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Journal articles on the topic "200310 Primary care"
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Li, Edward C., Kimberley J. Campbell, Bridgette Kanz Schroader, David Campbell, Stephen Chaplin, and Gary H. Lyman. "Trends in pegfilgrastim average sales price and cost-effectiveness of primary prophylaxis for patients at intermediate risk for febrile neutropenia." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 58. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.58.
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58 Background: The introduction of biosimilar colony-stimulating factors has led to the reduction in prices for these historically expensive therapies. To understand the impact of recent pricing trends on delivering efficient care, the cost-effectiveness of primary prophylaxis (PP) versus secondary prophylaxis (SP) using pegfilgrastim was assessed in patients with breast cancer, non–small-cell lung cancer (NSCLC), and non-Hodgkin lymphoma (NHL) receiving potentially curative chemotherapy at intermediate risk for febrile neutropenia per NCCN guidelines. Methods: A Markov decision analytic model was constructed from the US payer perspective over a lifetime horizon to evaluate pegfilgrastim PP versus SP in patients with breast cancer, NSCLC, and NHL receiving curative chemotherapy at intermediate risk of FN. Modeled chemotherapy regimens were adjuvant docetaxel (breast cancer), adjuvant carboplatin/paclitaxel (NSCLC), and R-CHOP (NHL) representing baseline FN risk of 16%, 18%, and 18%, respectively. Historical average sales prices (ASP) according to the Centers for Medicare and Medicaid Services of all pegfilgrastim products were obtained from January 2017 to April 2021. When more than one pegfilgrastim product was available, the average ASP was used as the cost input for the model. Cost-effectiveness for the base case scenario of each cancer type was evaluated over the range of years for cost per quality-adjusted life year (QALY) gained. Results: Pegfilgrastim as PP vs. SP provided an additional 0.069, 0.112, and 0.166 QALYs for breast cancer, NSCLC, and NHL, respectively. The peak ASP for pegfilgrastim was $4,554 per 6 mg during July 2018. Afterwards, a linear regression observed a declining ASP of approximately $134 dollars every 3 months to $3,024 per 6 mg during April 2021. At peak ASP, the incremental cost-effectiveness ratios (ICERs) for pegfilgrastim PP in patients with breast cancer, NSCLC, and NHL were $200,320, $113,942, and $103,495 per QALY, respectively. For April 2021, the ICERs were $124,845, $67,294, and $57,269 per QALY, respectively (Table). Conclusions: The trend of decreasing pegfilgrastim ASP improved the cost-effectiveness of PP vs. SP across intermediate risk breast cancer, NHL, and NSCLC indications between July 2018 to April 2021. For the most recent ASP, PP was cost-effective at a willingness-to-pay threshold of $100,000/QALY for NSCLC and NHL, and $150,000/QALY for breast cancer. This analysis provides support to expand the use of growth factor PP to intermediate risk patients. [Table: see text]
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"MANAGING DYSLIPIDAEMIA IN TYPE 2 DIABETES IN PRIMARY CARE." Practical Diabetes International 17, no. 7 (2000): S1—S8. http://dx.doi.org/10.1002/1528-252x(200010)17:7<::aid-pdi114>3.0.co;2-2.
Full textDissertations / Theses on the topic "200310 Primary care"
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Tatar, Mehtap. "Health for all by the year 2000 and primary health care : the Turkish case." Thesis, University of Nottingham, 1992. http://eprints.nottingham.ac.uk/13688/.
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This study aims at analyzing Turkish health policy from a Primary Health Care perspective as pronounced in Alma-Ata, 1978. The Alma-Ata Declaration has long been regarded as a watershed in the health field and 134 countries, including Turkey, have endorsed the Declaration showing their support for the views expressed in the Document. However, although the international community gave its full support, in practice, different interpretations and implementation of the principles have emerged. Turkey, one of the countries where health has rarely occupied the agenda, has been undergoing radical reforms since the mid 1980s with the ultimate aim of achieving Health for all by the Year 2000 through Primary Health Care. There is full commitment at the national policy-making level to endorse policies coherent with the principles of Alma-Ata. However, not all policies adopted seem to be consonant with what was declared in Alma-Ata requiring a detailed analysis of the policies suggested and implemented. In the light of this, the aims of the study are: (1) to analyze Turkish health policy since the 1960s from a Primary Health Care perspective with the aim of exploring the Turkish response to Alma-Ata; (2) to explore the perceptions of Turkish health policy-makers about Primary Health Care and related issues; (3) to discuss the prospects for Primary Health Care in Turkey. Basic principles of the Primary Health Care approach as declared in Alma-Ata have been taken as a guideline in analyzing Turkish health policy and the perceptions of the Turkish health policy-makers. These principles and their implementation, or the way they are perceived, have guided the research in answering the question ''what are the prospects for Primary Health Care in Turkey?" The nature of the research, based on document analysis and semi-structured interviews, has necessitated a qualitative stance. It was concluded that the Turkish version of Primary Health Care differs from the Declaration in a number of ways. A number of possible reasons for this have been offered. The perceptions of the policy-makers on certain issues that are closely related with the Approach, inter alia, has been found as one of the most possible explanations behind the current situation and a need to alter the ascendant approach towards health issues in general has been emphasized.
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Zimba, Anthony Andile. "A descriptive analysis of how primary health care services have developed in the Cape Metropolitan Area from the period: pre-1994 to post-2000 elections." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52632.
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Assignment (MPA)--University of Stellenbosch, 2002.ENGLISH ABSTRACT: Primary Health Care (PHC) approach is currently receiving tremendous attention worldwide as a mechanism to ensure effective and efficient public health services. The concept has evolved from the Alma Ata conference (1978). Since then many countries began to reorient their health services to achieve the goals of availability, accessibility and affordability of health care for all citizens and a number of management issues came to the forefront. Therefore, the provision of comprehensive PHC services is the key aspect to improving health services. A district health system has been identified as an ideal model for comprehensive PHC services to all the citizens in South Africa. Public health services in the Cape Metropolitan Area are characterised by functional fragmentation. Two public authorities render Primary Health Care services, namely the: Provincial Administration of the Western Cape through CHSO, and the Municipal Health Department. The fragmented nature of the public health services, which result in poor coordination of service delivery between the two health authorities, compromises the quality of service delivery. Historically, PHC services in the Cape Metropolitan Area - and indeed in the whole South Africa - have developed in a skewed manner. This work is an attempt at conceptualising the implications and consequences of this skewed health development. South Africa is presently undergoing fundamental reform, which has brought the PHC into disarray of fundamental change. Since the South African health care system is a highly complex institution, attempts have been made to critically analyse those aspects and features of inequality, inaccessibility, and inequity. Among these is the historical and present development of Cape Metropolitan Area health care and the structural features it assumed with the passing of time, trends and characteristics. In order to examine the theory in practice, the evolvement of PHC in the Cape Metropolitan Area will be analysed. The analysis highlights how different political formations have affected the development of PHC services and points out obstacles and limitations throughout the process, which had to be dealt with. Transformation of the existing health services, based on the principles of PHC, requires the redressing the imbalances of the past. Therefore, the integration of the two health authorities into one entity would best achieve the principles of district health system and will ensure comprehensive PRe.
AFRIKAANSE OPSOMMING: Die Primêre Gesondheidsorg benadering geniet tans wereldwyd erkenning as 'n meganisme om doeltreffende openbare gesondheidsdienslewering te versker. Die konsep, wat ontwikkel en gegroei het uit die Alma Ata-konferensie van 1978, is reeds deur verskeie regerings ge-implementeer ten einde die doelwitte van beskikbaarheid, toeganklikheid en bekostigbaarheid van gesondheidsorg vir alle landsburgers te verseker. Die voorsiening van omvattende Primêre Gesondheidsorgdienste word erken as 'n noodsaaklike middelom gesondheidsorg te verbeter. Die Distrikgesondheid-stelsel is geidentifiseer as 'n ideale model vir die implementering van omvattende Primêre Gesondheidsorgdienste in Suid Afrika. Publieke Gesondheidsdienste in die Kaapse Metropolitaanse-gebied word gekenmerk deur die feit dat dit funksioneel gefragmenteer is. Twee publieke owerhede, te wete die Provinsiale Administrasie van die Wes Kaap en die Kaapse Stadsraad lewer Primêre Gesondheidsorgdienste, wat aanleiding gee tot swak koordinering met die gevolg dat dienslewering daaronder ly. Primêre Gesondheidsdienste in die Kaapse Metropolitaansegebied, soos in die res van Suid Afrika, het op 'n onlogiese, skewe manier ontwikkel Hierdie werk is 'n poging om die gevolge en implikasies van die onlogiese, skewe gesondheids-ontwikkeling te konseptualiseer. Daar is gepoog om die uiters gekompliseerde gesondheidsdiens-stelsel in Suid Afrika krities te analiseer met spesifieke verwysing na die kenmenrke van ongelykheid, ontoeganklikheid en onbillikheid. Dit sluit die historiese en huidige ontwikkeling van gesondheidsorg in die Kaapse Metropolitaanse gebied en die strukturele kenmerke in wat deur die loop van jare as gevolg van verskeie invloede en neigings sigbar geraak het. Die ontwikkeling van Primêre Gesondheidsorg in die Kaapse Metropolitaanse-gebied word ge-analiseer ten einde bogenoemde teorie in die praktyk te bevestig. Die analise beklemtoon die invloed van verskillende politieke rolspelers op ,die ontwikkeling van Primêre Gesondheidsorgdienste en bevestig die struikelblokke en beperkings wat deurentyd opgeduik het. Transformasie van gesondheidsdienste soos dit tans daaruit sien, gegrond op die beginsels van Primêre Gesondheidsorg, vereis dat die ongelykhede van die verlede aangespreek word. Die integrasie van die twee gesondheidsdiensowerhede sal die beginsels van die Gesondheidsdistrik-stelsel verwesenlik, wat daartoe sal aanleiding gee dat omvattende Primêre Gesondheidsorg 'n werklikheid word.
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Adan, Hag Hersi Muna. "An exploration of strong opioid utilisation in non-cancer pain patients in UK primary care, 2000-2010." Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/53322/.
