Leadership ethics and the problem of Dirty Hands in the political economy of contemporary Africa

Cet article discute des problèmes de gouvernance et de corruption en Afrique dans le cadre d’un débat politique et philosophique large entre universalisme et relativisme, idéalisme et réalisme, ainsi que entre individualisme et communautarisme. Premièrement, je défends que l’approche réaliste de l’éthique politique et du leadership ne permet pas de différencier entre les éléments descriptifs et prescriptifs de la gouvernance et peut aisément être utilisée pour justifier « les Mains Sales » des dirigeants au nom de l’intérêt supérieur de la nation, même dans les cas où l’intérêt personnel est la seule force motivationnelle pour les actions qui sapent les codes sociaux et éthiques ordinaires. Deuxièmement, l’article montre la faillite de la confiance publique dans le gouvernement et la faiblesse de l’Etat renforce les politiques communautariennes sub-nationales qui tendent à être fondées sur l’ethnie et exclusive, et par conséquent, qui viole le cœur de l’éthique publique, c’est-à-dire l’impartialité. Finalement, l’article suggère que les principes d’éthique universels pour les services publiques soient introduits en complément plutôt qu’en concurrence avec les éthiques locales, socialement et culturellement limitée au privé. Cela requière, d’une part, que nous comprenions mieux la complexité historique, les circonstances économiques et sociales et les arrangements politiques transitionnels dans les pays africains. D’autre part, un nous devons investir dans une éducation éthique civique et professionnel réflexive qui adopte un point de vue nuancé entre le réalisme politique et l’idéalisme comme point de départ des réformes institutionnelles, aussi bien que modalité de changement des comportements à long terme.

Ist der Ernährungsführerschein eine geeignete Primärpräventionsmaßnahme, um die Ernährungssituation zu verbessern?

Das Ernährungsverhalten einer Bevölkerung hat einen wesentlichen Einfluss auf das Wohlbefinden, die Gesundheit und Leistungsfähigkeit der Menschen. Ernährungsbedingte, chronische Erkrankungen weisen in den westlichen Industrienationen eine hohe Inzidenz und Prävalenz auf. Präventionsmaßnahmen im Setting Schule sollen das Ernährungsverhalten der Kinder- und Jugendlichen positiv beeinflussen. Gerade in diesem Setting können Personen mit unterschiedlichem sozioökonomischem Status, sowie Personen aus diversen Lebensbereichen angesprochen werden. Der Ernährungsführerschein (EFS) ist eine schulbasierte Primärpräventions-maßnahme, der in der 3. Jahrgangsstufe/Grundschule durchgeführt wird. In 6 – 7 Unterrichtseinheiten erfolgt eine praxisnahe Vermittlung von Grundkenntnissen über Ernährung, Lebensmittel und deren Zubereitung. Der EFS möchte eine Verhaltensänderung der Schulkinder bewirken. Sie erlernen Kompetenzen, damit sie in der Lage sind, sich selbst eine gesunde Mahlzeit zubereiten zu können. Aber kann dieses Projekt eine nachhaltige Verhaltensänderung bewirken? Die folgende Studie mit Mixed-Methods-Ansatz im Explanatory-Sequential-Design versucht genau dieser Frage nachzugehen. Auf eine quantitative Prä- und Postbefragung in 16 Klassen an 12 Grundschulen im Landkreis Marburg Biedenkopf und insgesamt 992 Befragungen folgte eine qualitative Studie mit neun problemzentrierten, leitfadengestützten Interviews. Der EFS zeigt keinen signifikanten Einfluss auf die Veränderung des Ernährungsverhaltens. Positiv zu bewerten ist, dass durch den EFS Alltagskompetenzen bei der Nahrungszubereitung gefördert wurden. Dieser positive Einfluss muss jedoch differenziert betrachtet werden, denn die qualitativen Studie zeigt, dass der EFS sehr gut in Familien aufgenommen wird, die sich bereits mit Ernährungsfragen auseinandersetzen und darauf achten, einen ernährungsphysiologisch günstigen Ernährungsstil zu leben oder anzustreben. In Familien der Billig- und Fleischesser konnte der EFS die Türen nicht öffnen. Aber gerade in diesem Segment wäre eine Veränderung des Essverhaltens induziert. Die Untersuchung ergab, dass der EFS für sich alleine nicht den Anspruch erheben kann, die Ernährungssituation der Kinder und Familien zu verbessern. Aber er bietet ein methodisch-didaktisch gut ausgearbeitetes Konzept und könnte als Baustein in die Entwicklung eines praxisnahen, erlebnisorientierten und ganzheitlichen Ernährungsbildungskonzepts unter Berücksichtigung diverser Settings und Lebenswelten der Kinder und Familien einfließen.

