    Sparrow, Robert; Budiyati, Sri; Yumna, Athia; Warda, Nila; Suryahadi, Asep; Bedi, Arjun S

    2017-02-01

    Indonesia has seen an emergence of local health care financing schemes over the last decade, implemented and operated by district governments. Often motivated by the local political context and characterized by a large degree of heterogeneity in scope and design, the common objective of the district schemes is to address the coverage gaps for the informal sector left by national social health insurance programs. This paper investigates the effect of these local health care financing schemes on access to health care and financial protection. Using data from a unique survey among District Health Offices, combined with data from the annual National Socioeconomic Surveys, the study is based on a fixed effects analysis for a panel of 262 districts over the period 2004-10, exploiting variation in local health financing reforms across districts in terms of type of reform and timing of implementation. Although the schemes had a modest impact on average, they do seem to have provided some contribution to closing the coverage gap, by increasing outpatient utilization for households in the middle quintiles that tend to fall just outside the target population of the national subsidized programs. However, there seems to be little effect on hospitalization or financial protection, indicating the limitations of local health care financing policies. In addition, we see effect heterogeneity across districts due to differences in design features. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. EVALUATION OF THE SUB-NATIONAL DECENTRALIZATION OF THE HEALTH IN VENEZUELA INFANTILE MATERNAL PROGRAM

    Directory of Open Access Journals (Sweden)

    Maritza Ávila Urdaneta

    2009-11-01

    Full Text Available The work approaches the evaluation of the decentralization of the health at sub-national level in Venezuela, maternal program Infantile (PROMIN, period 1998-2004: Case of study, Estado Zulia. With the samples of ten Municipalities and Coordinators of Health (CH. Of the results and conclusions, it is appraised that in Venezuela with the Model of Integral Attention with respect to the PROMIN (1998-2004, the reason of Maternal Mortality RMM average for the country ascends to 60 by 100,000 NVR (OPS, 2003, whereas in Zulia was in 79,9; they emphasize the Municipalities: Cañada de Urdaneta with but the high one of 214.13, followed of Mara 149.44 by 100,000 NVR. Key words: Sub-national decentralization of the Health, Infantile Maternal Program, Indicating of Morbidity and Mortality, Coordination of the Municipal Health.

  5. DOES FISCAL DISCIPLINE TOWARDS SUBNATIONAL GOVERNMENTS AFFECT CITIZENS' WELL-BEING? EVIDENCE ON HEALTH

    OpenAIRE

    Piacenza, Massimiliano; Turati, Gilberto

    2014-01-01

    This paper aims at assessing the impact of fiscal discipline towards sub-national governments on citizens' well-being. We model fiscal discipline by considering the expectations of deficit bailouts by Central Government, and focus on a particular dimension of well-being, namely health outcomes at the regional level. We study then how bailout expectations affect the expenditure for health care policies carried out by Regional Governments: in the presence of opportunistic behaviours by local go...

  6. You'll never lobby alone : explaining the participation of sub-national authorities in the European Commissions open consultations

    OpenAIRE

    Hecke, Van, Matti; Bursens, Peter; Beyers, Jan

    2016-01-01

    Abstract: The multi-level system of the EU constrains the institutionalized representation of the regional tier of government. Consequently, sub-national authorities seek to represent their interests through various lobbying practices, including taking part in the European Commissions open consultations. In this paper, we argue that varying levels with which SNAs take part in open consultations cannot be adequately explained by regional-level conditions such as resources or autonomy. Instead,...

  7. National and subnational HIV/AIDS coordination: are global health initiatives closing the gap between intent and practice?

    Directory of Open Access Journals (Sweden)

    Rukhadze Natia

    2010-03-01

    Full Text Available Abstract Background A coordinated response to HIV/AIDS remains one of the 'grand challenges' facing policymakers today. Global health initiatives (GHIs have the potential both to facilitate and exacerbate coordination at the national and subnational level. Evidence of the effects of GHIs on coordination is beginning to emerge but has hitherto been limited to single-country studies and broad-brush reviews. To date, no study has provided a focused synthesis of the effects of GHIs on national and subnational health systems across multiple countries. To address this deficit, we review primary data from seven country studies on the effects of three GHIs on coordination of HIV/AIDS programmes: the Global Fund to Fight AIDS, Tuberculosis and Malaria, the President's Emergency Plan for AIDS Relief (PEPFAR, and the World Bank's HIV/AIDS programmes including the Multi-country AIDS Programme (MAP. Methods In-depth interviews were conducted at national and subnational levels (179 and 218 respectively in seven countries in Europe, Asia, Africa and South America, between 2006 and 2008. Studies explored the development and functioning of national and subnational HIV coordination structures, and the extent to which coordination efforts around HIV/AIDS are aligned with and strengthen country health systems. Results Positive effects of GHIs included the creation of opportunities for multisectoral participation, greater political commitment and increased transparency among most partners. However, the quality of participation was often limited, and some GHIs bypassed coordination mechanisms, especially at the subnational level, weakening their effectiveness. Conclusions The paper identifies residual national and subnational obstacles to effective coordination and optimal use of funds by focal GHIs, which these GHIs, other donors and country partners need to collectively address.

  8. Burden of disease in Japan: using national and subnational data to inform local health policy.

    Science.gov (United States)

    Gilmour, Stuart; Liao, Yi; Bilano, Ver; Shibuya, Kenji

    2014-05-01

    The Global Burden of Disease (GBD) study has been instrumental in guiding global health policy development since the early 1990s. The GBD 2010 project provided rich information about the key causes of mortality, disability-adjusted life years, and their associated risk factors in Japan and provided a unique opportunity to incorporate these data into health planning. As part of the latest update of this project, GBD 2013, the Japanese GBD collaborators plan to update and refine the available burden of disease data by incorporating sub-national estimates of the burden of disease at the prefectural level. These estimates will provide health planners and policy makers at both the national and prefectural level with new, more refined tools to adapt local public health initiatives to meet the health needs of local populations. Moreover, they will enable the Japanese health system to better respond to the unique challenges in their rapidly aging population and as a complex combination of non-communicable disease risk factors begin to dominate the policy agenda. Regional collaborations will enable nations to learn from the experiences of other nations that may be at different stages of the epidemiological transition and have different exposure profiles and associated health effects. Such analyses and improvements in the data collection systems will further improve the health of the Japanese, maintain Japan's excellent record of health equity, and provide a better understanding of the direction of health policy in the region.

  9. Burden of Disease in Japan: Using National and Subnational Data to Inform Local Health Policy

    Directory of Open Access Journals (Sweden)

    Stuart Gilmour

    2014-05-01

    Full Text Available The Global Burden of Disease (GBD study has been instrumental in guiding global health policy development since the early 1990s. The GBD 2010 project provided rich information about the key causes of mortality, disability-adjusted life years, and their associated risk factors in Japan and provided a unique opportunity to incorporate these data into health planning. As part of the latest update of this project, GBD 2013, the Japanese GBD collaborators plan to update and refine the available burden of disease data by incorporating sub-national estimates of the burden of disease at the prefectural level. These estimates will provide health planners and policy makers at both the national and prefectural level with new, more refined tools to adapt local public health initiatives to meet the health needs of local populations. Moreover, they will enable the Japanese health system to better respond to the unique challenges in their rapidly aging population and as a complex combination of non-communicable disease risk factors begin to dominate the policy agenda. Regional collaborations will enable nations to learn from the experiences of other nations that may be at different stages of the epidemiological transition and have different exposure profiles and associated health effects. Such analyses and improvements in the data collection systems will further improve the health of the Japanese, maintain Japan's excellent record of health equity, and provide a better understanding of the direction of health policy in the region.

  10. Does fiscal discipline towards subnational governments affect citizens' well-being? Evidence on health.

    Science.gov (United States)

    Piacenza, Massimiliano; Turati, Gilberto

    2014-02-01

    This paper aims to assess the impact on citizens' well-being of fiscal discipline imposed by the central government on subnational governments. Because healthcare policies involve strategic interactions between different layers of governments in many different countries, we focus on a particular dimension of well-being, namely citizens' health. We model fiscal discipline by considering government expectations of future deficit bailouts from the central government. We then study how these bailout expectations affect the expenditure for healthcare policies carried out by decentralized governments. To investigate this issue, we separate efficient health spending from inefficiencies by estimating an input requirement frontier. This allows us to assess the effects of bailout expectations on both the structural component of health expenditure and its deviations from the 'best practice'. The evidence from the 15 Italian ordinary statute regions (observed from 1993 to 2006) points out that bailout expectations do not significantly influence the position of the frontier, thus not affecting citizens' health. However, they do appear to exert a remarkable impact on excess spending. Copyright © 2013 John Wiley & Sons, Ltd.

  11. Evaluating the sub-national fidelity of national Initiatives in decentralized health systems: Integrated Primary Health Care Governance in Nigeria.

    Science.gov (United States)

    Eboreime, Ejemai Amaize; Abimbola, Seye; Obi, Felix Abrahams; Ebirim, Obinna; Olubajo, Olalekan; Eyles, John; Nxumalo, Nonhlanhla Lynette; Mambulu, Faith Nankasa

    2017-03-21

    Policy making, translation and implementation in politically and administratively decentralized systems can be challenging. Beyond the mere sub-national acceptance of national initiatives, adherence to policy implementation processes is often poor, particularly in low and middle-income countries. In this study, we explore the implementation fidelity of integrated PHC governance policy in Nigeria's decentralized governance system and its implications on closing implementation gaps with respect to other top-down health policies and initiatives. Having engaged policy makers, we identified 9 core components of the policy (Governance, Legislation, Minimum Service Package, Repositioning, Systems Development, Operational Guidelines, Human Resources, Funding Structure, and Office Establishment). We evaluated the level and pattern of implementation at state level as compared to the national guidelines using a scorecard approach. Contrary to national government's assessment of level of compliance, we found that sub-national governments exercised significant discretion with respect to the implementation of core components of the policy. Whereas 35 and 32% of states fully met national criteria for the structural domains of "Office Establishment" and Legislation" respectively, no state was fully compliant to "Human Resource Management" and "Funding" requirements, which are more indicative of functionality. The pattern of implementation suggests that, rather than implementing to improve outcomes, state governments may be more interested in executing low hanging fruits in order to access national incentives. Our study highlights the importance of evaluating implementation fidelity in providing evidence of implementation gaps towards improving policy execution, particularly in decentralized health systems. This approach will help national policy makers identify more effective ways of supporting lower tiers of governance towards improvement of health systems and outcomes.

  12. The role of leadership in people-centred health systems: a sub-national study in The Gambia.

    Science.gov (United States)

    Chigudu, Simukai; Jasseh, Momodou; d'Alessandro, Umberto; Corrah, Tumani; Demba, Adama; Balen, Julie

    2018-01-01

    Recently, increasing attention has been given to behavioural and relational aspects of the people who both define and shape health systems, placing them at the core. A growing refrain includes the assertion that important decisions determining health system performance, including agenda setting, policy formulation and policy implementation, are made by people. Within this actor-oriented approach, good leadership has been identified as a key contributing factor in health systems strengthening. However, leadership remains ill-defined and under-researched, especially in resource-limited settings, and understanding the links between leadership and health outcomes remains a challenge. We explore the concept and practice of healthcare leadership at sub-national level in a low-income country setting, using a people-centric research methodology. In June and July 2013, 15 in-depth interviews were conducted with key informants in formal healthcare leadership roles across urban, peri-urban and rural settings of The Gambia, West Africa. Participants included the entire spectrum of Regional Health Team (RHT) Directors and Chief Executive Officers of all government hospitals, as well as one clinical officer-in-charge in a secondary-level major health centre. We found reference to several important aspects of, and approaches to, leadership, including (i) setting a clear vision; (ii) engendering shared leadership; and (iii) paying attention to human relations in management. Participants described attending to constituencies in government, international development agencies and civil society, as well as to the populations they serve. By illuminating the multi-polar networks within which these leaders are embedded, and through which they operate, we provide insight into the complex 'organizational ecology' of the Gambian health system. There is a need to further research and develop healthcare leadership across all levels, within various political, socio-economic and cultural

  13. Marginal benefit incidence of public health spending: evidence from Indonesian sub-national data

    NARCIS (Netherlands)

    Kruse, I.; Pradhan, M.; Sparrow, R.

    2009-01-01

    We examine the marginal effects of decentralized public health spending by incorporating estimates of behavioural responses to changes in public health spending through benefit incidence analysis. The analysis is based on a panel dataset of 207 Indonesian districts over a 4-year period from 2001 to

  14. Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia

    Directory of Open Access Journals (Sweden)

    Ensor Tim

    2012-08-01

    Full Text Available Abstract Background Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. Methods A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Findings Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population

  15. Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia.

    Science.gov (United States)

    Ensor, Tim; Firdaus, Hafidz; Dunlop, David; Manu, Alex; Mukti, Ali Ghufron; Ayu Puspandari, Diah; von Roenne, Franz; Indradjaya, Stephanus; Suseno, Untung; Vaughan, Patrick

    2012-08-29

    Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population, particularly numbers of births, infants and children and also key

  16. National and subnational hypertension prevalence estimates for the Republic of Ireland: better outcome and risk factor data are needed to produce better prevalence estimates.

    LENUS (Irish Health Repository)

    Barron, Steve

    2014-01-10

    Hypertension is a global public health challenge. National prevalence estimates can conceal important differences in prevalence in subnational areas. This paper aims to develop a consistent set of national and subnational estimates of the prevalence of hypertension in a country with limited data for subnational areas.

  17. Influencing public health without authority.

    Science.gov (United States)

    Suresh, K

    2012-01-01

    This paper analyzes the present processes, products and needs of post-graduate public health education for the health programming, implementation and oversight responsibilities at field level and suggests some solutions for the institutes to adopt or adapt for improving the quality of their scholars. Large number of institutions has cropped up in India in the recent years to meet the growing demand of public health specialists/practitioners in various national health projects, international development partners, national and international NGOs. Throwing open MPH courses to multi-disciplinary graduate's is a new phenomenon in India and may be a two edged sword. On one hand it is advantageous to produce multi-faceted Public health postgraduates to meet the multi tasking required, on the other hand getting all of them to a common basic understanding, demystifying technical teaching and churning out products that are acceptable to the traditional health system. These Institutions can and must influence public health in the country through producing professionals of MPH/ MD degree with right attitude and skill-mix. Engaging learners in experimentation, experience sharing projects, stepping into health professionals' roles and similar activities lead to development of relatively clear and permanent neural traces in the brain. The MPH institutes may not have all efficient faculties, for which they should try to achieve this by inviting veterans in public health and professionals from corporate health industry for interface with students on a regular basis. The corporate and public health stalwarts have the capacities to transmit the winning skills and knowledge and also inspire them to adopt or adapt in order to achieve the desired goals.

  18. Monitoring subnational violence in Asia | IDRC - International ...

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

    This makes it difficult to understand why some countries experience ethnic riots and others do not, or why many stable, middle-income countries, especially in Asia, have protracted subnational conflicts. Previous research supported by The Asia Foundation has highlighted that more and better data, produced at a ...

  19. Avoiding the Fiscal Pitfalls of Subnational Regulation

    OpenAIRE

    International Finance Corporation; World Bank; Multilateral Investment Guarantee Agency

    2011-01-01

    Since investment climate reforms in developing countries started gaining traction in the 1990s, most efforts have focused on issues at the national level, achieving varying degrees of success for reasons that are relatively well understood. This handbook provides an overview of efforts and achievements in subnational investment climate reforms. It is organized as follows. Chapter 2 reviews...

  20. Subnational insolvency : cross-country experiences and lessons

    OpenAIRE

    Liu, Lili; Waibel, Michael

    2008-01-01

    Subnational insolvency is a reoccurring event in development, as demonstrated by historical and modern episodes of subnational defaults in both developed and developing countries. Insolvency procedures become more important as countries decentralize expenditure, taxation, and borrowing, and broaden subnational credit markets. As the first cross-country survey of procedures to resolve subna...

  1. Subnational electoral contexts and corruption in Mexico

    OpenAIRE

    Faughnan, Brian M.; Hiskey, Jonathan; Revey, Scott D.

    2014-01-01

    "Scholars of the world's most recent democratization processes have tended to focus on how national-level institutions have developed and how citizens have interpreted and responded to those developments. In this paper, we argue that the distinct subnational political environments that emerge from uneven national regime transitions are important determinants of how people view their political world. Specifically, we argue that citizens' experiences with and attitudes towards corruption are pa...

  2. Sub-national Revenue Mobilization in Peru

    OpenAIRE

    Canavire-Bacarreza, Gustavo; Martinez-Vazquez, Jorge; Sepulveda, Cristian

    2012-01-01

    This paper analyzes the problem of sub-national revenue mobilization in Peru and proposes several policy reforms to improve collection performance while maintaining a sound revenue structure. In particular, the paper analyzes the current revenues of regional and municipal governments and identifies the main priorities for reform. Among the most important problems are the acute inequalities and inefficiencies associated with revenue sharing from extractive industries. These revenues represent ...

  3. [Subnational analysis of probability of premature mortality caused by four main non-communicable diseases in China during 1990-2015 and " Health China 2030" reduction target].

    Science.gov (United States)

    Zeng, X Y; Li, Y C; Liu, S W; Wang, L J; Liu, Y N; Liu, J M; Zhou, M G

    2017-03-06

    Objective: To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015. Methods: Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan). Results: From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on

  4. Sub-national mapping of population pyramids and dependency ratios in Africa and Asia

    Science.gov (United States)

    Pezzulo, Carla; Hornby, Graeme M.; Sorichetta, Alessandro; Gaughan, Andrea E.; Linard, Catherine; Bird, Tomas J.; Kerr, David; Lloyd, Christopher T.; Tatem, Andrew J.

    2017-07-01

    The age group composition of populations varies substantially across continents and within countries, and is linked to levels of development, health status and poverty. The subnational variability in the shape of the population pyramid as well as the respective dependency ratio are reflective of the different levels of development of a country and are drivers for a country's economic prospects and health burdens. Whether measured as the ratio between those of working age and those young and old who are dependent upon them, or through separate young and old-age metrics, dependency ratios are often highly heterogeneous between and within countries. Assessments of subnational dependency ratio and age structure patterns have been undertaken for specific countries and across high income regions, but to a lesser extent across the low income regions. In the framework of the WorldPop Project, through the assembly of over 100 million records across 6,389 subnational administrative units, subnational dependency ratio and high resolution gridded age/sex group datasets were produced for 87 countries in Africa and Asia.

  5. Subnational taxation in developing countries : a review of the literature

    OpenAIRE

    Bird, Richard M.

    2010-01-01

    This paper reviews the literature on tax assignment in decentralized countries. Ideally, own-source revenues should be sufficient to enable at least the richest subnational governments to finance from their own resources all locally-provided services that primarily benefit local residents. Subnational taxes should also not unduly distort the allocation of resources. Most importantly, to the extent ...

  6. Laws for fiscal responsibility for subnational discipline : international experience

    OpenAIRE

    Liu, Lili; Steven B. Webb

    2011-01-01

    Fiscal responsibility laws are institutions with which multiple governments in the same economy -- national and subnational --can commit to help avoid irresponsible fiscal behavior that could have short-term advantages to one of them but that would be collectively damaging. Coordination failures with subnational governments in the 1990s contributed to macroeconomic instability and led seve...

  7. Promoting hand hygiene in healthcare through national/subnational campaigns.

    Science.gov (United States)

    Mathai, E; Allegranzi, B; Kilpatrick, C; Bagheri Nejad, S; Graafmans, W; Pittet, D

    2011-04-01

    The World Health Organization (WHO) First Global Patient Safety Challenge conducted a baseline survey of coordinated large-scale activities in improving hand hygiene in healthcare in 2007. The survey was repeated in early 2009 to assess current status and generate information on factors contributing to success. Coordinated activities were identified through WHO regional offices and experts in the field. An online survey using a structured questionnaire was conducted during March-April 2009. Personnel involved in all 38 campaigns/programmes in 2009 completed the survey. Of these, 29 were active national/subnational-level initiatives and 22 (75.8%) were initiated after the Challenge launch in October 2005. Main targets were general, district, and university hospitals with increasing coverage of long-term care facilities and primary care. The scope varied from awareness-raising to formal scaled-up activities with ongoing evaluation. Most initiatives (20/29) obtained funding from multiple sources with governments among the main funders; governments also initiated 25/29 (86.2%) programmes. The facilitator role played by the Challenge in initiating and supporting activities with tools and recommendations was clearly identified. The perceived significance of specific barriers varied considerably across initiatives. Those related to commitment (priority and support) and resource availability were important across all regions. Hand hygiene is being promoted in healthcare in many nations/subnations with clear objectives, strategies, and governmental support through policies and resource allocation. While this is important for sustainability, further action is required to initiate coordinated activities across the world, including countries with limited resources. Copyright © 2011 World Health Organization. Published by Elsevier Ltd on behalf of the Healthcare Infection Society. Published by Elsevier Ltd.. All rights reserved.

  8. NATIONAL INSTITUTIONS AND SUBNATIONAL DEVELOPMENT IN AFRICA.

    Science.gov (United States)

    Michalopoulos, Stelios; Papaioannou, Elias

    We investigate the role of national institutions on subnational African development in a novel framework that accounts for both local geography and cultural-genetic traits. We exploit the fact that the political boundaries on the eve of African independence partitioned more than 200 ethnic groups across adjacent countries subjecting similar cultures, residing in homogeneous geographic areas, to different formal institutions. Using both a matching type and a spatial regression discontinuity approach we show that differences in countrywide institutional structures across the national border do not explain within-ethnicity differences in economic performance, as captured by satellite images of light density. The average noneffect of national institutions on ethnic development masks considerable heterogeneity partially driven by the diminishing role of national institutions in areas further from the capital cities.

  9. NATIONAL INSTITUTIONS AND SUBNATIONAL DEVELOPMENT IN AFRICA*

    Science.gov (United States)

    Michalopoulos, Stelios; Papaioannou, Elias

    2014-01-01

    We investigate the role of national institutions on subnational African development in a novel framework that accounts for both local geography and cultural-genetic traits. We exploit the fact that the political boundaries on the eve of African independence partitioned more than 200 ethnic groups across adjacent countries subjecting similar cultures, residing in homogeneous geographic areas, to different formal institutions. Using both a matching type and a spatial regression discontinuity approach we show that differences in countrywide institutional structures across the national border do not explain within-ethnicity differences in economic performance, as captured by satellite images of light density. The average noneffect of national institutions on ethnic development masks considerable heterogeneity partially driven by the diminishing role of national institutions in areas further from the capital cities. PMID:25802926

  10. An Effective Health and Medical Technical Authority

    Science.gov (United States)

    Fogarty, Jennifer A.

    2009-01-01

    The NASA Governance model directed the formation of three Technical Authorities, Engineering; Safety and Mission Assurance; and Health and Medical, to ensure that risks are identified and adjudicated efficiently and transparently in concert with the spaceflight programs and projects. The Health and Medical Technical Authority (HMTA) has been implemented at the Johnson Space Center (JSC) and consists of the Chief Medical Office (CMO), the Deputy CMO, and HMTA Delegates. The JSC HMTA achieves the goals of risk identification and adjudication through the discharge of the appropriate technical expertise to human space flight programs and projects and the escalation of issues within program and technical authority boards. The JSC HMTA relies on subject matter experts (SMEs) in the Space Life Sciences Directorate at JSC as well as experts from other Centers to work crew health and performance issues at the technical level, develop requirements, oversee implementation and validation of requirements, and identify risks and non-compliances. Once a risk or potential noncompliance has been identified and reported to the programs or projects, the JSC HMTA begins to track it and closely monitor the program's or project's response. As a risk is developed or a non-compliance negotiated, positions from various levels of decision makers are sought at the program and project control boards. The HMTA may support a program or project position if it is satisfied with the decision making and vetting processes (ex. the subject matter expert voiced his/her concerns and all dissenting opinions were documented) and finds that the position both acknowledges the risk and cost of the mitigation and resolves the issue without changing NASA risk posture. The HMTA may disagree with a program or project position if the NASA risk posture has been elevated or obfuscated. If the HMTA does disagree with the program or project position, it will appeal to successively higher levels of authority so that

  11. The politics of subnational undemocratic regime reproduction in Argentina and Mexico

    OpenAIRE

    Giraudy, Agustina

    2010-01-01

    This article studies the continued existence of subnational undemocraticregimes in Argentina and Mexico, two countries that have recently experiencednational democratization. The first part of the article offers a conceptualizationof subnational democracy and measures its territorial extension across all subnational units. The second part explores a common, albeit not systematically tested explanation about subnational undemocratic regime continuity, namely, that these regimes persist because...

  12. Poverty Mapping Project: Global Subnational Prevalence of Child Malnutrition

    Data.gov (United States)

    National Aeronautics and Space Administration — The Global Subnational Prevalence of Child Malnutrition dataset consists of estimates of the percentage of children with weight-for-age z-scores that are more than...

  13. Poverty Mapping Project: Global Subnational Infant Mortality Rates

    Data.gov (United States)

    National Aeronautics and Space Administration — The Global Subnational Infant Mortality Rates consists of estimates of infant mortality rates for the year 2000. The infant mortality rate for a region or country is...

  14. A MULTIDISCIPLINARY APPROACH TO SUB-NATIONAL SUSTAINABILITY

    Science.gov (United States)

    The USEPA is investigating sustainability metrics from an economic and environmental perspective to determine their applicability at a sub-national level. Metrics are derived from Ecological Footprint, Emergy Analysis, Net Regional Product, and Fisher Information. We chose severa...

  15. SUB-NATIONAL SUSTAINABILITY FROM A MULTIDISCIPLINARY APPROACH

    Science.gov (United States)

    The USEPA is investigating sustainability metrics from an economic and environmental perspective to determine their applicability at a sub-national level. Metrics are derived from Ecological Footprint, Emergy Analysis, Net Regional Product, and Fisher Information. We chose severa...

  16. SUBNATIONAL REGIONALISM IN A SUPRANATIONAL CONTEXT: THE CASE OF HUNGARY

    Directory of Open Access Journals (Sweden)

    David Ellison

    2008-04-01

    Full Text Available European economic integration drives a political economy of regionalism that—far more than traditional divisions between labor and capital—defines the principal axis of political-economic division in the New Europe. The New Economy drives a radical shift in EU policy from cohesion or redistribution toward innovation promotion, affecting distributional struggles and policy approaches at the EU, national and subnational levels. Shifting strategies pose significant challenges at the national and subnational levels with important implications for future EU, national and subnational economic and regional development policy goals. At the national level, and in particular less developed economies, the New Economy creates incentives for the increasing centralization of decision-making. EU-level reforms, such as the Lisbon Agenda and an increasing emphasis on cohesion as opposed to structural funding, do much to strengthen these trends. Subnational regions, at least in the near term, may be the principal losers. But such trends are likely to strengthen future demands for greater subnational political decentralization.

  17. Challenges of citizen participation in regional health authorities.

    Science.gov (United States)

    Frankish, C James; Kwan, Brenda; Ratner, Pamela A; Higgins, Joan Wharf; Larsen, Craig

    2002-05-01

    Citizen participation has been included as part of health reform, often in the form of lay health authorities. In Canada, these authorities are variously known as regional health boards or councils. A set of challenges is associated with citizen participation in regional health authorities. These challenges relate to: differences in opinion about whether there should be citizen participation at all; differences in perception of the levels and processes of participation; differences in opinion with respect to the roles and responsibilities of health authority members; differences in opinion about the appropriate composition of the authorities; differences in opinion about the requisite skills and attributes of health authority members; having a good support base (staff, good information, board development); understanding and operationalizing various roles of the board (governance and policy setting) versus the board staff (management and administration); difficulties in ensuring the accountability of the health authorities; and measuring the results of the work and decisions of the health authorities. Despite these challenges, regional health authorities are gaining support as both theoretically sound and pragmatically based approaches to health-system reform. This review of the above challenges suggests that each of the concerns remains a significant threat to meaningful public participation.

  18. Sub-national assessment of inequality trends in neonatal and child mortality in Brazil

    Directory of Open Access Journals (Sweden)

    Sousa Angelica

    2010-09-01

    Full Text Available Abstract Objective Brazil's large socioeconomic inequalities together with the increase in neonatal mortality jeopardize the MDG-4 child mortality target by 2015. We measured inequality trends in neonatal and under five mortality across municipalities characterized by their socio-economic status in a period where major pro poor policies were implemented in Brazil to infer whether policies and interventions in newborn and child health have been successful in reaching the poor as well as the better off. Methods Using data from the 5,507 municipalities in 1991 and 2000, we developed accurate estimates of neonatal mortality at municipality level and used these data to investigate inequality trends in neonatal and under five mortality across municipalities characterized by socio-economic status. Results Child health policies and interventions have been more effective in reaching the better off than the worst off. Reduction of under five mortality at national level has been achieved by reducing the level of under five mortality among the better off. Poor municipalities suffer from worse newborn and child health than richer municipalities and the poor/rich gaps have increased. Conclusion Our analysis highlights the importance of monitoring progress on MDGs at sub-national level and measuring inequality gaps to accurately target health and inter-sectoral policies. Further efforts are required to improve the measurement and monitoring of trends in neonatal and under five mortality at sub-national level, particularly in developing countries and countries with large socioeconomic inequalities.

  19. Distinctive identity claims in federal systems: Judicial policing of subnational variance

    DEFF Research Database (Denmark)

    Abat Ninet, Antoni; Gardner, James A.