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Background Opioids are the most potent analgesics available and their treatment is well established in cancer and acute pain. However, their long-term use in non-cancer pain is worrisome due to insufficient evidence on long-term effectiveness and safety. Population-based research examining the utilisation of opioids in non-cancer pain patients in UK primary care remains limited and little information exists on patients receiving long-term therapy. Aims This thesis aimed to examine the demographics, clinical traits, prescribing patterns and healthcare use of non-cancer pain patients prescribed strong opioids in primary care, with a focus on long-term strong opioid use. Methods The thesis was a retrospective observational study using the Clinical Practice Research Datalink. Prescription data of four strong opioids (morphine, buprenorphine, fentanyl and oxycodone) issued between 2000-2010 to adults (aged ≥18 years) without cancer diagnosis 12 months within the date of first prescription use were included. The annual prevalence and incidence of non-cancer pain patients prescribed strong opioids over the 11 years were initially assessed using joinpoint regression analysis, and the users' demographic and clinical characteristics were explored descriptively. The numbers of prescriptions per patients, total number of days of drug supply, and total oral morphine equivalent daily dose (OMED) were subsequently calculated annually and compared between long-term (>90 days/year) and short-term (≤90 days/year) users. Multivariate linear regression modelling with generalized estimating equations was consecutively used to identify baseline and time-varying covariates linked to long-term strong opioid use. Lastly, long-term strong opioid users' primary and secondary healthcare use was quantified using CPRDs' data link with Hospital Episode Statistics (HES), and the nature of hospital admissions and patient-level factors of influence were determined by multivariate regression data analysis. Results A total of 135,941 non-cancer pain patients (63.34% female, mean age 66.34±17.98 years) were prescribed strong opioids and were included in the analysis. The incidence of long-term prescribing (>90 days) continued to increase by 16.96% per year (95%CI: 13.70%, 20.30%, p < 0.001) from 3.60 (95%CI: 3.38, 3.82) per 10,000 person-years in 2001 to 12.75 (95%CI: 12.41, 13.10) per 10,000 person-years in 2010. The mean number of pain diagnoses amongst long-term users was 3.00±2.16, with back pain, abdominal pain and osteoarthritis presenting the most common diagnostic disorders, and the mean number of co-morbidities was 2.04±1.70. Depression and anxiety were prevalent in 50.02% and 22.13% of long-term users, respectively. The mean daily oral morphine equivalent dose (OMED) of long-term users (95.88±109.03 mg/day/year) was almost twice that of short-term users (54.80±54.55mg/day/year). Over a quarter (26.01%) of long-term users received high oral morphine equivalent daily dose and their mean annual OMED was 221.19±148.07mg/day and mean annual days' supply was 277.05±84.55 days. Forty-one percent of long-term users had one or more all cause in-patient admissions during the study period, and a rising trend of admission spells was noted annually by 28.16% (95% CI: 26.40, 29.90, p < 0.001). Musculoskeletal pain disorders were the main cause of hospital admissions and re-admissions. Factors associated with hospitalisation included; greater GP visits per year (>3 consultations/year), >120mg morphine equivalent daily dose (aRR: 1.37; 95%CI: 1.27, 1.49) and co-prescriptions of psychoactive medications, including antidepressants (aRR: 1.07; 95%CI: 1.00, 1.14), benzodiazepines (aRR: 1.17; 95%CI: 1.09, 1.26) and non-benzodiazepines (aRR: 1.15; 95%CI: 1.05, 1.27). Conclusions Prescribing of strong opioids over the 11 years was characterized by a shift towards long-term prescribing. Primary care non-cancer pain patients exposed to strong opioids long-term were typified by multiple pain and co-morbid illnesses that included common psychiatric disorders, which suggest complex, and vulnerable, high-risk patients that are susceptible to negative health consequences. The thesis has identified several covariates linked to strong opioid-utilisation and healthcare use, which exemplifies key findings that can be used to inform clinical decision-making, targeted management interventions and monitoring of non-cancer pain patients treated with strong opioids long-term.
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Williams, Stephanie Ann Ross. "Development and organizational change in primary care : a study of local health groups in Wales 1999-2001." Thesis, Cardiff University, 2008. http://orca.cf.ac.uk/54523/.
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This study was designed to explore organizational change in primary health care, specifically the introduction of Local Health Groups which were meant to create radical change at local level across Wales. The aim was to gain a better understanding of the factors that influence the formation and development of organizations receptive to change. The specific questions included: firstly, what structural and organizational changes were made for the promotion and development of Local Health Groups Secondly, what leadership behaviours did the selected health professionals apply to their roles as Chairmen, in terms of building organizations capable of change and development And thirdly, what lessons can be learned for leadership and organisational reform, and policy implementation at local level for the future The policy decision to devolve decision-making in health care to primary care professionals at local level provided the opportunity to conduct a prospective study. A case study approach was selected to explore the experiences of all 22 Local Health Groups, through the reported experiences of the Chairmen as the lead figures responsible for forming and developing the new organizations. Data were collected using three waves of face-to-face interviews, supplemented with Minutes of Board Meetings tracing the study period: April 1999 to October 2001. Some limited observation of key events was also carried out. The study was conducted at a time of considerable turbulence in the health system in Wales. Firstly, it appears from this study that the structural changes made to implement the new policy were inadequate to that task. But some Chairmen appeared to exercise specific skills that enabled them to manage the consequent uncertainty in the system more comfortably than others. In addition, key leadership behaviours appeared to influence the development of change promoting organizations. These included strategic vision: the ability of the lead figures to articulate an attractive vision of the future, and persuade others to pursue it. Secondly, the ability to forge constructive working relationships with a wide variety of stakeholder organizations proved to be pivotal. Thirdly, the ability to identify key features of the organization and build on them to create unique organizational identities and services emerged as a key leadership behaviour in this context.
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Campos, Sandra Solange Leite. "HansenÃase no municÃpio de Sobral, CearÃ: anÃlise epidemiolÃgica e operacional das aÃÃes de eliminaÃÃo no perÃodo de 1997 a 2003." Universidade Federal do CearÃ, 2005. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=7589.
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Campos, S. S. L. HansenÃase no MunicÃpio de Sobral, CearÃ: AnÃlise EpidemiolÃgica e Operacional das AÃÃes de EliminaÃÃo no PerÃodo de 1997 a 2003. Fortaleza-Cearà 2005. DissertaÃÃo de Mestrado em SaÃde PÃblica [Epidemiologia] â Departamento de SaÃde ComunitÃria â Faculdade de Medicina â Universidade Federal do CearÃ. O cenÃrio polÃtico dos Ãltimos 20 anos vem permitindo grandes discussÃes e avanÃos no sentido da descentralizaÃÃo das aÃÃes na atenÃÃo bÃsica. A implementaÃÃo das aÃÃes de controle da hansenÃase no sistema pÃblico brasileiro mantÃm-se como um desafio constante, ainda presente no sÃculo XXI. Nesse contexto, o Programa de SaÃde da FamÃlia vem representando a estratÃgia para a reorientaÃÃo e reestruturaÃÃo do sistema Ãnico de saÃde. O presente estudo tem como objetivo principal descrever, do ponto de vista epidemiolÃgico, os fatores que influenciaram o processo de integraÃÃo das aÃÃes de controle da hansenÃase na atenÃÃo bÃsica no MunicÃpio de Sobral de 1997 a 2003. Tomou-se como base Sobral uma vez que representa um dos municÃpios cearenses considerados prioritÃrios, alÃm de ser um exemplo de sucesso do desenvolvimento da atenÃÃo bÃsica à saÃde. Foi reconstruÃdo o processo de eliminaÃÃo das aÃÃes de controle da hansenÃase na atenÃÃo bÃsica do MunicÃpio de Sobral a partir da descriÃÃo histÃrica no perÃodo de 1997 a 2003. A anÃlise dos indicadores epidemiolÃgicos e operacionais essenciais preconizados pelo Programa Nacional de EliminaÃÃo da HansenÃase no perÃodo de estudo permitiu o reconhecimento de altos coeficientes de detecÃÃo, principalmente em 2003. AlÃm disso, importantes inconsistÃncias relativas à anÃlise mais detalhada de variÃveis como idade, formas clÃnicas e classificaÃÃo operacional em 2003 sinalizam para a possibilidade de inadequaÃÃo diagnÃstica. Por fim, procedeu-se à contextualizaÃÃo do processo de descentralizaÃÃo das aÃÃes de controle da hansenÃase no MunicÃpio de Sobral relacionando-o aos indicadores epidemiolÃgicos no perÃodo. Ressalta-se nesse estudo a potencialidade do desenvolvimento da atenÃÃo integral aos pacientes com hansenÃase na atenÃÃo bÃsica, com efetivo envolvimento e controle dos movimentos sociais. Inclui-se nessa anÃlise a necessidade de se avaliar e monitorar o cenÃrio epidemiolÃgico mesmo em situaÃÃes em que se pressupostamente observa sucesso das aÃÃes de controle, como foi o caso do MunicÃpio de Sobral.Campos, S. S. L. Leprosy in the Municipality of Sobral, State of CearÃ: Epidemiological and Operational Analysis of Elimination Measures from 1997 to 2003. Fortaleza-Cearà 2005. Dissertation of Master Degree in Public Health [Epidemiology] - Department of Community Health - School of Medicine - Federal University of CearÃ. In the last 20 years, Brazilian health policy has been provoking fruitful discussions on the decentralization of the primary health care system. Even in the 21st century, the implementation of leprosy control measures on the public health level has been an ongoing challenge. In this context, the Family Health Program is a strategy for the reorientation and restructuring of the unified health system. This study has the objective to describe the epidemiologic factors that influenced the process of integration of leprosy control measures in the primary health care system in the Municipality of Sobral from 1997 to 2003. Sobral has been selected, as it represents one of the prioritized Municipalities for leprosy control in Cearà and as it is an example of successful implementation of an effective primary health care system. The process of leprosy elimination in the primary health care of Sobral was analyzed based on a retrospective description in the period from 1997 to 2003. The analysis of the epidemiological and operational indicators favored by the National Program of Leprosy Elimination, revealed high detection rates, mainly in 2003. Besides, considerable inconsistencies in age, clinical forms and operational classification indicate the possibility of diagnostic errors. Finally, in this study the process of integration of leprosy control measures in the Municipality of Sobral has been related to the epidemiological indicators. The possibility to develop integrated health care for leprosy patients in the primary health care system with effective involvement and control of community associations and other nongovernmental organizations is emphasized. The need to evaluate and monitor the epidemiology of leprosy, even in situations in which control measures seem to be successful, as it is the case with Sobral, is also discussed.
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Maimela, Eric. "Evaluation of tuberculosis treatment outcomes and the determinants of treatment failures in the Eastern Cape Province, 2003-2005." Diss., Pretoria: [s.n.], 2009. http://upetd.up.ac.za/thesis/available/etd-11262009-001135/.
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Wittchen, Hans-Ulrich, Petra Krause, Michael Höfler, Susanne Winter, Barbara Spiegel, Göran Hajak, Dieter Riemann, David Pittrow, Axel Steiger, and Hildegard Pfister. "NISAS-2000 - die "Nationwide Insomnia Screening and Awareness Study"." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-102912.