Pecha Kucha: Bay 8

Abstract Following the success of Bay 9's Pecha Kucha, this week Bay 8 are providing the next instalment of the newly established tradition of Pecha Kucha. In 6m40s and 20 slides, each member of Bay 8 will introduce themselves, explaining their background and research interests, so you can put a name to the face, and chat after the event if you have common interests. These mini talks aim to support the collaborative nature of WAIS by introducing each member to the wider group. This week the bay members and Pecha Kuchas are: - The Public Health Analogy in Web Security (Huw) - Social Networking Features in Digital Behaviour Change Interventions (Roushdat) - Computers, Psychology and a lot of coffee (Anna) - Law, computer science and that annoying thing you have to say you’ve read before you can use a website (Emma)

Behavioral changes, used and benefits of a community program for the promotion in physical activity

Objective: To determine the change of behavior in physical activity and the characteristics associated with the use and benefits of Local Physical Activity Center (CLAF) in the population of the town of Santa Fe de Bogota. Materials and methods: We conducted a longitudinal study before and after, which was assessed at admission and 3 months in the intervention program CLAF physical activity, behavior change compared to the physical activity of users. Inclusion criteria: were being active user of CLAF, aged between 15 and 65 years and voluntarily express their participation in the study. Exclusion criteria: Fill incomplete measurement instruments used. The sampling frame of CLAF users, we selected n=55 subjects. To gather information, a questionnaire, which contained the behavioral stages of change, also conducted a survey which determined semistructured features about the benefits and use of CLAF. Results: The total study participants was n = 55, mean age was 40.4 ± 15.3 years, with a minimum 15 and maximum of 64 years, 83.6% were women. 78.2% do not know the purpose of the Local Centre for Physical Activity. The outreach strategy that most came to the group was 58.2 with a verbal type. The time for links to CLAF more frequently in the group evaluated was 1 to 6 months 36.4. The motivation to regularly attend the CLAF in the majority was to improve the physical and / or a 74.5% mental. 89.1% would be willing to recommend to others the use of CLAF. A 81.8% of the population physical activity performed by more than 150 min / wk at moderate intensity; Post CLAF intervention in the subjects showed positive changes in the level of physical activity (p<0.001, Test de Wilcoxon) and behavioral state (p<0.001, Test de Wilcoxon).

¿La tomografía de codo cambia la conducta tomada previamente con radiografía en fracturas de cúpula radial? un estudio de concordancia