    2016-01-01

    It is characteristic of federal states that the scope of subnational power and autonomy are subjects of frequent dispute, and that disagreements over the reach of national and subnational power may be contested in a wide and diverse array of settings. Subnational units determined to challenge...... nationally imposed limits on their power typically have at their disposal many tools with which to press against formal boundaries. Federal systems, moreover, frequently display a surprising degree of tolerance for subnational obstruction, disobedience, and other behaviors intended to expand subnational...

  20. 75 FR 27348 - Public Health Services Act; Delegation of Authority

    Science.gov (United States)

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health Preparedness...

  1. [Toward a renewed definition of health (author's transl)].

    Science.gov (United States)

    Menchaca, F J

    1978-01-01

    With several arguments and testimonies is founded the need for a renewed definition of health. It is offered to the discusion the following project; Health could be conceived as the model of a capacity of vital normatization which allows the person to enjoy his paycophysic harmony in dynamic equilibrium with his natural and social circumstances. The author thinks that at preent time, and humanistic definition like this, could not be easily understood and applied because of power structures and materialistic forces which act on the man of today. Notwithstanding this objetion, moral exigences and a personal feeling of sympathy toward the health matters, push the author to offer this project to the discusion.

  2. Subnational variation for care at birth in Tanzania: is this explained by place, people, money or drugs?

    Directory of Open Access Journals (Sweden)

    Corinne E. Armstrong

    2016-09-01

    Full Text Available Abstract Background Tanzania achieved the Millennium Development Goal for child survival, yet made insufficient progress for maternal and neonatal survival and stillbirths, due to low coverage and quality of services for care at birth, with rural women left behind. Our study aimed to evaluate Tanzania’s subnational (regional-level variations for rural care at birth outcomes, i.e., rural women giving birth in a facility and by Caesarean section (C-section, and associations with health systems inputs (financing, health workforce, facilities, and commodities, outputs (readiness and quality of care and context (education and GDP. Methods We undertook correlation analyses of subnational-level associations between health system inputs, outputs, context, and rural care at birth outcomes; and constructed implementation readiness barometers using benchmarks for each health system input indicator. We used geographical information system (GIS mapping to visualise subnational variations in care at birth for rural women, with a focus on service availability and readiness, and collected qualitative data to investigate financial flows from national to council level to understand variation in financing inputs. Results We found wide subnational variation for rural care at birth outcomes, health systems inputs, and contextual indicators. There was a positive association between rural women giving birth in a facility and by C-section; maternal education; workforce and facility density; and quality of care. There was a negative association between these outcomes and proportion of all births to rural women, total fertility rate, and availability of essential commodities at facilities. Per capita recurrent expenditure was positively associated with facility births (correlation coefficient = 0.43; p = 0.05 but not with C-section. Qualitative results showed that the health financing system is complex and insufficient for providing care at birth services

  3. [The absence of stewardship in the Chilean health authority after the 2004 health reform].

    Science.gov (United States)

    Herrera, Tania; Sánchez, Sergio

    2014-11-26

    Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authority’s stewardship role.

  4. Weber, authority and the organisation of health care.

    Science.gov (United States)

    Alaszewski, A; Manthorpe, J

    The third paper in the series on sociology discusses the work of Max Weber. It traces the origins and main themes of his work. The parallels between his work and contemporary issues in the organisation of health care are outlined, in particular, the insights provided into bureaucracy and authority.

  5. Comparing methods for assessing the effectiveness of subnational REDD+ initiatives

    Science.gov (United States)

    Bos, Astrid B.; Duchelle, Amy E.; Angelsen, Arild; Avitabile, Valerio; De Sy, Veronique; Herold, Martin; Joseph, Shijo; de Sassi, Claudio; Sills, Erin O.; Sunderlin, William D.; Wunder, Sven

    2017-07-01

    The central role of forests in climate change mitigation, as recognized in the Paris agreement, makes it increasingly important to develop and test methods for monitoring and evaluating the carbon effectiveness of REDD+. Over the last decade, hundreds of subnational REDD+ initiatives have emerged, presenting an opportunity to pilot and compare different approaches to quantifying impacts on carbon emissions. This study (1) develops a Before-After-Control-Intervention (BACI) method to assess the effectiveness of these REDD+ initiatives; (2) compares the results at the meso (initiative) and micro (village) scales; and (3) compares BACI with the simpler Before-After (BA) results. Our study covers 23 subnational REDD+ initiatives in Brazil, Peru, Cameroon, Tanzania, Indonesia and Vietnam. As a proxy for deforestation, we use annual tree cover loss. We aggregate data into two periods (before and after the start of each initiative). Analysis using control areas (‘control-intervention’) suggests better REDD+ performance, although the effect is more pronounced at the micro than at the meso level. Yet, BACI requires more data than BA, and is subject to possible bias in the before period. Selection of proper control areas is vital, but at either scale is not straightforward. Low absolute deforestation numbers and peak years influence both our BA and BACI results. In principle, BACI is superior, with its potential to effectively control for confounding factors. We conclude that the more local the scale of performance assessment, the more relevant is the use of the BACI approach. For various reasons, we find overall minimal impact of REDD+ in reducing deforestation on the ground thus far. Incorporating results from micro and meso level monitoring into national reporting systems is important, since overall REDD+ impact depends on land use decisions on the ground.

  6. The HIV epidemic and prevention response in Tigrai, Ethiopia: a synthesis at sub-national level.

    Science.gov (United States)

    Barnabas, GebreAb; Pegurri, Elisabetta; Selassie, Hiwot Haile; Naamara, Warren; Zemariam, Samuel

    2014-06-20

    This study, the first of its kind carried out at sub-national level in Ethiopia, was conducted in order to understand the dynamics of HIV transmission at regional and district level in Tigrai, Ethiopia; and to assess the adequacy of the HIV prevention response. Routine data from health centres, data from available published and grey literature and studies, and primary qualitative information were triangulated to draw an updated picture of the HIV epidemic, HIV response and resource allocation in Tigrai. HIV prevalence in Tigrai was 1.8% in 2011 (EDHS). ANC data show that there has been a continuous decline in the prevalence of HIV in both urban and rural areas (urban: 14.9% in 2001 to 5.0% in 2009; rural: 5.2% in 2001 to 1.3% in 2009, ANC surveillance data). Variability in prevalence by zone and by district was observed. Possible reasons for higher prevalence include the presence of mobile seasonal workers, highly urbanized centres, a high concentration of economic activity and connecting roads and large commercial farms. Sex workers, seasonal farm workers and HIV negative partners in discordant couples were identified as being at higher risk. There is no evidence that programme planning is done on the basis of geographical variations in HIV prevalence and there are gaps in programmes and services for certain high risk population groups. Considerable efforts have been invested in the HIV prevention response in Tigrai however, these efforts do not fully respond to the actual needs. For a more effective and targeted HIV prevention response, studies and data syntheses need to be carried out at sub-national level in order to accurately identify local specificities and plan accordingly. Resources should be targeted towards areas where transmission is linked to sex work, mobility and the mobile labour workforce.

  7. Organizational leadership and its relationship to regional health authority actions to promote health.

    Science.gov (United States)

    Barrett, Linda L; Plotnikoff, Ronald C; Raine, Kim

    2007-01-01

    The purpose of this paper is to examine organizational leadership and its relationship to regional health authority actions to promote health. Through use of four previously developed measures of Perceived Organizational Leadership for Health Promotion, this paper focused on leadership as a distributed entity within regional health authority (RHA) jurisdictions mandated to address the health of the population in the province of Alberta, Canada. First, examination of differentials between organizational levels (i.e. board members, n = 30; middle/senior management, n = 58; and service providers, n = 56) on ratings of the four leadership measures revealed significant differences. That is, board members tended to rate leadership components significantly higher than service providers and middle/senior managers: from across all 17 RHAs; and in low health promotion capacity and high health promotion capacity RHAs. Second, regression analyses identified that the leadership measures "Practices for Organizational Learning" and "Wellness Planning" were positively associated with health authority actions on improving population heart health (heart health promotion). The presence of a "Champion for Heart Health Promotion" and the leadership measures "Workplace Milieu" and "Organization Member Development" were also positively associated with health authority actions for health promotion. A subsidiary aim revealed low to moderate positive relationships of the dimensions of Leadership, Infrastructure and Will to Act with one another, as proposed by the Alberta Model on "Organizational Capacity Building for Health Promotion." This paper, conducted on the baseline dataset (n = 144) of the "Alberta Heart Health Project's Dissemination Phase", represents a rare effort to examine leadership at a collective organizational level.

  8. Gridded Population of the World, Version 3 (GPWv3): Subnational Administrative Boundaries

    Data.gov (United States)

    National Aeronautics and Space Administration — Gridded Population of the World, Version 3 (GPWv3) Subnational Administrative Boundaries are the basis of the population data products in GPWv3. Due to copyright...

  9. The absence of stewardship in the Chilean health authority after the 2004 health reform

    Directory of Open Access Journals (Sweden)

    Tania Herrera

    2014-11-01

    Full Text Available Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authority’s stewardship role

  10. National and subnational all-cause and cause-specific child mortality in China, 1996-2015: a systematic analysis with implications for the Sustainable Development Goals.

    Science.gov (United States)

    He, Chunhua; Liu, Li; Chu, Yue; Perin, Jamie; Dai, Li; Li, Xiaohong; Miao, Lei; Kang, Leni; Li, Qi; Scherpbier, Robert; Guo, Sufang; Rudan, Igor; Song, Peige; Chan, Kit Yee; Guo, Yan; Black, Robert E; Wang, Yanping; Zhu, Jun

    2017-02-01

    China has achieved Millennium Development Goal 4 to reduce under-5 mortality rate by two-thirds between 1990 and 2015. In this study, we estimated the national and subnational levels and causes of child mortality in China annually from 1996 to 2015 to draw implications for achievement of the SDGs for China and other low-income and middle-income countries. In this systematic analysis, we adjusted empirical data on levels and causes of child mortality collected in the China Maternal and Child Health Surveillance System to generate representative estimates at the national and subnational levels. In adjusting the data, we considered the sampling design and probability, applied smoothing techniques to produce stable trends, fitted livebirth and age-specific death estimates to natvional estimates produced by the UN for international comparison, and partitioned national estimates of infrequent causes produced by independent sources to the subnational level. Between 1996 and 2015, the under-5 mortality rate in China declined from 50·8 per 1000 livebirths to 10·7 per 1000 livebirths, at an average annual rate of reduction of 8·2%. However, 181 600 children still died before their fifth birthday, with 93 400 (51·5%) deaths occurring in neonates. Great inequity exists in child mortality across regions and in urban versus rural areas. The leading causes of under-5 mortality in 2015 were congenital abnormalities (35 700 deaths, 95% uncertainty range [UR] 28 400-45 200), preterm birth complications (30 900 deaths, 24 200-40 800), and injuries (26 600 deaths, 21 000-33 400). Pneumonia contributed to a higher proportion of deaths in the western region of China than in the eastern and central regions, and injury was a main cause of death in rural areas. Variations in cause-of-death composition by age were also examined. The contribution of preterm birth complications to mortality decreased after the neonatal period; congenital abnormalities remained an

  11. National and Subnational Population-Based Incidence of Cancer in Thailand: Assessing Cancers with the Highest Burdens

    Directory of Open Access Journals (Sweden)

    Shama Virani

    2017-08-01

    Full Text Available In Thailand, five cancer types—breast, cervical, colorectal, liver and lung cancer—contribute to over half of the cancer burden. The magnitude of these cancers must be quantified over time to assess previous health policies and highlight future trajectories for targeted prevention efforts. We provide a comprehensive assessment of these five cancers nationally and subnationally, with trend analysis, projections, and number of cases expected for the year 2025 using cancer registry data. We found that breast (average annual percent change (AAPC: 3.1% and colorectal cancer (female AAPC: 3.3%, male AAPC: 4.1% are increasing while cervical cancer (AAPC: −4.4% is decreasing nationwide. However, liver and lung cancers exhibit disproportionately higher burdens in the northeast and north regions, respectively. Lung cancer increased significantly in northeastern and southern women, despite low smoking rates. Liver cancers are expected to increase in the northern males and females. Liver cancer increased in the south, despite the absence of the liver fluke, a known factor, in this region. Our findings are presented in the context of health policy, population dynamics and serve to provide evidence for future prevention strategies. Our subnational estimates provide a basis for understanding variations in region-specific risk factor profiles that contribute to incidence trends over time.

  12. Attempted suicide and contact with the primary health authorities

    DEFF Research Database (Denmark)

    Stenager, E N; Jensen, Knud

    1994-01-01

    In a study describing suicide attempters' approach to the health and social welfare authorities prior to a suicide attempt, it was found that one-fourth of the patients seeking help requested therapeutic consultations and only a few asked for medicinal treatment. Forty-four percent had taken newly...... prescribed medicine for the parasuicide. It is concluded that the availability of psychological support and a more restrictive prescription of medicine could have a preventive effect on parasuicidal behaviour. Patients suffering from depression and pain have more often than other patients been in contact...... with their general practitioner prior to the suicide attempt. Postgraduate courses for practitioners on depression diagnostics and suicidal behaviour are proposed as a measure in suicide prevention....

  13. Characterizing the epidemiological transition in Mexico: national and subnational burden of diseases, injuries, and risk factors.

    Science.gov (United States)

    Stevens, Gretchen; Dias, Rodrigo H; Thomas, Kevin J A; Rivera, Juan A; Carvalho, Natalie; Barquera, Simón; Hill, Kenneth; Ezzati, Majid

    2008-06-17

    Rates of diseases and injuries and the effects of their risk factors can have substantial subnational heterogeneity, especially in middle-income countries like Mexico. Subnational analysis of the burden of diseases, injuries, and risk factors can improve characterization of the epidemiological transition and identify policy priorities. We estimated deaths and loss of healthy life years (measured in disability-adjusted life years [DALYs]) in 2004 from a comprehensive list of diseases and injuries, and 16 major risk factors, by sex and age for Mexico and its states. Data sources included the vital statistics, national censuses, health examination surveys, and published epidemiological studies. Mortality statistics were adjusted for underreporting, misreporting of age at death, and for misclassification and incomparability of cause-of-death assignment. Nationally, noncommunicable diseases caused 75% of total deaths and 68% of total DALYs, with another 14% of deaths and 18% of DALYs caused by undernutrition and communicable, maternal, and perinatal diseases. The leading causes of death were ischemic heart disease, diabetes mellitus, cerebrovascular disease, liver cirrhosis, and road traffic injuries. High body mass index, high blood glucose, and alcohol use were the leading risk factors for disease burden, causing 5.1%, 5.0%, and 7.3% of total burden of disease, respectively. Mexico City had the lowest mortality rates (4.2 per 1,000) and the Southern region the highest (5.0 per 1,000); under-five mortality in the Southern region was nearly twice that of Mexico City. In the Southern region undernutrition and communicable, maternal, and perinatal diseases caused 23% of DALYs; in Chiapas, they caused 29% of DALYs. At the same time, the absolute rates of noncommunicable disease and injury burdens were highest in the Southern region (105 DALYs per 1,000 population versus 97 nationally for noncommunicable diseases; 22 versus 19 for injuries). Mexico is at an advanced stage

  14. Characterizing the epidemiological transition in Mexico: national and subnational burden of diseases, injuries, and risk factors.

    Directory of Open Access Journals (Sweden)

    Gretchen Stevens

    2008-06-01

    Full Text Available BACKGROUND: Rates of diseases and injuries and the effects of their risk factors can have substantial subnational heterogeneity, especially in middle-income countries like Mexico. Subnational analysis of the burden of diseases, injuries, and risk factors can improve characterization of the epidemiological transition and identify policy priorities. METHODS AND FINDINGS: We estimated deaths and loss of healthy life years (measured in disability-adjusted life years [DALYs] in 2004 from a comprehensive list of diseases and injuries, and 16 major risk factors, by sex and age for Mexico and its states. Data sources included the vital statistics, national censuses, health examination surveys, and published epidemiological studies. Mortality statistics were adjusted for underreporting, misreporting of age at death, and for misclassification and incomparability of cause-of-death assignment. Nationally, noncommunicable diseases caused 75% of total deaths and 68% of total DALYs, with another 14% of deaths and 18% of DALYs caused by undernutrition and communicable, maternal, and perinatal diseases. The leading causes of death were ischemic heart disease, diabetes mellitus, cerebrovascular disease, liver cirrhosis, and road traffic injuries. High body mass index, high blood glucose, and alcohol use were the leading risk factors for disease burden, causing 5.1%, 5.0%, and 7.3% of total burden of disease, respectively. Mexico City had the lowest mortality rates (4.2 per 1,000 and the Southern region the highest (5.0 per 1,000; under-five mortality in the Southern region was nearly twice that of Mexico City. In the Southern region undernutrition and communicable, maternal, and perinatal diseases caused 23% of DALYs; in Chiapas, they caused 29% of DALYs. At the same time, the absolute rates of noncommunicable disease and injury burdens were highest in the Southern region (105 DALYs per 1,000 population versus 97 nationally for noncommunicable diseases; 22 versus

  15. Characterizing the Epidemiological Transition in Mexico: National and Subnational Burden of Diseases, Injuries, and Risk Factors

    Science.gov (United States)

    Stevens, Gretchen; Dias, Rodrigo H; Thomas, Kevin J. A; Rivera, Juan A; Carvalho, Natalie; Barquera, Simón; Hill, Kenneth; Ezzati, Majid

    2008-01-01

    Background Rates of diseases and injuries and the effects of their risk factors can have substantial subnational heterogeneity, especially in middle-income countries like Mexico. Subnational analysis of the burden of diseases, injuries, and risk factors can improve characterization of the epidemiological transition and identify policy priorities. Methods and Findings We estimated deaths and loss of healthy life years (measured in disability-adjusted life years [DALYs]) in 2004 from a comprehensive list of diseases and injuries, and 16 major risk factors, by sex and age for Mexico and its states. Data sources included the vital statistics, national censuses, health examination surveys, and published epidemiological studies. Mortality statistics were adjusted for underreporting, misreporting of age at death, and for misclassification and incomparability of cause-of-death assignment. Nationally, noncommunicable diseases caused 75% of total deaths and 68% of total DALYs, with another 14% of deaths and 18% of DALYs caused by undernutrition and communicable, maternal, and perinatal diseases. The leading causes of death were ischemic heart disease, diabetes mellitus, cerebrovascular disease, liver cirrhosis, and road traffic injuries. High body mass index, high blood glucose, and alcohol use were the leading risk factors for disease burden, causing 5.1%, 5.0%, and 7.3% of total burden of disease, respectively. Mexico City had the lowest mortality rates (4.2 per 1,000) and the Southern region the highest (5.0 per 1,000); under-five mortality in the Southern region was nearly twice that of Mexico City. In the Southern region undernutrition and communicable, maternal, and perinatal diseases caused 23% of DALYs; in Chiapas, they caused 29% of DALYs. At the same time, the absolute rates of noncommunicable disease and injury burdens were highest in the Southern region (105 DALYs per 1,000 population versus 97 nationally for noncommunicable diseases; 22 versus 19 for injuries

  16. Multilevel governance challenges in transitioning towards a national approach for REDD+:Evidence from 23 subnational REDD+ initiatives

    OpenAIRE

    Ravikumar, Ashwin; Larson, Anne M; Duchelle, Amy E; Myers, Rodd; Gozales Tovar, Jazmin

    2015-01-01

    Although REDD+ was conceived as a national approach to reducing emissions from deforestation and forest degradation, many of the early advances have been at the subnational level. It is critical to link these subnational efforts to emerging national REDD+ frameworks, including with respect to finance and benefit distribution, setting reference levels, measurement, reporting and verification (MRV), land policy and safeguards. We use evidence from interviews with proponents from 23 subnational ...

  17. GPs' compliance with health and safety legislation and their occupational health needs in one London health authority.

    Science.gov (United States)

    Kennedy, Ioanna; Williams, Siân; Reynolds, Anne; Cockcroft, Anne; Solomon, Jack; Farrow, Stephen

    2002-01-01

    This survey assessed general practitioners' (GPs') knowledge of and compliance with, health and safety legislation and occupational health guidance in one London health authority. The response rate was 85%. Although the majority of practices were aware of the most important piece of legislation--The Management of Health and Safety at Work Regulations, 1992--less than one in ten practices had carried out the required systematic risk assessments. Compliance with other health and safety legislation and related employment issues was also poor. The health of GPs and their staff may be at risk and these general practices may be vulnerable to prosecution by the Health and Safety Executive. PMID:12236278

  18. [Strengthening of the steering role of health++ authorities in health care reforms].

    Science.gov (United States)

    Marín, J M

    2000-01-01

    Strengthening the ability of health authorities to provide leadership and guidance, now and in the future, is an important issue within the context of health sector reform. It means, among other things, redefining the role of health in light of leading social and economic trends seen in the world at the beginning of the 21st century, increasing participation in health by nongovernmental entities, moving toward participatory democracy in many countries, and modifying concepts of what is considered "public" and "private." Within this scenario, it is necessary to redirect the role of the health sector toward coordinating the mobilization of national resources, on a multisectoral scale, in order to improve equity and social well-being and to channel the limited available resources to the most disadvantaged groups in society. The liberalization of the production and distribution of health-related goods and services, including insurance, challenges the exercise of authority in the area of health. Furthermore, the formation of regional economic blocks and the enormous weight wielded by multinational companies in the areas of pharmaceuticals and other medical supplies and technologies are forcing the health sector to seek ways of harmonizing health legislation and international negotiations. According to many experts, all of these demands surpass the ability of Latin American ministries of health to effectively respond, given most countries' current organizational, legal, and political conditions and technical infrastructure. The countries of the Americas must make it a priority to strengthen their health officials' ability to provide leadership and guidance in order to meet present and future challenges.

  19. Challenges to Local Government Innovation: Legal and Institutional Impediments to the Exercise of Innovative Economic Development Policy by Subnational Jurisdictions

    Directory of Open Access Journals (Sweden)

    Adam Grydehøj

    2013-04-01

    Full Text Available A local government can use innovative governance practices to expand its jurisdictional capacity, thereby promoting local economic development. There are, however, legal and institutional impediments to the exercise of such innovative economic development policy. Using the subnational jurisdiction of Shetland as a case study, this paper considers how local government innovation can be a key driver of economic development. Local government innovation can nevertheless become subject to legal challenges by authorities in the higher-level jurisdictions (Scotland, the United Kingdom, and the European Union in the case of Shetland. Community concerns related to standards of good governance can compound these difficulties, resulting in a significant decrease in democratic accountability and a weakening of the local government’s de facto capacity to plan and implement policy. Before local governments can make the most of multilevel governance, local communities and high-lever jurisdictions must re-assess standards of legitimacy for local government functions and structures.

  20. Arctic strategies of sub-national regions : Why and how sub-national regions of Northern Finland and Sweden mobilize as Arctic stakeholders

    OpenAIRE

    Eliasson, Kristoffer

    2015-01-01

    The stakes are high in the Arctic region in terms of economic opportunities, environmental challenges and political interests, not least considering the fact that stakeholders include the most powerful nations in the world. This study departs from the notion that sub-national levels of government, in areas most affected by developments in the Arctic; risk being put in the background in favor of high-level and high-tension politics. Using theories on paradiplomacy and marginality, this study m...

  1. Developing strategies to enhance health services research capacity in a predominantly rural Canadian health authority.

    Science.gov (United States)

    Miller, Jennifer; Bryant Maclean, Leslie; Coward, Patricia; Broemeling, Anne-Marie

    2009-01-01

    This article outlines the planning, implementation and preliminary evaluation of a research capacity building (RCB) initiative within a predominantly rural Canadian health authority, Interior Health (IH), including initiative characteristics and key activities designed to initiate and enhance health services research capacity within the organization. Interior Health is one of 5 geographic health authorities in British Columbia. Over half of the population IH serves is considered to be rural/remote (approximately 3 people/km2), contributing to difficulties in sharing research information (ie geographical distance to meet in-person and a diverse set of needs and/or priority topics that warrant research support). An initial assessment of IH research capacity in 2006, using an organizational self-assessment tool and discussions with key stakeholders, revealed a need for enhanced communication of health research results, research education and networking opportunities for staff at all levels of the organization. Staff noted barriers to using and sharing research such as lack of time, resources and skills for, and value placed on, participating in research, as well as lack of awareness of linkages with local academic health researchers, including faculty located at two universities within the region. In response to this baseline assessment and stakeholder feedback, short-term funding has allowed for the initial development of RCB strategies in both urban and rural/remote areas of the region, including: IH Research Brown Bag Lunch Seminars; IH Research Skills Workshop Series; literature syntheses/summaries on priority topic areas; research collaboration/partnerships with health authorities, research networks and academic researchers; and an annual IH Research Conference. Although currently a poorly defined term, RCB is a concept that speaks to the need for improvement in the skills and assets that can facilitate the production and application research. It is difficult to

  2. Should health authorities offer risk-sharing contracts to pharmaceutical firms? A theoretical approach.

    Science.gov (United States)

    Antonanzas, Fernando; Juarez-Castello, Carmelo; Rodriguez-Ibeas, Roberto

    2011-07-01

    In this paper, we characterise the risk-sharing contracts that health authorities can design when they face a regulatory decision on drug pricing and reimbursement in a context of uncertainty. We focus on two types of contracts. On the one hand, the health authority can reimburse the firm for each treated patient regardless of health outcomes (non risk-sharing). Alternatively, the health authority can pay for the drug only when the patient is cured (risk-sharing contract). The optimal contract depends on the trade-off between the monitoring costs, the marginal production cost and the utility derived from treatment. A non-risk-sharing agreement will be preferred by the health authority, if patients who should not be treated impose a relatively low cost to the health system. When this cost is high, the health authority would prefer a risk-sharing agreement for relatively low monitoring costs.

  3. An Investigation of (Non- Inclusive Growth in Nigeria’s Sub-Nationals: Evidence from Elasticity Approach

    Directory of Open Access Journals (Sweden)

    Enobong Udoh

    2017-11-01

    Full Text Available This paper aims to estimate and rank the performance of sub-nationals in terms of their quality of growth using an index of inequality elasticity of poverty. The study puts forward a scenario matrix to hypothesize the four qualities of growth according to its interactions with inequality and poverty. This model is useful for developing countries that lack GDP data at the sub-national level, provided growth (at the national level has been positive for the period under review. The study found that for Nigeria’s sub-nationals, the null hypothesis of non-inclusive growth was rejected for the different poverty measures.

  4. 76 FR 31337 - Public Health Service Act (PHS); Delegation of Authority

    Science.gov (United States)

    2011-05-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Service Act (PHS); Delegation of Authority Notice is hereby given that pursuant to Section 3306(14) of the Public Health Service Act (PHS), I...

  5. Sub-national entities’ participation in Brazil’s foreign policy and in regional integration processes

    Directory of Open Access Journals (Sweden)

    Deisy Ventura

    2012-09-01

    Full Text Available This article focuses on how sub-national entities’ gradual participation in Brazilian foreign policy has come about, with reference to a decentralised scenario of the decision-making process in Itamaraty, where the ministries and presidential organs have a voice on many strategic themes, mainly concerning development. The article examines the insertion of sub-national entities into the decision-making process in the Southern Common Market (Mercosur, and concludes that in spite of the incipient participation, relevant contributions to the process of regional integration have arisen. Regarding the hypothesis that the participation of the federative entities in the decision-making process generates local and regional development, we argue that this is an alternative to increasing state efficiency. In conclusion, and despite the incipient institutionalisation that does not guarantee their vote in the decision-making process, at least their voice is heard.

  6. Contrasts in China and Soviet reform: sub-national and national causes

    OpenAIRE

    Lai, Hongyi

    2005-01-01

    Why did reform in China and the former Soviet Union produce drastically different outcomes? Why did some provinces in China embrace faster economic reform than others? This article argues that the state sector and reform initiatives in the sub-national units, reform strategies, entrenchment and maturation of central planning, the size of the defence industry, policy choice and the historical context help explain the differences in Soviet and Chinese reform courses and outcomes. A predominant ...

  7. Subnational fiscal sustainability analysis : what can we learn from Tamil Nadu ?

    OpenAIRE

    Ianchovichina, Elena; Liu, Lili; Nagarajan, Mohan

    2006-01-01

    In the late 1990s the Indian state of Tamil Nadu experienced an unprecedented fiscal deterioration, which was part of the widespread fiscal deterioration in Indian states. This deterioration was troubling because current expenditure outgrew total revenue, leaving little fiscal space for infrastructure spending. The paper presents a framework for subnational fiscal sustainability analysis and applies it to Tamil Nadu where subsequent fiscal adjustment has been ambitious and politically challen...

  8. Social capital and the social economy in a sub-national island jurisdiction

    OpenAIRE

    Groome Wynne, Barbara

    2008-01-01

    This paper begins with an explanation of social capital and its manifestation in structures and institutes of the social economy. It then describes how Prince Edward Island (PEl) is using social capital in the pursuit of economic sustainability. Next, the paper explores case studies of other sub-national island jurisdictions (SNIJs) and highlights how PEl could learn from the successes and failures of these other islands. Finally, it generates suggestions on how to more effe...

  9. Understanding the Complexities of Subnational Incentives in Supporting a National Market for Distributed Photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Bush, B.; Doris, E.; Getman, D.