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ZIEL: Ermittlung der Stichtagsprävalenz von Insomnie und anderen Schlafstörungen in deutschen Allgemeinarztpraxen sowie Bestimmung hausärztlicher Erkennensraten. METHODIK: Bundesweite Zufallsauswahl von 539 Arztpraxen. Charakterisierung der Arzt- und Praxismerkmale mittels initialer Vorstudie. Darauf folgend eine Stichtagsbefragung aller Hausarzt-Patienten mittels Schlaffragebogen (PSQI) und klinischen Fragen (N = 19155 Fälle) sowie klinisch-ärztliche Beurteilung durch den behandelnden Artz mittels CGI und Fragebogen. ERGEBNISSE: 1. Trotz nur moderater Kompetenzeinschätzungen hinsichtlich Diagnose und Therapie behandeln Hausärzte Insomnien und andere Schlafstörungen vorwiegend selbst, auch wenn diese einen hohen Behandlungsaufwand erfordern. 2. Die Stichprobe kann als typisch für die Hausarzt-Klientel angesehen werden. 3. Schlafstörungen sind der dritthäufigste Konsultationsanlass. Nahezu jeder zweite Patient berichtete, in den vergangenen 2 Wochen unter Schlafbeschwerden gelitten zu haben, 26,5% erfüllten aufgrund der subjektiven Angaben die Studienkriterien (DSM-IV) für Insomnie. 4. Auch die Ärzte beurteilten 46,4% aller ihrer Patienten mittels CGI zumindest als Grenzfälle einer Schlafstörung, 85,6% wurden als chronisch eingeordnet. Die ärtzlich beurteilte Insomnieprävalenz betrug 25,9%, die anderer Schlafstörungen 13,7%. 5. Nur 54,3% aller Insomniepatienten wurden auch als solche vom Hausarzt diagnostiziert. DISKUSSION: Die Studie liefert erstmals bundesrepräsentative, differenzierte epidemiologische Daten zu der Prävalenz, dem Schweregrad, den Einschränkungen und den Verlaufsmustern von Insomnien und Schlafstörungen. Die außerordentlich große Häufigkeit und die zum Teil markanten Defizite hinsichtlich Erkennen und Diagnostik in der primärärztlichen Versorgungen werden diskutiertAIM: To estimate the point prevalence of insomnia, recognition and prescription behavior in primary care. METHODS: Nationwide sample of 539 primary care settings along with their characterization (stage 1). Standardized assessment of all attenders (N = 19.155 patients) on the NISAS target day using a sleep questionnaire (PSQI) and additional questions to cover psychosocial and additional clinical variables. All patients were evaluated by the primary care doctors using a standardized clinical appraisal questionnaire, including a CGI-rating. RESULTS: Prevalence insomnia according to DSM-IV was 26.5%. Recognition of presence of any clinically significant sleep disorder was 72%, recognition of insomnia was poor 54.3%. 85.6% of insomnia patients were rated as chronic. Close to 50% of all insomnia cases did not receive a specific insomnia therapy. Herbals, followed by hypnotics and sedatives and antidepressants were the three most frequent treatments applied, psychotherapy was only seldomly indicated. DISCUSSION: NISAS provides for the first time nationally representative estimates of interventions for insomnia in primary care. The relatively low treatment rates and the high proportion of chronic patients receiving longterm prescription of benzodiazepines seem to be critical. Priorities for future agenda to improve this situation are discussed
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Assis, Elisangela Gisele de. "A transferência da política do tratamento diretamente observado em diferentes níveis de gestão para o controle da tuberculose." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-06042016-200031/.
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Trata-se de estudo qualitativo desenvolvido por meio de análise de discurso cujo objetivo foi analisar a discursividade dos gestores em diferentes níveis de gestão sobre transferência da política do tratamento diretamente observado (TDO) no controle da tuberculose. Para isto, esta análise parte do contexto de decisão macropolítico para o contexto micropolítico tendo como cenário local o município de Ribeirão Preto-SP, considerado prioritário para o controle da doença. Foram entrevistados quatro sujeitos-gestores envolvidos com a política do TDO nas instâncias estadual, regional, municipal e no nível intermediário entre a regional e o município, mediante aceite de termo de compromisso. Os dados foram coletados no período de agosto a dezembro de 2013, as entrevistas foram audiogravadas, transcritas, respeitando-a na sua íntegra. O corpus da pesquisa foi composto por recortes, formação discursiva e marcas linguísticas, quais foram selecionados dos discursos dos sujeitos. A análise ocorreu mediante a fundamentação teórico-metodológica da Análise de Discurso (AD) de matriz francesa, que se sustenta sobre três vertentes teóricas: o Materialismo Histórico, a Linguística e a Psicanálise. Este tipo de análise não visa uma análise exaustiva horizontal ou de toda extensão do objeto de pesquisa, por entender que este não se esgota e que um discurso institui-se sempre em relação aos outros. Busca-se apoiar na exaustividade vertical com o intuito de contemplar o objetivo do trabalho e da temática abordada. Os dados foram organizados sob o eixo da temática da transferência de políticas e da temática da TB os quais apontaram para diferentes efeitos de sentido durante a transferência da política do TDO como o silenciamento, apagamento, polifonia, polissemia e contradição durante o processo de transferência desta política nos diferentes níveis de gestão, que passou gradativamente pelo processo de transferência autoritária para a transferência voluntária da maior instancia política para a menor. Destaca-se que no município este processo ocorreu de forma incompleta visto que não houve a superação do paradigma da desconcentração das ações de TB para a Atenção Primária em Saúde (APS)This qualitative study was conducted using discourse analysis, the objective of which was analyzed the reports of different level managers regarding policy transfer of Directly Observed Treatment (DOT) in the control of tuberculosis. This analysis starts with the context of macro-political decisions in the micro-political context and the local setting was the city of Ribeirão Preto, SP, Brazil, considered a priority in the control of the disease. Four managers involved with the DOT policy at the state, regional, and city levels and another manager in the intermediate level between region and city were interviewed after signing consent forms. Data were collected from August to December 2013. The interviews were recorded, transcribed, respecting it in its entirety. The study\'s corpus was composed of excerpts, discursive formations and linguistics marks, which were selected from the participants\' reports according to the guiding question. Analysis was based on the French theoretical-methodological framework of Discourse Analysis, which in turn is grounded on three theoretical aspects: the Historical Materialism, Linguistics and Psychoanalysis. An exhaustive horizontal analysis, or an analysis that encompasses the entire extent of the research\'s object, is not intended in this type of analysis because the topic is not exhausted and discourses are always instituted in relation to others. The objective is to be supported in vertical exhaustiveness to contemplate the objective of the study and the topic under study. Data were organized under policy transfer\' and tuberculosis\' thematic axis, which indicate different effects of meanings during DOT policy transfer, such as muting, blanking, polyphony, polysemy, and contradictions during this policy transfer process at the different levels of management, which gradually moved from an authoritative transfer to a voluntary transfer, from a higher political instance to a lower one. Nonetheless, this process was not completed in the city because the paradigm decentralizing TB actions from Primary Health Care (PHC) was not overcome
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Marold, Dorothee. "Primäre Strahlentherapie des Prostatakarzinoms in Nordbayern: "Patterns of Care" 1998-2000 : retrospektive Analyse von 148 Patienten in Nordbayern." kostenfrei, 2008. http://nbn-resolving.de/urn/resolver.pl?urn=nbn:de:bvb:20-opus-29056.
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Bastos, Rita Maria Rodrigues. "Avaliação da atenção primária à saúde no estado de Minas Gerais, entre 2000 e 2011, utilizando o indicador internações por condições sensíveis à atenção primária." Universidade Federal de Juiz de Fora, 2013. https://repositorio.ufjf.br/jspui/handle/ufjf/1680.
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FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais
A necessidade de se avaliar as políticas de saúde implementadas para a estruturação da atenção primária em todo o território nacional levou o Ministério da Saúde a institucionalizar indicadores de avaliação já utilizados em diversos países, entre eles, as Internações por Condições Sensíveis à Atenção Primária (ICSAP). Objetivo: Avaliar a atenção primária no Estado de Minas Gerais entre 2000 e 2011, com o uso do indicador ICSAP. Métodos: Trata-se de um estudo ecológico dos municípios mineiros, utilizando dados do Sistema de Informação Hospitalar, Sistema de Informação Ambulatorial, Departamento de Informática do Sistema Único Brasileiro, Censos 2000-2010 e dados do Instituto Brasileiro de Geografia e Estatística. A dimensão espacial correspondeu ao estado de Minas Gerais e a dimensão temporal teve como limites os anos de 2000 e 2011. Ambas foram submetidas a três recortes, para que a análise das ICSAP fossem realizadas sob diferentes perspectivas. Utilizou-se os municípios mineiros como unidades de análise, agregando-os por Regionais de Saúde (RS). Analisou-se as taxas de ICSAP quanto à permanência hospitalar, proporção de óbitos e relação com a cobertura pela Saúde da Família. Foram comparados os anos de 2000 e 2010. Posteriormente os municípios foram analisados no triênio 2009-2011, utilizando-se a análise das internações por infecções de rins e trato urinário sensíveis à atenção primária (IRTU-CSAP) em indivíduos enrte 40 e 59 anos, agregando-os por RS, porte populacional e cobertura pela saúde da família. As IRTU-CSAP foram analisadas, por sexo, quanto à permanência hospitalar, proporção de óbitos e os gastos com as internações. Por fim, analisou-se as causas mais freqüentes de ICSAP por sexo e faixa etária no município de Juiz de Fora, comparando-se os quadriênios 2002-2005 e 2006-2009. Para as análises estatísticas foram utilizados o Teste t para dados pareados, Anova seguida do teste post hoc de Scheffe e Dunnett T3 e correlação de pearson. Resultados: As taxas gerais de ICSAP no estado diminuíram entre 2000 e 2010, mas não foram observadas correlação com a expansão da Estratégia de Saúde da Família. As RS que apresentaram maiores taxas foram as de Ubá e Leopoldina. As causas mais freqüentes das hospitalizações foram a Insuficiência Cardíaca e as Gastroenterites. Algumas causas apresentaram aumento das taxas, a exemplo das Infecções de Rim e Trato Urinário, tornando-se a terceira causa mais freqüente no estado, em 2010. A permanência hospitalar e a proporção de óbitos por ICSAP aumentaram no estado. Juiz de Fora se destacou por ser sede de uma das 7 duas únicas RS que apresentaram elevação das taxas de ICSAP no estado. Conclusão: As iniciativas governamentais, como a expansão da Estratégia de Saúde da Família e a Regionalização da Saúde, não foram efetivas para a diminuição das internações por condições sensíveis à atenção primária em Minas Gerais. As características dos municípios influenciaram de formas distintas no comportamento das taxas, permanência hospitalar e proporção de óbitos por ICSAP. Evidencia-se aumento das desigualdades entre algumas Regionais de Saúde, o que alerta para a necessidade de se priorizar a estruturação da atenção primária em regiões do estado onde as internações potencialmente evitáveis permanecem mais elevadas.