Las fracturas de la cúpula radial corresponden a un tercio de todas las fracturas del codo en adultos (1), por lo que se toman radiografías o tomografías, sin embargo no existe literatura que soporte la realización de la tomografía como estudio complementario, por lo que preguntamos ¿La tomografía de codo cambia la conducta tomada previamente con radiografía en fracturas de cúpula radial? Se propone un estudio de concordancia, donde se evalúan las radiografías y tomografías por parte de dos cirujanos de codo, de pacientes con diagnóstico de fractura de cúpula radial valorados en urgencias de dos hospitales de tercer nivel de Bogotá desde enero 2011 a enero 2013. Se revisaron 116 historias, 99 cumplieron los criterios, las radiografías fueron revisadas por dos ortopedistas de codo quienes realizaron clasificación de Mason obteniendo un κ 1 (p˂ 0,00), propuesta de tratamiento postradiografía κ 0,934 (p˂ 0,000 IC95% 0.85, 1). Tratamiento post-tomografía de codo κ 0.949 (p˂ 0,00 IC95% 0.867,1). Concordancia intra-ortopedista de la conducta pre y post-tomografía hay cambio en la conducta del ortopedista 1 en 32.6% (κ 0.674 p˂ 0,00 IC95% 0.52, 0.818) y del ortopedista 2 en 36% (κ 0.64 p˂ 0,00 IC95% 0.452, 0.792). Se dividieron los pacientes en Mason I, II, III con concordancia considerable en los pacientes Mason I y III, mientras que en Mason II fue una concordancia aceptable lo que significa que el uso de tomografía de codo cambia la conducta en general pero sobretodo en pacientes clasificados Masson II.

Actitudes hacia el VIH/SIDA, el cáncer y la enfermedad de Alzheimer

Esta revisión de la literatura tuvo como objetivo describir las actitudes hacia el VIH/SIDA, el cáncer y la Enfermedad de Alzheimer desde el modelo tripartito. Se revisaron 109 artículos publicados entre 2005 y 2015 en algunas bases de datos especializadas y herramientas de análisis de impacto. También se incluyeron fuentes secundarias ampliándose la búsqueda a los últimos 20 años (1995-2015). Los resultados mostraron que la mayoría de los estudios realizados sobre las actitudes hacia estas tres enfermedades son de tipo cuantitativo y la información se analizó con base en los componentes del modelo tripartito. Algunos aspectos sociodemográficos como el sexo y la edad están asociados con las actitudes hacia las tres enfermedades y predominan las creencias erróneas sobre ellas respecto a sus causas, curso y tratamiento. También predominan actitudes negativas hacia las tres enfermedades y las conductas e intenciones conductuales son diversas hacia cada una de ellas. No se hallaron antecedentes empíricos del estudio de la estructura de las actitudes propuesta por el modelo tripartito hacia las tres enfermedades. La Salud Pública ha liderado la investigación con base en el modelo de conocimientos, actitudes y prácticas propuesto por la OMS.

Electricity use in the commercial kitchen

Academic and industrial literature concerning the energy consumption of commercial kitchens is scarce. Electricity consumption data were collected from distribution board current transformers in a sample of fourteen UK public house restaurants. This was set up to identify patterns of appliance use as well as to assess the total energy consumption of these establishments. The electricity consumption in the selected commercial kitchens was significantly higher than current literature estimates. On average, 63% of the premises electricity consumption was attributed to the catering activity. Key appliances that contributed to the samples average electricity consumption were identified as refrigeration (70 kwh, 41%), fryers (11 kwh, 13%), combi-ovens (35 kwh, 12%) bain maries (27 kwh, 9%) and grills (37kwh, 12%). Behavioral factors and poor maintenance were identified as major contributors to excessive electricity usage with potential savings of 70% and 45% respectively. Initiatives are required to influence operator behavior, such as the expansion of mandatory energy labeling, improved feedback information and the use of behavior change campaigns. Strict maintenance protocols and more appropriate sizing of refrigeration would be of great benefit to energy reduction.

Consideration of persuasive technology on users acceptance of e-commerce: exploring perceived persuasiveness

Persuasive technologies, used within in the domain of interactive technology, are used broadly in social contexts to encourage customers towards positive behavior change. In the context of e-commerce, persuasive technologies have already been extensively applied in the area of marketing to enhancing system credibility, however the issue of ‘persuasiveness’, and its role on positive user acceptance of technology, has not been investigated in the technology acceptance literature. This paper reviews theories and models of users’ acceptance and use in relation with persuasive technology, and identifies their limitation when considering the impact of persuasive technology on users’ acceptance of technology; thus justifying a need to add consideration of ‘perceived persuasiveness’. We conclude by identifying variables associated with perceived persuasiveness, and suggest key research directions for future research.