    2014-09-01

    Subnational policies pertaining to photovoltaic (PV) systems have increased in volume in recent years and federal incentives are set to be phased out over the next few. Understanding how subnational policies function within and across jurisdictions, thereby impacting PV market development, informs policy decision making. This report was developed for subnational policy-makers and researchers in order to aid the analysis on the function of PV system incentives within the emerging PV deployment market. The analysis presented is based on a 'logic engine,' a database tool using existing state, utility, and local incentives allowing users to see the interrelationships between PV system incentives and parameters, such as geographic location, technology specifications, and financial factors. Depending on how it is queried, the database can yield insights into which combinations of incentives are available and most advantageous to the PV system owner or developer under particular circumstances. This is useful both for individual system developers to identify the most advantageous incentive packages that they qualify for as well as for researchers and policymakers to better understand the patch work of incentives nationwide as well as how they drive the market.

  10. Conceptions of authority within contemporary social work practice in managed mental health care organizations.

    Science.gov (United States)

    Bransford, Cassandra L

    2005-07-01

    This article examines how social workers may use their authority to create managed mental health care organizations that support the principles and values of professional social work practice. By exploring research and theoretical contributions from a multidisciplinary perspective, the author suggests ways that social workers may incorporate empowerment strategies into their organizational practices to create more socially responsible and humane mental health organizations. (c) 2005 APA, all rights reserved.

  11. [Health care for undocumented migrants--a quantitative study on the role of local health authorities in Germany].

    Science.gov (United States)

    Mylius, M; Frewer, A

    2014-07-01

    Public welfare on a municipal level for groups with special health risks has been an important topic of public health service for more than a century. This notion has been taken up by the German "Protection against Infection Act" (IfSG) in § 19 IfSG. Local health service authorities may provide out-patient treatment in addition to counselling and diagnosis for patients with sexually transmitted infections and tuberculosis, which is covered by public resources in cases of apparent need. Due to altered legislation and increased global mobility, this may become important for migrants without access to regular health care.Aims of this study were recording, counselling, diagnosis and out-patient treatment of migrants without legal residence status under the German Protection against Infection Act in the public health care system.An electronic mail survey of all local health authorities (n=384) by means of a standardised questionnaire was undertaken. Data were analysed using descriptive statistics. In the annex of the questionnaire the participants were asked to describe a case study.139 of 384 local health authorities completed the questionnaire (36.2%) of whom approximately a quarter (24.6%) described contacts to "illegal" migrants. Contacts to migrants without legal residence status are more frequent in cities with more than 100,000 inhabitants than in ismaller cities (pmigrants for counseling and diagnosis. 25 of the local health authorities (18.4%) indicated the capability to provide treatment in accordance with § 19 IfSG. A majority of these local health authorities also have contacts to undocumented migrants (75%). 16 local health authorities (13.3%) provide out-patient treatment for diseases not listed in Protection against Infection Act. 56 authorities (46.7%) refer patients to aid organisations or to resident doctors.Only a small number of local health authorities have contacts to migrants without health insurance. The option-al out-patient treatment is

  12. Sub-national population policy: the case of North Sulawesi.

    Science.gov (United States)

    Jones, G W

    1989-04-01

    Since the 1970s, Indonesia has placed increasing emphasis on the development of stronger planning capacity at the regional level; however, the concept of regional autonomy is still viewed with suspicion given Indonesia's history of regional separatist movements. This fact has implications for the need for national population policy to be formulated and implemented with a view toward the varying conditions faced by different provinces and regions. The author presents a case study of fertility, mortality, migration, urbanization, and the development of human capital in 1 Indonesian province--North Sulawesi--to illustrate that special characteristics and internal diversity can demand individualized responses by policy makers. In terms of these 5 areas, the following observations can be made about conditions in North Sulawesi: 1) mortality rates are already below the national average, although infant mortality remains unacceptably high; 2) fertility rates are also well below the national average and approaching replacement level without any aggressive family planning outreach activities, but there remains a need to identify the ultimate fertility target and the extent to which intervention is required; 3) there is little scope for absorbing transmigrants, but there are some major issues regarding population redistribution within the province; 4) although there are no large cities, the increasing dominance of Manado is a concern; and 5) the quality of education and an employment structure to match the well-educated labor force are more important than an expansion of these services. A central concern is the ability of North Sulawesi to prevent "brain drain" to Jakarta; however, the province's capacity to do so is dependent on decisions made in Jakarta about the allocation of revenue, regulations regarding the processing of copra and cloves, new air routes, and the extent of regional autonomy to be tolerated in decisions affecting provincial growth.

  13. 78 FR 14303 - Statement of Delegation of Authority; Health Resources and Services Administration and Centers...

    Science.gov (United States)

    2013-03-05

    ... HUMAN SERVICES Statement of Delegation of Authority; Health Resources and Services Administration and Centers for Disease Control and Prevention I hereby delegate to the Administrator, Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and Prevention (CDC), with...

  14. Why the European Food Safety Authority was right to reject health claims for probiotics.

    NARCIS (Netherlands)

    Katan, M.B.

    2012-01-01

    Probiotics are microbes that are claimed to promote health and well-being when added to foods. However, the European Food Safety Authority (EFSA) has so far advised negatively about health claims for probiotics. Companies and scientists have protested against these rejections, sometimes in vigorous

  15. "Your body is your business card": Bodily capital and health authority in the fitness industry.

    Science.gov (United States)

    Hutson, David J

    2013-08-01

    Although scholars have noted the connection between appearance and assumptions of health, the degree to which these assumptions matter for establishing authority in social interaction remains less clear. Using a theoretical framework involving "bodily capital"--that is, the value generated from appearance, attractiveness, and physical ability--I investigate the role of appearance in the U.S. fitness industry. Drawing on data from interviews with 26 personal trainers and 25 clients between 2010 and 2011, I find that a trainer's fit-appearing physique imbues their interactions with a degree of moral and health authority. This corporeal credibility engenders trust among clients and allows exercise to be understood as a form of health work. The implications for academics and medical practitioners reach beyond the gym setting and extend recent research linking appearance to health, authority, and medical credibility. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Subnational distribution of average farm size and smallholder contributions to global food production

    Science.gov (United States)

    Samberg, Leah H.; Gerber, James S.; Ramankutty, Navin; Herrero, Mario; West, Paul C.

    2016-12-01

    Smallholder farming is the most prevalent form of agriculture in the world, supports many of the planet’s most vulnerable populations, and coexists with some of its most diverse and threatened landscapes. However, there is little information about the location of small farms, making it difficult both to estimate their numbers and to implement effective agricultural, development, and land use policies. Here, we present a map of mean agricultural area, classified by the amount of land per farming household, at subnational resolutions across three key global regions using a novel integration of household microdata and agricultural landscape data. This approach provides a subnational estimate of the number, average size, and contribution of farms across much of the developing world. By our estimates, 918 subnational units in 83 countries in Latin America, sub-Saharan Africa, and South and East Asia average less than five hectares of agricultural land per farming household. These smallholder-dominated systems are home to more than 380 million farming households, make up roughly 30% of the agricultural land and produce more than 70% of the food calories produced in these regions, and are responsible for more than half of the food calories produced globally, as well as more than half of global production of several major food crops. Smallholder systems in these three regions direct a greater percentage of calories produced toward direct human consumption, with 70% of calories produced in these units consumed as food, compared to 55% globally. Our approach provides the ability to disaggregate farming populations from non-farming populations, providing a more accurate picture of farming households on the landscape than has previously been available. These data meet a critical need, as improved understanding of the prevalence and distribution of smallholder farming is essential for effective policy development for food security, poverty reduction, and conservation agendas.

  17. The extractive industry in Latin America and the Caribbean: health impact assessment as an opportunity for the health authority.

    Science.gov (United States)

    Drewry, Jonathan; Shandro, Janis; Winkler, Mirko S

    2017-03-01

    The extractive industries have contributed to the economic and social development of Latin America and the Caribbean for centuries. We have undertaken a narrative review to assess the role of the health authority in the decision-making process as it relates to extractive industry projects. A narrative literature review was conducted with a keyword search conducted using PubMed, Scientific Electronic Library Online and Google. This was complemented with manual searches of relevant journals and reference lists of primary articles. A broad body of literature from Latin America and the Caribbean region provides evidence that the public health of communities engaged in extractive industry is not being assured and that significant gaps exist in aligning public and private sector efforts to improve health. Inclusion of the health authority in impact assessment has the potential to result in lasting positive effects on communities involved directly and indirectly in the extractive industry, while preventing a large range of potential adverse health impacts.

  18. CHIS – Letter from French health insurance authorities "Assurance Maladie" and “frontalier” status

    CERN Document Server

    2014-01-01

    Certain members of the personnel residing in France have recently received a letter, addressed to themselves and/or their spouse, from the French health insurance authorities (Assurance Maladie) on the subject of changes in the health insurance coverage of “frontalier” workers.   It should be recalled that employed members of personnel (MPE) are not affected by the changes made by the French authorities to frontalier  workers' "right to choose" (droit d'option) in matters of health insurance (see the CHIS website for more details), which took effect as of 1 June 2014, as they are not considered to be frontalier workers. Associated members of the personnel (MPA) are not affected either, unless they live in France and are employed by a Swiss institute. For the small number of MPAs in the latter category who might be affected, as well as for family members who do have frontalier status, CERN is still in discussion with the authorities o...

  19. The effect of parental immigration authorization on health insurance coverage for migrant Latino children.

    Science.gov (United States)

    Weathers, Andrea C; Minkovitz, Cynthia S; Diener-West, Marie; O'Campo, Patricia

    2008-06-01

    To examine if immigration authorization among parents is associated with health insurance coverage for migrant Latino children. A cross-sectional household survey of 300 migrant families for which one child, aged <13 years, was randomly selected. Most children lacked insurance (73%) and had unauthorized parents (77%). Having an authorized parent or parental stay of more than 5 years in the US were each positively associated with children's health insurance coverage [OR: 4.9; 95% CI: (2.7-8.7) and [OR = 6.7; 95% CI: (3.8-12.0), respectively]. The effect of parental authorization did not persist in multivariable logistic regression analysis; however, more than 5 years of parental stay in the US remained associated with children's insurance coverage [OR = 4.8; 95% CI (1.8-12.2)], regardless of parental authorization. Increased parental familiarity with US health and/or social services agencies, rather than parental authorization status, is important to obtaining health insurance for migrant children. Efforts to insure eligible migrant children should focus on recently arrived families.

  20. Disinfection methods in general practice and health authority clinics: a telephone survey

    OpenAIRE

    Farrow, S.C.; Kaul, S.; Littlepage, B.C.

    1988-01-01

    Concern about the epidemic of the acquired immune deficiency syndrome led to discussions in one health district about the dangers of cross-infection from instruments in general practice and health authority clinics. In order to establish what current disinfection practices were in use a telephone survey was adopted as a quick and easy method of data collection. Information was collected on who was responsible for disinfection as well as details of how each instrument was disinfected. Results ...

  1. Accuracy of Nearly Extinct Cohort Methods for Estimating Very Elderly Subnational Populations

    Directory of Open Access Journals (Sweden)

    Wilma Terblanche

    2015-01-01

    Full Text Available Increasing very elderly populations (ages 85+ have potentially major implications for the cost of income support, aged care, and healthcare. The availability of accurate estimates for this population age group, not only at a national level but also at a state or regional scale, is vital for policy development, budgeting, and planning for services. At the highest ages census-based population estimates are well known to be problematic and previous studies have demonstrated that more accurate estimates can be obtained indirectly from death data. This paper assesses indirect estimation methods for estimating state-level very elderly populations from death counts. A method for incorporating internal migration is also proposed. The results confirm that the accuracy of official estimates deteriorates rapidly with increasing age from 95 and that the survivor ratio method can be successfully applied at subnational level and internal migration is minor. It is shown that the simpler alternative of applying the survivor ratio method at a national level and apportioning the estimates between the states produces very accurate estimates for most states and years. This is the recommended method. While the methods are applied at a state level in Australia, the principles are generic and are applicable to other subnational geographies.

  2. The role of change management in the District Health Authority Consolidation (Transition and Design) project in Nova Scotia.

    Science.gov (United States)

    Stevenson, Colin; Burstall, Dawn

    2016-03-01

    The District Health Authority Consolidation (Transition and Design) project in Nova Scotia was initiated to consolidate the existing nine district health authorities into one provincial health authority. This article provides an overview of the internal change management approach and activities that were developed to support the various phases of the design and transition process. Three phases of work are outlined, and specific change management activities are described as are lessons learned from the overall approach. © 2016 The Canadian College of Health Leaders.

  3. Who said it? Establishing professional attribution among authors of Veterans' Electronic Health Records.

    Science.gov (United States)

    Reeves, Ruth M; FitzHenry, Fern; Brown, Steve H; Kotter, Kristen; Gobbel, Glenn T; Montella, Diane; Murff, Harvey J; Speroff, Ted; Matheny, Michael E

    2012-01-01

    A practical data point for assessing information quality and value in the Electronic Health Record (EHR) is the professional category of the EHR author. We evaluated and compared free form electronic signatures against LOINC note titles in categorizing the profession of EHR authors. A random 1000 clinical document sample was selected and divided into 500 document sets for training and testing. The gold standard for provider classification was generated by dual clinician manual review, disagreements resolved by a third reviewer. Text matching algorithms composed of document titles and author electronic signatures for provider classification were developed on the training set. Overall, detection of professional classification by note titles alone resulted in 76.1% sensitivity and 69.4% specificity. The aggregate of note titles with electronic signatures resulted in 95.7% sensitivity and 98.5% specificity. Note titles alone provided fair professional classification. Inclusion of author electronic signatures significantly boosted classification performance.

  4. Bioethical responsibilities of the health authority in health care and biomedical research

    Directory of Open Access Journals (Sweden)

    Rodrigo A. Salinas

    2015-01-01

    Full Text Available The reflection on bioethical contents of health policies and their effects on the demands for social justice has been a preferred concern of those who have driven the health reforms that were behind the creation of the National Health Service and, more recently, the regime of health guarantees. In the course of the years, the concern for the vindication of individual rights in the context of health care and research has joined to citizen demands for equitable access to health actions. For this purpose, in 2006 and 2012, specific laws addressing these matters were enacted and in the last year, regulations that make them operative emerged and are being implemented. The wording of the articles of both laws, in the effort to rescue individual rights, raises an imbalance in some respects, with regard to the social impact of their implementation. In certain subjects, its provisions run counter to existing codes of professional ethics in the country and in others; its implementation allows the privatization of the process of ethical review of pharmacological research, which was restricted to public health services. The absence of starting up of the National Bioethics Commission, pending since 2006, has prevented the creation of a pluralistic spaTce for deliberation on these issues and others as provided by law.

  5. Authority Delegation in Boyerahmad Health Centers through Model to Combine Suggestions System and Delphi Method 2012

    Directory of Open Access Journals (Sweden)

    M Momeninezhad

    2013-11-01

    Full Text Available Background & aim: Authority delegation means to transmit part of organization`s manager and leader`s special authorities and executive duties, regardless its root to subordinates and heads of units and related offices to speed up implementing affairs and organizational purposes quickly and on time. The purpose of this study was to inspect authority delegation in health centers of Boyerahmad district through using model to combine suggestions (to identify process and Delphi method (expert`s opinions . Methods: This cross-sectional study was implemented in two stages at first stage, research community was authorities of Boyerahmad health centers (58 persons, their suggestions about requested processes to delegate were gathered by total count through open questionnaires and in second stage, which was Delphi, suggestions gathered from previous stage judged by 30 experts. Data of both stages analyzed by help of Chi-square, correlation coefficient tests. Results: Findings showed that 73.85% of suggestions were able to be delegated, based on expert`s opinion. 40% of suggestions were in domain of official, 36.92% financial and 23.08% hygienic. 88% less than 6 years management background. 20.69% had no academic studies and only 27% were general physicians. Conclusion: By participation of environmental management levels, several processes may be specified and identify cases which are possible to delegate them executively using Delphi (expert`s opinion and this model can be used as a trust worthy method to delegate authority for decentralization. Key words: Participation Management, Health centers, Authority delegation

  6. Measuring the authority of local public health directors in the context of organizational structure: an exploratory, multimodal approach.

    Science.gov (United States)

    Miner Gearin, Kimberly J; Thrash, Allison M Rick; Frauendienst, Renee; Myhre, Julie; Gyllstrom, M Elizabeth; Riley, William J; Schroeder, Janelle

    2012-11-01

    Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

  7. Greenland as a self-governing sub-national territory in international relations: past, current and future perspectives

    DEFF Research Database (Denmark)

    Ackrén, Maria; Jakobsen, Uffe

    2015-01-01

    . This article reviews developments from the World War II to the present regarding international relations from a Greenlandic perspective. As a self-governing sub-national territory within the realm of Denmark, Greenland does not have the ultimate decision-making power within foreign and security policy. The new...

  8. Multilevel governance challenges in transitioning towards a national approach for REDD+: evidence from 23 subnational REDD+ initiatives

    Directory of Open Access Journals (Sweden)

    Ashwin Ravikumar

    2015-09-01

    Full Text Available Although REDD+ was conceived as a national approach to reducing emissions from deforestation and degradation, many of the early advances have been at the subnational level. It is critical to link these subnational efforts to emerging national REDD+ frameworks, including with respect to finance and benefit distribution, setting reference levels, measurement, reporting and verification (MRV, land policy and safeguards. We use evidence from interviews with proponents from 23 subnational REDD+ initiatives in six countries to characterize the multilevel governance challenges for REDD+. We analyse the differences in perceived challenges between subnational jurisdictional programs and project-based initiatives, and then analyse proponents’ perceptions of the relationship between government policies at multiple levels and these REDD+ initiatives. We find important multilevel governance challenges related to vertical coordination and information sharing and horizontal and inter-sectoral tensions, as well as concerns over accountability, equity and justice. Though the shift to a nested, jurisdictional or national REDD+ is sometimes approached as a technical design issue, this must be accompanied by an understanding of the interests and power relations among actors at different levels. We outline challenges and suggest priority areas for future research and policy, as countries move towards a national REDD+ system.

  9. [Health education and group work during in-patient rehabilitation following myocardial infarction (author's transl)].

    Science.gov (United States)

    Herzog, M; König, K; Maas, A; Neufert, R

    1982-02-01

    Starting from the usual in-patient rehabilitation measures for myocardial infarction patients and based on the authors' clinical experiences, a working model is presented concerning the health educational care of patients undergoing rehabilitation procedures immediately following infarction or bypass operation. The new concept is based on a psychosomatic view of the cardiovascular diseases, and uses group-dynamic elements in its methodological approach. The rehabilitational tasks of health education are understood as therapeutic strategies and are aimed at achieving changes on the attitudinal and behavioural level.

  10. NATIONAL AND SUB-NATIONAL OFFSHORING IMPACT ON EMPLOYMENT: AN APPLICATION TO MADRID REGION

    Directory of Open Access Journals (Sweden)

    María Ángeles Tobarra Gómez

    2016-07-01

    Full Text Available The effect of delocalization on a national economy has been widely studied, however subnational delocalization remains as an unvisited field for researchers. This paper studies the effects of fragmentation and the subsequent localization outside or abroad on the level of industrial and services employment in Madrid region. We work with Madrid data from regional input-output tables and estimate a labour demand function using panel data. Our results show a significant and small negative effect on regional employment of intra-industrial inputs from the national economy and abroad, while imported inputs from other sectors and origins are complementary to employment, resulting in a positive net effect on employment. The increasing specialization in main activities and the use of external providers by firms have a positive impact on the employment of Madrid region.

  11. Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis.

    Science.gov (United States)

    Shiferaw, Solomon; Abdullah, Muna; Mekonnen, Yared; Maïga, Abdoulaye; Akinyemi, Akanni; Amouzou, Agbessi; Friedman, Howard; Barros, Aluisio J D; Hounton, Sennen

    2015-01-01

    Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR) and distribution of births by demographic risk factors as defined by mother's age, birth interval, and birth order at the sub-national level in Ethiopia. Analyses used data from three Demographic and Health Surveys in Ethiopia (2000, 2005, and 2011), which are nationally representative data collected through questionnaire-based interviews from women 15-49 using a stratified, two-stage cluster sampling. First, we examined the trends of and relationship between TFR (in the 3 years before each survey) and modern contraceptive use among currently married women in all administrative regions over the time period 2000-2011 using linear regression analysis. We also examined the relationship between birth risks and under-five mortality using the no-risk group as a reference. Finally, multiple logistic regression analysis was performed to estimate the relationship between the effect of being a resident in one of the regions and having an avoidable birth risk (which includes births to mothers younger than 18 and older than 34 years, birth interval of less than 24 months and birth order higher than third) after adjusting for select covariates including wealth, educational status, residence, religion and exposure to family planning information. Sub-national-level regression analysis showed an inverse relationship between modern contraceptive use among married women and the TFR, with an average decrease of TFR by one child per woman associated with a 13 percentage point increase in modern contraceptive use between 2000 and 2011. A high percentage of births in Ethiopia (62%) fall in one of the risk categories (excluding first births), with wide regional variation from 55% in

  12. Using business intelligence to analyze and share health system infrastructure data in a rural health authority.

    Science.gov (United States)

    Haque, Waqar; Urquhart, Bonnie; Berg, Emery; Dhanoa, Ramandeep

    2014-08-06

    Health care organizations gather large volumes of data, which has been traditionally stored in legacy formats making it difficult to analyze or use effectively. Though recent government-funded initiatives have improved the situation, the quality of most existing data is poor, suffers from inconsistencies, and lacks integrity. Generating reports from such data is generally not considered feasible due to extensive labor, lack of reliability, and time constraints. Advanced data analytics is one way of extracting useful information from such data. The intent of this study was to propose how Business Intelligence (BI) techniques can be applied to health system infrastructure data in order to make this information more accessible and comprehensible for a broader group of people. An integration process was developed to cleanse and integrate data from disparate sources into a data warehouse. An Online Analytical Processing (OLAP) cube was then built to allow slicing along multiple dimensions determined by various key performance indicators (KPIs), representing population and patient profiles, case mix groups, and healthy community indicators. The use of mapping tools, customized shape files, and embedded objects further augment the navigation. Finally, Web forms provide a mechanism for remote uploading of data and transparent processing of the cube. For privileged information, access controls were implemented. Data visualization has eliminated tedious analysis through legacy reports and provided a mechanism for optimally aligning resources with needs. Stakeholders are able to visualize KPIs on a main dashboard, slice-and-dice data, generate ad hoc reports, and quickly find the desired information. In addition, comparison, availability, and service level reports can also be generated on demand. All reports can be drilled down for navigation at a finer granularity. We have demonstrated how BI techniques and tools can be used in the health care environment to make informed

  13. Why the European Food Safety Authority was right to reject health claims for probiotics.

    Science.gov (United States)

    Katan, M B

    2012-06-01

    Probiotics are microbes that are claimed to promote health and well-being when added to foods. However, the European Food Safety Authority (EFSA) has so far advised negatively about health claims for probiotics. Companies and scientists have protested against these rejections, sometimes in vigorous language. I argue that EFSA could not have acted differently, given EU regulations and the lack of convincing evidence for some of the claimed effects of probiotics on human health and well-being. One EU regulation that makes it hard to demonstrate the benefits of probiotics is the prohibition of medical claims, i.e. claims that a food prevents or cures a disease. If this prohibition did not exist, manufacturers of nutritional treatments might circumvent the costly procedures required for drugs, and market their products to ill people without thorough proof that they are effective and safe. However, the prohibition is also a legal fiction, because promotion of health and prevention of disease is largely the same thing. EFSA has recently indicated that it will allow health claims based on the ability of probiotics to reduce infections. To a certain extent, this abolishes the distinction between health claims and medical claims. It remains to be seen if probiotics producers can convince EFSA that their products prevent or cure infections and other diseases in humans.

  14. [Drug evaluation by the French National Health Authority for reimbursement decisions].

    Science.gov (United States)

    Bouvenot, Gilles

    2005-11-01

    The French National Health Authority (NHA) is a scientific agency created by the French government in order to provide independent information and recommendations on health-related issues, and a coherent framework for improving healthcare practices. NHA's responsibility for periodically reviewing medicinal products for inclusion on the list of products eligible for reimbursement by the national health insurance system has been delegated to the Transparency Commission. The latter appraises the therapeutic value of medicinal products, based on clinical performance (efficacy and tolerability), the therapeutic contribution, and the expected impact on public health. If the Transparency Commission deems that a product has sufficient therapeutic value to warrant reimbursement, and if this opinion is approved by the Health Ministry, the Union of National Health Insurance Funds sets the refunding level according to the product's therapeutic value. The latter is re-assessed every 5 years, based on contemporary medical knowledge. The Transparency Commission also assesses the possible added therapeutic value of new products, i.e. their advantages over existing treatments. This is taken into account in setting the approved price. Transparency Commission opinions become part of the product's credentials, and are used by other NHA commissions to formulate "Recommendations for improving medical practices" and "Quality and distribution of medical information".

  15. [Hygiene in Urological Surgeries - Results of the Health Authority's Visit to all Urological Surgeries in Braunschweig].

    Science.gov (United States)

    Buhr-Riehm, B; Lenz, T

    2015-07-01

    Following a patient complaint, the Health Department carried out a hygiene inspection of a urological practice in Braunschweig in February 2013. The topic of the complaint was that a patient assumed having acquired a resistant pathogen in the practice. In the subsequent visit, significant hygiene defects were found, particularly with regard to the processing of medical devices. This led to a decision to commit all urological practices in Braunschweig to hygiene inspections as part of a priority project. In retrospect, the hygiene surveys were justified. Deficiencies included inadequate preparation of medical products, procedures in practice inconsistent with hygiene plans, poor knowledge of hygiene procedures among assistant staff and doctors, lack of expertise of assistant staff and lack of hygiene risk awareness by doctors. Positive experiences were: open communication in a good atmosphere with the Practice managers, willingness to change, good cooperation between the Health Authority and the Labor Inspectorate and Physicians' Association. The claimed deficits were corrected by spring 2014 by the practice operators. The consulting expertise of the health authorities was made use of continuously. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Health, Climate Change and Energy Vulnerability: A Retrospective Assessment of Strategic Health Authority Policy and Practice in England

    Directory of Open Access Journals (Sweden)

    J. Richardson B.Sc., Ph.D., RN., DipDN., CPsychol., PGCE.

    2008-01-01

    Full Text Available Background A number of policy documents suggest that health services should be taking climate change and sustainability seriously and recommendations have been made to mitigate and adapt to the challenges health care providers will face. Actions include, for example, moving towards locally sourced food supplies, reducing waste, energy consumption and travel, and including sustainability in policies and strategies. A Strategic Health Authority (SHA is part of the National Health Service (NHS in England. They are responsible for developing strategies for the local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between the U.K. Department of Health and the NHS. They also ensure that national priorities are integrated into local plans. Thus they are in a key position to influence policies and practices to mitigate and adapt to the impact of climate change and promote sustainability. Aim The aim of this study was to review publicly available documents produced by Strategic Health Authorities (SHA to assess the extent to which current activity and planning locally takes into consideration climate change and energy vulnerability. Methods A retrospective thematic content analysis of publicly available materials was undertaken by two researchers over a six month period in 2008. These materials were obtained from the websites of the 10 SHAs in England. Materials included annual reports, plans, policies and strategy documents. Results Of the 10 SHAs searched, 4 were found to have an absence of content related to climate change and sustainability. Of the remaining 6 SHAs that did include content related to climate change and energy vulnerability on their websites consistent themes were seen to emerge. These included commitment to a regional sustainability framework in collaboration with other agencies in the pursuit and promotion of sustainable development. Results indicate that many SHAs in England

  17. Health, Climate Change and Energy Vulnerability: A Retrospective Assessment of Strategic Health Authority Policy and Practice in England

    Directory of Open Access Journals (Sweden)

    J. Richardson

    2008-01-01

    Full Text Available Background: A number of policy documents suggest that health services should be taking climate change and sustainability seriously and recommendations have been made to mitigate and adapt to the challenges health care providers will face. Actions include, for example, moving towards locally sourced food supplies, reducing waste, energy consumption and travel, and including sustainability in policies and strategies. A Strategic Health Authority (SHA is part of the National Health Service (NHS in England. They are responsible for developing strategies for the local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between the U.K. Department of Health and the NHS. They also ensure that national priorities are integrated into local plans. Thus they are in a key position to influence policies and practices to mitigate and adapt to the impact of climate change and promote sustainability.Aim: The aim of this study was to review publicly available documents produced by Strategic Health Authorities (SHA to assess the extent to which current activity and planning locally takes into consideration climate change and energy vulnerability.Methods: A retrospective thematic content analysis of publicly available materials was undertaken by two researchers over a six month period in 2008. These materials were obtained from the websites of the 10 SHAs in England. Materials included annual reports, plans, policies and strategy documents.Results: Of the 10 SHAs searched, 4 were found to have an absence of content related to climate change and sustainability. Of the remaining 6 SHAs that did include content related to climate change and energy vulnerability on their websites consistent themes were seen to emerge. These included commitment to a regional sustainability framework in collaboration with other agencies in the pursuit and promotion of sustainable development.Results indicate that many SHAs in England

  18. Transformation management of primary health care services in two selected local authorities in Gauteng

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    W Sibaya

    2000-09-01

    Full Text Available The transformation of health services in South Africa today is governed by the political, policy and legislative frameworks. This article focuses on the transformation of a primary health care service within a local authority in Gauteng. The purpose with this article is to explore and describe the perceptions (expectations and fears of selected managers employed in this primary health care service. The results are utilised to compile a strategy (framework for transformation management and leadership within the primary health care service. A qualitative research design was utilised and the data was collected by means of individual interviews with selected managers in the service, followed by a content analysis. The expectations and fears of managers focus mainly on personnel matters, community participation/satisfaction, salaries and parity, inadequate stocks/supplies and medication, the deterioration of quality service delivery and the need for training and empowerment. These results are divided into structure, process and outcome dimensions and are embodied in the conceptual framework for the transformation and leadership strategy. It is recommended that standards for transformation management be formulated and that the quality of transformation management be evaluated accordingly.