The need to evaluate the health policies implemented for the structuring of primary care nationwide prompted the Ministry of Health to institutionalize assessment indicators already in use in several countries, including the indicator Hospitalizations for Primary Health Care Sensitive Conditions (HPHSC). Objective: To evaluate the primary care in the State of Minas Gerais, between 2000 and 2011, using the indicator HSPHC. Methods: This is an ecological study of Minas Gerais municipalities, using data from the Hospital Informations System, Ambulatory Information System, Computing Department of System Unique of Healph, and 2000- 2010 Census data from the Brazilian Institute of Geography and Statistics. The spatial dimension corresponded to the state of Minas Gerais and the temporal dimension was limited to the years between 2000 and 2011. Both were subjected to three selections, so that an analysis of HPHSC were performed under different views. Used the Minas Gerais municipalities as units of analysis, aggregating them by Regionals Health (RH). HPHSC rates were analyzed regarding to hospital stay, proportion of deaths and the relation with coverage by Family Health. The years between 2000 and 2010 were compared. Subsequently, the cities were analyzed in the three-years period 2009-2011, using the analysis of hospitalizations for infections of the kidneys and urinary tract sensitive to primary health (IKUT-PH) in individuals from 40 to 59 years, aggregated by RH, population size and coverage by family health. The IKUT-PH were analyzed by sex, regarding to hospital stay, number of deaths and costs of hospitalizations. Finally, were analyzed the most frequent causes of HPHSC by sex and age in the city of Juiz de Fora, comparing the four-years periods 2002-2005 and 2006-2009. For statistical analyzes we used the t test for paired data, ANOVA followed by post hoc Dunnett T3 and Scheffe test and correlation of Pearson. Results: Overall rates of HPHSC in the state declined between 2000 and 2010, but were not verified any correlations with the expansion on the Family Health Strategy. The RH showed that the highest rates were in Ubá and Leopoldina. The most frequent causes of hospitalization were heart failure and gastroenteritis. Some causes had higher rates, such as infections of the Kidney and Urinary Tract, making it the third most frequent cause in the state in 2010. The hospital stay and the proportion of deaths for HPHSC increased in the state. Juiz de Fora is highlighted as home to one of only two RH in which the HPHSC rate increased in the State. Conclusion: The governmental actions, such as the expansion of the Family Health Strategy and the Health Regionalization, were not efective on decreasing the HPHSC in Minas Gerais. The characteristics of the municipalities affected in different ways in the behavior of rates, hospital stay and proportion of deaths by HPHSC. It is evidenced an increase in inequalities among the Regionals Health, what warns to the need of structuring the primary care in some regions of the State where the hospitalization due to potentially avoidable causes remains high.
Books on the topic "200310 Primary care"
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E, Schadé, and Netherlands. Ministerie van Welzijn, Volksgezondheid en Cultuur. Stuurgroep Toekomstscenario's Gezondheidszorg., eds. Primary care and home care scenarios, 1990-2005: Scenario report commissioned by the Steering Committee on Future Health Scenarios. Dordrecht: Kluwer Academic Publishers, 1993.
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Moon, Graham. Policy and place: General medical practice in the UK. Houndmills, Basingstoke, Hampshire: Macmillan Press, 2000.
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Kolmos, Keith M. NASCAR 2000: Prima's Official Strategy Guide. Rocklin, USA: Prima Games, Prima Publishing, 1999.
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Mantelli, Alessandro. E-learning sostenibile per la didattica del giapponese Progettare per l’apprendimento autonomo. Venice: Fondazione Università Ca’ Foscari, 2021. http://dx.doi.org/10.30687/978-88-6969-554-4.
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With the Lisbon 2000 Strategy, the focus of education systems has shifted from contents to competencies and due to the constant update of new technologies, education has to be considered as a lifelong process. In this context, online technologies play an increasingly crucial role. While research on learning software has mainly focused on the contents and digital medium in teaching, this study examines aspects of the digital artifacts that have been rarely investigated but are fundamental to increase the learner’s motivation, including system, interface, navigation, and graphics. Specifically, this work develops a new framework to analyse user experience and sustainability strategies that have been implemented in the case study JaLea. The analysis of primary data, collected with surveys and interviews, allows determining whether these strategies are effective for the creation of e-learning systems that are useful for the learner’s personal study, as well as investigate possible developments for teaching environments.
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United Nations Children's Fund. (UNICEF). Eliminating social distance between north and south cost-effective goals for the 1990s. New York: UNICEF, 1989.
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Jaycox, Lisa H., Eunice C. Wong, Lynsay Ayer, and Wong Naftel. Evaluating the Implementation of the Re-Engineering Systems of Primary Care Treatment in the Military (RESPECT-Mil). RAND Corporation, The, 2015.
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Steering Committee Steering Committee on Future Health Scenarios, S. E. Kooiker, E. Schadé, W. G. W. Boerma, and H. J. Wennink. Primary Care and Home Care Scenarios 1990-2005: Scenario Report Commissioned by the Steering Committee on Future Health Scenarios. Springer London, Limited, 2012.
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Moon, Graham, and Nancy North. Policy and Place. Palgrave Macmillan, 2000.
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James A, Green. Part 2 The Post-Cold War Era (1990–2000), 46 The Great African War and the Intervention by Uganda and Rwanda in the Democratic Republic of Congo—1998–2003. Oxford University Press, 2018. http://dx.doi.org/10.1093/law/9780198784357.003.0046.
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This chapter considers the Great African War of 1998-2003. The first section sets out the factual context of the interventions of Uganda, Rwanda and (on a much lower scale) Burundi in the territory of the Democratic Republic of Congo (DRC). It also considers the counter-force employed by the DRC and other states acting in support of the DRC’s government. The second section considers the positions of the main state protagonists on both sides, as well as of international organisations and states not involved in the conflict. The third section analyses the legality of the actions of the various states involved, including – but not limited to – a consideration of the 2005 International Court of Justice merits decision in the Armed Activities (DRC v Uganda) case. The ad bellum implications of the conflict stretch beyond that decision, but the proceedings at the Court have become its primary legacy in this context.
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Martin, Daniel. Extreme Asia. Edinburgh University Press, 2015. http://dx.doi.org/10.3366/edinburgh/9780748697458.001.0001.
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This book explains and analyses the unprecedented rise in visibility of ‘cult’ Asian cinema in the UK, especially between the years 2000 and 2005. Considering multiple factors behind the cultural, critical and economic success of Asia cinema in the West, this book focuses specifically on the hugely influential and pioneering (if deeply problematic) Tartan Films (formerly Metro-Tartan) Asia Extreme brand. This book is structured as a series of case studies, examining different films, filmmakers and distribution events in order to sketch an historical overview of this developing film cycle, paying attention primarily to the marketing and critical reception of these films. The Asia Extreme brand incorporated multiple genres – primarily horror, action, and erotic thrillers – and also elided the differences between various national cinemas. The role of Orientalism in both the marketing and reception of films from Hong Kong, Japan, and South Korea is also examined in detail.
Book chapters on the topic "200310 Primary care"
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Kreimeier, U., S. Prückner, and K. Peter. "Permissive Hypotension during Primary Resuscitation from Trauma and Shock." In Yearbook of Intensive Care and Emergency Medicine 2001, 331–41. Berlin, Heidelberg: Springer Berlin Heidelberg, 2001. http://dx.doi.org/10.1007/978-3-642-59467-0_29.
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Eggimann, P., and D. Pittet. "Education as a Primary Tool for Prevention of Catheter-related Infections." In Yearbook of Intensive Care and Emergency Medicine 2001, 137–50. Berlin, Heidelberg: Springer Berlin Heidelberg, 2001. http://dx.doi.org/10.1007/978-3-642-59467-0_13.
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Bramwell, Donna, Kath Checkland, Jolanta Shields, and Pauline Allen. "2000s: Transforming Community Services." In Community Nursing Services in England, 61–73. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-17084-3_6.
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AbstractThe new millennium saw the publication of The NHS Plan in 2000, which bought a welcome focus to community health services (CHS) and the role of community nursing. We outline the proposals contained in the plan which furthered the quasi-marketisation of the NHS and increased commissioning of health care at the local level of Primary Care Trusts (PCTs)—replacing Health Authorities (HAs) and Primary Care Groups (PCGs). A further review by Lord Darzi and subsequent policy, Transforming Community Services: Enabling new patterns of provision (DoH, 2009) instigated the separation of commissioning/provision and laid out timetables for how PCTs were to do this. The long held roles of the district nursing service continues in this era, although not always clearly defined, understood or acknowledged and policy attempts to expand their remit feature heavily. This included more clinical tasks as well as focusing on such things as public health/health protection and promotion programmes that improve health and reduce inequalities. This chapter also describes the uncertainty for frontline nurses that the Transforming Community Services (TCS) brought in terms of who their employer would be or what management arrangements they would work under given the establishment of some standalone Trusts, some third sector and some combined acute/community Trusts. The aims of the TCS programme were bold but in reality achieved little by the end of the era.
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Reith, Gerda, and Heather Wardle. "The Framing of Gambling and the Commercial Determinants of Harm: Challenges for Regulation in the UK." In The Global Gambling Industry, 71–86. Wiesbaden: Springer Fachmedien Wiesbaden, 2022. http://dx.doi.org/10.1007/978-3-658-35635-4_6.
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AbstractThis article argues that the framing of gambling is crucial for how it is dealt with at every level; from legislative, regulatory and commercial practice to the terms of media and civic debate. Whoever frames the debate has power over the ways that we can and cannot think about gambling, as well as what we can do about it.We take the example of Britain as a case study in which, despite recent repeated calls for gambling to be regarded as a public health issue, it continues to be framed primarily in terms of economic activity and consumerism. We argue that this framing is the product of a particular political-economic model and that it is embedded in legislation and regulatory practice. We go on to describe the commercial landscape of gambling that has been produced by this framework as one which produces harm. As such, we make the point that framing is a key component of the commercial determinants of harm in gambling. The final section of our paper considers the various forms of political and commercial influence that infiltrate and shape the framing of gambling in Britain. This work was funded by Wellcome Trust through a Humanities and Social Sciences Fellowship to Heather Wardle (grant number: 200306).
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Anderson, James G., and E. Andrew Balas. "Computerization of Primary Care in the United States." In Handbook of Research on Advances in Health Informatics and Electronic Healthcare Applications, 385–409. IGI Global, 2010. http://dx.doi.org/10.4018/978-1-60566-030-1.ch023.
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The objective of this study was to assess the current level of information technology use by primary care physicians in the U.S. Primary care physicians listed by the American Medical Association were contacted by e-mail and asked to complete a Web-based questionnaire. A total of 2,145 physicians responded. Overall, between 20% and 25% of primary care physicians reported using electronic medical records, e-prescribing, point-of-care decision support tools, and electronic communication with patients. This indicates a slow rate of adoption since 2000. Differences in adoption rates suggest that future surveys need to differentiate primary care and office-based physicians by specialty. An important finding is that one-third of the physicians surveyed expressed no interest in the four IT applications. Overcoming this barrier may require efforts by medical specialty societies to educate their members in the benefits of IT in practice. The majority of physicians perceived benefits of IT, but they cited costs, vendor inability to deliver acceptable products, and concerns about privacy and confidentiality as major barriers to implementation of IT applications. Overcoming the cost barrier may require that payers and the federal government share the costs of implementing these IT applications.