Design and baseline characteristics of the Food4Me study: a web-based randomised controlled trial of personalised nutrition in seven European countries

Improving lifestyle behaviours has considerable potential for reducing the global burden of non-communicable diseases, promoting better health across the life-course and increasing well-being. However, realising this potential will require the development, testing and implementation of much more effective behaviour change interventions than are used conventionally. Therefore, the aim of this study was to conduct a multi-centre, web-based, proof-of-principle study of personalised nutrition (PN) to determine whether providing more personalised dietary advice leads to greater improvements in eating patterns and health outcomes compared to conventional population-based advice. A total of 5,562 volunteers were screened across seven European countries; the first 1,607 participants who fulfilled the inclusion criteria were recruited into the trial. Participants were randomly assigned to one of the following intervention groups for a 6-month period: Level 0-control group-receiving conventional, non-PN advice; Level 1-receiving PN advice based on dietary intake data alone; Level 2-receiving PN advice based on dietary intake and phenotypic data; and Level 3-receiving PN advice based on dietary intake, phenotypic and genotypic data. A total of 1,607 participants had a mean age of 39.8 years (ranging from 18 to 79 years). Of these participants, 60.9 % were women and 96.7 % were from white-European background. The mean BMI for all randomised participants was 25.5 kg m(-2), and 44.8 % of the participants had a BMI ≥ 25.0 kg m(-2). Food4Me is the first large multi-centre RCT of web-based PN. The main outcomes from the Food4Me study will be submitted for publication during 2015.

Using virtual environments for trigger identification in addiction treatment

This paper presents a novel application of virtual environments to assist in encouraging behavior change in individuals who misuse drugs or alcohol. We describe the user-centered design of a series of scenes to engage users in the identification of triggers and to encourage discussions about relevant coping skills. Results from the initial testing of this application with six service users showed variation in user responses. Results also suggested that the system should encourage group discussion and that it was linked to a small improvement in users’ confidence in understanding and identifying triggers.

Changes in physical activity following a genetic-based internet-delivered personalized intervention: randomized controlled trial (Food4Me)

Background: There is evidence that physical activity (PA) can attenuate the influence of the fat mass- and obesity-associated (FTO) genotype on the risk to develop obesity. However, whether providing personalized information on FTO genotype leads to changes in PA is unknown. Objective: The purpose of this study was to determine if disclosing FTO risk had an impact on change in PA following a 6-month intervention. Methods: The single nucleotide polymorphism (SNP) rs9939609 in the FTO gene was genotyped in 1279 participants of the Food4Me study, a four-arm, Web-based randomized controlled trial (RCT) in 7 European countries on the effects of personalized advice on nutrition and PA. PA was measured objectively using a TracmorD accelerometer and was self-reported using the Baecke questionnaire at baseline and 6 months. Differences in baseline PA variables between risk (AA and AT genotypes) and nonrisk (TT genotype) carriers were tested using multiple linear regression. Impact of FTO risk disclosure on PA change at 6 months was assessed among participants with inadequate PA, by including an interaction term in the model: disclosure (yes/no) × FTO risk (yes/no). Results: At baseline, data on PA were available for 874 and 405 participants with the risk and nonrisk FTO genotypes, respectively. There were no significant differences in objectively measured or self-reported baseline PA between risk and nonrisk carriers. A total of 807 (72.05%) of the participants out of 1120 in the personalized groups were encouraged to increase PA at baseline. Knowledge of FTO risk had no impact on PA in either risk or nonrisk carriers after the 6-month intervention. Attrition was higher in nonrisk participants for whom genotype was disclosed (P=.01) compared with their at-risk counterparts. Conclusions: No association between baseline PA and FTO risk genotype was observed. There was no added benefit of disclosing FTO risk on changes in PA in this personalized intervention. Further RCT studies are warranted to confirm whether disclosure of nonrisk genetic test results has adverse effects on engagement in behavior change.