  19. [Institutional violence, medical authority, and power relations in maternity hospitals from the perspective of health workers].

    Science.gov (United States)

    Aguiar, Janaina Marques de; d'Oliveira, Ana Flávia Pires Lucas; Schraiber, Lilia Blima

    2013-11-01

    The current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of São Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of "humor", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a "difficult" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., "for the patient's own good"), and rendered invisible in the daily routine of care provided by maternity services.

  20. What is the role and authority of gatekeepers in cluster randomized trials in health research?

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    Gallo Antonio

    2012-07-01

    Full Text Available Abstract This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the CRT is to be set on a firm ethical foundation. This paper addresses the sixth of the questions posed, namely, what is the role and authority of gatekeepers in CRTs in health research? ‘Gatekeepers’ are individuals or bodies that represent the interests of cluster members, clusters, or organizations. The need for gatekeepers arose in response to the difficulties in obtaining informed consent because of cluster randomization, cluster-level interventions, and cluster size. In this paper, we call for a more restrictive understanding of the role and authority of gatekeepers. Previous papers in this series have provided solutions to the challenges posed by informed consent in CRTs without the need to invoke gatekeepers. We considered that consent to randomization is not required when cluster members are approached for consent at the earliest opportunity and before any study interventions or data-collection procedures have started. Further, when cluster-level interventions or cluster size means that obtaining informed consent is not possible, a waiver of consent may be appropriate. In this paper, we suggest that the role of gatekeepers in protecting individual interests in CRTs should be limited. Generally, gatekeepers do not have the authority to provide proxy consent for cluster members. When a municipality or other community has a legitimate political authority that is empowered to make such decisions, cluster permission may be appropriate; however, gatekeepers may usefully protect cluster interests in other ways. Cluster consultation may ensure that the CRT addresses local health needs, and is conducted in accord with local values and customs. Gatekeepers may also play an important role in protecting the

  1. Child Safety Reference Frameworks: a Policy Tool for Child Injury Prevention at the Sub-national Level.

    Science.gov (United States)

    Scholtes, Beatrice; Schröder-Bäck, Peter; Mackay, Morag; Vincenten, Joanne; Brand, Helmut

    2017-06-01

    The aim of this paper is to present the Child Safety Reference Frameworks (CSRF), a policy advice tool that places evidence-based child safety interventions, applicable at the sub-national level, into a framework resembling the Haddon Matrix. The CSRF is based on work done in previous EU funded projects, which we have adapted to the field of child safety. The CSRF were populated following a literature review. Four CSRF were developed for four domains of child safety: road, water and home safety, and intentional injury prevention. The CSRF can be used as a reference, assessment and comparative tool by child safety practitioners and policy makers working at the sub-national level.

  2. DEVELOPMENT SUB-NATIONAL AND POLITICAL CONDUCT OF INDUSTRIAL BOURGEOISIE IN RIO GRANDE DO SUL DURING THE 1990S

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    Marco Andre Cadoná

    2012-12-01

    Full Text Available During the 1990s, before the States nation crisis, economic openness and integration into the globalization of capital in the country, subnational governments in Brazil have increasingly pressured by the bourgeoisie of their respective territories for the definition of "competitive strategies", to create more favorable conditions of competitiveness for the capital already located locally and to international capital invested in the country during that decade. Thus, the "subnational spaces" gained importance as sites of struggle, especially for the forces representing the capital. In Rio Grande do Sul, the interest in making the country competitive in attracting gaucho capital boosted the industrial bourgeoisie to a broad political mobilization in defense of an adaptation project subject to the logic of the sub-space of globalization of capital.

  3. 14 CFR 1204.508 - Delegation of authority of certain civil rights functions to Department of Health, Education, and...

    Science.gov (United States)

    2010-01-01

    ... rights functions to Department of Health, Education, and Welfare. 1204.508 Section 1204.508 Aeronautics... Department of Health, Education, and Welfare. (a) Pursuant to the authority of § 1250.111(c) of this chapter..., Department of Health, Education, and Welfare, on March 15, 1966: (1) Responsibilities with respect to...

  4. The Modernization of the Audit Courts of Brazil: PROMOEX deployment assessment in Audit Courts subnational

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    Diones Gomes da Rocha

    2017-09-01

    Full Text Available Mainly since the Brazilian Federal Constitution of 1988, the Brazilian Courts of Accounts (TC had expanded its expertise to carry out the control of management of public entities on different perspectives, such as operational, accounting, budgetary and financial. The differences between these institutions in terms of economic, technological and human resources were factors that made it difficult to adapt these institutions to the new acquired competences. The Promoex then emerged as a solution for modernization of Brazilian subnational Courts of Accounts. Such solution had funds of US $ 64.4 million dollars. The purpose of this research, therefore, is to assess the implementation of this program by 33 TCs. The evaluation was conducted from documents collected from web pages of MPOG, ATRICON, IRB and the Portal of Brazil Courts of Accounts. The Loan Agreement 1628-OC / BR, Object Compliance Report, Progress Reports of the 1st and 2nd semesters of 2013 (final report, and surveys conducted by the FIA and FGV also were scrutinized. The results indicate that the Promoex was less than expected; the modernization proposals were more focused on solving administrative problems, as well as by the low impact of Promoex over the actions developed by the TCs.

  5. Advancing reference emission levels in subnational and national REDD+ initiatives: a CLASlite approach.

    Science.gov (United States)

    Reimer, Florian; Asner, Gregory P; Joseph, Shijo

    2015-12-01

    Conservation and monitoring of tropical forests requires accurate information on their extent and change dynamics. Cloud cover, sensor errors and technical barriers associated with satellite remote sensing data continue to prevent many national and sub-national REDD+ initiatives from developing their reference deforestation and forest degradation emission levels. Here we present a framework for large-scale historical forest cover change analysis using free multispectral satellite imagery in an extremely cloudy tropical forest region. The CLASlite approach provided highly automated mapping of tropical forest cover, deforestation and degradation from Landsat satellite imagery. Critically, the fractional cover of forest photosynthetic vegetation, non-photosynthetic vegetation, and bare substrates calculated by CLASlite provided scene-invariant quantities for forest cover, allowing for systematic mosaicking of incomplete satellite data coverage. A synthesized satellite-based data set of forest cover was thereby created, reducing image incompleteness caused by clouds, shadows or sensor errors. This approach can readily be implemented by single operators with highly constrained budgets. We test this framework on tropical forests of the Colombian Pacific Coast (Chocó) - one of the cloudiest regions on Earth, with successful comparison to the Colombian government's deforestation map and a global deforestation map.

  6. A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights

    Science.gov (United States)

    Misselhorn, Alison

    2017-01-01

    Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred ‘globalised’ foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels. PMID:28829787

  7. A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights.

    Directory of Open Access Journals (Sweden)

    Alison Misselhorn

    Full Text Available Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred 'globalised' foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels.

  8. Air pollution co-benefits of low carbon policies in road transport: a sub-national assessment for India

    Science.gov (United States)

    Mittal, Shivika; Hanaoka, Tatsuya; Shukla, Priyadarshi R.; Masui, Toshihiko

    2015-08-01

    This letter assesses low carbon scenarios for India at the subnational level in the passenger road transport sector. We estimate the future passenger mobility demand and assess the impact of carbon mitigation policies using the Asia-Pacific Integrated Assessment/Enduse models. This letter focuses on the transitions of energy and emissions of passenger transport in India in alternate scenarios i.e. the business-as-usual scenario and a low carbon scenario that aligns to the 2 °C temperature stabilization target agreed under the global climate change negotiations. The modelling results show that passenger mobility demand will rise in all sub-national regions of India in the coming few decades. However, the volume and modal structure will vary across regions. Modelling assessment results show that aligning global low carbon policies with local policies has potential to deliver significant air quality co-benefits. This analysis provides insights into the comparative dynamics of environmental policymaking at sub-national levels.

  9. A non-repudiated and traceable authorization system based on electronic health insurance cards.

    Science.gov (United States)

    Chen, Chin-Ling; Lu, Ming-Shaw; Guo, Zong-Min

    2012-08-01

    Since anamnesis management in health care is directly relative to patients' privacy protection, how to resist malicious behaviors is an important issue in information security. In recent years, the developed electronic health insurance cards (eHIC) has been widely adopted as an identification certificate, which involves lots applications and provides convenience to both the patients and relative medical workers as well. There always existed some disputes and moral standards for these medical doctors who are to be confronted with these challenges. For example: The doctor discloses patient's anamnesis without patient's consent and anamnesis by the illegal access…etc. As required in E-Health, the current systems are almost offline system, which are not suitable to support online E-anamnesis sharing access to reduce the consumption of the medical treatment and fulfill a secure audit channel. In this paper, to solve these problems, an eHIC-based online authorization system with non-repudiated and traceable properties is proposed. According to our simulation results, not only the patient's privacy could be fully protected, but also the medical revenue could be raised extensively.

  10. Decision maker views on priority setting in the Vancouver Island Health Authority

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    Mitton Craig

    2008-07-01

    Full Text Available Abstract Background Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers. Methods We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported. Results Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity. Conclusion This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers.

  11. National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

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    Farzadfar Farshad

    2011-10-01

    Full Text Available Abstract Background Mortality from cardiovascular and other chronic diseases has increased in Iran. Our aim was to estimate the effects of smoking and high systolic blood pressure (SBP, fasting plasma glucose (FPG, total cholesterol (TC, and high body mass index (BMI on mortality and life expectancy, nationally and subnationally, using representative data and comparable methods. Methods We used data from the Non-Communicable Disease Surveillance Survey to estimate means and standard deviations for the metabolic risk factors, nationally and by region. Lung cancer mortality was used to measure cumulative exposure to smoking. We used data from the death registration system to estimate age-, sex-, and disease-specific numbers of deaths in 2005, adjusted for incompleteness using demographic methods. We used systematic reviews and meta-analyses of epidemiologic studies to obtain the effect of risk factors on disease-specific mortality. We estimated deaths and life expectancy loss attributable to risk factors using the comparative risk assessment framework. Results In 2005, high SBP was responsible for 41,000 (95% uncertainty interval: 38,000, 44,000 deaths in men and 39,000 (36,000, 42,000 deaths in women in Iran. High FPG, BMI, and TC were responsible for about one-third to one-half of deaths attributable to SBP in men and/or women. Smoking was responsible for 9,000 deaths among men and 2,000 among women. If SBP were reduced to optimal levels, life expectancy at birth would increase by 3.2 years (2.6, 3.9 and 4.1 years (3.2, 4.9 in men and women, respectively; the life expectancy gains ranged from 1.1 to 1.8 years for TC, BMI, and FPG. SBP was also responsible for the largest number of deaths in every region, with age-standardized attributable mortality ranging from 257 to 333 deaths per 100,000 adults in different regions. Discussion Management of blood pressure through diet, lifestyle, and pharmacological interventions should be a priority in Iran

  12. SECURITY RISKS, MYTHS IN A TRANSITIONING SUB-NATIONAL REGIONAL ECONOMY (CROSS RIVER STATE AND IMAGINATIVE GEOGRAPHIES OF NIGERIA

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    J. K. UKWAYI

    2015-03-01

    Full Text Available The emergence of an “international community” through accumulation of perceived risks that contrasts with those risks (of considerably lower levels of seriousness compared to those perceived constitutes one of the interesting (or intriguing subjects of risks and disaster studies surrounding the 9/11 era. The constructions of “imaginative geographies”, have frequently been biased in the practices that underlie the mapping of the foreign places tend to put-down the affected regions in their “paintings” for the global community. The latter are subsequently “demonized” in their ratings of competence for participating in world trade, tourism, travel, among other social/cultural, and economic and political activities. The objective of this article is to highlight how the exaggeration of risks (contrasted to actually existing/lived risks, practices that are frequently associated with such adverse “imaginative geographies” poses sub-national regional development dilemma in Nigeria’s Niger Delta. We trace the roots of adverse “imaginative geographies” of Nigeria to the Abacha dictatorship (1993-1997. Then we highlight the mixed characteristics of the Niger Delta conditions during the “return of positive image recapture” by Nigeria’s federal government (re-democratisation of the Fourth Republic, 1999-present, re-branding campaigns; as well as adverse conditions present. Most significantly, we show that despite these adversities, a combination of favorable geographical size, differentiation, sub-national regional security programme formulation and management taking aims at diversification have created “large oases” of peace and security in Cross River State, a part of the Niger Delta that has been completely unscathed by insurgencies of the nearby sub-national region and further away national origin. Apart from identifying sub-national regions qualifying for delisting from “adverse imaginative geographies” due to

  13. States with stronger health insurance rate review authority experienced lower premiums in the individual market in 2010-13.

    Science.gov (United States)

    Karaca-Mandic, Pinar; Fulton, Brent D; Hollingshead, Ann; Scheffler, Richard M

    2015-08-01

    States have varying degrees of review authority over health insurance carriers' rates, including prior approval authority over proposed rates and requirements for loss ratios, the proportion of premium revenues spent on medical claims. The Affordable Care Act (ACA) requires carriers in certain categories of health insurance to provide public justification for rate increases of 10 percent or more. We collected data on how states changed their rate review authority and requirements during 2010-13, the years immediately after enactment of the ACA, and we combined these data with carrier filings. We found that adjusted premiums in the individual market in states that had prior-approval authority combined with loss ratio requirements were lower in 2010-13 ($3,489) than premiums in states with no rate review authority or that had only file-and-use regulations, which gave the states no authority to block rate increases ($3,617). Adjusted premiums declined modestly in prior-approval states with loss ratio requirements, from $3,526 in 2010 to $3,452 in 2013, while premiums increased from $3,422 to $3,683 in states with no rate review authority or file-and-use regulations only. Our findings suggest that states with prior approval authority and loss ratio requirements constrained health insurance premium increases. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Clinical negligence in ophthalmology: fifteen years of national health service litigation authority data.

    Science.gov (United States)

    Mathew, Rashmi G; Ferguson, Veronica; Hingorani, Melanie

    2013-04-01

    To categorize and understand the reasons behind ophthalmic clinical negligence claims in the National Health Service and how such claims can be avoided. Retrospective analyses of all ophthalmic clinical negligence claims between 1995 and 2009 were carried out. Data were obtained from the National Health Service Litigation Authority through the Freedom of Information Act. Claims were classified according to ophthalmic subspecialty, mean payment per subspecialty, severity, paid-to-closed ratio, and cost. One thousand two hundred fifty-three ophthalmology-related claims occurring from 1995 through 2009. Of these, 963 claims were closed over the 15-year period. Eighty-four were excluded because of insufficient case data. Retrospective analysis of all public sector ophthalmology litigation claims over a 15-year period in England. Subspecialty pertaining to claim, mean payment per claim, and severity of outcome of clinical incident. Nine hundred sixty-three claims were closed over a 15-year period, of which 67% resulted in payment. The total cost of claims was £32.1 million ($50.3 million), with a mean payment per claim of £33 300 ($52 300). The specialties with the highest mean payment per claim were neuro-ophthalmology and pediatric ophthalmology. Cataract subspecialty had the highest number of claims, accounting for 34% of all claims. Overall, the number of litigation claims in ophthalmology is low, relative to the high volume of outpatient and surgical workload. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  15. What's buzzing on your feed? Health authorities' use of Facebook to combat Zika in Singapore.

    Science.gov (United States)

    Vijaykumar, Santosh; Meurzec, Rianne Wally; Jayasundar, Karthikayen; Pagliari, Claudia; Fernandopulle, Yohan

    2017-11-01

    In 2016, Singapore grappled with one of the largest Zika outbreaks in Southeast Asia. This study examines the use of Facebook for Zika-related outreach by the Ministry of Health (MOH) and the National Environmental Agency (NEA) from March 1, 2015, to September 1, 2016, and public response to this effort. Despite nearly equivalent outreach, MOH's Facebook posts received more likes (µ = 3.49) and shares (µ = 30.11), whereas NEA's posts received more comments (µ = 4.55), with NEA posting mostly on prevention (N = 30) and MOH on situational updates (N = 24). Thematic analyses identified prevention-related posts as garnering the most likes (N = 1277), while update-related posts were most shared (N = 1059) and commented upon (N = 220). Outreach ceased briefly for 2 months after Singapore's first imported case of Zika, but increased following the outbreak of locally transmitted cases in August 2016. Public engagement was significantly higher during Zika compared with prior haze and dengue outbreaks. The results indicate the value of Facebook as a tool for rapid outreach during infectious disease outbreaks, and as a "listening" platform for those managing the situation. We discuss implications for public health communication research and policy. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Social participation in health in Brazil and England: inclusion, representation and authority.

    Science.gov (United States)

    Barnes, Marian; Coelho, Vera Schattan

    2009-09-01

    This article offers a brief description and analysis of public participation in health in Brazil and England in order to highlight different motivators and tensions within an acceptance of participation as official policy. The article draws on a range of research in both countries and an analysis of official documents relating to participation. It is based on collaboration between researchers deriving from broad programmes of work on public participation in which the authors are involved. There is a tension between different principles underpinning collective public involvement in health both within and between countries. Different aspirations or claims have been made about what such participation will achieve and there are trade-offs between design principles that have consequences for issues such as who takes part and thus also for what can be achieved. The democratic origins of public participation are more evident in the Brazilian situation than in England, but there are still questions about the inclusivity of the practices through which this is achieved. The English picture is both more diverse and dynamic, but formal decision-making power of participatory forums is less than in Brazil. Whilst social justice claims for participation have been made in both countries, there is as yet limited evidence that these have been realized.

  17. Associations between key intervention coverage and child mortality: an analysis of 241 sub-national regions of sub-Saharan Africa.

    Science.gov (United States)

    Akachi, Yoko; Steenland, Maria; Fink, Günther

    2017-12-21

    Reducing child mortality remains a key objective in the Sustainable Development Goals. Although remarkable progress has been made with respect to under-5 mortality over the last 25 years, little is known regarding the relative contributions of public health interventions and general improvements in socioeconomic status during this time period. We combined all available data from the Demographic and Health Survey (DHS) to construct a longitudinal, multi-level dataset with information on subnational-level key intervention coverage, household socioeconomic status and child health outcomes in sub-Saharan Africa. The dataset covers 562 896 child records and 769 region-year observations across 24 countries. We used multi-level multivariable logistics regression models to assess the associations between child mortality and changes in the coverage of 17 key reproductive, maternal, newborn and child health interventions such as bednets, water and sanitation infrastructure, vaccination and breastfeeding practices, as well as concurrent improvements in social and economic development. Full vaccination coverage was associated with a 30% decrease in the odds of child mortality [odds ratio (OR) 0.698, 95% confidence interval (CI) 0.564, 0.864], and continued breastfeeding was associated with a 24% decrease in the odds of child mortality (OR 0.759, 95% CI 0.642, 0.898). Our results suggest that changes in vaccination coverage, as well as increases in female education and economic development, made the largest contributions to the positive mortality trends observed. Breastfeeding was associated with child survival but accounts for little of the observed declines in mortality due to declining coverage levels during our study period. Our findings suggest that a large amount of progress has been made with respect to coverage levels of key health interventions. Whereas all socioeconomic variables considered appear to strongly predict health outcomes, the same was true only for very

  18. The concept of ''equity'' in health-promotion articles by Nordic authors - a matter of some confusion and misconception.

    Science.gov (United States)

    Povlsen, Lene; Borup, Ina K; Fosse, Elisabeth

    2011-03-01

    This paper focuses on equity in health, one of the key principles of the Ottawa Charter. It aims at analysing and discussing how the concept was defined, applied, and integrated in health-promotion articles by authors with a Nordic affiliation. Abstracts were first identified by the search word ''health promotion'' as a key word. The search was limited to 1986-2008 and abstracts written in English by authors with a Nordic affiliation. Abstracts/articles for the present study were subsequently selected from these abstracts using the search word ''equity'' and analysed by quantitative and qualitative content analysis. A majority of the 18 articles in the study did not include any proper definition of the term ''equity in health''. Most articles dealt with health in general or ''Health for All'' aspects and did not focus on specific strategies for vulnerable individuals or groups. The theoretical papers had a clear focus on equity aspects even though the concept of equity was sometimes included in an implicit way. In contrast, most papers reporting empirical studies did not specifically target equity aspects. Instead, the analysis gave the impression that many authors used the term ''equity'' synonymously with ''equality in health''. The findings may indicate that the concept of ''equity in health'' has been attenuated or even forgotten by Nordic health-promotion researchers and needs to be re-established as a strong concern within health promotion.

  19. Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

    Science.gov (United States)

    Martineau, F P; Graff, H; Mitchell, C; Lock, K

    2014-09-01

    The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

  20. [Health reform and the creation of the Sistema Único de Saúde: notes on contexts and authors].

    Science.gov (United States)

    Paiva, Carlos Henrique Assunção; Teixeira, Luiz Antonio

    2014-01-01

    Within the context of the return to democracy, the new constitution enacted in 1988 transformed health into an individual right and initiated the process of creating a public, universal and decentralized health system, profoundly altering the organization of public health in Brazil. This article discusses the main institutional, political and social aspects of this health reform, along with the changes, the continuities and the major initiatives, based on the literature published by the most widely read authors in this field of study. Without purporting to offer an exhaustive analysis, we discuss how the historiography written by authors who were also actors in the process assess its main features, along with the genesis of the process and the legacy of health reform in Brazil.

  1. Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe.

    Science.gov (United States)

    Silhol, Romain; Gregson, Simon; Nyamukapa, Constance; Mhangara, Mutsa; Dzangare, Janet; Gonese, Elizabeth; Eaton, Jeffrey W; Case, Kelsey K; Mahy, Mary; Stover, John; Mugurungi, Owen

    2017-04-01

    More cost-effective HIV control may be achieved by targeting geographical areas with high infection rates. The AIDS Impact model of Spectrum - used routinely to produce national HIV estimates - could provide the required subnational estimates but is rarely validated with empirical data, even at a national level. The validity of the Spectrum model estimates were compared with empirical estimates. Antenatal surveillance and population survey data from a population HIV cohort study in Manicaland, East Zimbabwe, were input into Spectrum 5.441 to create a simulation representative of the cohort population. Model and empirical estimates were compared for key demographic and epidemiological outcomes. Alternative scenarios for data availability were examined and sensitivity analyses were conducted for model assumptions considered important for subnational estimates. Spectrum estimates generally agreed with observed data but HIV incidence estimates were higher than empirical estimates, whereas estimates of early age all-cause adult mortality were lower. Child HIV prevalence estimates matched well with the survey prevalence among children. Estimated paternal orphanhood was lower than empirical estimates. Including observations from earlier in the epidemic did not improve the HIV incidence model fit. Migration had little effect on observed discrepancies - possibly because the model ignores differences in HIV prevalence between migrants and residents. The Spectrum model, using subnational surveillance and population data, provided reasonable subnational estimates although some discrepancies were noted. Differences in HIV prevalence between migrants and residents may need to be captured in the model if applied to subnational epidemics.

  2. Operational research to inform a sub-national surveillance intervention for malaria elimination in Solomon Islands

    Directory of Open Access Journals (Sweden)

    Atkinson Jo-An

    2012-03-01

    Full Text Available Abstract Background Successful reduction of malaria transmission to very low levels has made Isabel Province, Solomon Islands, a target for early elimination by 2014. High malaria transmission in neighbouring provinces and the potential for local asymptomatic infections to cause malaria resurgence highlights the need for sub-national tailoring of surveillance interventions. This study contributes to a situational analysis of malaria in Isabel Province to inform an appropriate surveillance intervention. Methods A mixed method study was carried out in Isabel Province in late 2009 and early 2010. The quantitative component was a population-based prevalence survey of 8,554 people from 129 villages, which were selected using a spatially stratified sampling approach to achieve uniform geographical coverage of populated areas. Diagnosis was initially based on Giemsa-stained blood slides followed by molecular analysis using polymerase chain reaction (PCR. Local perceptions and practices related to management of fever and treatment-seeking that would impact a surveillance intervention were also explored using qualitative research methods. Results Approximately 33% (8,554/26,221 of the population of Isabel Province participated in the survey. Only one subject was found to be infected with Plasmodium falciparum (Pf (96 parasites/μL using Giemsa-stained blood films, giving a prevalence of 0.01%. PCR analysis detected a further 13 cases, giving an estimated malaria prevalence of 0.51%. There was a wide geographical distribution of infected subjects. None reported having travelled outside Isabel Province in the previous three months suggesting low-level indigenous malaria transmission. The qualitative findings provide warning signs that the current community vigilance approach to surveillance will not be sufficient to achieve elimination. In addition, fever severity is being used by individuals as an indicator for malaria and a trigger for timely treatment

  3. Operational research to inform a sub-national surveillance intervention for malaria elimination in Solomon Islands

    Science.gov (United States)

    2012-01-01

    Background Successful reduction of malaria transmission to very low levels has made Isabel Province, Solomon Islands, a target for early elimination by 2014. High malaria transmission in neighbouring provinces and the potential for local asymptomatic infections to cause malaria resurgence highlights the need for sub-national tailoring of surveillance interventions. This study contributes to a situational analysis of malaria in Isabel Province to inform an appropriate surveillance intervention. Methods A mixed method study was carried out in Isabel Province in late 2009 and early 2010. The quantitative component was a population-based prevalence survey of 8,554 people from 129 villages, which were selected using a spatially stratified sampling approach to achieve uniform geographical coverage of populated areas. Diagnosis was initially based on Giemsa-stained blood slides followed by molecular analysis using polymerase chain reaction (PCR). Local perceptions and practices related to management of fever and treatment-seeking that would impact a surveillance intervention were also explored using qualitative research methods. Results Approximately 33% (8,554/26,221) of the population of Isabel Province participated in the survey. Only one subject was found to be infected with Plasmodium falciparum (Pf) (96 parasites/μL) using Giemsa-stained blood films, giving a prevalence of 0.01%. PCR analysis detected a further 13 cases, giving an estimated malaria prevalence of 0.51%. There was a wide geographical distribution of infected subjects. None reported having travelled outside Isabel Province in the previous three months suggesting low-level indigenous malaria transmission. The qualitative findings provide warning signs that the current community vigilance approach to surveillance will not be sufficient to achieve elimination. In addition, fever severity is being used by individuals as an indicator for malaria and a trigger for timely treatment-seeking and case reporting

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

    Science.gov (United States)

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

    2017-01-01

    Summary Background In the past two decades, the under-5 mortality rate in China has fallen substantially, but progress with regards to the Millennium Development Goal (MDG) 4 at the subnational level has not been quantified. We aimed to estimate under-5 mortality rates in mainland China for the years 1970 to 2012. Methods We estimated the under-5 mortality rate for 31 provinces in mainland China between 1970 and 2013 with data from censuses, surveys, surveillance sites, and disease surveillance points. We estimated under-5 mortality rates for 2851 counties in China from 1996 to 2012 with the reported child mortality numbers from the Annual Report System on Maternal and Child Health. We used a small area mortality estimation model, spatiotemporal smoothing, and Gaussian process regression to synthesise data and generate consistent provincial and county-level estimates. We compared progress at the county level with what was expected on the basis of income and educational attainment using an econometric model. We computed Gini coefficients to study the inequality of under-5 mortality rates across counties. Findings In 2012, the lowest provincial level under-5 mortality rate in China was about five per 1000 livebirths, lower than in Canada, New Zealand, and the USA. The highest provincial level under-5 mortality rate in China was higher than that of Bangladesh. 29 provinces achieved a decrease in under-5 mortality rates twice as fast as the MDG 4 target rate; only two provinces will not achieve MDG 4 by 2015. Although some counties in China have under-5 mortality rates similar to those in the most developed nations in 2012, some have similar rates to those recorded in Burkina Faso and Cameroon. Despite wide differences, the inter-county Gini coefficient has been decreasing. Improvement in maternal education and the economic boom have contributed to the fall in child mortality; more than 60% of the counties in China had rates of decline in under-5 mortality rates

  5. Spatiotemporal Evolution of Ebola Virus Disease at Sub-National Level during the 2014 West Africa Epidemic: Model Scrutiny and Data Meagreness.

    Directory of Open Access Journals (Sweden)

    Eva Santermans

    Full Text Available The Ebola outbreak in West Africa has infected at least 27,443 individuals and killed 11,207, based on data until 24 June, 2015, released by the World Health Organization (WHO. This outbreak has been characterised by extensive geographic spread across the affected countries Guinea, Liberia and Sierra Leone, and by localized hotspots within these countries. The rapid recognition and quantitative assessment of localised areas of higher transmission can inform the optimal deployment of public health resources.A variety of mathematical models have been used to estimate the evolution of this epidemic, and some have pointed out the importance of the spatial heterogeneity apparent from incidence maps. However, little is known about the district-level transmission. Given that many response decisions are taken at sub-national level, the current study aimed to investigate the spatial heterogeneity by using a different modelling framework, built on publicly available data at district level. Furthermore, we assessed whether this model could quantify the effect of intervention measures and provide predictions at a local level to guide public health action. We used a two-stage modelling approach: a a flexible spatiotemporal growth model across all affected districts and b a deterministic SEIR compartmental model per district whenever deemed appropriate.Our estimates show substantial differences in the evolution of the outbreak in the various regions of Guinea, Liberia and Sierra Leone, illustrating the importance of monitoring the outbreak at district level. We also provide an estimate of the time-dependent district-specific effective reproduction number, as a quantitative measure to compare transmission between different districts and give input for informed decisions on control measures and resource allocation. Prediction and assessing the impact of control measures proved to be difficult without more accurate data. In conclusion, this study provides us a

  6. Availability of information in Public Health on the Internet: An analysis of national health authorities in the Spanish-speaking Latin American and Caribbean countries.