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Campbell, John. "Appendix 1 Primary Care in the New Medical Schools." In Academic General Practice in the UK Medical Schools, 1948–2000, 123–30. Edinburgh University Press, 2011. http://dx.doi.org/10.1515/9780748643745-037.
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Welzant, J. Heather. "Impact on Learner Experience." In Developments in Intelligent Agent Technologies and Multi-Agent Systems, 292–304. IGI Global, 2011. http://dx.doi.org/10.4018/978-1-60960-171-3.ch018.
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This qualitative case study investigated how the integration of a Problem-Based Learning (PBL) curriculum in an online MBA program impacted the learner experience. The learner experience included three stances as created by Savin-Baden (2000). The stances were personal, pedagogical and interactional. The overarching theme was to examine the experiences of eight learners all in different BPL courses and at different stages in an online MBA program (the beginning, the middle and at the end of the program). The primary research question was: How does problem-based learning (PBL) in online MBA courses impact the learner experience? Purposeful sampling, specifically multiple variation sampling was chosen. The data was collected in accordance with Yin’s (2003) five key components derived from documentation, archival records and interviews. The variety of data collection methods served to triangulate sources corroborating findings and offsetting the pitfalls of any one given method. Data analysis consisted of the constant comparison method using NVivo7 as the primary data management tool. Key findings correlated with the Savin-Baden (2000) study revealing how the stances were interdependent upon one another.
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O’Hara, Michael W., and Lisa S. Segre. "Perinatal depression across the world: Prevalence, risk factors, and detection in primary care." In Perinatal Psychiatry. Oxford University Press, 2014. http://dx.doi.org/10.1093/oso/9780199676859.003.0011.
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This chapter, like the entire volume, is dedicated to the memory of Channi Kumar. I first met Channi in August 1984 in Oakland, California, at the biennial meeting of the Marcé Society, hosted by James Hamilton. I had already been impressed by Channi’s research but knew him only through his published work. In person, the man did not disappoint. He was elegant and kind, a man who treated everyone with respect. Over the years, my affection and admiration for Channi grew through many stimulating discussions and delightful social occasions. Even our last series of meetings focused on a new, exciting initiative of Channi’s: the ‘Transcultural Study,’ which he envisioned as a way to harmonize the detection, assessment, and treatment of perinatal mood disorders, across western Europe and even the United States, Asia, and Africa. Through experiences like these, Channi made my life richer, personally and professionally; and I greatly miss him as a mentor and a friend, and feel privileged, along with my colleague Lisa Segre, to contribute a small piece to honor this great psychiatrist and humanitarian. Michael W. O’Hara Perinatal depression is a significant mental health problem that afflicts women around the world at a time when they are highly vulnerable—pregnant or managing a new infant. In one form or another, perinatal depression has been recognized for thousands of years; however, only in the past 50 years has there been a sustained focus on the non-psychotic mental illnesses experienced by some during pregnancy and the postpartum period. The literature of the 1960s contains only a few papers with the words postpartum depression, postnatal depression, or perinatal depression. Not until the 1970s did these terms come into common use. Indeed, a search for at least one of these terms on the PsycNET database (from entries catalogued between 1884 and 9 September 2012) revealed the vast majority (2,743 or 75%) of 3,651 papers, books, and book chapters on perinatal depression were published after 2000. These findings show how work in the field of perinatal mental illness has expanded exponentially.
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Eduarda Serafim Crispim, Maria, Gabriela Trigueiro Lopes Ramalho, Flaviana Ribeiro Coutinho de Mendonça Furtado, Beatriz Ribeiro Coutinho de Mendonça Furtado, Gabriela Braga Santos, and Raoany Pontes Guerra. "PRIMARY CARE AS A TOOL TO FIGHT VIOLENCE AGAINST WOMEN: AN INTERNATIONAL APPROACH." In Estudos Interdisciplinares em Ciências da Saúde, 142–46. Editora Acadêmica Periodicojs, 2022. http://dx.doi.org/10.51249/easn05.2022.840.
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Introduction: Domestic violence against women is recognized as a global public health problem, requiring strategic direction. The WHO in its global plan to address interpersonal violence stated that there are four strategic directions: strengthening health system governance, strengthening health service delivery and professional response capacity, strengthening program prevention, and improving information and evidence. The most mental health sequelae for female victims are depression, anxiety, post-traumatic stress disorder, and substance use. The role of primary care varies, starting with preventing, identifying and evaluating women, being a longitudinal care, as it is common for aggression to be repeated. The aim of this study is to assess how different countries deal with violence against women, and thus, indicate effective forms of intervention. Methodology: This is a literature review study, with a qualitative approach. A search was carried out in the PubMed database with the descriptors “Domestic and Sexual Violence against Women” and “primary care” between the years 2003 to 2020. After eligibility criteria, eleven articles were selected, all in English. Results: Studies from different countries were found. Each country with a cut of the theme related to cultural disparities. So in India it was discussed how loveless marriages arranged by families can be related to domestic violence. In Canada, there is a study of ways to approach women victims of intimate partner violence. Some people argued that health professionals should ask women about domestic violence. They argue that ‘screening’ can encourage revealing abuse or acknowledging their own experience as violence. Others argue that such screening should be targeted at high-risk groups. Studies have suggested that women have a preference for screening methods that do not involve health professionals, given the sensitive nature of domestic violence. Personalized online interactions are currently being studied to help women in situations of violence. These can improve access to information and support for safety and well-being planning, particularly for women who are reluctant. Conclusion: It is necessary to train professionals to identify and approach violence against women, in addition, it is necessary to formulate well-defined public policies that guarantee comprehensive care. Increasing screening sensitivity, appropriate treatment for physical and psychological sequelae.
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Lai, Daniel T. H., Jussi Pakkanen, Rezaul Begg, and Marimuthu Palaniswami. "Computational Intelligence and Sensor Networks for Biomedical Systems." In Encyclopedia of Healthcare Information Systems, 261–73. IGI Global, 2008. http://dx.doi.org/10.4018/978-1-59904-889-5.ch036.
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Sensor networks (SN) is an emergent technology which combines small sensors outfitted with wireless transmitters to form a network with more powerful sensing capabilities (Akyildiz, Su, Sankarasubramaniam, & Cayirci, 2002; Chong & Kumar, 2003). The primary application for SN technology is monitoring environmental changes making it ideal for deployment in patient monitoring systems. In contrast to other monitoring technologies such as video, SN offers a potentially cheaper solution consisting of cost effective interconnected sensors which cooperatively sense the surroundings. Individual sensor information is then fused to derive an instantaneous description of the environment. In this article, we review briefly the recent applications of CI and SN technologies in health care, mentioning some of the challenges in deploying these technologies. This is followed by an example of a biomedical system incorporating both technologies in a single paradigm. The state of current systems and their advantages over existing methods are highlighted with examples focusing primarily on intelligent automated diagnostic systems to augment clinician diagnoses and health care monitoring systems for continuous patient observation.
Conference papers on the topic "200310 Primary care"
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Clarke, M., and R. W. Jones. "An IT approach to cardiovascular care based on primary care." In Computers in Cardiology, 2003. IEEE, 2003. http://dx.doi.org/10.1109/cic.2003.1291102.
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Gómez, MC García, C. Galisteo, MP Lisbona, M. Sanmartí, M. Castellanos, N. Navarro, and C. Alegre. "AB0229 Influence of rheumatologist in primary care." In Annual European Congress of Rheumatology, Annals of the rheumatic diseases ARD July 2001. BMJ Publishing Group Ltd and European League Against Rheumatism, 2001. http://dx.doi.org/10.1136/annrheumdis-2001.777.
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Carey, Iain, Emma Banchoff, Niranjanan Nirmalananthan, Tess Harris, Stephen DeWilde, Umar Chaudhry, and Derek Cook. "OP89 Prevalence and incidence of recorded neuromuscular conditions in primary care in the UK between 2000 and 2019." In Society for Social Medicine Annual Scientific Meeting Abstracts. BMJ Publishing Group Ltd, 2021. http://dx.doi.org/10.1136/jech-2021-ssmabstracts.89.
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Rosenberger, G. Walter, Peter E. Klauser, George P. Binns, and Gary P. Wolf. "Using Parametric Simulation to Optimize Suspension Design." In ASME 2003 International Mechanical Engineering Congress and Exposition. ASMEDC, 2003. http://dx.doi.org/10.1115/imece2003-55257.
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A project to design and implement suspension improvements to Amtrak’s F-40 Non-Powered Control Unit (NPCU) cars is described. The cars, built from former F-40 locomotives, had a history of poor ride quality. Rail Sciences Inc. (RSI) inspected one of the cab cars and measured its ride quality. Peter Klauser modeled the vehicle in NUCARS™ and validated the model against the test data. The vehicle response was primarily in pitch and bounce modes. To optimize the suspension, Klauser simulated vehicle response for a range of four suspension parameters: primary stiffness and damping, and secondary stiffness and damping. Nearly 2600 suspension combinations were considered. Simulation file setup and data analysis were performed automatically using parameter analysis software interacting with NUCARS™. The result was a five-dimensional response contour for each output variable, such as the engineer’s seat vertical and lateral accelerations, and car body acceleration. The most cost effective stiffness and damping parameters were selected from the response contour and translated into component specifications. RSI then provided Amtrak with new axle box springs and dampers, and re-tested the vehicle. The test result closely followed the predicted results from the simulation. Engineer’s seat vertical and cab lateral accelerations improved by 42% and 32% respectively for the worst-case conditions in the test territory.
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Geba, GP, JR Lisse, M. Perlman, AB Polis, ME Dixon, CS Skalky, T. Dobbins, et al. "SAT0096 Gastrointestinal tolerability in primary care patients treated with naproxen or rofecoxib for osteoarthritis (oa): the advantage trial." In Annual European Congress of Rheumatology, Annals of the rheumatic diseases ARD July 2001. BMJ Publishing Group Ltd and European League Against Rheumatism, 2001. http://dx.doi.org/10.1136/annrheumdis-2001.471.
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Medici, Bjarke, Birte Nygaard, Jeppe la Cour, Mia Grand, Volkert Siersma, Dagny Nicolaisdottir, Bent Lind, Niels Olivarius, and Christen Andersen. "40 Changes in prescription routines for treating hypothyroidism between 2001 and 2015 – a population-based study of 929,684 primary care patients in copenhagen." In Preventing Overdiagnosis, Abstracts, August 2018, Copenhagen. BMJ Publishing Group Ltd, 2018. http://dx.doi.org/10.1136/bmjebm-2018-111070.40.
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Arzhaev, Alexey, and Sergey Butorin. "Improvement of Integrity Concepts for NPP Primary Circuit Piping." In ASME 2008 9th Biennial Conference on Engineering Systems Design and Analysis. ASMEDC, 2008. http://dx.doi.org/10.1115/esda2008-59586.
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Operating NPPs license extension activities in Russia produced strong demand for safety improvement of plants build according to earlier standards. Installation of additional supports as pipe whip restraints is one of requirement in acting regulatory documentation which should be followed or compensated by appropriate measures like Leak Before Break (LBB) analyses and improvement of In-Service Inspection (ISI) and Leak Detecting System (LDS). Basic document for LBB concept application to Russian NPP piping is RD 95 10547-99. Its requirements correspond to classical LBB principles used in many countries in Europe, USA and Japan. In many real cases requirements of RD 95 10547-99 could not be applied to safety important NPP piping systems due to the presence of specific features of operational degradation due to some corrosion mechanisms: for example, erosion-corrosion (E-C) for carbon steel piping and intergranular stress corrosion cracking (IGSSC) for heat affected zones of austenitic piping weldments. For special case of RBMK piping with outer diameter 325 mm (potentially susceptible to IGSCC) special Break Preclusion Concept has been developed in Russia after IAEA Extrabudgetary Program in 2000–2002. Contrary to LBB Concept demanding for all four basic principles to be completely fulfilled BP Concept accepts some principles to be fulfilled in a balanced way with demonstration of monitored degradation effectively achieved in operation. Special BP Concept is being developed now to support integrity assessment of RBMK carbon steel steam and feed water piping potentially susceptible to E-C which requires another set of measures to demonstrate principle of controlled degradation in operation then in case of austenitic steel piping. General scheme of piping integrity analyses according to LBB and BP Concepts is discussed and examples of specific approaches to achieve controlled degradation are illustrated in paper. As result of LBB and BP Concepts application it is possible to substantiate reject of additional piping whip restraints implementation on-site. Examples of similar safety methodology development in other countries have been reported at IAEA Specialists Meeting on LBB in Kiev, Ukraine in November 2006.
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Kielb, Robert E., John W. Barter, Jeffrey P. Thomas, and Kenneth C. Hall. "Blade Excitation by Aerodynamic Instabilities: A Compressor Blade Study." In ASME Turbo Expo 2003, collocated with the 2003 International Joint Power Generation Conference. ASMEDC, 2003. http://dx.doi.org/10.1115/gt2003-38634.
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In this paper, we investigate non-synchronous vibrations (NSV) in turbomachinery, an aeromechanic phenomenon in which rotor blades are driven by a fluid dynamic instability. Unlike flutter, a self-excited vibration in which vibrating rotor blades and the resulting unsteady aerodynamic forces are mutually reinforcing, NSV is primarily a fluid dynamic instability that can cause large amplitude vibrations if the natural frequency of the instability is near the natural frequency of the rotor blade. In this paper, we present both experimental and computational data. Experimental data was obtained from a full size compressor rig where the instrumentation consisted of blade-mounted strain gages and case-mounted unsteady pressure transducers. The computational simulation used a three-dimensional Reynolds averaged Navier-Stokes (RANS) time accurate flow solver. The computational results suggest that the primary flow features of NSV are a coupled suction side vortex shedding and a tip flow instability. The simulation predicts a fluid dynamic instability frequency that is in reasonable agreement with the experimentally measured value.
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Aliza, Ana Dyah, and Farida Kartini. "Student Perception of the Preceptorship Model in Midwifery Care: A Scoping Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.43.
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ABSTRACT Background: Preceptorship is a time-limited, education-focused model for teaching and learning within a clinical environment that uses a clinical staff as role models. Its primary goal is to assist new staff and students in adapting to their roles, develop clinical skills and socialize the novice to a department or institution. This difference has caused various opinions from related parties. This study aimed to determine the implementation of a tutorial system from different levels of student education to the entire midwifery health care system. Subjects and Method: A scoping review method was conducted in eight stages including (1) Identification of study problems; (2) Determining priority problem and study question; (3) Determining framework; (4) Literature searching; (5) Article selection; (6) Critical appraisal; (7) Data extraction; and (8) Mapping. The search included PubMed, Wiley, Google Scholar, dan Sciendirect. The inclusion criteria were English-language and full-text articles published between 2000 and 2019. The data were selected by the PRISMA flow chart. Results: Ten articles from total of 803 articles found. It was divided into two categories: Elements in the preceptorship model and application of preceptorship. Preceptorship can help preceptors to improve teaching effectiveness and create an effective learning environment so that preceptors can perform clinical skills to improve the quality of education. The problem that arises in preceptorship in many student reports is the difficulty students experience in finding their clinical practice area. Professional organizations provide several solutions to the issues that occur in a preceptorship, one of which is paying attention to student attendance and facilitating students to give input and ideas. Conclusion: The application of the principles in the practice of midwifery clinics varies because the guideline instruments are not standardized. Keywords: Perspectives, Preceporship, Students, Midwifery Correspondence: Ana Dyah Aliza, Universitas ‘Aisyiyah Yogyakarta. Jalan Ringroad Barat No.63, Mlangi, Nogotirto, Gamping Sleman, Yogyakarta, Email: anadyahaliza@gmail.com Mobile: 085600072744. DOI: https://doi.org/10.26911/the7thicph.03.43
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Hodges, Richard N. "Active Draft Cushioning in Unit Train Service." In ASME 2001 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2001. http://dx.doi.org/10.1115/imece2001/rtd-25707.
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Abstract Since the 1960’s, end-of-car cushioning has been a critical technology for rail cars that carry fragile commodities such as automobiles, airplane components, newsprint or coiled metal rolls. Because the primary benefit of the technology has been in impact protection, these units have historically returned back to the draft stops after an impact in order to maximize the protection available for subsequent impacts. This technology often did not provide the best protection for the car during in-train service, when buff and draft slack action put significant shocks into the car and cargo. Once returned to the draft stops, the cushioning unit offers no further protection from draft slack action during train movement. This results in potentially high draft coupler forces. A new cushioning technology, called active draft preload, provides improved control of in-train forces by positioning the cushioning device several inches from the draft stops so that adequate protection is provided for the in-train environment. Testing conducted in unit train service has documented the improvement in ride quality obtained from active draft cushioning applied to the rail cars.
Reports on the topic "200310 Primary care"
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Berkman, Nancy D., Eva Chang, Julie Seibert, Rania Ali, Deborah Porterfield, Linda Jiang, Roberta Wines, Caroline Rains, and Meera Viswanathan. Management of High-Need, High-Cost Patients: A “Best Fit” Framework Synthesis, Realist Review, and Systematic Review. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer246.
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Background. In the United States, patients referred to as high-need, high-cost (HNHC) constitute a very small percentage of the patient population but account for a disproportionally high level of healthcare use and cost. Payers, health systems, and providers would like to improve the quality of care and health outcomes for HNHC patients and reduce their costly use of potentially preventable or modifiable healthcare services, including emergency department (ED) and hospital visits. Methods. We assessed evidence of criteria that identify HNHC patients (best fit framework synthesis); developed program theories on the relationship among contexts, mechanisms, and outcomes of interventions intended to change HNHC patient behaviors (realist review); and assessed the effectiveness of interventions (systematic review). We searched databases, gray literature, and other sources for evidence available from January 1, 2000, to March 4, 2021. We included quantitative and qualitative studies of HNHC patients (high healthcare use or cost) age 18 and over who received intervention services in a variety of settings. Results. We included 110 studies (117 articles). Consistent with our best fit framework, characteristics associated with HNHC include patient chronic clinical conditions, behavioral health factors including depression and substance use disorder, and social risk factors including homelessness and poverty. We also identified prior healthcare use and race as important predictors. We found limited evidence of approaches for distinguishing potentially preventable or modifiable high use from all high use. To understand how and why interventions work, we developed three program theories in our realist review that explain (1) targeting HNHC patients, (2) engaging HNHC patients, and (3) engaging care providers in these interventions. Theories identify the need for individualizing and tailoring services for HNHC patients and the importance of building trusting relationships. For our systematic review, we categorized evidence based on primary setting. We found that ED-, primary care–, and home-based care models result in reduced use of healthcare services (moderate to low strength of evidence [SOE]); ED, ambulatory intensive caring unit, and primary care-based models result in reduced costs (low SOE); and system-level transformation and telephonic/mail models do not result in changes in use or costs (low SOE). Conclusions. Patient characteristics can be used to identify patients who are potentially HNHC. Evidence focusing specifically on potentially preventable or modifiable high use was limited. Based on our program theories, we conclude that individualized and tailored patient engagement and resources to support care providers are critical to the success of interventions. Although we found evidence of intervention effectiveness in relation to cost and use, the studies identified in this review reported little information for determining why individual programs work, for whom, and when.
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Khan, Mahreen. The Environmental Impacts of War and Conflict. Institute of Development Studies, March 2022. http://dx.doi.org/10.19088/k4d.2022.060.
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In modern warfare, the first widely acknowledged scientific study and documented case of environmental damage during conflict was the (direct and deliberate) use of Agent Orange and other toxic chemicals by US forces, from 1961-1971, during the Vietnam War in a policy known as herbicide. The Vietnam War has been relatively well documented for the sheer horror and magnitude of the devastation to natural habitats and because it was the first war where television and global media brought vivid images and accounts into people’s homes, making the war a matter of political and public conscience This helped stir academic and scientific interest and facilitated evidence collection and documentation of environmental damages. This helpdesk report is a rapid literature review on the main environmental impacts of war and conflict, drawing primarily on academic, and peer reviewed literature and only some policy and practitioner sources, as per the request. Where current situations are discussed, such as the ongoing Ukraine war, a few blogs are referred to. Within the literature focused on the environmental impacts of conflict, common case studies include: the North Atlantic Treaty Organisation (NATO) bombing of Kosovo (1999), and the conflict in the Donbas region of Ukraine (2014). Interestingly there is comparatively less literature on the conflicts in Afghanistan (2001-2021), the Iraq-Iran War (1980-1988), the Gulf Wars (1991 and 2003), the Yemeni civil war (2014 – present) and the ongoing war in Syria (since 2011) despite their relatively greater severity, intensity and duration.
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Uhl, Stacey, Shazia Mehmood Siddique, Liam McKeever, Aaron Bloschichak, Kristen D’Anci, Brian Leas, Nikhil K. Mull, and Amy Y. Tsou. Malnutrition in Hospitalized Adults: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer249.
