Rationale and knowledge for the universal implementation of sanitation in areas of social vulnerability

The adoption of principles of equality and universality stipulated in legislation for the sanitation sector requires discussions on innovation. The existing model was able to meet sanitary demands, but was unable to attend all areas causing disparities in vulnerable areas. The universal implementation of sanitation requires identification of the know-how that promotes it and analysis of the model adopted today to establish a new method. Analysis of how different viewpoints on the restructuring process is necessary for the definition of public policy, especially in health, and understanding its complexities and importance in confirming social practices and organizational designs. These are discussed to contribute to universal implementation of sanitation in urban areas by means of a review of the literature and practices in the industry. By way of conclusion, it is considered that accepting a particular concept or idea in sanitation means choosing some effective interventions in the network and on the lives of individual users, and implies a redefinition of the space in which it exercises control and management of sewerage networks, such that connected users are perceived as groups with different interests.

Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women ('Option B+') in Malawi

OBJECTIVE To explore the levels and determinants of loss to follow-up (LTF) under universal lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') in Malawi. DESIGN, SETTING, AND PARTICIPANTS We examined retention in care, from the date of ART initiation up to 6 months, for women in the Option B+ program. We analysed nationwide facility-level data on women who started ART at 540 facilities (n = 21 939), as well as individual-level data on patients who started ART at 19 large facilities (n = 11 534). RESULTS Of the women who started ART under Option B+ (n = 21 939), 17% appeared to be lost to follow-up 6 months after ART initiation. Most losses occurred in the first 3 months of therapy. Option B+ patients who started therapy during pregnancy were five times more likely than women who started ART in WHO stage 3/4 or with a CD4 cell count 350 cells/μl or less, to never return after their initial clinic visit [odds ratio (OR) 5.0, 95% confidence interval (CI) 4.2-6.1]. Option B+ patients who started therapy while breastfeeding were twice as likely to miss their first follow-up visit (OR 2.2, 95% CI 1.8-2.8). LTF was highest in pregnant Option B+ patients who began ART at large clinics on the day they were diagnosed with HIV. LTF varied considerably between facilities, ranging from 0 to 58%. CONCLUSION Decreasing LTF will improve the effectiveness of the Option B+ approach. Tailored interventions, like community or family-based models of care could improve its effectiveness.

The determinants of physician and pharmacist utilization and equity of access under Korean universal health insurance

This study examines the social and behavioral determinants of two types of primary care, seeing a physician or a pharmacist, for Koreans and evaluates the equity of the Korean national health insurance system. The study applies the Aday and Andersen access framework to cross-sectional data from the 1992 Korean National Health Interview Survey (N = 21,841).^ The study found that in Korea, the elderly were most likely, and children least likely, to have used physician services. Women, household heads, those in small families, and the less educated were more likely than their counterparts to use physician and pharmacist services. Health status and need were important determinants of Koreans seeing a doctor or a pharmacist. Differences in need substantially accounted for the original differences observed between subgroups. Resources associated with having insurance coverage, a regular source of care, and place of residence (rural/urban) ameliorated to some extent the subgroup differences in the use of physicians' and pharmacists' services among Koreans. They were also major independent predictors of access. Having insurance remains a particularly important predictor of who uses physician services. Among the insured, trade-offs in the use of physician and pharmacist services were found in the current system, i.e., uninsured and poor Koreans were more likely to use pharmacist services, while insured and rural Koreans were more likely to use doctor services. Among the insured, cost sharing rates are lower for physician than for pharmacist services. Self-employed persons were less likely than government and industrial workers to use physician services. An underlying expectation under universal health insurance was that the Korean health care system would be equitable. The research results, however, did not fully support this expectation.^ The policy implications of these findings are that measures are required to extend insurance coverage to the uninsured, to equalize differences in benefit packages between health plans, and to expand the availability of physicians in rural areas. Further research is also needed to understand those who do not currently have a regular source of care and why and the access barriers that may exist for selected demographic subgroups (those in large families and unmarried or divorced/widowed persons). ^

RELIGIÃO E MARKETING PESSOAL: UMA ANÁLISE DA IMAGEM PESSOAL DOS BISPOS, PASTORES, OBREIROS E OBREIRAS DA IGREJA UNIVERSAL DO REINO DE DEUS

Este trabalho tem por objetivo analisar a forma de construção da imagem dos bispos, pastores, obreiros e obreiras da Igreja Universal do Reino de Deus (IURD), por meio da ferramenta de marketing pessoal (MP). A utilização do MP por tais agentes religiosos é uma maneira de melhorar a interação simbólica entre líderes e fiéis e atrair o público para os templos. A IURD foi escolhida para esta análise por usar de vários procedimentos que estão relacionados com as técnicas de MP, no sentido de sofisticar a aparência visual de sua liderança, a fim de representar um discurso de prosperidade disseminado pela instituição. Cremos que é dessa forma que a IURD atrai o público por meio da imagem criada dos líderes, mediante uma aparência visual sofisticada. Na pesquisa dessa Igreja, encontramos que a ferramenta de MP usada pelos seus membros hierárquicos contribui para o crescimento e a consolidação desse empreendimento no mercado religioso. A construção da imagem que estamos tratando é planejada a partir da matriz imagética do líder principal da Igreja Universal, Edir Bezerra Macedo. Por meio da imagem central do bispo Macedo é que a liderança é marcada ou estigmatizada com um perfil estético respaldado por uma noção de sucesso. Utilizamos a pesquisa bibliográfica e observação participante como método de pesquisa e ainda, pesquisamos o jornal Folha Universal e averiguamos alguns programas televisivos exibidos na TV Record, analisando o marketing pessoal da liderança em questão. Assim, verificamos que as interfaces de presentação da boa imagem produzida por meio de técnicas corporais, roupas e acessórios, favorece a representação desses líderes nos seus principais canais de comunicação, templos e televisão.(AU)

RELIGIÃO E MARKETING PESSOAL: UMA ANÁLISE DA IMAGEM PESSOAL DOS BISPOS, PASTORES, OBREIROS E OBREIRAS DA IGREJA UNIVERSAL DO REINO DE DEUS

Este trabalho tem por objetivo analisar a forma de construção da imagem dos bispos, pastores, obreiros e obreiras da Igreja Universal do Reino de Deus (IURD), por meio da ferramenta de marketing pessoal (MP). A utilização do MP por tais agentes religiosos é uma maneira de melhorar a interação simbólica entre líderes e fiéis e atrair o público para os templos. A IURD foi escolhida para esta análise por usar de vários procedimentos que estão relacionados com as técnicas de MP, no sentido de sofisticar a aparência visual de sua liderança, a fim de representar um discurso de prosperidade disseminado pela instituição. Cremos que é dessa forma que a IURD atrai o público por meio da imagem criada dos líderes, mediante uma aparência visual sofisticada. Na pesquisa dessa Igreja, encontramos que a ferramenta de MP usada pelos seus membros hierárquicos contribui para o crescimento e a consolidação desse empreendimento no mercado religioso. A construção da imagem que estamos tratando é planejada a partir da matriz imagética do líder principal da Igreja Universal, Edir Bezerra Macedo. Por meio da imagem central do bispo Macedo é que a liderança é marcada ou estigmatizada com um perfil estético respaldado por uma noção de sucesso. Utilizamos a pesquisa bibliográfica e observação participante como método de pesquisa e ainda, pesquisamos o jornal Folha Universal e averiguamos alguns programas televisivos exibidos na TV Record, analisando o marketing pessoal da liderança em questão. Assim, verificamos que as interfaces de presentação da boa imagem produzida por meio de técnicas corporais, roupas e acessórios, favorece a representação desses líderes nos seus principais canais de comunicação, templos e televisão.(AU)

Erosion of universal health coverage in Spain

Whereas the recent UN resolution urges governments to accelerate progress towards universal access to affordable and quality health-care services, the Spanish Government, bypassing the parliamentary procedure, enacted a Royal Decree to limit access to free services at the point of delivery for all-undermining the principle of universal coverage. Spanish health and social service budgets have been subjected to large cuts (13,7% in 2012 and 16,2% in 2013) with some regions imposing additional budget cuts.

Mutual recognition in goods and services: an economic perspective. Bruges European Economic Policy (BEEP) Briefing 2/2002