    Science.gov (United States)

    Novillo-Ortiz, David; Hernández-Pérez, Tony; Saigí-Rubió, Francesc

    2017-04-01

    Access to reliable and quality health information and appropriate medical advice can contribute to a dramatic reduction in the mortality figures of countries. The governments of the Americas are faced with the opportunity to continue working on this challenge, and their institutional presence on their websites should play a key role in this task. In a setting where the access to information is essential to both health professionals and citizens, it is relevant to analyze the role of national health authorities. Given that search engines play such a key role in the access to health information, it is important to specifically know - in connection to national health authorities - whether health information offered is easily available to the population, and whether this information is well-ranked in search engines. Quantitative methods were used to gather data on the institutional presence of national health authorities on the web. An exploratory and descriptive research served to analyze and interpret data and information obtained quantitatively from different perspectives, including an analysis by country, and also by leading causes of death. A total of 18 web pages were analyzed. Information on leading causes of death was searched on websites of national health authorities in the week of August 10-14, 2015. The probability of finding information of national health authorities on the 10 leading causes of death in a country, among the top 10 results on Google, is 6.66%. Additionally, ten out the 18 countries under study (55%) do not have information ranked among the top results in Google when searching for the selected terms. Additionally, a total of 33 websites represent the sources of information with the highest visibility for all the search strategies in each country on Google for the ten leading causes of death in a country. Two websites, the National Library of Medicine and Wikipedia, occur as a result with visibility in the total of eighteen countries of the

  7. A Socio-Ecological Approach for Identifying and Contextualising Spatial Ecosystem-Based Adaptation Priorities at the Sub-National Level.

    Directory of Open Access Journals (Sweden)

    Amanda Bourne

    Full Text Available Climate change adds an additional layer of complexity to existing sustainable development and biodiversity conservation challenges. The impacts of global climate change are felt locally, and thus local governance structures will increasingly be responsible for preparedness and local responses. Ecosystem-based adaptation (EbA options are gaining prominence as relevant climate change solutions. Local government officials seldom have an appropriate understanding of the role of ecosystem functioning in sustainable development goals, or access to relevant climate information. Thus the use of ecosystems in helping people adapt to climate change is limited partially by the lack of information on where ecosystems have the highest potential to do so. To begin overcoming this barrier, Conservation South Africa in partnership with local government developed a socio-ecological approach for identifying spatial EbA priorities at the sub-national level. Using GIS-based multi-criteria analysis and vegetation distribution models, the authors have spatially integrated relevant ecological and social information at a scale appropriate to inform local level political, administrative, and operational decision makers. This is the first systematic approach of which we are aware that highlights spatial priority areas for EbA implementation. Nodes of socio-ecological vulnerability are identified, and the inclusion of areas that provide ecosystem services and ecological resilience to future climate change is innovative. The purpose of this paper is to present and demonstrate a methodology for combining complex information into user-friendly spatial products for local level decision making on EbA. The authors focus on illustrating the kinds of products that can be generated from combining information in the suggested ways, and do not discuss the nuance of climate models nor present specific technical details of the model outputs here. Two representative case studies from

  8. Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

    Directory of Open Access Journals (Sweden)

    Dionne Francois

    2011-07-01

    Full Text Available Abstract Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement.

  9. 75 FR 42760 - Office of Rural Health Policy; Statement of Delegation of Authority

    Science.gov (United States)

    2010-07-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Office of Rural Health Policy; Statement of... and Human Services, delegated to the Administrator, Health Resources and Services Administration (HRSA...

  10. Author Details

    African Journals Online (AJOL)

    Specific Health-Related Quality of Life Among Nigerians with Parkinson's Disease Abstract PDF. ISSN: 1597-4292. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

  11. Wheat yield loss attributable to heat waves, drought and water excess at the global, national and subnational scales

    Science.gov (United States)

    Zampieri, M.; Ceglar, A.; Dentener, F.; Toreti, A.

    2017-06-01

    Heat waves and drought are often considered the most damaging climatic stressors for wheat. In this study, we characterize and attribute the effects of these climate extremes on wheat yield anomalies (at global and national scales) from 1980 to 2010. Using a combination of up-to-date heat wave and drought indexes (the latter capturing both excessively dry and wet conditions), we have developed a composite indicator that is able to capture the spatio-temporal characteristics of the underlying physical processes in the different agro-climatic regions of the world. At the global level, our diagnostic explains a significant portion (more than 40%) of the inter-annual production variability. By quantifying the contribution of national yield anomalies to global fluctuations, we have found that just two concurrent yield anomalies affecting the larger producers of the world could be responsible for more than half of the global annual fluctuations. The relative importance of heat stress and drought in determining the yield anomalies depends on the region. Moreover, in contrast to common perception, water excess affects wheat production more than drought in several countries. We have also performed the same analysis at the subnational level for France, which is the largest wheat producer of the European Union, and home to a range of climatic zones. Large subnational variability of inter-annual wheat yield is mostly captured by the heat and water stress indicators, consistently with the country-level result.

  12. Author Details

    African Journals Online (AJOL)

    Permala, R. Vol 2 (1998) - Articles Environmental Health Impact Assessment Of A “Black Spot Area” In Mauritius Abstract. ISSN: 1694-0342. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy ...

  13. Weight-Related Health Behaviors and Body Mass: Associations between Young Adults and Their Parents, Moderated by Parental Authority

    Science.gov (United States)

    Niemeier, Brandi S.; Hektner, Joel M.

    2012-01-01

    Background: Parents' behaviors could contribute to the development of their children's weight-related health behaviors. Purpose: Relationships of young adults' (N = 151) and their parents' weight-related behaviors were examined along with parental authority styles. Methods: Questionnaires were completed by young adults and their parents.…

  14. Social media in public health: an analysis of national health authorities and leading causes of death in Spanish-speaking Latin American and Caribbean countries.

    Science.gov (United States)

    Novillo-Ortiz, David; Hernández-Pérez, Tony

    2017-02-03

    Information and communications technologies, like social media, have the potential to reduce some barriers in disease prevention and control in the Americas. National health authorities can use these technologies to provide access to reliable and quality health information. A study was conducted to analyze availability of information about the leading causes of death on social media channels of national health authorities in 18 Spanish-speaking Latin American and Caribbean countries. We gathered data of national health authorities's institutional presence in social media. Exploratory-descriptive research was useful for analysis and interpretation of the data collected. An analysis was carried out for 6 months, from April 1 to September 30, 2015. Sixteen of the 18 countries studied have institutional presences on social media. National health authorities have a presence in an average of almost three platforms (2.8%). An average of 1% of the populations with Internet access across the 18 countries in this study follows national health authorities on social media (approximately, an average of 0.3% of the total population of the countries under study). On average, information on 3.2 of the 10 leading causes of death was posted on the national health authorities' Facebook pages, and information on 2.9 of the 10 leading causes of death was posted on their Twitter profiles. Additionally, regarding public health expenditures and the possibility of retrieving information on the leading causes of death, an apparent negative correlation exists in the case of Facebook, r(13) = -.54, P = .03 and a weak negative correlation in the case of Twitter, r(14) = -.26, P = .31, for the countries with presences in those networks. National health authorities can improve their role in participating in conversations on social media regarding the leading causes of death affecting their countries. Taking into account Internet accessibility levels in the countries under study

  15. 75 FR 55582 - National Institutes of Health Statement of Organization, Functions, and Delegations of Authority

    Science.gov (United States)

    2010-09-13

    ... supporting minority health or other health disparities research; (5) Provides leadership for a national and... research; (9) Develops and revises, as necessary, the national definition for health disparity population in consultation with the Agency for Healthcare Research and Quality; (10) Provides leadership for the...

  16. 42 CFR 32.90 - Notification to health authorities regarding discharged patients.

    Science.gov (United States)

    2010-10-01

    ... discharged patients. 32.90 Section 32.90 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... patients. Upon the discharge of a patient the medical officer in charge shall give notification of such... discharged patient is to reside. The notification shall also set forth the clinical findings and other...

  17. 75 FR 40842 - Public Health Service Act (PHS), Delegation of Authority

    Science.gov (United States)

    2010-07-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Service Act (PHS), Delegation of... Services under the following section under Title XXVI of the Public Health Service Act, and the Ryan White...

  18. Author Details

    African Journals Online (AJOL)

    Olamoyegun, KD. Vol 7, No 1 (2013) - Articles Assessment of diabetes-related knowledge among health care providers in a tertiary health institution in Nigeria Abstract. ISSN: 2251-0362. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  19. Author Details

    African Journals Online (AJOL)

    Akinlade, OM. Vol 7, No 1 (2013) - Articles Assessment of diabetes-related knowledge among health care providers in a tertiary health institution in Nigeria Abstract. ISSN: 2251-0362. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  20. Author Details

    African Journals Online (AJOL)

    Kolawole, B. Vol 7, No 1 (2013) - Articles Assessment of diabetes-related knowledge among health care providers in a tertiary health institution in Nigeria Abstract. ISSN: 2251-0362. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

  1. Author Details

    African Journals Online (AJOL)

    du Plessis, LM. Vol 6, No 1 (2014) - Articles Health-promoting schools as a service learning platform for teaching health-promotion skills. Abstract PDF · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of ...

  2. Author Details

    African Journals Online (AJOL)

    Mahunnah, RLA. Vol 9, No 2 (2007) - Articles Traditional health practitioner and the scientist: Bridging the gap in contemporary health research in Tanzania Abstract PDF. ISSN: 1821-9241. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  3. Author Details

    African Journals Online (AJOL)

    Adah, SO. Vol 4, No 1 (2009) - Articles The impact of advocacy and community mobilization on the utilization of health services at the Comprehensive Health Centre, Gindiri. Abstract PDF. ISSN: 2006-0734. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

  4. The 'market' for medical and health information in transition: the case of the Hong Kong Hospital Authority libraries.

    Science.gov (United States)

    Cheng, G

    1996-06-01

    The last few years have been a period of transition not only for hospitals and their governance but also for post-graduate medical education in Hong Kong. Both trends have a direct impact on the information market place. This article starts by studying the provision of medical and health-related information in Hong Kong. The two university medical and dental libraries, together with the hospital and health sciences libraries in government hospitals and the Department of Health, house the major collections on medicine and health care. The demand for medical and health care information is increasingly felt with the takeover of 39 hospitals by the statutory Hong Kong Hospital Authority in 1991. The major problems and issues in planning for library information services are the historically uneven development of libraries, discrepancies in funding, the changes in organizational and management structure, and the competition with higher development priorities within the organization. In view of current technology and the availability of rich external resources, the adopted strategies tend towards the formation of 10 library service networks, development of integrated library information systems on the Health Authority-wide area network, and the devolution of management responsibilities. The future challenges in store for the information professional are examined.

  5. Perceptions of the authority of health information. Case study: digital interactive television and the Internet.

    Science.gov (United States)

    Nicholas, David; Huntington, Paul; Williams, Peter; Gunter, Barrie

    2003-12-01

    As part of a Department of Health funded project nearly 2000 people were surveyed as to their use of two digital health information services, one on the Web and the other on digital interactive television (DiTV). The website was of a commercial company-Surgerydoor-and the DiTV service NHS based. This paper concentrates on the issue of trust in digital health information. Two of the main findings were that advertising was found to have an effect on trust, though the quality and type of advertising will impact in different ways on trustworthiness. DiTV subscribers who had either used the Living Health channel which carried NHS branded health information or had heard of the service, were more likely to say that the NHS was a symbol of trust for them compared with DiTV subscribers who had not used the service.

  6. The role of Swedish Radiation Protection Authority in the field of public health; SSI:s roll i folkhaelsoarbetet - redovisning av regeringsuppdrag inom folkhaelsoomraadet

    Energy Technology Data Exchange (ETDEWEB)

    Cederlund, Torsten; Finck, Robert; Mjoenes, Lars; Moberg, Leif; Soederman, Ann-Louis; Wiklund, Aasa; Yuen Katarina; Oelander Guer, Hanna

    2004-09-01

    The Swedish Government has requested the Swedish Radiation Protection Authority (SSI) to make an account of the authority's role in the field of public health. Radiation Protection consists largely of preventive actions in order to protect man and the environment against harmful effects of radiation. The SSI thus considers most of the authority's activities to be public health related. The report describes a number of radiation protection areas from a health perspective. The measures taken by the authority in these areas are also described along with planned activities. In some areas the authority also points out additional measures.

  7. The role of Swedish Radiation Protection Authority in the field of public health 2008; SSI:s roll i folkhaelsoarbetet 2008 - redovisning av regeringsuppdrag inom folkhaelsoomraadet

    Energy Technology Data Exchange (ETDEWEB)

    Hyrke, Lena; Almen, Anja; Blixt, Anders; Brewitz, Erica; Mjoenes, Lars; Moberg, Leif; Skeppstroem, Kirlna; Wester, Ulf

    2008-04-15

    The Swedish Government has requested that the Swedish Radiation Protection Authority (SSI) to make an account of the authority's role in the field of public health. Radiation Protection consists largely of preventive actions in order to protect man and the environment against harmful effects of radiation. The SSI thus considers most of the authority's activities to be public health related. The report describes a number of radiation protection areas from a health perspective. The measures taken by the authority in these areas are also described along with planned activities. In some areas the authority also points out additional measures

  8. Scientific Method and the Regulation of Health and Nutritional Claims by the European Food Safety Authority

    Science.gov (United States)

    Hoad, Darren

    2011-01-01

    The protection of European consumers from the false or misleading scientific and nutritional claims of food manufacturers took a step forward with the recent opinions of the European Food Safety Authority (EFSA). As a risk assessment agency, the EFSA recently assessed and rejected a vast number of food claim forcing the withdrawal of many claims…

  9. Exploring the use of social network analysis to measure communication between disease programme and district managers at sub-national level in South Africa.

    Science.gov (United States)

    Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

    2015-06-01

    With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in

  10. Subnational mobility and consumption-based environmental accounting of US corn in animal protein and ethanol supply chains.

    Science.gov (United States)

    Smith, Timothy M; Goodkind, Andrew L; Kim, Taegon; Pelton, Rylie E O; Suh, Kyo; Schmitt, Jennifer

    2017-09-19

    Corn production, and its associated inputs, is a relatively large source of greenhouse gas emissions and uses significant amounts of water and land, thus contributing to climate change, fossil fuel depletion, local air pollutants, and local water scarcity. As large consumers of this corn, corporations in the ethanol and animal protein industries are increasingly assessing and reporting sustainability impacts across their supply chains to identify, prioritize, and communicate sustainability risks and opportunities material to their operations. In doing so, many have discovered that the direct impacts of their owned operations are dwarfed by those upstream in the supply chain, requiring transparency and knowledge about environmental impacts along the supply chains. Life cycle assessments (LCAs) have been used to identify hotspots of environmental impacts at national levels, yet these provide little subnational information necessary for guiding firms' specific supply networks. In this paper, our Food System Supply-Chain Sustainability (FoodS3) model connects spatial, firm-specific demand of corn purchasers with upstream corn production in the United States through a cost minimization transport model. This provides a means to link county-level corn production in the United States to firm-specific demand locations associated with downstream processing facilities. Our model substantially improves current LCA assessment efforts that are confined to broad national or state level impacts. In drilling down to subnational levels of environmental impacts that occur over heterogeneous areas and aggregating these landscape impacts by specific supply networks, targeted opportunities for improvements to the sustainability performance of supply chains are identified.

  11. Views of general practitioners in the Oxford region on microcomputing and collaboration with health authorities and family practitioner committees.

    Science.gov (United States)

    Brown, S

    1988-03-01

    A postal questionnaire was sent to the senior partners of all 353 general practices in the Oxford region to investigate their interest in microcomputing and in pooling data with other general practitioners, health authorities and family practitioner committees. The response rate was 58%. Twenty per cent of responders already used a microcomputer and a further 59% intended to purchase a microcomputer for the practice. Nearly all the practices with an interest in microcomputing wanted to use it to produce age-sex registers, to establish recall groups and for repeat prescribing. Approximately 90% of interested practices reported that they would be prepared to link their data with family practitioner committees or health authorities, while 76% were interested in collaborating with other general practitioners for research. The results show that general practitioners will require support in utilizing the data that they produce.

  12. The role of state mental health authorities in managing change for the implementation of evidence-based practices.

    Science.gov (United States)

    Isett, Kimberley Roussin; Burnam, M Audrey; Coleman-Beattie, Brenda; Hyde, Pamela S; Morrissey, Joseph P; Magnabosco, Jennifer L; Rapp, Charles; Ganju, Vijay; Goldman, Howard H

    2008-06-01

    The evidence-based practice demonstration for services to adults with serious mental illness has ended its pilot stage. This paper presents the approaches states employed to combine traditional policy levers with more strategic/institutional efforts (e.g., leadership) to facilitate implementation of these practices. Two rounds of site visits were completed and extensive interview data collected. The data were analyzed to find trends that were consistent across states and across practices. Two themes emerged for understanding implementation of evidence-based practices: the support and influence of the state mental health authority matters and so does the structure of the mental health systems.

  13. Review and evaluation of electronic health records-driven phenotype algorithm authoring tools for clinical and translational research.

    Science.gov (United States)

    Xu, Jie; Rasmussen, Luke V; Shaw, Pamela L; Jiang, Guoqian; Kiefer, Richard C; Mo, Huan; Pacheco, Jennifer A; Speltz, Peter; Zhu, Qian; Denny, Joshua C; Pathak, Jyotishman; Thompson, William K; Montague, Enid

    2015-11-01

    To review and evaluate available software tools for electronic health record-driven phenotype authoring in order to identify gaps and needs for future development. Candidate phenotype authoring tools were identified through (1) literature search in four publication databases (PubMed, Embase, Web of Science, and Scopus) and (2) a web search. A collection of tools was compiled and reviewed after the searches. A survey was designed and distributed to the developers of the reviewed tools to discover their functionalities and features. Twenty-four different phenotype authoring tools were identified and reviewed. Developers of 16 of these identified tools completed the evaluation survey (67% response rate). The surveyed tools showed commonalities but also varied in their capabilities in algorithm representation, logic functions, data support and software extensibility, search functions, user interface, and data outputs. Positive trends identified in the evaluation included: algorithms can be represented in both computable and human readable formats; and most tools offer a web interface for easy access. However, issues were also identified: many tools were lacking advanced logic functions for authoring complex algorithms; the ability to construct queries that leveraged un-structured data was not widely implemented; and many tools had limited support for plug-ins or external analytic software. Existing phenotype authoring tools could enable clinical researchers to work with electronic health record data more efficiently, but gaps still exist in terms of the functionalities of such tools. The present work can serve as a reference point for the future development of similar tools. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. THE NATIONAL AUTHORITY FOR ANIMAL HEALTH AND FOOD SAFETY, THE MAIN BODY INVOLVED IN FOOD SAFETY IN ROMANIA

    Directory of Open Access Journals (Sweden)

    PETRUTA-ELENA ISPAS

    2012-05-01

    Full Text Available This paper is intended to present the role, functions and responsibilities of the National Authority for Animal Health and Food Safety as the main body involved in food safety in Romania. It will be also exposed the Regulation 178/2002 of the European Parliament and the Council, the general food ”law” in Europe, and Law 150/2004, which transposed into Romanian legislation Regulation 178/2002.

  15. Views of general practitioners in the Oxford region on microcomputing and collaboration with health authorities and family practitioner committees

    OpenAIRE

    Brown, Susan

    1988-01-01

    A postal questionnaire was sent to the senior partners of all 353 general practices in the Oxford region to investigate their interest in microcomputing and in pooling data with other general practitioners, health authorities and family practitioner committees. The response rate was 58%. Twenty per cent of responders already used a microcomputer and a further 59% intended to purchase a microcomputer for the practice. Nearly all the practices with an interest in microcomputing wanted to use it...

  16. Contextualizing Obesity and Diabetes Policy: Exploring a Nested Statistical and Constructivist Approach at the Cross-National and Subnational Government Level in the United States and Brazil

    Directory of Open Access Journals (Sweden)

    Eduardo J. Gómez

    2017-11-01

    Full Text Available Background This article conducts a comparative national and subnational government analysis of the political, economic, and ideational constructivist contextual factors facilitating the adoption of obesity and diabetes policy. Methods We adopt a nested analytical approach to policy analysis, which combines cross-national statistical analysis with subnational case study comparisons to examine theoretical prepositions and discover alternative contextual factors; this was combined with an ideational constructivist approach to policy-making. Results Contrary to the existing literature, we found that with the exception of cross-national statistical differences in access to healthcare infrastructural resources, the growing burden of obesity and diabetes, rising healthcare costs and increased citizens’ knowledge had no predictive affect on the adoption of obesity and diabetes policy. We then turned to a subnational comparative analysis of the states of Mississippi in the United States and Rio Grande do Norte in Brazil to further assess the importance of infrastructural resources, at two units of analysis: the state governments versus rural municipal governments. Qualitative evidence suggests that differences in subnational healthcare infrastructural resources were insufficient for explaining policy reform processes, highlighting instead other potentially important factors, such as state-civil societal relationships and policy diffusion in Mississippi, federal policy intervention in Rio Grande do Norte, and politicians’ social construction of obesity and the resulting differences in policy roles assigned to the central government. Conclusion We conclude by underscoring the complexity of subnational policy responses to obesity and diabetes, the importance of combining resource and constructivist analysis for better understanding the context of policy reform, while underscoring the potential lessons that the United States can learn from Brazil.

  17. Monitoring and evaluation of aquatic resource health and use suitability in Tennessee Valley Authority reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Dycus, D.L.; Meinert, D.L.

    1993-06-01

    TVA initiated a Reservoir Monitoring Program in 1990 with two objectives -- to evaluate the health of the reservoir ecosystem and to examine how well each reservoir meets the swimmable and fishable goals of the Clean Water Act. In 1990 reservoir health was evaluated subjectively using a weight-of-evidence approach (a reservoir was deemed healthy if most of the physical, chemical, and biological monitoring components appeared healthy). In the second year (1991) a more objective, quantitative approach was developed using information on five important indicators of reservoir health -- dissolved oxygen, chlorophyll, sediment quality, benthic macroinvertebrates, and fishes. The most recent information (1992) was evaluated with the same basic approach, modified to incorporate improvements based on comments from reviewers and additional data. Reservoirs were stratified into two groups for evaluation: run-of-the-river reservoirs and tributary storage reservoirs. Key locations are sampled in each reservoir (forebay, transition zone or midreservoir, inflow, and major embayments) for most or all of these five reservoir health indicators. For each indicator (or metric), scoring criteria have been developed that assign a score ranging from 1 to 5 representing poor to good conditions, respectively. Scores for the metrics at a location are summed and then the sums for all locations are totaled. Each reservoir has one to four sample locations depending on reservoir characteristics. The resultant total is divided by the maximum possible score (all metrics good at all locations) for the reservoir. Thus, the possible range of scores is from 20 percent (all metrics poor) to 100 percent (all metrics good). This reservoir ecological health evaluation method is proving to be a valuable tool for providing the public with information about the condition of the Valley`s reservoirs, for allowing meaningful comparisons among reservoirs, and for tracking changes in reservoir health with time.

  18. 75 FR 38112 - Organization, Functions, and Delegations of Authority; Part G; Indian Health Service; Proposed...

    Science.gov (United States)

    2010-07-01

    ... control requirements in the Federal Managers' Financial Integrity Act; (6) provides assistance and support to special assigned task groups; (7) conducts special program or management integrity reviews as...; Indian Health Service; Proposed Functional Statement Program Integrity and Ethics Staff (PIES) (GAL1) (1...

  19. Building the capacity of health authorities to influence land use and transportation planning: Lessons learned from the Healthy Canada by Design CLASP Project in British Columbia.

    Science.gov (United States)

    Miro, Alice; Perrotta, Kim; Evans, Heather; Kishchuk, Natalie A; Gram, Claire; Stanwick, Richard S; Swinkels, Helena M

    2014-08-06

    The main objective of the Healthy Canada by Design CLASP Initiative in British Columbia (BC) was to develop, implement and evaluate a capacity-building project for health authorities. The desired outcomes of the project were as follows: 1) increased capacity of the participating health authorities to productively engage in land use and transportation planning processes; 2) new and sustained relationships or collaborations among the participating health authorities and among health authorities, local governments and other built environment stakeholders; and 3) indication of health authority influence and/or application of health evidence and tools in land use and transportation plans and policies. This project was designed to enhance the capacity of three regional health authorities, namely Fraser Health, Island Health and Vancouver Coastal Health, and their staff. These were considered the project's participants. The BC regions served by the three health authorities cover the urban, suburban and rural spectrum across relatively large and diverse geographic areas. The populations have broad ranges in socio-economic status, demographic profiles and cultural and political backgrounds. The Initiative provided the three health authorities with a consultant who had several years of experience working on land use and transportation planning. The consultant conducted situational assessments to understand the baseline knowledge and skill gaps, assets and objectives for built environment work for each of the participating health authorities. On the basis of this information, the consultant developed customized capacity-building work plans for each of the health authorities and assisted them with implementation. Capacity-building activities were as follows: researching health and built environment strategies, policies and evidence; transferring health evidence and promising policies and practices from other jurisdictions to local planning contexts; providing training and

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    Oduntan, OA. Vol 19 (2013): Supplement 1 - March - Articles The health effects of welding on welders in the Capricorn District, Limpopo Province, South Africa Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Mokaba, ME. Vol 19 (2013): Supplement 1 - March - Articles The health effects of welding on welders in the Capricorn District, Limpopo Province, South Africa Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Lasisi, Olalekan Taiwo. Vol 10, No 2 (2016) - Articles Pig slaughtering in southwestern Nigeria: peculiarities, animal welfare concerns and public health implications. Abstract PDF. ISSN: 2006-0165. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Polich, Erin. Vol 7, No 1 (2014) - Articles Editorial: Health care in times of crisis. Abstract PDF. ISSN: 2309-4613. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER ...

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    Owoyemi, AO. Vol 14, No 1 (2007) - Articles Review of public health implications of cell phone radiation and other sources of non-ionizing radiation and ionizing radiation. Abstract. ISSN: 1117-4153. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Seloilwe, ES. Vol 19 (2013): Supplement 1 – September - Articles Integrating mental health into the basic nursing curriculum: Benefits and opportunities. Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Omuemu, V. Vol 15, No 2 (2013) - Articles Hand hygiene practices among doctors in a tertiary health facility in southern Nigeria Abstract. ISSN: 2276-7096. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of ...

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    Ambekar, K.B. Vol 3, No 1 (2009) - Articles Hand hygiene and health: an epidemiological study of students in Amravati Abstract PDF. ISSN: 2006-0165. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of ...

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    Ajonuma, LC. Vol 7, No 4 (2010) - Articles Nottingham health profile a reliable tool to measure quality of life of Filipinos with chronic kidney diseases undergoing hemodialysis. Abstract. ISSN: 0856-8960. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

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    Fungo, B. Vol 7, No 1 (2010) - Articles Traditional medicine as an alternative form of health care system: A preliminary case study of Nangabo sub-county, central Uganda Abstract PDF. ISSN: 0189-6016. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

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    Guernina, Zoubida. Vol 10, No 2 (2002) - Articles Vulnerability, Borderline Personality Disorders. Clinical and Therapeutic Issues in Mental Health Using A Cognitive Analytical Model. Abstract. ISSN: 1117-1421. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

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    and over-nutrition among adult Kenyan women; evidence from the Kenya demographic and health survey 2008-09. Abstract. ISSN: 0856-8960. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Forson, PK. Vol 49, No 4 (2015) - Articles Hiv/Aids prevalence at the accident & emergency centre of a tertiary and referral health institution in Ghana Abstract PDF. ISSN: 0016-9560. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Goodman, O.O.. Vol 4, No 4 (2016) - Original Article Effect of health workers sensitization on satisfaction with immunization services among mothers of under fives in Ilorin, North Central Nigeria Abstract PDF. ISSN: 2467-8252. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Waswa, J. Vol 8, No 2 (2011) - Articles Influence of Percieved body Image on Nutrient Intake and Nutritional Health of Female Students of Moi University Abstract. ISSN: 0856-8960. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Marindo, Ravayi. Vol 42, No 1 (2017) - Articles Gendered Epidemics and Systems of Power in Africa: A Feminist Perspective on Public Health Governance Abstract PDF. ISSN: 0850-3907. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Mishamandani, M.E.. Vol 8, No 3 (2016): Special Issue - Articles The efficacy of psycho training on improvement of organizational behavior and mental health. Abstract PDF. ISSN: 1112-9867. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Sattari, K. Vol 8, No 3 (2016): Special Issue - Articles The efficacy of psycho training on improvement of organizational behavior and mental health. Abstract PDF. ISSN: 1112-9867. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for ...