Engagement and retention of participants in a physical activity website

Background: Websites have the potential to deliver enhanced versions of targeted and tailored physical activity programs to large numbers of participants. We describe participant engagement and retention with a stage-based physical activity website in a workplace setting. Methods:  We analyzed data from participants in the website condition of a randomized trial designed to test the efficacy of a print- vs. website-delivered intervention. They received four stage-targeted e-mails over 8 weeks, with hyperlinks to the website. Both objective and self-reported website use data were collected and analyzed. Results: Overall, 327 were randomized to the website condition and 250 (76%) completed the follow-up survey. Forty-six percent (n = 152) visited the website over the trial period. A total of 4,114 hits to the website were recorded. Participants who entered the site spent on average 9 min per visit and viewed 18 pages. Website use declined over time; 77% of all visits followed the first e-mail. Conclusions: Limited website engagement, despite the perceived usefulness of the materials, demonstrates possible constraints on the use of e-mails and websites in delivering health behavior change programs. In the often-cluttered information environment of workplaces, issues of engagement and retention in website-delivered programs require attention.

Intervening to improve health indicators among Australian farm families

The Sustainable Farm Families project (http://www.sustainablefarmfamilies.org.au/) was a 3-year demonstration and education project designed to influence farmer behavior with respect to family health and well-being among cropping and grazing farmers in Victoria, New South Wales, and South Australia, Australia. The project was conducted by the Western District Health Service, Hamilton, Australia, in partnership with farmers; Farm Management 500 (peer discussion group); the Victorian Farmers Federation; Royal Melbourne Institute of Technology; and Land Connect. During the 3 years of the project, 128 farmers—men (70) and women (58)—were enrolled. The project utilized a combination of small group workshops, individualized health action plans, and health education opportunities to encourage farm safety and health behavior changes and to elicit sustained improvements in the following health indicators: body mass index (BMI), total cholesterol, fasting blood glucose, and blood pressure. Mean changes in these health indicators were analyzed using repeated measures analysis of variance (ANOVA) and McNemar's test compared the proportion of individuals with elevated indicators. Among participants with elevated values at baseline, the following average reductions were observed: BMI 0.44 kg/m2 (p = .0034), total cholesterol 48.7 mg/dl (p < .0001), blood glucose 10.1 mg/dl (p = .0016), systolic blood pressure 12.5 mm Hg (p < .0001), and diastolic blood pressure 5.0 mm Hg (p = .0007). The proportion of participants with elevated total cholesterol at baseline decreased after 24 months (p < .001). Such findings suggest that proactive intervention by farmer associations, rural health services, and government agencies may be an effective vehicle for promoting voluntary farm safety and health behavior change while empowering farm families to achieve measurable reductions in important health risk factors.

Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals

Background

Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses' opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore.
Methods

Nurses were surveyed to identify their perceptions regarding barriers to implementation of clinical practice guidelines in their practice setting. The validated questionnaire, 'Barriers and facilitators assessment instrument', was administered to nurses (n = 1830) working in the medical, surgical, geriatric units, at five acute care hospitals in Singapore.
Results

An 80.2% response rate was achieved. The greatest barriers to implementation of clinical practice guidelines reported included: knowledge and motivation, availability of support staff, access to facilities, health status of patients, and, education of staff and patients.
Conclusion

Numerous barriers to the use of the Fall Prevention Clinical Practice Guideline have been identified. This study has laid the foundation for further research into implementation of clinical practice guidelines in Singapore by identifying barriers to change in acute care settings.

Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

Background: