1000 resultados para CHALLENGES


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Introduction The ultimate aim of Cochrane systematic reviews is to inform policy and practice decisions for better health outcomes. However, due to the increasing numbers of scientific publications, wading through the available evidence of both individual studies and systematic reviews can be challenging and overwhelming even for avid authors and readers. This paper briefly describes the first overview (a systematic review of reviews) of the Cochrane Public Health Group (CPHG) in development and proposes a way forward for the methodologies under consideration.

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Nature exists. Humans exist. The behaviour of one impacts upon the other. The behaviour of humans is governed by the artificial contrivance described as the law. While the law can in this way control the behaviour of humans and the impact that human behaviour has on nature, the behaviour of nature is governed – if at all- in accordance with nature’s own sets of values which are quintessentially a matter for nature. The relationship between nature and humans may be the object of rules of law, but traditional legal doctrine dictates that humans but not nature are the subjects of the rules of law. The jurisprudence of the earth – it would appear – seeks to equalise in the eyes of the law nature as part of the global environment and humans as part of the global environment. How might this be done?

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The people of Bangladesh are underprivileged from continuous grid electricity. Despite the plentiful supply of renewable sources of energy in Bangladesh, currently their contribution to the electricity supply remains inconsequential. Use of renewable energy is considered an indispensable component of sustainable energy systems, as renewable energy resources emit less greenhouse gas emissions compared to other non-renewable energy systems. Out of the various renewable sources, solar and biogas and to a limited extend, wind and hydro-power are effectively used. Though the biogas production was the leading and most appropriate renewable energy resource in our country, it has become notably insignificant due to the lack of appropriate strategies and institutional settings. To address this, this article examines Bangladesh's current energy strategies and institutional settings and investigates future strategies for the advancement of biogas production. This article argues that further significant efforts could be made toward energy sustainability in Bangladesh and the development for a national sustainable energy policy.

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Background Many countries are scaling up malaria interventions towards elimination. This transition changes demands on malaria diagnostics from diagnosing ill patients to detecting parasites in all carriers including asymptomatic infections and infections with low parasite densities. Detection methods suitable to local malaria epidemiology must be selected prior to transitioning a malaria control programme to elimination. A baseline malaria survey conducted in Temotu Province, Solomon Islands in late 2008, as the first step in a provincial malaria elimination programme, provided malaria epidemiology data and an opportunity to assess how well different diagnostic methods performed in this setting. Methods During the survey, 9,491 blood samples were collected and examined by microscopy for Plasmodium species and density, with a subset also examined by polymerase chain reaction (PCR) and rapid diagnostic tests (RDTs). The performances of these diagnostic methods were compared. Results A total of 256 samples were positive by microscopy, giving a point prevalence of 2.7%. The species distribution was 17.5% Plasmodium falciparum and 82.4% Plasmodium vivax. In this low transmission setting, only 17.8% of the P. falciparum and 2.9% of P. vivax infected subjects were febrile (≥38°C) at the time of the survey. A significant proportion of infections detected by microscopy, 40% and 65.6% for P. falciparum and P. vivax respectively, had parasite density below 100/μL. There was an age correlation for the proportion of parasite density below 100/μL for P. vivax infections, but not for P. falciparum infections. PCR detected substantially more infections than microscopy (point prevalence of 8.71%), indicating a large number of subjects had sub-microscopic parasitemia. The concordance between PCR and microscopy in detecting single species was greater for P. vivax (135/162) compared to P. falciparum (36/118). The malaria RDT detected the 12 microscopy and PCR positive P. falciparum, but failed to detect 12/13 microscopy and PCR positive P. vivax infections. Conclusion Asymptomatic malaria infections and infections with low and sub-microscopic parasite densities are highly prevalent in Temotu province where malaria transmission is low. This presents a challenge for elimination since the large proportion of the parasite reservoir will not be detected by standard active and passive case detection. Therefore effective mass screening and treatment campaigns will most likely need more sensitive assays such as a field deployable molecular based assay.

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In recent times significant change has occurred to the Australian health and safety regulatory context. In this paper we consider the potential response of smaller firms in general, and ethnic owned and/or operated smaller firms in particular. We draw on literature examining smaller firms' responses to regulation and apply this to what little we know about smaller ethnic firms in Australia in the context of the regulatory change. We highlight the challenges to owner managers and what could be done to engage and support smaller ethnic firms to realise the opportunities resulting from this regulatory change.

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In this final chapter we will raise a number of issues that we have encountered as we have put this collection of papers together. In doing this, we also reflect upon the seven challenges for video game theory that Bernard Perron and Mark Wolf(2009)put forward in the introduction to the second video game theory reader given it is probably one of the most recent assessments in the area at the time of writing. These challenges are concerned with Terminology and Accuracy, History, Methodology, Technology, Interactivity, Play and the Integration of Interdisciplinary Approaches. These issues will be brought up throughout this chapter, but not necessarily in mutually exclusive fashion...