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Objectives. To review the association between malnutrition and clinical outcomes among hospitalized patients, evaluate effectiveness of measurement tools for malnutrition on clinical outcomes, and assess effectiveness of hospital-initiated interventions for patients diagnosed with malnutrition. Data sources. We searched electronic databases (Embase®, MEDLINE®, PubMed®, and the Cochrane Library) from January 1, 2000, to June 3, 2021. We hand-searched reference lists of relevant studies and searched for unpublished studies in ClinicalTrials.gov. Review methods. Using predefined criteria and dual review, we selected (1) existing systematic reviews (SRs) to assess the association between malnutrition and clinical outcomes, (2) randomized and non-randomized studies to evaluate the effectiveness of malnutrition tools on clinical outcomes, and (3) randomized controlled trials (RCTs) to assess effectiveness of hospital-initiated treatments for malnutrition. Clinical outcomes of interest included mortality, length of stay, 30-day readmission, quality of life, functional status, activities of daily living, hospital acquired conditions, wound healing, and discharge disposition. When appropriate, we conducted meta-analysis to quantitatively summarize study findings; otherwise, data were narratively synthesized. When available, we used pooled estimates from existing SRs to determine the association between malnutrition and clinical outcomes, and assessed the strength of evidence. Results. Six existing SRs (including 43 unique studies) provided evidence on the association between malnutrition and clinical outcomes. Low to moderate strength of evidence (SOE) showed an association between malnutrition and increased hospital mortality and prolonged hospital length of stay. This association was observed across patients hospitalized for an acute medical event requiring intensive care unit care, heart failure, and cirrhosis. Literature searches found no studies that met inclusion criteria and assessed effectiveness of measurement tools. The primary reason studies did not meet inclusion criteria is because they lacked an appropriate control group. Moderate SOE from 11 RCTs found that hospital-initiated malnutrition interventions likely reduce mortality compared with usual care among hospitalized patients diagnosed with malnutrition. Low SOE indicated that hospital-initiated malnutrition interventions may also improve quality of life compared to usual care. Conclusions. Evidence shows an association between malnutrition and increased mortality and prolonged length of hospital stay among hospitalized patients identified as malnourished. However, the strength of this association varied depending on patient population and tool used to identify malnutrition. Evidence indicates malnutrition-focused hospital-initiated interventions likely reduce mortality and may improve quality of life compared to usual care among patients diagnosed with malnutrition. Research is needed to assess the clinical utility of measurement tools for malnutrition.
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McNaught, Tim. A Problem-Driven Approach to Education Reform: The Story of Sobral in Brazil. Research on Improving Systems of Education (RISE), March 2022. http://dx.doi.org/10.35489/bsg-rise-ri_2022/039.
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For more than two decades, the Brazilian municipality of Sobral has focused intensively on improving the quality of its public education system; the resulting success has been remarkable. In 2005, the Brazilian federal government started calculating a Basic Education Development Index (IDEB in Portuguese), which measures the quality of education in schools across the country. In the inaugural results in 2005, 1,365 municipalities had a better score for primary education than Sobral. By 2017, Sobral made national news by ranking number one in the entire country for both primary and lower secondary education (Cruz and Loureiro, 2020). These results are even more impressive when considering that Sobral is located in the northeastern state of Ceará, which is the fifth poorest state in Brazil in terms of GDP per capita (Cruz and Loureiro, 2020). The case of Sobral exhibits many elements that are similar to Problem Driven Iterative Adaptation (PDIA), an approach wherein problems are key to driving change (Andrews et al., 2015). The PDIA approach relies on reformers to identify problems that matter, break them down into their root causes, identify entry points, act, stop to reflect, and then iterate and adapt their way to a solution.1 This process of constant feedback and experimentation by local actors allows for the development of a solution that fits the local context. This paper explores the transformation of Sobral’s education system through the lens of PDIA2 , with an emphasis on the early reform period of 2000-2004. Many excellent papers have been written, in Portuguese and English, about the case of Sobral; this paper draws heavily on this existing literature.3 The paper is also supported by interviews from key individuals who either were closely involved with the reform efforts or have studied them. The paper follows the narrative of the Sobral story, starting in 1997, and uses boxes and other diagrams to view the reform efforts through the lens of PDIA. Finally, the paper explains how the reform efforts grew and scaled over the years, not only within Sobral, but also to other municipalities in Ceará and across Brazil.
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Ossoff, Will, Naz Modirzadeh, and Dustin Lewis. Preparing for a Twenty-Four-Month Sprint: A Primer for Prospective and New Elected Members of the United Nations Security Council. Harvard Law School Program on International Law and Armed Conflict, December 2020. http://dx.doi.org/10.54813/tzle1195.
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Under the United Nations Charter, the U.N. Security Council has several important functions and powers, not least with regard to taking binding actions to maintain international peace and security. The ten elected members have the opportunity to influence this area and others during their two-year terms on the Council. In this paper, we aim to illustrate some of these opportunities, identify potential guidance from prior elected members’ experiences, and outline the key procedures that incoming elected members should be aware of as they prepare to join the Council. In doing so, we seek in part to summarize the current state of scholarship and policy analysis in an effort to make this material more accessible to States and, particularly, to States’ legal advisers. We drafted this paper with a view towards States that have been elected and are preparing to join the Council, as well as for those States that are considering bidding for a seat on the Council. As a starting point, it may be warranted to dedicate resources for personnel at home in the capital and at the Mission in New York to become deeply familiar with the language, structure, and content of the relevant provisions of the U.N. Charter. That is because it is through those provisions that Council members engage in the diverse forms of political contestation and cooperation at the center of the Council’s work. In both the Charter itself and the Council’s practices and procedures, there are structural impediments that may hinder the influence of elected members on the Security Council. These include the permanent members’ veto power over decisions on matters not characterized as procedural and the short preparation time for newly elected members. Nevertheless, elected members have found creative ways to have an impact. Many of the Council’s “procedures” — such as the “penholder” system for drafting resolutions — are informal practices that can be navigated by resourceful and well-prepared elected members. Mechanisms through which elected members can exert influence include the following: Drafting resolutions; Drafting Presidential Statements, which might serve as a prelude to future resolutions; Drafting Notes by the President, which can be used, among other things, to change Council working methods; Chairing subsidiary bodies, such as sanctions committees; Chairing the Presidency; Introducing new substantive topics onto the Council’s agenda; and Undertaking “Arria-formula” meetings, which allow for broader participation from outside the Council. Case studies help illustrate the types and degrees of impact that elected members can have through their own initiative. Examples include the following undertakings: Canada’s emphasis in 1999–2000 on civilian protection, which led to numerous resolutions and the establishment of civilian protection as a topic on which the Council remains “seized” and continues to have regular debates; Belgium’s effort in 2007 to clarify the Council’s strategy around addressing natural resources and armed conflict, which resulted in a Presidential Statement; Australia’s efforts in 2014 resulting in the placing of the North Korean human rights situation on the Council’s agenda for the first time; and Brazil’s “Responsibility while Protecting” 2011 concept note, which helped shape debate around the Responsibility to Protect concept. Elected members have also influenced Council processes by working together in diverse coalitions. Examples include the following instances: Egypt, Japan, New Zealand, Spain, and Uruguay drafted a resolution that was adopted in 2016 on the protection of health-care workers in armed conflict; Cote d’Ivoire, Kuwait, the Netherlands, and Sweden drafted a resolution that was adopted in 2018 condemning the use of famine as an instrument of warfare; Malaysia, New Zealand, Senegal, and Venezuela tabled a 2016 resolution, which was ultimately adopted, condemning Israeli settlements in Palestinian territory; and A group of successive elected members helped reform the process around the imposition of sanctions against al-Qaeda and associated entities (later including the Islamic State of Iraq and the Levant), including by establishing an Ombudsperson. Past elected members’ experiences may offer some specific pieces of guidance for new members preparing to take their seats on the Council. For example, prospective, new, and current members might seek to take the following measures: Increase the size of and support for the staff of the Mission to the U.N., both in New York and in home capitals; Deploy high-level officials to help gain support for initiatives; Partner with members of the P5 who are the informal “penholder” on certain topics, as this may offer more opportunities to draft resolutions; Build support for initiatives from U.N. Member States that do not currently sit on the Council; and Leave enough time to see initiatives through to completion and continue to follow up after leaving the Council.
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DeJaeghere, Joan, Bich-Hang Duong, and Vu Dao. Teaching Practices That Support and Promote Learning: Qualitative Evidence from High and Low Performing Classes in Vietnam. Research on Improving Systems of Education (RISE), January 2021. http://dx.doi.org/10.35489/bsg-rise-ri_2021/024.
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This Insight Note contributes to the growing body of knowledge on teaching practices that foster student learning and achievement by analysing in-depth qualitative data from classroom observations and teacher interviews. Much of the research on teachers and teaching in development literature focuses on observable and quantified factors, including qualifications and training. But simply being qualified (with a university degree in education or subject areas), or trained in certain ways (e.g., coaching versus in-service) explains very little of the variation in learning outcomes (Kane and Staiger, 2008; Wößmann, 2003; Das and Bau, 2020). Teaching is a complex set of practices that draw on teachers’ beliefs about learning, their prior experiences, their content and pedagogical knowledge and repertoire, and their commitment and personality. Recent research in the educational development literature has turned to examining teaching practices, including content knowledge, pedagogical practices, and teacher-student interactions, primarily through quantitative data from knowledge tests and classroom observations of practices (see Bruns, De Gregorio and Taut, 2016; Filmer, Molina and Wane, 2020; Glewwe et al, in progress). Other studies, such as TIMSS, the OECD and a few World Bank studies have used classroom videos to further explain high inference factors of teachers’ (Gallimore and Hiebert, 2000; Tomáš and Seidel, 2013). In this Note, we ask the question: What are the teaching practices that support and foster high levels of learning? Vietnam is a useful case to examine because student learning outcomes based on international tests are high, and most students pass the basic learning levels (Dang, Glewwe, Lee and Vu, 2020). But considerable variation exists between learning outcomes, particularly at the secondary level, where high achieving students will continue to upper-secondary and lower achieving students will drop out at Grade 9 (Dang and Glewwe, 2018). So what differentiates teaching for those who achieve these high learning outcomes and those who don’t? Some characteristics of teachers, such as qualifications and professional commitment, do not vary greatly because most Vietnamese teachers meet the national standards in terms of qualifications (have a college degree) and have a high level of professionalism (Glewwe et al., in progress). Other factors that influence teaching, such as using lesson plans and teaching the national curriculum, are also highly regulated. Therefore, to explain how teaching might affect student learning outcomes, it is important to examine more closely teachers’ practices in the classroom.
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Perera, Duminda, Ousmane Seidou, Jetal Agnihotri, Mohamed Rasmy, Vladimir Smakhtin, Paulin Coulibaly, and Hamid Mehmood. Flood Early Warning Systems: A Review Of Benefits, Challenges And Prospects. United Nations University Institute for Water, Environment and Health, August 2019. http://dx.doi.org/10.53328/mjfq3791.