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    Hoseini, S. Vol 8, No 3 (2016): Special Issue - Articles Design health village with the approach of sustainable architecture and utilization of intelligent principles. Abstract PDF. ISSN: 1112-9867. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Thompson, A. Vol 19, No 2 (2013) - Articles Alpha Theta Meditation: Phenomenological, neurophysiologic, mindfulness, mood, health and sport implications. Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES.

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    Ezegwui, HU. Vol 50, No 3 (2009) - Articles Caesarean section in a Secondary Health Hospital in Awka, Nigeria Abstract. ISSN: 2229-774X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact ...

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    Bakare, A.A.. Vol 13 (2015) - Articles Perceived public health effects of occupational and residential exposure to electronic wastes in Lagos, Nigeria Abstract. ISSN: 1596-972X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Asekomeh, God'spower. Vol 14, No 2 (2014) - Articles Profile of Generic and Disease-Specific Health-Related Quality of Life Among Nigerians with Parkinson's Disease Abstract PDF. ISSN: 1597-4292. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

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    Memarianfard, M. Vol 8, No 3 (2016): Special Issue - Articles Health risks zonation in megacities vis-à-vis PM using GIS-based model. Abstract PDF. ISSN: 1112-9867. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Ahmed, U.A. Vol 17, No 1 (2010) - Articles Cardiovascular health benefits of some locally adoptable exercise techniques. Abstract. ISSN: 1117-4153. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

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    Okafor, IP. Vol 14, No 2 (2014) - Articles Rural-urban disparities in maternal immunization knowledge and childhood health-seeking behavior in Nigeria: A mixed method study. Abstract PDF. ISSN: 1680-6905. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

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    Okafor, IP. Vol 11, No 1 (2014) - Articles Predictors of maternal health service utilization: a community based, rural-urban comparison in Nigeria Abstract. ISSN: 0856-8960. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

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    Mosha, H. Vol 15, No 1 (2008) - Articles Increasing Quality and Access to Oral Health Care through Public-Private Partnerships Abstract. ISSN: 0856-0625. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of ...

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    Benedict, P. Vol 13, No 1 (2006) - Articles Dental caries knowledge and perceptions among mothers attending reproductive and child health clinics, Kinondoni, Tanzania Abstract. ISSN: 0856-0625. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Shu'aibu, J. Vol 6, No 2 (2015) - Articles Pattern of unintentional childhood injuries seen at the accident and emergency (A&E) departments of three tertiary health care centres in Jos Abstract. ISSN: 2141-9884. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

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    AlSharrad, SN. Vol 47, No 3 (2011) - Articles Monitoring the standard of care of diabetes mellitus type 2 in a primary health care setting. Abstract PDF. ISSN: 2090-2948. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Adams, C. Vol 19, No 2 (2013) - Articles Alpha Theta Meditation: Phenomenological, neurophysiologic, mindfulness, mood, health and sport implications. Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Andersson, H. Vol 36, No 2 (2014) - Articles Neurophysiological, Psychological, Sport and Health dimensions of three meditation techniques. Abstract. ISSN: 0379-9069. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Joshua, LA. Vol 3, No 1 (2009) - Articles Politics, Health and Military Diplomacy : A Critical Review Abstract. ISSN: 0331-3131. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News.

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    Atanda, P.O.. Vol 11, No 2 (2016) - Articles Physico-thermal characteristics and health risk evaluation of randomly selected brake pads in the Nigerian market. Abstract. ISSN: 0795-5111. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Nuhu, Assouman. Vol 4, No 1 (2017): Series F - Articles Health care consumer's perception of the Electronic Medical Record (EMR) system within a referral hospital in Kigali, Rwanda Abstract PDF. ISSN: 2305-2678. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Kumurenzi, Anne. Vol 4, No 1 (2017): Series F - Articles Health care consumer's perception of the Electronic Medical Record (EMR) system within a referral hospital in Kigali, Rwanda Abstract PDF. ISSN: 2305-2678. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Ogunleye, AJ. Vol 1, No 4 (2012) - Articles Effects of Self Esteem, Emotional Health and Social Competence on Romantic Relationship of Adolescents in Nigeria Abstract PDF. ISSN: 2227-5452. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Mwisongo, A.J.. Vol 3, No 2 (2001) - Articles Major health problems in some selected districts of Tanzania Abstract PDF. ISSN: 1821-9241. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact ...

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    Agara, AJ. Vol 11, No 2 (2008) - Articles Management of perceived mental health problems by spiritual. Abstract PDF. ISSN: 1994-8220. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact ...

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    Bolaji, Iyanda Adisa. Vol 5 (2016) - Articles Health Implications of Internet Addiction among In-School Adolescents in Ogbomoso North Local Government Area of Oyo State Abstract. ISSN: 2026-6081. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Asuquo, EF. Vol 9, No 1&2 (2010) - Articles Organizational climate and nurses' job satisfaction in Cross River State, Health Institutions, Nigeria Abstract. ISSN: 1596-2911. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

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    Mandala, C. Vol 20, No 1 (2008) - Articles Costing of Community Health Service Packages - The Malawi Social Action Fund (MASAF) Experience Abstract PDF. ISSN: 1995-7262. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Agbor, MA. Vol 13, No 3 (2013) - Articles Smokeless tobacco use, tooth loss and oral health issues among adults in Cameroon Abstract PDF. ISSN: 1680-6905. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Parthasarathi, V. Vol 13, No 2 (2013) - Articles Developing antiviral surgical gown using nonwoven fabrics for health care sector. Abstract PDF. ISSN: 1680-6905. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Yar, DD. Vol 49, No 4 (2015) - Articles Hiv/Aids prevalence at the accident & emergency centre of a tertiary and referral health institution in Ghana Abstract PDF. ISSN: 0855-0328. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Eni, DD. Vol 2, No 1 (2011) - Articles Distribution and Utilization of Health Facilities in Calabar Metropolis, Nigeria Abstract. ISSN: 2141-4343. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact ...

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    Omokanye, HK. Vol 6, No 3 (2012) - Articles Clinico-mycological profile of otomycosis in two tertiary health institutions in Nigeria – a prospective study. Abstract. ISSN: 0795-3038. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Casciola, Julia. Vol 106, No 7 (2016) - Articles Editorial: Overview of the 2016 South African Health Review Abstract PDF. ISSN: 0256-95749. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact ...

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    Sibaya, MN. Vol 19 (2013): Supplement 1 - October - Articles Application of grounded theory approach in the analysis of integrated primary health care. Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Khong, W.L.. Vol 9, No 3S (2017): Special Issue - Articles National instruments labVIEW and video imaging technique for health status monitoring. Abstract PDF. ISSN: 1112-9867. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Ofukwu, R.A. Vol 9, No 1 (2010) - Articles Prevalence and Public Health Potentials of Mycobacterium bovis in Excretions of Slaughter Cattle in Makurdi, Nigeria Abstract · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Escalante, IP. Vol 11, No 1 (2014) - Articles Integrative health care method based on combined complementary medical practices: rehabilitative acupuncture, homeopathy and chiropractic. Abstract PDF. ISSN: 0189-6016. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Ojule, JD. Vol 30, No 3 (2011) - Articles Family Planning Practice in a Tertiary Health Institution in Southern Nigeria Abstract PDF. ISSN: 0189-160X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

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    Gipson, JD. Vol 14, No 4 (2010) - Articles Assessing the Importance of Gender Roles in Couples' Home-Based Sexual Health Services in Malawi Abstract PDF. ISSN: 1118-4841. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Adeyemi, JD. Vol 12, No 1 (2014) - Articles Community psychiatric service in a Nigerian rural centre: Bridging mental health gap. Abstract. ISSN: 0189-1774. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions ...

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    Oresegun, M O. Vol 18, No 2 (2006) - Articles Health risk assessment of doses to patients\\' eyes from dental X-ray examination. Abstract PDF. ISSN: 1595-0611. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Onasanya, SA. Vol 6, No 3 (2013) - Articles Lifestyle, Fitness and Health Promotion Initiative of the University of Ilorin, Nigeria: An Educational Media Intervention Abstract PDF. ISSN: 1998-0507. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Kamulegeya, LH. Vol 15, No 3 (2015) - Articles The scourge of head injury among commercial motorcycle riders in Kampala; a preventable clinical and public health menace. Abstract PDF. ISSN: 1680-6905. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

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    Dagli, E. Vol 18, No 1 (2015) - Articles Oral health and related factors in a group of children with cystic fibrosis in Istanbul, Turkey Abstract PDF. ISSN: 1119-3077. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Defar, A. Vol 27, No 1 (2013) - Articles Occupational induced health problems in floriculture workers in Sebeta and surrounding areas, West Shewa, Oromia, Ethiopia Abstract PDF. ISSN: 1021-6790. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Fono-Tamo, R.S.. Vol 11, No 2 (2016) - Articles Physico-thermal characteristics and health risk evaluation of randomly selected brake pads in the Nigerian market. Abstract. ISSN: 0795-5111. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Gómez, REL. Vol 11, No 1 (2014) - Articles Integrative health care method based on combined complementary medical practices: rehabilitative acupuncture, homeopathy and chiropractic. Abstract PDF. ISSN: 0189-6016. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Abdullah, KF. Vol 9, No 2 (2000) - Articles Operating room health team knowledge and performance regarcing the application of infection control measures: A suggested policy. Abstract. ISSN: 1110-5593. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

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    Ogunlade, S.O. Vol 9, No 3 (2006) - Articles Prevalence and pattern of back pain among pregnant women attending ante-natal clinics in selected health care facilities. Abstract PDF. ISSN: 1119-5096. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Janse van Rensburg, Estie. Vol 27, No 1 (2015) - Articles Does forgiveness mediate the impact of school bullying on adolescent mental health? Abstract. ISSN: 1728-0583. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

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    Kruger, W. Vol 8, No 2-3 (2009) - Articles Volcanic Ash from the 1999 Eruption of Mount Cameroon Volcano: Characterization and Implications to Health Hazards Abstract PDF · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Bashir, AA. Vol 7, No 1 (2012) - Articles Occupational Hazards and HBV infection among health care workers in Public Teaching Hospitals in Khartoum State, Sudan: A multiple Discriminant Analysis Abstract. ISSN: 1858-5051. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Elkhidir, IM. Vol 7, No 1 (2012) - Articles Occupational Hazards and HBV infection among health care workers in Public Teaching Hospitals in Khartoum State, Sudan: A multiple Discriminant Analysis Abstract. ISSN: 1858-5051. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Abou El-Magd, SAM. Vol 1, No 1 (2008) - Articles Ergonomic Aspects And Health Hazards On Computer Workstations' Operators At Zagazig University: An Occupational Risk Management Approach. Abstract. ISSN: 1687-8671. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Mohammed, AH. Vol 1, No 1 (2008) - Articles Ergonomic Aspects And Health Hazards On Computer Workstations' Operators At Zagazig University: An Occupational Risk Management Approach. Abstract. ISSN: 1687-8671. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Ahmed-Refat, AR. Vol 1, No 1 (2008) - Articles Ergonomic Aspects And Health Hazards On Computer Workstations' Operators At Zagazig University: An Occupational Risk Management Approach. Abstract. ISSN: 1687-8671. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Amofah, G. Vol 48, No 2 (2014) - Articles Recommendations from a Meeting on Health Implications of Genetically Modified Organism (GMO) Abstract PDF. ISSN: 0855-0328. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

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    Ojehanon, PI. Vol 11, No 2 (2012) - Articles Cigarette smoking, tooth brushing characteristics, and perceived efficacy in gingivodental health among undergraduates in a Nigerian University Abstract. ISSN: 1596-6569. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Bale, O.O.J.. Vol 29, No 1 (2002) - Articles A case study of possible health hazards associated with poultry houses. Abstract. ISSN: 0331-2062. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

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    Chande-Mallya, R. Vol 19, No 1 (2015) - Articles Usage of E-resources in Postgraduate Research at Muhimbili University of Health and Allied Sciences: A Citation Analysis Abstract. ISSN: 0856-6739. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Tanya, AKN. Vol 6, No 1 (2006) - Articles Health benefits and risks of genetically modified foods. Abstract PDF · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER ...

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    Ntata, PRT. Vol 10, No 3 (2008) - Articles Socio-demographic characteristics and sexual health related attitudes and practices of men having sex with men in central and southern Malawi Abstract PDF. ISSN: 1821-9241. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Ubaoji, Kingsley Ikechukwu. Vol 6, No 1 (2016): Special Edition - Articles A review on acrylamide in foods: Sources and implications to health. Abstract PDF. ISSN: 2346-7126. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Ahiaku, Francis. Vol 23, No 1 (2017) - Articles Patients' knowledge and perception of anaesthesia and the anaesthetist at a tertiary health care facility in Ghana Abstract PDF. ISSN: 2220-1173. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Alimi, Olorunfemi Y. Vol 4, No 2 (2016) - Articles Determinants of Inclusive Growth in Africa: Role of Health and Demographic Changes Abstract PDF. ISSN: 1821-8148. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Ojehanon, PI. Vol 11, No 1 (2009) - Articles Nutrition And Oral Health Abstract PDF. ISSN: 0795-0268. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER RESOURCES.

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    Chuke, PI. Vol 14, No 3 (2011) - Articles Contents and readability of currently used surgical/ procedure informed consent forms in Nigerian tertiary health institutions. Abstract PDF. ISSN: 1119-3077. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Mwakalobo, ABS. Vol 28, No 2 (2013) - Articles Animal health constraints perceived to be important in Kilosa and Gairo Districts, Morogoro, Tanzania: Implications on disease prevention and control. Abstract. ISSN: 0856-1451. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Abegunde, B. Vol 17, No 1 (2012) - Articles Effect of Social Networking on Health Abstract. ISSN: 0331-3727. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER ...

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    Addy, BS. Vol 49, No 1 (2015) - Articles Knowledge of Pharmacogenetics among Healthcare Professionals and Faculty Members of Health Training Institutions in Ghana Abstract PDF. ISSN: 0855-0328. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

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    Rabasa, AI. Vol 57, No 5-6 (2010) - Articles Management of Childhood Tuberculosis: The Experience in a Tertiary Health Care Facility in Nigeria. Abstract. ISSN: 0189-0964. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

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    Ekwempu, AI. Vol 15, No 1 (2013) - Articles Assessment of the Health Seeking Behaviour of Medical Laboratory Scientists in North Central Nigeria Abstract. ISSN: 2276-7096. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Parshotam, RK. Vol 21, No 2 (2015) - Articles Views of schizophrenia patients on the effects of cannabis on their mental health. Abstract PDF. ISSN: 2078-6786. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

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    Smyth, AM. Vol 36, No 2 (2014) - Articles Neurophysiological, Psychological, Sport and Health dimensions of three meditation techniques. Abstract. ISSN: 0379-9069. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

  6. Neo-Patrimonialism and Subnational Authoritarianism in Mexico. The Case of Oaxaca Neopatrimonialismo y autoritarismo subnacional en México. El caso de Oaxaca

    Directory of Open Access Journals (Sweden)

    Julián Durazo Herrmann

    2010-01-01

    Full Text Available How do subnational authoritarian enclaves emerge (or survive ina democratic transition at the federal level? How can they endure large-scalesocial protests, like the one that shook Oaxaca in 2006? While federal tolerancefor subnational authoritarian practices is a necessary condition, it isinsufficient in itself to explain why subnational political systems sustain andeventually reproduce authoritarian practices in the first place. In this article,therefore, I focus on the internal dimension of subnational authoritarianism.I argue that, because of its reliance on two distinct sources of legitimacy,Oaxaca’s neo-patrimonial domination system was able to respond to theformal democratizing pressures emanating from the federal transition withoutlosing its authoritarian nature. This process of hybridization transformedOaxacan institutions, but left social structures and the political dynamics thatemerge from them – the sources of subnational authoritarianism – almostintact. By exploring the evolution of neo-patrimonialism and hybridizationin Oaxaca from a theoretical perspective, I address the issues of change andcontinuity in the emergence of subnational authoritarian enclaves, in Mexicoand elsewhere. ¿Cómo es que algunos enclaves autoritarios subnacionales emergen (o susbsisten tras las transiciones a la democracia de sus federaciones? ¿Cómo sobreviven a movilizaciones masivas como las que conoció Oaxaca en 2006? La tolerancia federal es una condición necesaria para el desarrollo de las prácticas autoritarias subnacionales, pero es insuficiente para explicar cómo dichas prácticas aparecen y se reproducen en algunos sistemas políticos subnacionales. Por ello, en este artículo estudio la dimensión interna del autoritarismo subnacional. Arguyo que, al basarse en dos fuentes distintas de legitimidad, el sistema oaxaqueño de dominación neopatrimonial fue capaz de responder a las presiones democráticas provenientes de la federaci

  7. Modelling of resource allocation to health care authorities in Stockholm county

    DEFF Research Database (Denmark)

    Andersson, Paula; Varde, E; Diderichsen, Finn

    2000-01-01

    Since the Stockholm County Council introduced a system of purchasers and providers there has been a quest for population-based resource allocation models to allocate monies to purchasers of health care. In contrast to models used in Britain, Swedish models have been based on individual level data...... before. We also show the effect of using more current data sources by replacing existing census variables with data from annually updated registers. Since the aim is to use the resource allocation models for prospective budgeting we test and evaluate the predictive power of the models one to two years...

  8. Trastuzumab treatment of early stage breast cancer is cost-effective from the perspective of the Belgian health care authorities.

    Science.gov (United States)

    Van Vlaenderen, I; Canon, J L; Cocquyt, V; Jerusalem, G; Machiels, J P; Neven, P; Nechelput, M; Delabaye, I; Gyldmark, M; Annemans, L

    2009-01-01

    Trastuzumab (Herceptin, Roche) is a recombinant, humanized monoclonal antibody directed against the neu-HER2 protein, since May 2002 reimbursed in Belgium for the treatment of metastatic HER2+ breast cancer and since June 2007 also in adjuvant therapy of HER2+ early stage breast cancer. The purpose of this study was to estimate the cost-effectiveness from the Belgian health care payer perspective of reimbursing trastuzumab in the Latter indication. A Markov state transition model was designed to adequately capture the natural history and course of disease for early stage breast cancer patients, and to simulate cost and disease progression over a life time perspective. The model estimates differences in outcomes for patients treated with adjuvant trastuzumab during 1 year compared to current therapy, and captures cost consequences and health benefits of trastuzumab treatment. Health benefits were expressed in terms of quality-adjusted life years gained, and future benefits were discounted at 1.5%. Costs were calculated from the perspective of the Belgian authorities' health care budget, and future costs were discounted at 3%. Where relevant, the costs per Markov state were obtained from the IMS Hospital Disease database. Additionally, an expert opinion analysis on resource use during the follow-up of treated early breast cancer patients provided the cost estimates for states with minor or without hospital costs. The incremental cost-effectiveness ratio based on a life time simulation was estimated at Euro 10,315 per quality-adjusted life year gained. It can be concluded that trastuzumab treatment of HER2+ early stage breast cancer patients is cost-effective from the perspective of the Belgian health care authorities.

  9. Implementing personalisation for people with mental health problems: a comparative case study of four local authorities in England.

    Science.gov (United States)

    Larsen, John; Ainsworth, Emily; Harrop, Clare; Patterson, Sue; Hamilton, Sarah; Szymczynska, Paulina; Tew, Jerry; Manthorpe, Jill; Pinfold, Vanessa

    2013-04-01

    Enhancing choice and control for people using services is a mental health and social-care service priority in England. Personalisation is a new policy and practice for delivery of social-care services where eligible adults are allocated a personal budget to spend to meet their agreed support needs. To describe approaches to introducing personal budgets to people with severe and enduring mental health needs, and to identify facilitators or barriers encountered. Within four English local authority (LA) areas, purposively selected to provide maximum variation, semi-structured interviews were undertaken with 58 participants from LAs, NHS trusts and third-sector organisations. An Interpretive Framework analysis considered within- and across-site insights. Issues arising from the implementation of personalisation for people with mental health needs are presented under two general themes: "responsibility and power" and "vision and leadership". Key challenges identified were complexities of working across NHS and LAs, the importance of effective leadership and engagement with service user representatives. Implementing personal budgets in mental health requires effective engagement of health and social-care systems. Change processes need strong leadership, clear vision and personal commitment, with ownership by all key stakeholders, including front-line practitioners.

  10. A Fiscal Need Approach to Sub-National Fiscal Equalization. Application to the Case of Chile

    National Research Council Canada - National Science Library

    S Leonardo E Letelier; M Francisco R Mesa

    2015-01-01

      This research is intended to measure the gap between the existing level of grants for municipalities for school level education, primary health services and other services, regarding a theoretically...

  11. OCCURRENCE OF LISTERIA MONOCYTOGENES IN READY TO EAT FOOD SAMPLES COLLECTED BY LOMBARDY REGION HEALTH AUTHORITIES IN 2009-2010

    Directory of Open Access Journals (Sweden)

    E. Oliverio

    2012-08-01

    Full Text Available The study provides data on the prevalence of Listeria monocytogenes in ready-to-eat food samples collected by Lombardy region health authorities and analyzed by Department of Food Microbiology, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna. From the total of 503 food samples analyzed, the pathogen was detected in 85 (16,9%. In particular it was highlighted in 8/152 (5,3% meat products, in 5/245 (2% dairy products and in 42/106 (39,6% fishery products. Given the considerable public health implications, the study confirms that a well-planned program of listeriosis surveillance should be enforced to suitably estimate the burden of disease and to prevent foodborne outbreaks.

  12. Duly Authorized Officers' practices under mental health law in New Zealand: Are nurses meeting the requirements of the law?

    Science.gov (United States)

    McKenna, Brian; Thom, Katey; O'Brien, Anthony; Crene, Sally; Simpson, Alexander

    2009-08-01

    The Mental Health (Compulsory Assessment and Treatment) Act (1992) introduced a number of statutory roles that are undertaken by mental health nurses. One of these roles is that of Duly Authorized Officer (DAO). The DAO is responsible for the procedural requirements necessary to facilitate compulsory assessment. Under Section 9(2)(d), the DAO is required to ensure that the purpose of the assessment and the requirements of the notice of assessment are explained to the person in the presence of a member of their family, a caregiver, or other person concerned with the welfare of the person. Three recent High Court decisions under the Habeas Corpus Act 2001 have challenged existing DAO practices in arranging the presence of a third party. This paper presents research, which focuses on unravelling some of the complexities associated with meeting this procedural requirement. It illustrates these complexities through a discussion of the results of an audit of files and three focus groups with mental health nurses who practise as DAO. The paper concludes that national guidelines for practice need to be developed for DAO to assist mental health nurses in meeting this statutory requirement.

  13. Combining high-resolution gross domestic product data with home and personal care product market research data to generate a subnational emission inventory for Asia.

    Science.gov (United States)

    Hodges, Juliet Elizabeth Natasha; Vamshi, Raghu; Holmes, Christopher; Rowson, Matthew; Miah, Taqmina; Price, Oliver Richard

    2014-04-01

    Environmental risk assessment of chemicals is reliant on good estimates of product usage information and robust exposure models. Over the past 20 to 30 years, much progress has been made with the development of exposure models that simulate the transport and distribution of chemicals in the environment. However, little progress has been made in our ability to estimate chemical emissions of home and personal care (HPC) products. In this project, we have developed an approach to estimate subnational emission inventory of chemical ingredients used in HPC products for 12 Asian countries including Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam (Asia-12). To develop this inventory, we have coupled a 1 km grid of per capita gross domestic product (GDP) estimates with market research data of HPC product sales. We explore the necessity of accounting for a population's ability to purchase HPC products in determining their subnational distribution in regions where wealth is not uniform. The implications of using high resolution data on inter- and intracountry subnational emission estimates for a range of hypothetical and actual HPC product types were explored. It was demonstrated that for low value products (500 US$ per capita/annum required to purchase product) the implications on emissions being assigned to subnational regions can vary by several orders of magnitude. The implications of this on conducting national or regional level risk assessments may be significant. Further work is needed to explore the implications of this variability in HPC emissions to enable the HPC industry and/or governments to advance risk-based chemical management policies in emerging markets. © 2013 SETAC.

  14. GeoCREV: veterinary geographical information system and the development of a practical sub-national spatial data infrastructure

    Directory of Open Access Journals (Sweden)

    Nicola Ferrè

    2011-05-01

    Full Text Available This paper illustrates and discusses the key issues of the geographical information system (GIS developed by the Unit of Veterinary Epidemiology of the Veneto region (CREV, defined according to user needs, spatial data (availability, accessibility and applicability, development, technical aspects, inter-institutional relationships, constraints and policies. GeoCREV, the support system for decision-making, was designed to integrate geographic information and veterinary laboratory data with the main aim to develop a sub-national, spatial data infrastructure (SDI for the veterinary services of the Veneto region in north-eastern Italy. Its implementation required (i collection of data and information; (ii building a geodatabase; and (iii development of a WebGIS application. Tools for the management, collection, validation and dissemination of the results (public access and limited access were developed. The modular concept facilitates the updating and development of the system according to user needs and data availability. The GIS management practices that were followed to develop the system are outlined, followed by a detailed discussion of the key elements of the GIS implementation process (data model, technical aspects, inter-institutional relationship, user dimension and institutional framework. Problems encountered in organising the non-spatial data and the future work directions are also described.

  15. Global Interconnectedness - Local Authorities and Transnational Networking

    Directory of Open Access Journals (Sweden)

    Hans Krause Hansen

    2006-09-01

    Full Text Available This article argues that, in their continuous and proclaimed efforts at "modernizing" themselves, public sector organizations, also at the sub-national level, increasingly envision the new media as an object of policy making and intervention. At the same time, this focus on the new media facilitates transborder networking, taking the shape of globalizing webs that connect the actors internationally through pro- cesses af mediation and with implications for relations af authority and modes of governance. As such, these webs both constitute and facilitate a form of everyday political globalization which is on the rise. Empirically, our account is based on studies of two local authorities, the cities of Vina del Mar in Chile and Bremen in Germany, as two of the transnational networks that connect them.

  16. One Health stakeholder and institutional analysis in Kenya

    Directory of Open Access Journals (Sweden)

    Tabitha Kimani

    2016-06-01

    Full Text Available Introduction: One Health (OH can be considered a complex emerging policy to resolve health issues at the animal–human and environmental interface. It is expected to drive system changes in terms of new formal and informal institutional and organisational arrangements. This study, using Rift Valley fever (RVF as a zoonotic problem requiring an OH approach, sought to understand the institutionalisation process at national and subnational levels in an early adopting country, Kenya. Materials and methods: Social network analysis methodologies were used. Stakeholder roles and relational data were collected at national and subnational levels in 2012. Key informants from stakeholder organisations were interviewed, guided by a checklist. Public sector animal and public health organisations were interviewed first to identify other stakeholders with whom they had financial, information sharing and joint cooperation relationships. Visualisation of the OH social network and relationships were shown in sociograms and mathematical (degree and centrality characteristics of the network summarised. Results and discussion: Thirty-two and 20 stakeholders relevant to OH were identified at national and subnational levels, respectively. Their roles spanned wildlife, livestock, and public health sectors as well as weather prediction. About 50% of national-level stakeholders had made significant progress on OH institutionalisation to an extent that formal coordination structures (zoonoses disease unit and a technical working group had been created. However, the process had not trickled down to subnational levels although cross-sectoral and sectoral collaborations were identified. The overall binary social network density for the stakeholders showed that 35 and 21% of the possible ties between the RVF and OH stakeholders existed at national and subnational levels, respectively, while public health actors’ collaborations were identified at community/grassroots level

  17. National and sub-national burden of visual impairment in Iran 1990-2013; study protocol.

    Science.gov (United States)

    Ashrafi, Elham; Mohammadi, Seyed-Farzad; Fotouhi, Akbar; Lashay, Alireza; Asadi-lari, Mohsen; Mahdavi, Alireza; Jabbarvand, Mahmoud; Sobhani, Sahar; Farzadfar, Farshad

    2014-12-01

    Although Visual impairment (VI) and its prevention is a public health issue, sub-optimal information about its magnitude in national level and its distribution is one of the impediments for visual health advocacy. In this article, we are detailing the approaches which will be taken to estimate the magnitude (prevalence, incidence, and burden), distribution, and trend (1990 to 2013) of low vision and blindness in Iran. Besides that, an attempt will be made to describe inequalities and their determinants. After finalizing the list of diseases, a systematic search will be started using confirmed search terms and all published and unpublished data will be extracted. Other data sources, including data from hospital records will be added to the data extraction sheet. Using distinct statistical models including spatio-temporal model and multilevel autoregressive model, we will estimate rate of burden measures of eye disease and their uncertainty interval by sex, age, year, and province as well as social determinants of visual impairment inequality. The results are to be reported in separated analyses of meta-analysis, trend, risk factors and diseases burden, inequality, Bayesian prediction modeling, and map for visualizing the results. The results of the current study will address gaps in different regions and have implication for evidence-based policy making in Iran.