Mutual recognition is a remarkable innovation facilitating economic intercourse across borders. In the EU's internal goods market it has been helpful in tackling or avoiding the remaining obstacles, namely, regulatory barriers between Member States. However, there is a curious paradox. Despite the almost universal acclaim of the great merits of mutual recognition the principle has, in and by itself, contributed only modestly to the actual realisation of free movement in the single market. It is also surprising that economists have not or hardly underpinned their widespread appreciation for the principle by providing rigorous analysis which could substantiate the case for mutual recognition for policy makers. Business in Europe has shown a sense of disenc hantment with the principle because of the many costs and uncertainties in its application in actual practice. The purpose of the present paper is to provide the economic and strategic arguments for employing mutual recognition much more systematically in the single market for goods and services. The strategic and the "welfare" gains are analysed and adetailed exposition of the fairly high information , transaction and compliance costs is provided. The information costs derive from the fact that mutual recognition remains a distant abstraction for day-to-day business life. Understandably, verifying the "equivalence" of objectives of health and safety between Member States is perceived as difficult and uncertain. This sentiment is exacerbated by the complications of interpreting the equivalence of "effects". In actual practice, these abstractions are expected to override clear and specific national product or services rules, which local inspectors or traders may find problematic without guidance. The paper enumerates several other costs including, inter alia, the absence of sectoral rule books and the next-to-prohibitive costs of monitoring of the application of the principle. The basic problems in applying mutual recognition in the entire array of services are inspected, showing why the principle can only be used in a limited number of services markets and even there it may contribute only modestly to genuine free movement and competitive exposure. A special section is devoted to a range of practical illustrations of the difficulties business experiences when relying on mutual recognition. Finally, the corollary of mutual recognition - regulatory competition - is discussed in terms of a cost/benefits analysis compared to what is often said to be the alternative , that is "harmonisation" , in EU parlance the "new approach" to approximation. The conclusion is that the manifold benefits of mutual recognition for Europe are too great to allow the present ambiguities to continue. The Union needs much more pro-active approaches to reduce the costs of mutual recognition as well as permanent monitoring structures for its application to services (analogous to those already successfully functioning in goods markets). Above all, what is required is a "mutual recognition culture" so that the EU can better enjoy the fruits of its own regulatory ingenuity.

Implementing universal newborn hearing screening programs : early identification of hearing loss.

Shipping list no.: 99-0282-P.

Universal free health care in Canada, 1947-1977 /

Item 507-C-1

RELIGIÃO E MARKETING PESSOAL: UMA ANÁLISE DA IMAGEM PESSOAL DOS BISPOS, PASTORES, OBREIROS E OBREIRAS DA IGREJA UNIVERSAL DO REINO DE DEUS

Este trabalho tem por objetivo analisar a forma de construção da imagem dos bispos, pastores, obreiros e obreiras da Igreja Universal do Reino de Deus (IURD), por meio da ferramenta de marketing pessoal (MP). A utilização do MP por tais agentes religiosos é uma maneira de melhorar a interação simbólica entre líderes e fiéis e atrair o público para os templos. A IURD foi escolhida para esta análise por usar de vários procedimentos que estão relacionados com as técnicas de MP, no sentido de sofisticar a aparência visual de sua liderança, a fim de representar um discurso de prosperidade disseminado pela instituição. Cremos que é dessa forma que a IURD atrai o público por meio da imagem criada dos líderes, mediante uma aparência visual sofisticada. Na pesquisa dessa Igreja, encontramos que a ferramenta de MP usada pelos seus membros hierárquicos contribui para o crescimento e a consolidação desse empreendimento no mercado religioso. A construção da imagem que estamos tratando é planejada a partir da matriz imagética do líder principal da Igreja Universal, Edir Bezerra Macedo. Por meio da imagem central do bispo Macedo é que a liderança é marcada ou estigmatizada com um perfil estético respaldado por uma noção de sucesso. Utilizamos a pesquisa bibliográfica e observação participante como método de pesquisa e ainda, pesquisamos o jornal Folha Universal e averiguamos alguns programas televisivos exibidos na TV Record, analisando o marketing pessoal da liderança em questão. Assim, verificamos que as interfaces de presentação da boa imagem produzida por meio de técnicas corporais, roupas e acessórios, favorece a representação desses líderes nos seus principais canais de comunicação, templos e televisão.(AU)

Some obstacles to the establishment of a universal method of education for parenthood by the P.N.E.U

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

Hospital discharge planning in the provision of food and nutrition services for older adults post discharge

This descriptive study examined whether discharge planning ensures that food and nutrition services are provided to older adults following hospital discharge. The questionnaire was distributed to discharge planning professionals in 11 South Florida hospitals. Of the 84 respondents (88% response rate), most were female nurse case managers. Almost all reported job barriers including excessive patient loads, too many responsibilities, and limited community services. While physicians, registered nurses, social workers, physical therapists, were deemed "very important" in discharge planning,registered dietitians were not, and almost half consulted them infrequently, if at all. Over 84% said nutrition-related medical conditions/factors, "strongly influenced" discharge planning. Many did not have adequate information about nutrition-related community resources, eg, home delivered meals, food stamps, outpatient registered dietitians. Therewere no universal approaches in meeting the nutrition needs in 6 case scenarios. More communication among community services and hospitals is needed.