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With an ever changing landscape including National Registration, endorsed areas of practice, establishment of Sport and Exercise Psychology coordinators within National Sporting Organisations, changes to the National and State Sporting Insitutions, this forum looks to explore through collegiate discussion the impacts, current and future implications for our profession across training, supervision, research and applied practice in Australia.

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Purpose – This paper seeks to analyse the process of packaged software selection in a small organization, focussing particularly on the role of IT consultants as intermediaries in the process. Design/methodology/approach – This is based upon a longitudinal, qualitative field study concerning the adoption of a customer relationship management package in an SME management consultancy. Findings – The authors illustrate how the process of “salesmanship”, an activity directed by the vendor/consultant and focussed on the interests of senior management, marginalises user needs and ultimately secures the procurement of the software package. Research limitations/implications – Despite the best intentions the authors lose something of the rich detail of the lived experience of technology in presenting the case study as a linear narrative. Specifically, the authors have been unable to do justice to the complexity of the multifarious ways in which individual perceptions of the project were influenced and shaped by the opinions of others. Practical implications – Practitioners, particularly those from within SMEs, should be made aware of the ways in which external parties may have a vested interest in steering projects in a particular direction, which may not necessarily align with their own interests. Originality/value – This study highlights in detail the role of consultants and vendors in software selection processes, an area which has received minimal attention to date. Prior work in this area emphasises the necessary conditions for, and positive outcomes of, appointing external parties in an SME context, with only limited attention being paid to the potential problems such engagements may bring.

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Megaprojects are described as large, complex and expensive construction projects. Recent studies have shown that megaprojects often result in cost overruns, time extensions and undesired outcomes. Regardless, megaprojects are common, particularly in developing countries, as they are a trigger for social and economic development (Li et al., 2010). Since 2007, the Government of Ecuador has begun an unprecedent investment in infrastructure. Through the National Water Secretary, the government has 16 projects in agenda accounting for over $ 3 billion, with 6 projects currently under construction. These projects are considered flagship infrastructure in the endeavour to enhance the country´s productivity.The Bulubulu-Naranjal-Cañar project, a $406 million multi-purpose hydraulic project for irrigation and flood control, consists of over 1,000 activities and was proposed to be completed by 2015. This novel project for Ecuador, presented as a case study, represents a challenge for project management and financing. The purpose of this preliminary study is to provide an insight to megaproject management in Ecuador, and propose improvements to megaproject management through optimization of stochastic project schedules.

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Female genital cutting (also often called female genital mutilation, or female circumcision) is a cultural practice that originated thousands of years ago. Female genital cutting has various forms, some of which are more invasive than others, but all of which produce health, legal and social consequences for those involved. Due to patterns of immigration in Australia, especially since the 1990s, there are women in Australia who have experienced female genital cutting. There may be some families, or some parents, who still hold a cultural commitment to female genital cutting. As a result, female genital cutting presents complex legal, ethical, medical and social challenges in contemporary Australian society. Medical practitioners and other health and welfare workers may encounter women who have experienced genital cutting and who require treatment for its sequelae. Currently, legislative frameworks for female genital cutting vary across states and territories, including the penalties for conducting it, and for removing a child for the purpose of conducting it outside Australia. This presentation provides an overview of the history, nature and consequences of the various forms of female genital cutting, and of the major Australian legal principles, ethical controversies, and medical, legal and social challenges in this field.

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The globalised world: The current higher education community The last decade has seen rapid changes in the landscape of higher education (HE) throughout the world, largely as a product of globalisation. A major effect has been to propel the interconnectedness between nations and people across the globe (Scholte, 2005). The use of information and communication technology (ICT) has diminished the distance between countries. The world’s economies are becoming more integrated and interrelated through neoliberal economic policies, free trade agreements and open access of goods and services beyond national borders, policies promulgated by organisations such as the World Trade Organization and The World Bank (Marginson & Ordorika, 2011; Mok, 2011). As a consequence, universities are operating at global, national and local levels simultaneously. In the Pacific region, new universities are emerging. For example, Fiji now has one regional and two national universities; Samoa has a national university and Solomon Islands has an institute of higher education. These new players add to regional competition as they open opportunities for global partnerships and transnational programmes. Thus, participating at these multiple levels is inevitable, and no university is immune to these changes (Marginson, Kaur & Sawir, 2011a). Universities are now part of the global HE community that cannot be confined within a nation’s borders. Transitional HE programmes are perhaps one of the most evident demonstrations of the interconnectedness of universities across countries in this global era.

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Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).