  18. How good is compliance with smoke-free legislation in India? Results of 38 subnational surveys.

    Science.gov (United States)

    Kumar, Ravinder; Goel, Sonu; Harries, Anthony D; Lal, Pranay; Singh, Rana J; Kumar, Ajay M V; Wilson, Nevin C

    2014-09-01

    India has been implementing smoke-free legislation since 2008 prohibiting smoking in public places. This study aimed to assess the level of compliance with smoke-free legislation (defined as the presence of no-smoking signage and the absence of active smoking, smoking aids, cigarette butts/bidi ends and smoking smell) and the role of enforcement systems in Indian jurisdictions. This was a cross-sectional, retrospective review of reports and primary data sheets of surveys conducted in 38 selected jurisdictions across India in 2012-2013. Of 20 455 public places (in 38 jurisdictions), 10 377 (51%) demonstrated full compliance with smoke-free law. Educational institutions and healthcare facilities performed well at 65% and 62%, respectively, while eateries and frequently visited other public places (such as bus stands, railway stations, shopping malls, stadia, cinema halls etc.) performed poorly at 37% and 27%, respectively. Absence of no-smoking signage was the largest contributor to non-compliance across all types of public places. Enforcement systems were present in all jurisdictions, but no associations could be demonstrated between these and smoke-free compliance. Smoke-free compliance in public places in India was suboptimal and was mainly related to the absence of no-smoking signage. This warrants further pragmatic and innovative ways to improve the situation. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Author! Author! Beverly Cleary

    Science.gov (United States)

    Brodie, Carolyn S.

    2005-01-01

    This article presents a brief biography of author Beverly Cleary. Born on April 12, 1916 in McMinnville, Oregon (Yamhill County), Beverly Cleary celebrated her eighty-ninth birthday in 2005. Cleary is probably best known for creating "Ramona" and the other children's book characters who live on Klickitat Street in Portland, Oregon. A selective…

  20. Assessment of human immediate response capability related to tsunami threats in Indonesia at a sub-national scale

    Directory of Open Access Journals (Sweden)

    J. Post

    2009-07-01

    Full Text Available Human immediate response is contextualized into different time compartments reflecting the tsunami early warning chain. Based on the different time compartments the available response time and evacuation time is quantified. The latter incorporates accessibility of safe areas determined by a hazard assessment, as well as environmental and demographic impacts on evacuation speed properties assessed using a Cost Distance Weighting GIS approach.

    Approximately 4.35 million Indonesians live in tsunami endangered areas on the southern coasts of Sumatra, Java and Bali and have between 20 and 150 min to reach a tsunami-safe area. Most endangered areas feature longer estimated-evacuation times and hence the population possesses a weak immediate response capability leaving them more vulnerable to being directly impacted by a tsunami. At a sub-national scale these hotspots were identified and include: the Mentawai islands off the Sumatra coast, various sub-districts on Sumatra and west and east Java. Based on the presented approach a temporal dynamic estimation of casualties and displacements as a function of available response time is obtained for the entire coastal area. As an example, a worst case tsunami scenario for Kuta (Bali results in casualties of 25 000 with an optimal response time (direct evacuation when receiving a tsunami warning and 120 000 for minimal response time (no evacuation. The estimated casualties correspond well to observed/reported values and overall model uncertainty is low with a standard error of 5%.

    The results obtained allow for prioritization of intervention measures such as early warning chain, evacuation and contingency planning, awareness and preparedness strategies down to a sub-district level and can be used in tsunami early warning decision support.

  1. Internal Variations in Health-care Federalism in Canada and the United States

    Directory of Open Access Journals (Sweden)

    Vandna Bhatia

    2014-12-01

    Full Text Available Federal systems are prone to dividing health benefits inconsistently across subnational jurisdictions. In this article, we examine how federalism intersects with economic and social factors, particularly gender and immigration status, to create structural barriers to accessing and receiving necessary healthcare. Drawing on insights from the historical institutionalist literature and the experiences of immigrant women in the Canadian and American health systems, we find significant subnational variations in access to health services and insurance coverage. Gaps in service – which are filled (if at all by costly, inaccessible private provision – are the product of piecemeal policymaking, as new programs and services are layered onto existing systems which are themselves outdated and anachronistic. Our analysis demonstrates the need to move beyond analyses of federal state architectures to an intersectional approach to better understand the differential negative impact of subnational variations on equity between social groups and their ability to access to basic health services.

  2. Communication with the public in the health-care system: a descriptive study of the use of social media in Local Health Authorities and public hospitals in Italy

    Directory of Open Access Journals (Sweden)

    Marina Vanzetta

    2014-06-01

    Full Text Available INTRODUCTION. In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN to equip themselves with instruments. Objectives. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. MATERIALS AND METHODS. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. RESULTS. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. CONCLUSIONS. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

  3. Communication with the public in the health-care system: a descriptive study of the use of social media in local health authorities and public hospitals in Italy.

    Science.gov (United States)

    Vanzetta, Marina; Vellone, Ercole; Dal Molin, Alberto; Rocco, Gennaro; De Marinis, Maria Grazia; Rosaria, Alvaro

    2014-01-01

    In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN) to equip themselves with instruments. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL) and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

  4. Comparators (medicinal and non medicinal) for marketing authorization, for public health, for payers and at the European level.

    Science.gov (United States)

    Berdaï, Driss; Hotton, Jean-Michel; Lechat, Philippe

    2010-01-01

    Drug evaluation is based on comparison. Thus, the choice of the comparator for any new treatment becomes a key issue, especially when there are great differences in medical practice and of use conditions of the comparators depending on the geographical zones and their evolution with time. The choice of the comparators must satisfy sometimes different expectations from the registration authorities and for insurance coverage. The universal comparator that allows answering all the clinical assessment questions does not exist. Placebo, when it can be used, remains a reference for the MA (marketing authorisation) application, but does not exclude the use of the reference drug available on the market and prescribed under optimal efficacy conditions. The reference treatment is sometimes a difficult choice due to the absence of validated therapeutic recommendations or if the recommendations vary depending on the countries. The expansion and international harmonization of prescription guidelines (clinical practice guidelines) would reinforce the robustness and efficiency of clinical research efforts with respect to the relevance of the comparison to reference treatments. This principle also applies to the use of a non-drug comparator when it has been recognized as the reference comparator in the treatment of the pathology in question. In as much as possible, the search for a consensus must also aim at defining in the clinical development recommendations significant thresholds for the size of evaluated effects. Optimization of the information made available after clinical trials could also be helped by the development of use of methodologies that allow assessing superiority on secondary criteria during a non-inferiority study on the main criterion. Finally, the development of early scientific consultations by the Haute Autorité de Santé (HAS, French Health Authority) would contribute to adapt phase III clinical trials better to questions concerning the assessment of the

  5. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

    Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

  6. Web GIS in practice III: creating a simple interactive map of England's Strategic Health Authorities using Google Maps API, Google Earth KML, and MSN Virtual Earth Map Control

    OpenAIRE

    Boulos Maged

    2005-01-01

    Abstract This eye-opener article aims at introducing the health GIS community to the emerging online consumer geoinformatics services from Google and Microsoft (MSN), and their potential utility in creating custom online interactive health maps. Using the programmable interfaces provided by Google and MSN, we created three interactive demonstrator maps of England's Strategic Health Authorities. These can be browsed online at http://www.healthcybermap.org/GoogleMapsAPI/ – Google Maps API (Appl...

  7. A retrospective study on the outcomes of cataract surgery in an Eastern Regional Health Authority hospital of Trinidad and Tobago

    Directory of Open Access Journals (Sweden)

    Ebiakpo-aboere Sonron

    2015-09-01

    Full Text Available Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA hospital in Trinidad and Tobago.Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA. The outcome variable of interest was Snellen’s post-operative (presenting VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses.Results. Good outcome (presenting VA 6/18 or better was seen in 350 (67% eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346–3.380], hypertension (OR = 0.520; 95% CI [0.381–0.928], surgical procedure (OR = 1.56; 95% CI [1.004–2.425], good preoperative VA (OR = 0.388, 95% CI [0.211–0.714], borderline preoperative VA (OR = 0.485; 95% CI = [0.278–0.843] and year of first visit to clinic (OR = 2.243; 95% CI [1.215–4.141].Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced.

  8. The Impact of Commercial Health Plan Prior Authorization Programs on the Utilization of Services for Low Back Pain

    Science.gov (United States)

    Goodman, Robert M.; Powell, Corey C.; Park, Paul

    2016-01-01

    Study Design. An observational study. Objective. The aim of this study was to evaluate the impact of a health plan's prior authorization (PA) programs for low back pain (LBP) in a non-Medicare population by assessing changes in pre-surgical nonoperative care; lumbar fusion trends; and overall back surgery rates compared with another health plan with a similar program and national benchmarks. The PA programs require mandatory physiatrist consultation before surgical evaluation, with subsequent additional LBP surgery PA. Summary of Background Data. LBP is prevalent and concern exists that spinal fusion is overutilized for LBP. Methods. Annual rates of lumbar fusion trended over 6 years, and analysis of changes in standardized costs for LBP-related services among a 501-member subset who underwent lumbar fusion before and after program implementations, during the period January 1, 2008, through December 31, 2013, among commercial members aged 18 and 65 years enrolled in a health maintenance organization with commercial membership averaging >500,000 annually. Results. After initiation of the physiatrist PA in December 2010, lumbar fusions decreased from 76.27/100,000 in 2010 to 62.63/100,000 in 2011 with subsequent increases to 64.24/100,000 and 73.84/100,000 in years 2012 and 2013. For members who had lumbar fusion, per-member, pre-surgical costs increased by $2,233 with the physiatrist PA and an additional $1,370 with implementation of the LBP surgery PA (March 2013). Spinal injections and inpatient admissions were the greatest contributors to the overall increase in costs. The physiatrist and LBP surgery PA programs were also associated with lengthening of LBP episodes ending in surgery by 309 and 198 days. Conclusion. Mandatory referral to a physiatrist before surgical evaluation did not result in persistent reduction in lumbar fusions. Instead, these programs were associated with the unintended consequence of increased costs from more nonoperative care for only a

  9. Social cost of carbon pricing of power sector CO2: accounting for leakage and other social implications from subnational policies

    Science.gov (United States)

    Bistline, John E.; Rose, Steven K.

    2018-01-01

    In environments where climate policy has partial coverage or unequal participation, carbon dioxide (CO2) emissions or economic activity may shift to locations and sectors where emissions are unregulated. This is referred to as leakage. Leakage can offset or augment emissions reductions associated with a policy, which has important environmental and economic implications. Although leakage has been studied at national levels, analysis of leakage for subnational policies is limited. This is despite greater market integration and many existing state and regional environmental regulations in the US. This study explores leakage potential, net emissions changes, and other social implications in the US energy system with regionally differentiated pricing of power sector CO2 emissions. We undertake an economic analysis using EPRI’s US-REGEN model, where power sector CO2 emissions are priced in individual US regions with a range of social cost of carbon (SCC) values. SCC estimates are being considered by policy-makers for valuing potential societal damages from CO2 emissions. In this study, we evaluate the emissions implications within the SCC pricing region, within the power sector outside the SCC region, and outside the power sector (i.e. in the rest of the energy system). Results indicate that CO2 leakage is possible within and outside the electric sector, ranging from negative 70% to over 80% in our scenarios, with primarily positive leakage outcomes. Typically ignored in policy analysis, leakage would affect CO2 reduction benefits. We also observe other potential societal effects within and across regions, such as higher electricity prices, changes in power sector investments, and overall consumption losses. Efforts to reduce leakage, such as constraining power imports into the SCC pricing region likely reduce leakage, but could also result in lower net emissions reductions, as well as larger price increases. Thus, it is important to look beyond leakage and consider a

  10. The microbiological quality of potable water on board ships docking in the UK and the Channel Islands: an association of Port Health Authorities and Health Protection Agency Study.

    Science.gov (United States)

    Grenfell, P; Little, C L; Surman-Lee, S; Greenwood, M; Averns, J; Westacott, S; Lane, C; Nichols, G

    2008-06-01

    Providing safe potable water onboard vessels presents particular challenges and contamination can occur directly from source waters as well as during loading, storage and distribution. Between May and October 2005, 950 potable water samples were collected from 342 ships docking at ports. Comparison with Guidelines found 9% of samples contained coliforms, Escherichia coli or enterococci and 2.8% had faecal indicators (E. coli or enterococci). Action levels of aerobic colony count (ACC) bacteria were detected in 20% (22 degrees C) and 21.5% (37 degrees C) of samples. ACC results from one-off sampling are not informative as this does not enable port health authorities to monitor ACC trends. They should be removed as a routine criterion for remedial action and vessels should adopt the WHO Water Safety Plan approach, whilst continuing to monitor water quality with public health-based indicators (e.g. chlorine residual, coliforms, E. coli and enterococci). Logistic regression analyses identified practices associated with water quality. Practices protective against coliforms, E. coli or enterococci in potable supplies were: good hose hygiene, processing water onboard, maintaining free chlorine residual at >or=0.2 mg/L. This emphasizes the importance of good hygiene during potable water loading and maintaining adequate disinfection of supplies onboard.

  11. What is subnational constitucionalism?

    Directory of Open Access Journals (Sweden)

    Julio Pinheiro Faro Homem de Siqueira

    2010-10-01

    Full Text Available Este pequeno enasio tem por objetivo delinear a noção de constitucionalismo subnacional por meio da tentativa de descrever o fenômeno desde algumas reflexões relevantes para entendê-lo. Cada componente da expressão é investigado separadamente. Algumas das características também são discutidas. E, ao final, tem-se uma noção do conceito, mesmo que ainda preliminar.

  12. Requirements of health policy and services journals for authors to disclose financial and non-financial conflicts of interest: a cross-sectional study.

    Science.gov (United States)

    Khamis, Assem M; Hakoum, Maram B; Bou-Karroum, Lama; Habib, Joseph R; Ali, Ahmed; Guyatt, Gordon; El-Jardali, Fadi; Akl, Elie A

    2017-09-19

    The requirements of the health policy and services journals for authors to report their financial and non-financial conflicts of interest (COI) are unclear. The present article aims to assess the requirements of health policy and services journals for authors to disclose their financial and non-financial COIs. This is a cross-sectional study of journals listed by the Web of Science under the category of 'Health Policy and Services'. We reviewed the 'Instructions for Authors' on the journals' websites and then simulated the submission of a manuscript to obtain any additional relevant information made available during that step. We abstracted data in duplicate and independently using a standardised form. Out of 72 eligible journals, 67 (93%) had a COI policy. A minority of policies described how the disclosed COIs of authors would impact the editorial process (34%). None of the policies had clear-cut criteria for rejection based on the content of the disclosure. Approximately a fifth of policies (21%) explicitly stated that inaccurate or incomplete disclosures might lead to manuscript rejection or retraction. No policy described whether the journal would verify the accuracy or completeness of authors' disclosed COIs. Most journals' policies (93%) required the disclosure of at least one form of financial COI. While the majority asked for specification of source of payment (71%), a minority asked for the amount (18%). Overall, 81% of policies explicitly required disclosure of non-financial COIs. A majority of health policy and services journal policies required the disclosure of authors' financial and non-financial COIs, but few required details on disclosed COIs. Health policy journals should provide specific definitions and instructions for disclosing non-financial COIs. A framework providing clear typology and operational definitions of the different types of COIs will facilitate both their disclosure by authors and reviewers and their assessment and management by

  13. Cultural vs. Economic: Re-Visiting the Determinants of Fertility at a Sub-National Level in the U.S, 1990 - 2000

    Directory of Open Access Journals (Sweden)

    Jeremy R. Porter

    2013-07-01

    Full Text Available It is widely accepted that through the past century, and especially since 1950, the world population has grown at an accelerating pace landing the current world's population at about 6.5 billion and, according to UN projections, it is expected to reach 9.1 billion by 2050 (Bongaarts 2005. However, this growth is not uniform and tends to vary both regionally and intra-regionally around the world (Bongaarts 1998. There are competing theories as to the true determinants of fertility levels and these identified patterns (Caldwell 2001. The bulk of these theories pit economic determinants versus socio-cultural determinants as the primary indicators concerning the onset of fertility decline. However, most of this work has had an international focus with very few examining sub-national trends in fertility patterns. This paper draws on the work of one study which examined sub-national trends in the U.S. in hopes of better understanding current trends in determining fertility in the U.S. (Cutright 1983. An OLS regression approach is employed allowing for the examination of the two competing theories. Findings suggest that, while both are certainly significant, the role of economic determinants.

  14. A Cross-Sectional Analysis of Acute Hepatitis B Virus Reported to the Vancouver Coastal Health Authority from 2000 to 2003

    Directory of Open Access Journals (Sweden)

    Yvette Leung

    2006-01-01

    Full Text Available BACKGROUND: Acute hepatitis B virus (HBV transmission remains a significant public health problem despite effective vaccination and prophylaxis strategies. Vancouver, British Columbia, has a large ethnic community from endemic areas, which may further impact on the epidemiology of acute HBV. A cross-sectional study of factors associated with acute HBV cases reported to the Vancouver Coastal Health Authority (Vancouver, British Columbia from 2000 to 2003 is reported.

  15. Health in All (Foreign) Policy: challenges in achieving coherence.

    Science.gov (United States)

    Labonté, Ronald

    2014-06-01

    Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. [Team building in health care by means of outdoor training. Evaluation of the experience of a Local Health Authority of Pinerolo].

    Science.gov (United States)

    Cominetti, Laura; Dimonte, Valerio

    2011-01-01

    It is always difficult to measure the quality and efficacy of a formative event. The event assessed in this study was an outdoor course and the aspects considered were the degree of satisfaction, the increase of knowledge, modifications in behavior and working actions and organized change (4 levels according to Kirkpatrick). Data were collected by means of a questionnaire which the 28 course participants were asked to fill in. Some aspects were statistically tested to evaluate eventual associations between the role of the participant and the answer given but these were not found to be significant. Results showed a good levels of satisfaction and knowledge increase which, in terms of working procedures and individual behavior, resulted in better team-building and mutual appreciation, whereas organizational changes were rather limited and sometimes reflected disappointment. The study made the Health Authority aware of the value of human resources and of the fact that a formative event which acts on feelings and behavior may be the key to success in bringing about deep and lasting changes.

  17. Strengthening collaboration on chemical hazards in food among food safety authorities and the World Health Organization in the Western Pacific Region

    Directory of Open Access Journals (Sweden)

    Jenny Bishop

    2012-06-01

    Full Text Available The objectives of this paper are to highlight the benefits of sharing information to Western Pacific Region Member States and to identify similarities at the regional level in terms of food safety issues and public health protection. In addition, it aims to propose an improved partnership among regional food safety authorities and WHO on targeted objectives.

  18. The United Nations System and the Process of Political Articulation of Local Authorities as a Global Actor

    Directory of Open Access Journals (Sweden)

    Mónica Salomón

    2008-06-01

    Full Text Available The recent creation of United Cities and Local Governments (UCLG, an organization of local authorities of universal scope, is the culmination of the emerging process of a new political actor on the international scene. The article describes and analyses some aspects of the interaction between this global political actor-in-themaking and the United Nations (UN system. The theoretical question it addresses is how the new global actor has — even if partially — achieved its objectives, given its limited power resources and the opposition of other (apparently more powerful actors: the central governments that run the UN system. Drawing on the literature on the foreign activities of subnational governments, as well as on the literature on transnational actors and the creation of global norms, the proposed explanation highlights the “mixed actor” (partially sovereignty-bound, partially sovereignty-free character of subnational governments acting internationally.

  19. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available AUTHOR GUIDELINES Indian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s. http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols 1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic

  20. 75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

    Science.gov (United States)

    2010-06-24

    ... HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan... Care Act (ACA), Public Law 111-148. Section 5201 of the ACA changes the Primary Care Loan (PCL) program by: (1) Reducing the number of years for the primary health care service requirement; (2) lowering...

  1. Using key performance indicators as knowledge-management tools at a regional health-care authority level.

    Science.gov (United States)

    Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

    2005-06-01

    The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

  2. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    in millimeters of mercury, unless other units are specifically required by the journal.Journals vary in the units they use for reporting hematologic, clinical chemistry, and other measurements. Authors must consult the Information for Authors of the particular journal and should report laboratory information in both local and International System of Units (SI.Editors may request that authors add alternative or non-SI units, since SI units are not universally used. Drug concentrations may be reported in either SI or mass units, but the alternative should be provided in parentheses where appropriate.k. Abbreviations and SymbolsUse only standard abbreviations; use of nonstandard abbreviations can be confusing to readers. Avoid abbreviations in the title of the manuscript. The spelled-out abbreviation followed by the abbreviation in parenthesis should be used on first mention unless the abbreviation is a standard unit of measurement.    ====================================SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from

  3. Identifying health insurance predictors and the main reported reasons for being uninsured among US immigrants by legal authorization status.

    Science.gov (United States)

    Vargas Bustamante, Arturo; Chen, Jie; Fang, Hai; Rizzo, John A; Ortega, Alexander N

    2014-01-01

    This study identifies differences in health insurance predictors and investigates the main reported reasons for lacking health insurance coverage between short-stayed (≤ 10 years) and long-stayed (>10 years) US immigrant adults to parse the possible consequences of the Affordable Care Act among immigrants by length of stay and documentation status. Foreign-born adults (18-64 years of age) from the 2009 California Health Interview Survey are the study population. Health insurance coverage predictors and the main reasons for being uninsured are compared across cohorts and by documentation status. A logistic-regression two-part multivariate model is used to adjust for confounding factors. The analyses determine that legal status is a strong health insurance predictor, particularly among long-stayed undocumented immigrants. Immigration status is the main reported reason for lacking health insurance. Although long-stayed documented immigrants are likely to benefit from the Affordable Care Act implementation, undocumented immigrants and short-stayed documented immigrants may encounter difficulties getting health insurance coverage. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Evidential Authorization*

    Science.gov (United States)

    Blass, Andreas; Gurevich, Yuri; Moskal, Michał; Neeman, Itay

    Consider interaction of principals where each principal has its own policy and different principals may not trust each other. In one scenario the principals could be pharmaceutical companies, hospitals, biomedical labs and health related government institutions. In another scenario principals could be navy fleets of different and not necessarily friendly nations. In spite of the complexity of interaction, one may want to ensure that certain properties remain invariant. For example, in the navy scenario, each fleet should have enough information from other fleets to avoid unfortunate incidents. Furthermore, one wants to use automated provers to prove invariance. A natural approach to this and many other important problems is to provide a high-level logic-based language for the principals to communicate. We do just that. Three years ago two of us presented the first incarnation of Distributed Knowledge Authorization Language (DKAL). Here we present a new and much different incarnation of DKAL that we call Evidential DKAL. Statements communicated in Evidential DKAL are supposed to be accompanied with sufficient justifications. In general, we construe the term “authorization” in the acronym “DKAL” rather liberally; DKAL is essentially a general policy language. There is a wide spectrum of potential applications of KAL. One ambitious goal is to provide a framework for establishing and maintaining invariants.

  5. [Description of the process of preparation and response of local health authorities facing the introduction of the Chikungunya virus in Colombia, 2014].

    Science.gov (United States)

    Alarcón-Cruz, Ángela P; Prieto-Suárez, Edgar

    2016-06-01

    Objective To describe the process of preparation and response of local health authorities in key public health issues while facing the introduction stage of an unusual virus: Chikungunya in Colombia in 2014. Methods A cross-sectional study was conducted using a survey that was developed for this study and sent to Public Health coordinators and to the person in charge of vector borne-diseases in the country's territorial entities. Results 23 out of the 35 territories at risk from the transmission of Chikungunya agreed to answer the survey. A global review of the survey scores for each evaluated section shows better performances in the areas of knowledge management, comprehensive patient care, epidemiological intelligence, and health promotion. According to the results of this study, the epidemiological surveillance system during the Chikungunya epidemic had a low acceptability and flexibility, possibly contributing to the underreporting of cases. Conclusions In general, knowledge and implementation by local authorities of the Integrated Health Strategy- EGI (Estrategia de Gestión Integral, by its Spanish acronym)- for vector-borne diseases was evident from the themes evaluated in this study. However, it is necessary to reinforce the communication of risks, laboratory, and outbreak and contingencies management areas faced during the introduction of new viruses.

  6. How efficient are New Zealand's District Health Boards at producing life expectancy gains for Māori and Europeans?

    Science.gov (United States)

    Sandiford, Peter; Consuelo, David Juan José Vivas; Rouse, Paul

    2017-04-01

    Use data envelopment analysis (DEA) to measure the efficiency of New Zealand's District Health Boards (DHBs) at achieving gains in Māori and European life expectancy (LE). Using life tables for 2006 and 2013, a two-output DEA model established the production possibility frontier for Māori and European LE gain. Confidence limits were generated from a 10,000 replicate Monte Carlo simulation. Results support the use of LE change as an indicator of DHB efficiency. DHB mean income and education were related to initial LE but not to its rate of change. LE gains were unrelated to either the initial level of life expectancy or to the proportion of Māori in the population. DHB efficiency ranged from 79% to 100%. Efficiency was significantly correlated with DHB financial performance. Changes in LE did not depend on the social characteristics of the DHB. The statistically significant association between efficiency and financial performance supports its use as an indicator of managerial effectiveness. Implications for public health: Efficient health systems achieve better population health outcomes. DEA can be used to measure the relative efficiency of sub-national health authorities at achieving health gain and equity outcomes. © 2016 The Authors.

  7. Author Details

    African Journals Online (AJOL)

    African Journal for Physical, Health Education, Recreation and Dance. ... Evaluation of Alpha Theta training on neurophysiology, mood, mindfulness, health and ... The psychology of the heart: Implications for health, physical activity and sport

  8. [The role of regional and local authorities in shaping health-conducive environmental determinants in the light of the Polish legislation].

    Science.gov (United States)

    Nosko, Jan

    2010-01-01

    This study is a continuation of earlier research concerning the role of public health administration (governmental and self-governmental) in health protection and health promotion. The aim of the study was to specify the function of local self-governments (at county, community and district levels) in shaping health-conducive environmental determinants. Polish legal acts concerning biological, chemical and physical hazards, binding up to November 30, 2009 were the subject of the study. All these acts were analyzed and the provisions referring to the control of the above mentioned hazards and obligations imposed on local self-governments to promote health-conducive environmental factors were identified. Of the 41 environment protection legal acts, 24 were selected as the most important from the point of the aim of the analysis. It was found that these acts underline the significance of environmental health determinants and explicitly formulate the role and duties of local authorities in the area of environmental health promotion, as well as in controlling and monitoring harmful biological, chemical and physical factors. The participation of local societies in these activities is also emphasized.

  9. The Baltimore Youth Ammunition Initiative: A Model Application of Local Public Health Authority in Preventing Gun Violence

    Science.gov (United States)

    Lewin, Nancy L.; Vernick, Jon S.; Beilenson, Peter L.; Mair, Julie S.; Lindamood, Melisa M.; Teret, Stephen P.; Webster, Daniel W.

    2005-01-01

    In 2002, the Baltimore City Health Department, in collaboration with the Baltimore Police Department and the Johns Hopkins Center for Gun Policy and Research, launched the Youth Ammunition Initiative. The initiative addressed Baltimore’s problem of youth gun violence by targeting illegal firearm ammunition sales to the city’s young people. The initiative included undercover “sting” investigations of local businesses and issuance of health department violation and abatement notices. Intermediate results included the passage of 2 Baltimore city council ordinances regulating ammunition sales and reducing the number of outlets eligible to sell ammunition. Although it is too early to assess effects on violent crime, the intervention could theoretically reduce youth violence by interrupting one source of ammunition to youths. More important, the initiative can serve as a policy model for health commissioners seeking to become more active in gun violence prevention efforts. PMID:15855448

  10. [Detection of a Disease Cluster by the Health Authorities of Stendal District due to Campylobacter jejuni in a Nursery After the Consumption of Raw Milk].

    Science.gov (United States)

    Hermann, N; Schubert, I

    2015-07-01

    A notification from a laboratory concerning the detection of Campylobacter jejuni in a 6-year-old boy initiated the investigation carried out by the health authorities from Stendal district, in order to explain the morbidity rate caused by the germ. The day after the boy's pediatrician informed about a visit to a farm, which was confirmed by the head of the nursery. She told the health authorities about the consumption of raw milk during their visit at the farm.The following days more children fell sick. Within 10 days the total number of diseased children was 21. The health authorities asked for stool samples of the diseased children, nursery nurses and the head of the farm since raw milk presents a potential cause of infection. The health authorities together with the Saxony-Anhalt State Office for Consumer Protection conducted a retrospective cohort study. The aim was to explain the association between the exposure from raw milk consumption and the occurrence of the disease from C. jejuni. Based on a questionnaire data about the food and milk intake at the nursery and at home and about the trip to the farm were collected. 91% of the children's cohort and 86% of the adults' cohort were captured.The exposed group at risk showed a higher risk of falling ill than the group, which was not exposed. The risk factor raw milk explained the difference. Furthermore, the analysis of milk samples taken by the district veterinary office from 2 cows and from the farm's tank was able to detect the germs. The correlation of the illness, the consumption of raw milk, the detection of C. jejuni in the samples taken from the children and the samples taken from the cows was evident. Based on the case the health authorities recommended that heads of nurseries as well as heads of dairy farming in the district of Stendal needed to be advised on raw milk. Nurseries are still allowed to take trips to farms. However, raw animal derivates including milk must not be consumed. © Georg Thieme

  11. Evidence from the national health account: the case of Dubai.

    Science.gov (United States)

    Hamidi, Samer

    2014-01-01

    National health accounts (NHAs) provide useful information to aid in understanding the health care financing system. This article aims to present a profile of health system financing in Dubai using data from the NHA. We also aim to compare the provider structure of financing schemes in Dubai with those of the State of Qatar and selected Organization for Economic Cooperation and Development (OECD) countries. The author analyzed secondary data published in NHAs for Dubai and Qatar, and data collected by the OECD countries and publicly available from the Statistical Office of the European Union (Eurostat), for 25 OECD countries for comparative analysis. All health financing measures used are as defined in the international System of Health Accounts (SHA). In Dubai, only 33% of current health expenditure (CHE) is funded by the government. However, the public sector is the main source of health funding in Qatar and most OECD countries, with an average of 79% and 72%, respectively. Households in Dubai spent about 22% of CHE, equivalent to an average US$187 per capita, ranking the highest among Gulf Cooperation Council (GCC) countries, and compared with 20% of CHE across OECD countries. Hospitals in Dubai accounted for 48% of CHE, which is much higher than Qatar (40%) and the OECD average (36%). The Dubai health care financing system differs substantially from that in OECD countries, as it is more private oriented. The findings point to several potential opportunities for growth and improvement. Policy areas that may be addressed using the information presented in this article are broad and include the following: shift from hospital care to ambulatory and day care, sustainability of health finance, shift the cost of health care to the private sector, introduce cost-containment measures, revise payment systems for health providers, and produce subnational accounts for non-communicable diseases. More investment in the translation of national health account data into policy

  12. The prevalence and performance of resistance exercise training activities in an Australian population in relation to health authority guidelines.