Putting Adequate Financial and Human Resources in Healthcare for Effective Universal Health Coverage in Kenya: Lessons and Experiences from China

In recent years, most low and middle-income countries, have adopted different approaches to universal health coverage (UHC), to ensure equity and financial risk protection in accessing essential healthcare services. UHC-related policies and delivery strategies are largely based on existing healthcare systems, a result of gradual development (based on local factors and priorities). Most countries have emphasized on health financing, and human resources for health (HRH) reform policies, based on good practices of several healthcare plans to deliver UHC for their population.

Health financing and labor market frameworks were used, to understand health financing, HRH dynamics, and to analyze key health policies implemented over the past decade in Kenya’s effort to achieve UHC. Through the understanding, policy options are proposed to Kenya; analyzing, and generating lessons from health financing, and HRH reforms experiences in China. Data was collected using mixed methods approach, utilizing both quantitative (documents and literature review), and qualitative (in-depth interviews) data collection techniques.

The problems in Kenya are substantial: high levels of out-of-pocket health expenditure, slow progress in expanding health insurance among informal sector workers, inefficiencies in pulling of health are revenues, inadequate deployed HRH, maldistribution of HRH, and inadequate quality measures in training health worker. The government has identified the critical role of strengthening primary health care and the National Hospital Insurance Fund (NHIF) in Kenya’s move towards UHC. Strengthening primary health care requires; re-defining the role of hospitals, and health insurance schemes, and training, deploying and retaining primary care professionals according to the health needs of the population; concepts not emphasized in Kenya’s healthcare reforms or programs design. Kenya’s top leadership commitment is urgently needed for tougher reforms implementation, and important lessons from China’s extensive health reforms in the past decade are beneficial. Key lessons from China include health insurance expansion through rigorous research, monitoring, and evaluation, substantially increasing government health expenditure, innovative primary healthcare strengthening, designing, and implementing health policy reforms that are responsive to the population, and regional approaches to strengthening HRH.

Photonic integrated circuits development: a universal transceiver for NG-PON2

In the last years there has been a clear evolution in the world of telecommunications, which goes from new services that need higher speeds and higher bandwidth, until a role of interactions between people and machines, named by Internet of Things (IoT). So, the only technology able to follow this growth is the optical communications. Currently the solution that enables to overcome the day-by-day needs, like collaborative job, audio and video communications and share of les is based on Gigabit-capable Passive Optical Network (G-PON) with the recently successor named Next Generation Passive Optical Network Phase 2 (NG-PON2). This technology is based on the multiplexing domain wavelength and due to its characteristics and performance becomes the more advantageous technology. A major focus of optical communications are Photonic Integrated Circuits (PICs). These can include various components into a single device, which simpli es the design of the optical system, reducing space and power consumption, and improves reliability. These characteristics make this type of devices useful for several applications, that justi es the investments in the development of the technology into a very high level of performance and reliability in terms of the building blocks. With the goal to develop the optical networks of future generations, this work presents the design and implementation of a PIC, which is intended to be a universal transceiver for applications for NG-PON2. The same PIC will be able to be used as an Optical Line Terminal (OLT) or an Optical Network Unit (ONU) and in both cases as transmitter and receiver. Initially a study is made of Passive Optical Network (PON) and its standards. Therefore it is done a theoretical overview that explores the materials used in the development and production of this PIC, which foundries are available, and focusing in SMART Photonics, the components used in the development of this chip. For the conceptualization of the project di erent architectures are designed and part of the laser cavity is simulated using Aspic™. Through the analysis of advantages and disadvantages of each one, it is chosen the best to be used in the implementation. Moreover, the architecture of the transceiver is simulated block by block through the VPItransmissionMaker™ and it is demonstrated its operating principle. Finally it is presented the PIC implementation.

Evaluation of Urban Spaces from the Perspective of Universal Design Principles: The Case of Konya/Turkey

During the process of accessing services provided within urban interior and outer spaces the elderly and disabled individuals encounter with a myriad of problems due to the limitations posed by structured environments. This limitation hinders elderly and disabled individuals from mobility without assistance, which in turn negatively affects their full participation to urban and social life. Rearrangement of urban spaces to meet the needs of elderly and disabled individuals would correspondingly bolster life quality of the entire range of users. Within the scope of present research, as mandated by universal design principles to stick to plans and designs approaches inclusive for all users, it is aimed to conduct evaluations on the use of urban outer spaces situated within Konya City Center. In the hypothetical and theoretical part of this paper, the perception of disability throughout historical process has been examined from a sociological perspective. In addition, concept of universal design, its principles and gravity have also been elaborated. In the part dealing with the case study, outer spaces within Konya City Center have been analyzed with respect to universal design principles and a range of suggestions have been developed.