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Floods are major water-related disasters that affect millions of people resulting in thousands of mortalities and billiondollar losses globally every year. Flood Early Warning Systems (FEWS) - one of the floods risk management measures - are currently operational in many countries. The UN Office for Disaster Risk Reduction recognises their importance and strongly advocates for an increase in their availability under the targets of the Sendai Framework for Disaster Risk Reduction, and Sustainable Development Goals (SDGs). However, despite widespread recognition of the importance of FEWS for disaster risk reduction (DRR), there’s a lack of information on their availability and status around the world, their benefits and costs, challenges and trends associated with their development. This report contributes to bridging these gaps by analyzing the responses to a comprehensive online survey with over 80 questions on various components of FEWS (risk knowledge, monitoring and forecasting, warning dissemination and communication, and response capabilities), investments into FEWS, their operational effectiveness, benefits, and challenges. FEWS were classified as technologically “basic”, “intermediate” and “advanced” depending on the existence and sophistication of FEWS` components such as hydrological data = collection systems, data transfer systems, flood forecasting methods, and early warning communication methods. The survey questionnaire was distributed to flood forecasting and warning centers around the globe; the primary focus was developing and least-developed countries (LDCs). The questionnaire is available here: https://inweh.unu.edu/questionnaireevaluation-of-flood-early-warning-systems/ and can be useful in its own right for similar studies at national or regional scales, in its current form or with case-specific modifications. Survey responses were received from 47 developing (including LDCs) and six developed countries. Additional information for some countries was extracted from available literature. Analysis of these data suggests the existence of an equal number of “intermediate” and “advanced” FEWS in surveyed river basins. While developing countries overall appear to progress well in FEWS implementation, LDCs are still lagging behind since most of them have “basic” FEWS. The difference between types of operational systems in developing and developed countries appear to be insignificant; presence of basic, intermediate or advanced FEWS depends on available investments for system developments and continuous financing for their operations, and there is evidence of more financial support — on the order of USD 100 million — to FEWS in developing countries thanks to international aid. However, training the staff and maintaining the FEWS for long-term operations are challenging. About 75% of responses indicate that river basins have inadequate hydrological network coverage and back-up equipment. Almost half of the responders indicated that their models are not advanced and accurate enough to produce reliable forecasts. Lack of technical expertise and limited skilled manpower to perform forecasts was cited by 50% of respondents. The primary reason for establishing FEWS, based on the survey, is to avoid property damage; minimizing causalities and agricultural losses appear to be secondary reasons. The range of the community benefited by FEWS varies, but 55% of FEWS operate in the range between 100,000 to 1 million of population. The number of flood disasters and their causalities has declined since the year 2000, while 50% of currently operating FEWS were established over the same period. This decline may be attributed to the combined DRR efforts, of which FEWS are an integral part. In lower-middle-income and low-income countries, economic losses due to flood disasters may be smaller in absolute terms, but they represent a higher percentage of such countries’ GDP. In high-income countries, higher flood-related losses accounted for a small percentage of their GDP. To improve global knowledge on FEWS status and implementation in the context of Sendai Framework and SDGs, the report’s recommendations include: i) coordinate global investments in FEWS development and standardise investment reporting; ii) establish an international hub to monitor the status of FEWS in collaboration with the national responsible agencies. This will support the sharing of FEWS-related information for accelerated global progress in DRR; iii) develop a comprehensive, index-based ranking system for FEWS according to their effectiveness in flood disaster mitigation. This will provide clear standards and a roadmap for improving FEWS’ effectiveness, and iv) improve coordination between institutions responsible for flood forecasting and those responsible for communicating warnings and community preparedness and awareness.
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Coulson, Saskia, Melanie Woods, Drew Hemment, and Michelle Scott. Report and Assessment of Impact and Policy Outcomes Using Community Level Indicators: H2020 Making Sense Report. University of Dundee, 2017. http://dx.doi.org/10.20933/100001192.
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Making Sense is a European Commission H2020 funded project which aims at supporting participatory sensing initiatives that address environmental challenges in areas such as noise and air pollution. The development of Making Sense was informed by previous research on a crowdfunded open source platform for environmental sensing, SmartCitizen.me, developed at the Fab Lab Barcelona. Insights from this research identified several deterrents for a wider uptake of participatory sensing initiatives due to social and technical matters. For example, the participants struggled with the lack of social interactions, a lack of consensus and shared purpose amongst the group, and a limited understanding of the relevance the data had in their daily lives (Balestrini et al., 2014; Balestrini et al., 2015). As such, Making Sense seeks to explore if open source hardware, open source software and and open design can be used to enhance data literacy and maker practices in participatory sensing. Further to this, Making Sense tests methodologies aimed at empowering individuals and communities through developing a greater understanding of their environments and by supporting a culture of grassroot initiatives for action and change. To do this, Making Sense identified a need to underpin sensing with community building activities and develop strategies to inform and enable those participating in data collection with appropriate tools and skills. As Fetterman, Kaftarian and Wanderman (1996) state, citizens are empowered when they understand evaluation and connect it in a way that it has relevance to their lives. Therefore, this report examines the role that these activities have in participatory sensing. Specifically, we discuss the opportunities and challenges in using the concept of Community Level Indicators (CLIs), which are measurable and objective sources of information gathered to complement sensor data. We describe how CLIs are used to develop a more indepth understanding of the environmental problem at hand, and to record, monitor and evaluate the progress of change during initiatives. We propose that CLIs provide one way to move participatory sensing beyond a primarily technological practice and towards a social and environmental practice. This is achieved through an increased focus in the participants’ interests and concerns, and with an emphasis on collective problem solving and action. We position our claims against the following four challenge areas in participatory sensing: 1) generating and communicating information and understanding (c.f. Loreto, 2017), 2) analysing and finding relevance in data (c.f. Becker et al., 2013), 3) building community around participatory sensing (c.f. Fraser et al., 2005), and 4) achieving or monitoring change and impact (c.f. Cheadle et al., 2000). We discuss how the use of CLIs can tend to these challenges. Furthermore, we report and assess six ways in which CLIs can address these challenges and thereby support participatory sensing initiatives: i. Accountability ii. Community assessment iii. Short-term evaluation iv. Long-term evaluation v. Policy change vi. Capability The report then returns to the challenge areas and reflects on the learnings and recommendations that are gleaned from three Making Sense case studies. Afterwhich, there is an exposition of approaches and tools developed by Making Sense for the purposes of advancing participatory sensing in this way. Lastly, the authors speak to some of the policy outcomes that have been realised as a result of this research.
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Salas, Humberto. Medición de la confianza empresarial: un enfoque regional desde la Araucanía. Universidad Autónoma de Chile, July 2020. http://dx.doi.org/10.32457/2050012728/975520193.
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Toloza et al. (2018) describen una dificultad contingente al indicar que en nuestro país no se cuenta con “información robusta” a nivel regional y sectorial para el uso de los distintos agentes económicos. El autor resalta la insuficiente información para la toma de decisiones a nivel territorial y señala que esta es una limitante y un desafío país, por lo que es necesaria la “creación de sistemas regionales integrados de información territorial” (p. 194) para estos fines. El problema anterior, sumado al dilema de comprender el mecanismo bajo el cual estos agentes (empresas, familias y gobierno) forman sus expectativas, representa uno de los desafíos más importantes de la macroeconomía moderna, fundamentalmente en lo que refiere a los ciclos de negocios. Esto, dado que la gran dificultad para estudiar este fenómeno con mayor nivel de desagregación se centra en la disponibilidad de información (Borraz y Gianelli, 2011). Considerando el carácter social que tiene la economía, su comportamiento se ve influenciado por las percepciones de los agentes económicos, respecto de los escenarios futuros. Estas percepciones guardan relación con la coyuntura económica, la política, el resto del mundo y el marco jurídico en un país, entre otros elementos. Es en este contexto en que los gobiernos y el sector privado deben alcanzar un consenso sobre políticas económicas y sociales que produzcan un entorno estable para las regiones (Después de la crisis, 2010). La experiencia internacional indica que una consolidación y un buen manejo de la política fiscal influye fuertemente en el corto plazo en el “sentimiento empresarial” (Michail, et al., 2018). Esta tesis la refuerzan Bachmann y Sims (2012), quienes plantean que una política económica orientada a la consolidación tiene un impacto potente en la economía, a través del canal de confianza empresarial, con efectos que no deben ser subestimados. Considerando que en la Araucanía este componente es importante, la política fiscal juega entonces un papel relevante en las expectativas del empresariado. Es así como en la región, las empresas, gremios, consumidores, comerciantes, agricultores e inversionistas poseen visiones relativas de lo que podría acontecer, considerando su experiencia y apreciaciones, que son muchas veces subjetivas. Se formulan así, período a período, supuestos sobre acontecimientos que buscan explicar escenarios futuros; a este proceso mental colectivo lo llamamos expectativas. No cabe duda de que estas determinan el comportamiento futuro del consumo, del ahorro y la inversión, e incluso de la orientación de la política pública, al impactar directamente en la actividad económica y, más importante, en la generación de empleo e ingresos de la fuerza de trabajo. En consecuencia la situación en la Araucanía no es difiere del problema de cómo los agentes económicos se forman expectativas y cómo logran interactuar con la estructura institucional de la economía, habiendo históricamente interés de los investigadores por incursionar en estas temáticas (Rosser, 2001). La utilización de indicadores que reflejan las expectativas de agentes económicos levantados por medio de encuestas es desarrollada en muchos países que cuentan con un sistema de estadísticas avanzado. Lanzilotta (2014) establece que los indicadores de este tipo son ampliamente utilizados en investigación aplicada, con el fin de capturar y anticipar los movimientos de numerosas variables, para así dar cuenta de la formación de expectativas y los planes de las empresas. El autor plantea que los indicadores de expectativas elaborados a partir tanto de encuestas a empresarios como a consumidores son ampliamente divulgados, principalmente con dos objetivos: explorar los mecanismos de formación de expectativas e identificar su poder predictivo. Es válido, entonces, examinar la forma en que las expectativas locales tienen efectos concretos para la comunidad y los mecanismos en que estas perspectivas afectan realmente el desempeño económico de un territorio. Es en este contexto que según lo expuesto por Salas (2018), la Facultad de Administración y Negocios de la Universidad Autónoma de Chile —con metodología de la Universidad del Desarrollo y el apoyo de la Multigremial de la Araucanía, representante de SOFOFA en la zona— ha aunado esfuerzos para medir la confianza empresarial en la región, desde junio de 2017, creando así el primer Índice de Confianza Empresarial de la Araucanía (ICE Araucanía). Esta iniciativa es relevante, considerando la escasa información para la toma de decisiones del empresariado local en la zona y que la disposición de esta permite a los distintos sectores competir en entornos cambiantes. Así se busca contribuir y hacernos cargo en parte de un problema general que dejó la última crisis económica mundial. Esta manifestó la debilidad de América Latina y de las regiones para competir en una economía global y compleja, debido a la poca información disponible para la toma de decisiones empresariales (Después de la crisis, 2010).
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Men in maternity study: A summary of the findings from pre-intervention interviews with women and their husbands attending antenatal clinics at ESIC facilities in Delhi. Population Council, 2002. http://dx.doi.org/10.31899/rh2002.1011.
Full textAbstract:
The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). The MiM intervention is facilitating the inclusion of men in their wives' antenatal and postpartum care with couple and individual counseling during pregnancy and at six weeks postpartum. The data presented in this update derives from a detailed Preliminary Findings Report. Interviews, conducted from November 2000 to November 2001, took place in all cases only after consent was first given by the women.