    Science.gov (United States)

    Humphries, Brendan; Stanton, Rob; Scanlan, Aaron; Duncan, Mitch J

    2017-09-29

    Resistance training research highlights the importance of training intensity to resistance exercise training (RET) and the associated benefits to health and function for healthy and at-risk populations. The American College of Sports Medicine (ACSM) recommend specific intensities, frequencies, repetitions, and number of exercises of RET to be performed to maintain health. The primary aim of this study was to describe the prevalence of achieving recommended levels of RET in relation to ACSM guidelines for intensity, frequency, repetitions, and number of exercises in a regional Australian population. A Computer-Assisted-Telephone-Interview (CATI) survey (n=1237) was conducted to determine RET participation. Participants were 18 years plus, residing in Central Queensland, Australia. The prevalence of respondents performing 'No RET', 'insufficient RET' and 'sufficient RET' were 79.6.0%, 15.2% and 5.2% respectively. Significantly higher proportions of younger adults adhered to all RET guidelines for intensity (19.2 vs 8.1%), frequency (19.9 vs 11.6%), repetitions (17.8 vs 6.3%), and number of exercises (8.2 vs 3.6%) (p15 years), and individuals engaging in sufficient levels of aerobic exercise training (AET) engaged in sufficient levels of RET (pACSM guidelines for the quantity and quality of RET that is likely to provide health benefits. This has implications for public health policy and the future development and promotion of population-level RET guidelines. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. Establishment of the South-Eastern Norway Regional Health Authority Resource Center for Children with Prenatal Alcohol/Drug Exposure

    Directory of Open Access Journals (Sweden)

    Gro C. C. Løhaugen

    2015-01-01

    Full Text Available This paper presents a new initiative in the South-Eastern Health Region of Norway to establish a regional resource center focusing on services for children and adolescents aged 2–18 years with prenatal exposure to alcohol or other drugs. In Norway, the prevalence of fetal alcohol spectrum (FAS is not known but has been estimated to be between 1 and 2 children per 1000 births, while the prevalence of prenatal exposure to illicit drugs is unknown. The resource center is the first of its kind in Scandinavia and will have three main objectives: (1 provide hospital staff, community health and child welfare personnel, and special educators with information, educational courses, and seminars focused on the identification, diagnosis, and treatment of children with a history of prenatal alcohol/drug exposure; (2 provide specialized health services, such as diagnostic services and intervention planning, for children referred from hospitals in the South-Eastern Health Region of Norway; and (3 initiate multicenter studies focusing on the diagnostic process and evaluation of interventions.

  14. Author reply: Steven A. Nissman - Electronic Health Records (Ophthalmology, Volume 116, Issue 5, May 2009, Pages 1018-1019)

    NARCIS (Netherlands)

    Chiang, Michael F.; Boland, Michael V.; Margolis, James W.; Lum, Flora; Abramoff, M.D.; Hildebrand, P. Lloyd

    2009-01-01

    We respect the thoughtfulness that Dr. Nissman invested into his decision-making process, and completely agree with his observation that implementation of electronic health record (EHR) systems may present difficulties for small ophthalmology practices. The low rate of EHR adoption in our survey and

  15. Author Details

    African Journals Online (AJOL)

    Rhetoric and Reality of Community Participation in Health Planning, Resource Allocation and Service Delivery: a Review of the Reviews, Primary Publications and Grey Literature Abstract PDF · Vol 2, No 1 (2013) - Articles Perceived Impact of Health Sector Reform on Motivation of Health Workers and Quality of Health Care ...

  16. Effects of decentralized health care financing on maternal care in Indonesia

    NARCIS (Netherlands)

    R. Hartwig (Renate); R.A. Sparrow (Robert); S. Budiyati (Sri); A. Yumna (Athia); N. Warda (Nila); A. Suryahadi (Asep); A.S. Bedi (Arjun Singh)

    2015-01-01

    textabstractWe exploit variation in the design of sub-national health care financing initiatives in Indonesian districts to assess the effects of these local schemes on maternal care from 2004 to 2010. The analysis is based on a district pseudo-panel, combining data from a unique survey among

  17. Author Details

    African Journals Online (AJOL)

    Ogunbanjo, OB. Vol 20, No 1 (2015) - Articles Forensic odontological observations in the victims of DANA air crash. Abstract PDF. ISSN: 1937-8688. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors ...

  18. Author Details

    African Journals Online (AJOL)

    Chimaobi, O. Vol 3, No 1 (2006) - Articles Progeria: A desequencer of nature. Abstract. ISSN: 0794-6961. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors · for Policy Makers · about Open ...

  19. Author Details

    African Journals Online (AJOL)

    Prinsloo, S. Vol 10, No 2 (2004) - Articles Electroconvulsive therapy and its use in modern-day psychiatry. Abstract PDF. ISSN: 2078-6786. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

  20. Author Details

    African Journals Online (AJOL)

    Pretorius, P.J.. Vol 10, No 2 (2004) - Articles Electroconvulsive therapy and its use in modern-day psychiatry. Abstract PDF. ISSN: 2078-6786. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

  1. Author Details

    African Journals Online (AJOL)

    Adu, M R. Vol 5, No 1 (2006) - Articles The ill effect of outages on National Electric Power Authority (NEPA): Ilorin 132/33kv substation as a case study. Abstract. ISSN: 1596-292X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Fabricius, Christo. Vol 32 (2016) - Articles Viewpoint Environmental Slogans: Memes with Diverging Interpretations Abstract PDF. ISSN: 2411-5959. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors ...

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    Macleod, MJ. Vol 27 (2011) - Articles Is Prior Statin Therapy Associated with Increased Hemorrhagic Stroke? Abstract. ISSN: 0303-691X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Bornman, CL. Vol 20, No 1 (2013) - Articles Organisational culture of the South African construction industry. Abstract PDF. ISSN: 1023-0564. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Author Details. Journal Home > Advanced Search > Author Details. Log in or Register to get access to ... Tree, Anthony J. Vol 86, No 1-2 (2015) - Articles The status of the Damara Tern in the Eastern Cape, South Africa § Abstract. ISSN: 0030-6525. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for ...

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    Kumar, Sunil. Vol 2, No 2 (2010) - Articles Surgicel as an Unusual Cause of Prolonged Drainage Abstract PDF. ISSN: 2006-8808. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors · for Policy ...

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    Ulkur, F. Vol 18, No 1 (2015) - Articles Interdisciplinary orthognathic treatment of high angle class III malocclusion. Abstract PDF. ISSN: 1119-3077. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy ...

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    Khedher, A. Vol 1, No 1 (2013) - Articles Association of sarcoidosis and myasthenia gravis: Case Report Abstract. ISSN: 2307-2482. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Reich, Adam. Vol 15, No 5 (2016) - Articles Ziziphus mauritiana leaf extract emulsion for skin rejuvenation. Abstract PDF. ISSN: 1596-9827. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Ikemelu, CRK. Vol 3, No 3 (2014) - Articles Data Mining for Cyber Security Abstract PDF. ISSN: 2227-5444. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about Open Access · FAQ's ...

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    Csongrady, KJ. Vol 6 (1984) - Articles Rainfall intensity data for Addis Ababa Abstract PDF. ISSN: 0514-6216. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors · for Policy Makers · about ...

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    Bassey, K.J.. Vol 8, No 3 (2002) - Articles On building a OR-based decision model via coherent pluralism. Abstract. ISSN: 1118-0579. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers ...

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    Mustapha, AM. Vol 21, No 3 (2013) - Articles Comparison of Transportation Algorithms Using Data from Katsina State Transport Authority, Katsina State, Nigeria Abstract PDF. ISSN: 0794-5698. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Osaji, EE. Vol 11, No 2 (2007) - Articles Exploration of the Energy Efficiency of the Greater London Authority Building (GLA Building/City Hall) Abstract PDF. ISSN: 1119-8362. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

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    Elkordufani, Y. Vol 12, No 4 (2009) - Articles The psychological impact of vitiligo in adult Sudanese patients. Abstract PDF. ISSN: 1994-8220. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Utulu, S. Vol 26 (2010) - Articles DNA Damage Induced in the Germ and Bone Marrow Cells of Mice by Caffeine Abstract. ISSN: 0303-691X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Ebiti, N.W. Vol 50, No 1 (2009) - Articles Anorexia nervosa in a Nigerian – a case report. Abstract. Nigerian Medical Journal. ISSN: AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about ...

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    Embu, HY. Vol 4, No 1 (2010) - Articles Anesthesia for surgery for typhoid perforation in a rural African hospital. Abstract. ISSN: 0331-3131. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Oyeyipo, I.P.. ISSN: 2467-8252. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about ...

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    Newton, K. Vol 5, No 3 (2007) - Articles The spectrum of pyogenic liver abscesses and the principles of therapy. Abstract. ISSN: 1812-1659. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Chaukimath, SP. Vol 5, No 6 (2015) - Articles Orgasm Induced Seizures: A Rare Phenomenon Abstract PDF. ISSN: 2141-9248. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about ...

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    Mtshali, S. Vol 21, No 3:2 (2015) - Articles Football Injuries during a South African University Sport Tournament Abstract. ISSN: 1117-4315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Streicher, H. Vol 32, No 1 (2010) - Articles Travel motives of participants in the Cape Argus Pick n Pay Cycle Tour Abstract. ISSN: 0379-9069. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Odejobi, O.A.. Vol 12, No 2 (2003) - Articles A Neuro-Linguistic Model for Speech Recognition in Tone Language Abstract. ISSN: 1019-1593. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy ...

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    Chopra, D. Vol 66 (2013) - Articles Terpyridyl Complexes as Antimalarial Agents Abstract PDF. ISSN: 0379-4350. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about Open Access ...

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    Audu-Peter, JD. Vol 7, No 1 (2010) - Articles Granule properties of paracetamol made with Bombax ceiba gum. Abstract. ISSN: 0189-8442. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Bode-Thomas, F. Vol 3, No 1 (2016) - Articles Enuresis among primary school children in Jos, Plateau State Abstract. ISSN: 2354-4325. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Author Details. Journal Home > Advanced Search > Author Details. Log in or Register to get access to full text downloads. ... Simulation study of excitation functions for cyclotron production of 99mTc using TALYS code. Abstract. ISSN: 0855-2215. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for ...

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    Hudson, J. Vol 11, No 2 (2007) - Articles Exploration of the Energy Efficiency of the Greater London Authority Building (GLA Building/City Hall) Abstract PDF. ISSN: 1119-8362. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

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    Kilenga, N. Vol 4, No 1 (2015) - Articles West Africa Ebola Virus Disease Epidemic: The Africa Experience Abstract. ISSN: 2276-6839. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Opayele, AV. Vol 16, No 1 (2016) - Articles Yellow fever vaccination in Nigeria: focus on Oyo State Abstract. ISSN: 1596-2407. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about Open ...

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    Farouk, L. Vol 26 (2010) - Articles Evaluation des Activities Analgesique et Antipyretique de Punica granatum. Abstract. ISSN: 0303-691X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Meludu, O. Vol 16 (2010) - Articles Epiboron Neutron Activation Analysis with Nigeria Research Reactor - 1. Abstract. ISSN: 1116-4336. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors ...

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    Ouagued, A. Vol 17 (2005) - Articles Etude experimentale des capteurs solaires a air: le sechage de la figue. Abstract. ISSN: 1111-0902. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers ...

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    Omar, J. Vol 37 (2011) - Articles A Prisoner's Right?: The legal case for rehabilitation. Abstract PDF. ISSN: 1991-3877. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors · for Policy Makers ...

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    Bahklia, AH. Vol 11, No 17 (2012) - Articles Thermo-aerobic bacteria from geothermal springs in Saudi Arabia Abstract PDF. ISSN: 1684-5315. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy ...

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    Adeoye, PO. Vol 9, No 1 (2010) - Articles Genital self-mutilation. Abstract PDF. ISSN: 1596-3519. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors · for Policy Makers · about Open Access ...

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    Allan, Alfred. Vol 11, No 2 (2005) - Articles Psychiatric diagnosis in legal settings. Abstract PDF. ISSN: 2078-6786. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... Journal Quality · for Researchers · for Journals · for Authors · for Policy Makers · about ...

  7. Effects of Stigma and Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority: An Evaluation of Disability Rights California and Mental Health America of California Trainings

    OpenAIRE

    Cerully, Jennifer L.; Collins, Rebecca L.; Wong, Eunice C.; Roth, Elizabeth; Marks, Joyce; Yu, Jennifer

    2016-01-01

    Describes the methods and results of a RAND evaluation of stigma and discrimination reduction trainings delivered by two program partners, Disability Rights California and Mental Health America of California.

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    2011) - Articles Hypoxic Ischaemic Encephalopathy among Asphyxiated Nigeran Newborns Abstract · Vol 12, No 1-2 (2013) - Articles Knowledge of Health Care Workers in a Nigerian Tertiary Health Facility on Post-Exposure Prophylaxis for HIV ...

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    Role of Reproductive Health Commodity Security on Maternal and Child Health Care in the West African Sub-Region Abstract PDF · Vol 2, No 1 (2011) - Articles Knowledge and Inventory Management of Misoprostol for Reproductive Health Services Amongst Community Pharmacists in Anambra and Delta States of Nigeria

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    Demographic and health indicators as predictors of life expectancy in African countries: Implications for population education and health promotion in Nigeria Abstract · Vol 10, No 1 (2013) - Articles HIV/ADIS knowledge achievement among health education students at the point of graduation in Delta state university Abraka: ...

  11. Early Patient Access to Medicines: Health Technology Assessment Bodies Need to Catch Up with New Marketing Authorization Methods.

    Science.gov (United States)

    Leyens, Lada; Brand, Angela

    National and international medicines agencies have developed innovative methods to expedite promising new medicines to the market and facilitate early patient access. Some of these approval pathways are the conditional approval and the adaptive pathways by the European Medicines Agency (EMA); the Promising Innovative Medicine (PIM) designation and the Early Access to Medicines Scheme (EAMS) by the Medicines and Healthcare Products Regulatory Agency (MHRA), as well as the Fast Track, Breakthrough or Accelerated Approval methods by the Food and Drug Administration (FDA). However, at least in Europe, these methods cannot achieve the goal of improving timely access for patients to new medicines on their own; the reimbursement process also has to become adaptive and flexible. In the past 2 years, the effective access (national patient access) to newly approved oncology drugs ranged from 1 to 30 months, with an extremely high variability between European countries. The goal of early patient access in Europe can only be achieved if the national health technology assessment bodies, such as NICE (ENG), HAS (FR), G-BA (DE) or AIFA (IT), provide harmonized, transparent, flexible, conditional and adaptive methods that adopt the level of evidence accepted by the medicines agencies. The efforts from medicines agencies are welcome but will be in vain if health technology assessments do not follow with similar initiatives, and the European 'postcode' lottery will continue. © 2016 S. Karger AG, Basel.

  12. Air pollution and related respiratory diseases: the experience of a local health authority in Liguria (north Italy).

    Science.gov (United States)

    Panatto, D; Amicizia, D; Marensi, L; Tatarek, R; Bosi, M; Tofanelli, V; Valerio, F; Sasso, T; Gasparini, R

    2011-03-01

    Numerous epidemiological studies have shown that air pollution due to both industry and heavy traffic has short- and long-term effects on health. The study was carried out in an industrial area with heavy urban and motorway traffic in the Province of Genoa (Italy). The study was carried out from June 2005 to July 2008. An epidemiologic study was conducted by monitoring an elementary/middle school situated in an area of recent industrial development and an elementary/middle school located in an area free from sources of industrial pollution. Furthermore, we conducted an investigation of workers in commercial premises situated in one area of heavy vehicular traffic. In the study areas, environmental monitoring campaigns were carried out in order to determine the association between indoor and outdoor pollution and respiratory disorders. The study did not bring to light any specific health problems attributable with certainty to industrial emissions. The impact of pollution caused by motor traffic proved to be greater than that due to industrial emissions. More exhaustive sampling campaigns should be implemented in order to quantify the effects of specific sources of emissions and to correlate these sources with pollutants (industry, urban traffic, motorway traffic).

  13. [The determination of resort and stress-areas by air pollution 1. Communication: health effects, methods, emission inventories (author's transl)].

    Science.gov (United States)

    Kofler, W

    1977-01-01

    The Alps and other mountainous areas are air-hygene problem zones: By distadvantageous geographical and meteorological conditions relativ small emissions can be the reason of high concentration of air pollutants in the ambient air. Therefore the separation of different stress zones by the air quality is an important data for land use planning with regards on health. Different methods which are internationally usual can not be used in mountainous areas (e.g., dispersion models, calculation according to the TAL). A method is introduced for determination and separation of the level of SO2 and particulate matter in a spreadout area which can be used also in complex terrain. This method was proved in air pollution studies in areas with more than 30000 km2 over four years. The investigations were based on a combination of emissions studies, measurements of immissions by continous working SO2 monitoring instruments, lead dioxide candles and Bergerhoff-instruments, and--if possible--meteorological investigations. Report 1 describes the health effects of SO2 and particulate matter, the used tentative methods (analysis for dustfall, the sulfation rate by lead dioxide candles, analysis for sulfur dioxide content by conductimetric and coulometric methods), the emission inventories and the net works.

  14. Investment-driven industrial localisation in Calabar, free trade zone and environs, south-eastern/southsouth, Nigeria: Evidence on recent sub-national regional economic diversification

    Directory of Open Access Journals (Sweden)

    Ingwe Richard

    2014-01-01

    Full Text Available The type of foreign direct investment (FDI mostly received by Nigeria in the past decades has formed one of the central points of the discussion of the nature of investment in development in this country acknowledged as Africa’s second largest economy. The way FDI receipt varies by size and type by sub-national regions (especially the 36 states, Federal Capital Territory in Abuja and the 774 Local Government Areas forming Nigeria’s federation has so been poorly addressed. However, scholars recently reported on the receipt of FDI in Cross River State following the state government’s policy that is being praised by Nigeria’s federal government agencies and international governmental organizations -including United Nations Systems in Nigeria, among others. The praises recognize Cross River State Government’s practice of good governance and cost-effective resource management as it confronts challenges including declining funds hitherto allocated from the pooled federation account. The objective of this article is to is to contribute towards understanding recent foreign direct investment in Cross River State. This article follows on theoretical perspectives and background recently reported by presenting findings of an empirical case study of recent and ongoing increasing investments in the Calabar Free Trade Zone (CFTZ city of Cross River State (Nigeria. We apply methods of descriptive case study to inform on the increasing commitment of foreign investments towards manufacturing engagement in Calabar urban region/environs. We present Calabar region’s previous/recent development challenges and provide some details of the recent increasing foreign investments in the Calabar FTZ city, before analyzing and synthesizing the recent increasing foreign investments in the Calabar FTZ city. It is demonstrated that the recent economic dynamics would engender a set of socio-economic, spatial and ecological/environmental responses and explain their

  15. Dependence and withdrawal reactions to benzodiazepines and selective serotonin reuptake inhibitors. How did the health authorities react?

    Science.gov (United States)

    Nielsen, Margrethe; Hansen, Ebba Holme; Gøtzsche, Peter C

    2013-01-01

    Our objective was to explore communications from drug agencies about benzodiazepine dependence and selective serotonin reuptake inhibitors (SSRIs) withdrawal reactions over time. Documentary study. We searched the web-sites of the European Medicines Agency and the drug agencies in USA, UK, and Denmark for documents mentioning benzodiazepines or SSRIs. We supplemented with other relevant literature that could contribute to our study. The searches were performed in 2009 in PubMed, Google, BMJ and JAMA. It took many years before the drug regulators acknowledged benzodiazepine dependence and SSRI withdrawal reactions and before the prescribers and the public were informed. Drug regulators relied mainly on the definitions of dependence and withdrawal reactions from the diagnostic psychiatric manuals, which contributed to the idea that SSRIs do not cause dependence, although it is difficult for many patients to stop treatment. In the perspective of a precautionary principle, drug agencies have failed to acknowledge that SSRIs can cause dependence and have minimised the problem with regard to its frequency and severity. In the perspective of a risk management principle, the drug agencies have reacted in concordance with the slowly growing knowledge of adverse drug reactions and have sharpened the information to the prescribers and the public over time. However, solely relying on spontaneous reporting of adverse effects leads to underestimation and delayed information about the problems. Given the experience with the benzodiazepines, we believe the regulatory bodies should have required studies from the manufacturers that could have elucidated the dependence potential of the SSRIs before marketing authorization was granted.

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    methylisorboneol (2-MIB) in water from Zuikerbosch Treatment Plant (Rand Water) using â-cyclodextrin polyurethanes. Abstract PDF. ISSN: 0378-4738. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    carnitine optimal combinations in MPP+- induced cellular model of Parkinson's disease. Abstract PDF. ISSN: 0795-8080. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    carnitine supplementation on growth performance, carcass traits and blood parameters of broiler chickens. Abstract PDF. ISSN: 2221-4062. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    adipogenic effects of slendesta, standard potato extracts containing 5% protease inhibitor II Abstract PDF. ISSN: 0189-6016. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    microfibrous membranes with osteogenic induction of rBMSC for tissue engineering. Abstract PDF. ISSN: 1596-9827. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    -microfibrous membranes with osteogenic induction of rBMSC for tissue engineering. Abstract PDF. ISSN: 1596-9827. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES.

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    Assisted Extraction of Steroidal Saponins from Dioscorea zingiberensis C. H. Wright Abstract PDF. ISSN: 1596-9827. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    communication-style and parental neglect as predictors of aggressive tendencies among Secondary School adolescents. Abstract. ISSN: 0189-0263. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

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    Annelida: Oligochaeta) of forests in Limpopo Province, South Africa: diversity, communities and conservation. Abstract. ISSN: 2224-073X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Psophocarpus Tetragonolobus), Pitanga cherries (Eugenia uniflora) and orchid fruit (Orchid fruit myristica) Abstract PDF. ISSN: 1684-5374. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Annonaceae) as a botanical insecticide against Callosobruchus maculatus Fabricius (Coleoptera:Bruchidae) Abstract. ISSN: 1597-0906. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    HUSK ASH-CARBIDE-WASTE STABILIZATION OF RECLAIMED ASPHALT PAVEMENT Abstract PDF. ISSN: 2467-8821. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

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  2. Author Affiliations

    Indian Academy of Sciences (India)

    Author Affiliations. Vidyanand Nanjundiah1 Stuart A Newman2. Developmental Biology and Genetics Laboratory, Indian Institute of Science, Bangalore 560 012, India; Department of Cell Biology and Anatomy, Basic Sciences Building, New York Medical College, Valhalla, New York 10595, USA ...

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    sadh/034/01/0001-0002. Author Affiliations. Raja Natarajan1. School of Technology and Computer Science, Tata Institute of Fundamental Research, Mumbai 400 005. Sadhana. Current Issue : Vol. 43, Issue 1 · Current Issue Volume 43 | Issue ...

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  15. Author response to letter. Ref: Madsen et al. "Unnecessary work tasks and mental health: a prospective analysis of Danish human service workers".

    Science.gov (United States)

    Madsen, Ida Eh; Rugulies, Reiner

    2015-03-01

    We read with interest the letter from Drs Durand-Moreau, Loddé, and Dewitte (1) regarding our article on unnecessary work tasks and mental health (2). The authors argue that: (i) the article is flawed by an imprecise one-item exposure measurement, (ii) the results may be affected by reverse causality, and (iii) ultimately the elimination of unnecessary work tasks may increase "psychic suffering". We would like to take this opportunity to address their concerns. We acknowledge, as we did in the article itself, that measuring unnecessary work tasks using only one item is less than ideal and could have increased measurement error in our analyses. The item we used to measure unnecessary work tasks assesses the employee's overall evaluation regarding the extent to which they must conduct work tasks that they, for whatever reason, deem unnecessary. We are unconvinced by the claim by Drs Durand-Moreau, Loddé, and Dewitte that this phenomenon is somehow unrelated to Semmer's definition of unnecessary tasks (3, 4), regardless of the sense-making processes underlying an individual employee's evaluation of a particular work task as unnecessary. Regarding the issue of reverse causality, the analyses were longitudinal and the effect estimates were adjusted for the baseline mental health level of the participants. Consequently, we examined changes in mental health over time, and our results cannot be explained by poorer mental health making workers think "that what they're doing is useless" as claimed in the commentary. Although causal inference is always a delicate issue when applying observational research methods, the adjustment for baseline mental health should account for reverse causality at least. Drs Durand-Moreau, Loddé, and Dewitte question that our findings suggest that the elimination of unnecessary work tasks may be beneficial to employee mental health. Instead they propose that unnecessary work tasks may be conducive to mental health because "some tasks may seem

  16. State Labour Inspectorate – specialized authority exercising supervising and control tasks in the field of labour security and health

    Directory of Open Access Journals (Sweden)

    Nicolae ROMANDAŞ

    2016-06-01

    Full Text Available In present, State Labour Inspectorate is the main supervisory body in health and safety at the work, and has all the rights to exercise an efficient control in order to target the compliance of employers of legal regulations which aim mentioned sphere. Therefore, the mechanism which involves changes in work culture, the most important from of them which refers to security and healthy of work place, take place in our society for harmonization and labor market adjustment. It is obviously that more units start to realize that human resources are most important capital of an organization and is the decisive factor in the production process. That’s why employers should be conscious about the fact that security of an employee it’s not an expanse, but a necessary investment to avoid some costs, direct or indirect caused by work stoppages in the case of a serious and imminent danger or in cases the most unfortunate, the consequences of accidents at work and occupational diseases.

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    Obi, C C. Vol 2, No 1 (2013) - Articles Inductivism and Science: An Appraisal of Scientific Methodology Abstract PDF. ISSN: 2227-5444. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...

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    RABOUDI, J. Vol 7, No 1 (2001) - Articles Calcul automatique de la stabilité des digues en terre compactée. Abstract. ISSN: 0796-5419. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...

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    Chahboune, Nouzha. Vol 93 (2015) - Articles Identification automatique des diatomées de la Merja fouarate : Une alternative à la détermination et à la classification manuelle. Abstract PDF. ISSN: 1997-5902. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

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    Baldé, S. Vol 1, No 1 (2001) - Articles Mesure automatique de la longueur de racines sur des images numérisées. Abstract. ISSN: 0851-4453. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

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    Legat, CK. Vol 8, No 2 (2000) - Articles An Application of the Transportation Model in the Distribution of UHT milk: The case of kenya Co-operative Creameries Ltd Abstract. ISSN: 0856-6372. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Samuel, NNC. Vol 4, No 1 (2015) - Articles Using Role Play to Teach Overpopulation to Basic Science Students: A Way Forward for Environmental Sustainability Abstract PDF. ISSN: 2227-5444. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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    Inuwa, Ibrahim. Vol 14, No 1 (2015) - Articles An Improved Data Warehouse Architecture for SPGS, MAUTECH, Yola, Nigeria Abstract PDF. ISSN: 1116-5405. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions ...

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    David-Okoro, IL. Vol 21, No 1 (2009) - Articles Solar electricity potentials and optimal angles for mounting solar panels in the six geopolitical zones of Nigeria Abstract. ISSN: 1595-0611. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

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    Odesanmi, AC. Vol 7, No 1&2 (2008) - Articles Jean Paul Sartre and the concept of determinism. Abstract. ISSN: 1596-6232. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News.

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    Falade, TO. Vol 30, No 3 (2010) - Articles Theoretical investigation of the performance of some environment-friendly refrigerants in a sub-cooling heat exchanger refrigeration system. Abstract PDF. ISSN: 0855-0395. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Akintunde, MA. Vol 30, No 3 (2010) - Articles Theoretical investigation of the performance of some environment-friendly refrigerants in a sub-cooling heat exchanger refrigeration system. Abstract PDF. ISSN: 0855-0395. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Bolaji, BO. Vol 30, No 3 (2010) - Articles Theoretical investigation of the performance of some environment-friendly refrigerants in a sub-cooling heat exchanger refrigeration system. Abstract PDF. ISSN: 0855-0395. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

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    Afrane, G. Vol 3, No 1 (2005) - Articles Analysis of the heat exchanger network of the topping unit of the Tema Oil Refinery Abstract · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...