Improving the health forecasting alert system for cold weather and heat-waves in England: a proof-of-concept using temperature-mortality relationships

Objectives In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office’s (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. Method The prototype health forecasting alert system introduces an “impact vs likelihood matrix” for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. Conclusions The prototype shows some clear improvements over the current alert system. It allows for a much greater degree of flexibility, provides more detailed regional information about the health risks associated with periods of extreme temperatures, and is more coherent with other weather alerts which may make it easier for front line responders to use. It will require validation and engagement with stakeholders before it can be considered for use.

Distortions in the investment goods sector and productivity decline

We study the impact of distortions in the investment goods sector on aggregate total factor productivity (TFP). We develop a two-sector neo-classical growth model in which TFP in the capital goods sector relative to TFP in the consumption sector is inversely related to the price of investment relative to consumption, so that we use relative prices to measure TFP in the investment goods sector. The model is calibrated to Brazil and we nd that distortions in the investment goods sector may explain most of the decline in Brazilian TFP relative to the United States since the mid-1970s.

Maritime sector and ports in the Caribbean: the case of CARICOM countries

Includes bibliography

Profit margins, financing and investment in the Peruvian business sector (1998-2008)

Includes bibliography

The impact of privatisation on the banking sector in the Caribbean

Includes bibliography

An assessment of the economic impact of climate change on the water sector in Grenada

Changing precipitation patterns and temperature relate directly to water resources and water security. This report presents the findings of an assessment of the water sector in Grenada with respect to the projected impact of climate change. Grenada‘s water resources comprise primarily surface water, with an estimated groundwater potential to satisfy about 10%-15% of the present potable requirement. On the smaller islands Carriacou and Petite Martinique, domestic water is derived exclusively from rainwater catchments. Rainfall seasonality is marked and the available surface water during the dry season declines dramatically. Changing land use patterns, increase in population, expansion in tourism and future implementation of proposed irrigation schemes are projected to increase future water requirements. Economic modeling approaches were implemented to estimate sectoral demand and supply between 2011 and 2050. Residential, tourism and domestic demand were analysed for the A2, B2 and BAU scenarios as illustrated. The results suggest that water supply will exceed forecasted water demand under B2 and BAU during all four decades. However under the A2 scenario, water demand will exceed water supply by the year 2025. It is important to note that the model has been constrained by the omission of several key parameters, and time series for climate indicators, data for which are unavailable. Some of these include time series for discharge data, rainfall-runoff data, groundwater recharge rates, and evapotranspiration. Further, the findings which seem to indicate adequacy of water are also masked by seasonality in a given year, variation from year to year, and spatial variation within the nation state. It is imperative that some emphasis be placed on data generation in order to better project for the management of Grenada‘s water security. This analysis indicates the need for additional water catchment, storage and distribution infrastructure, as well as institutional strengthening, in order to meet the future needs of the Grenadian population. Strategic priorities should be adopted to increase water production, increase efficiency, strengthen the institutional framework, and decrease wastage. Grenada has embarked on several initiatives that can be considered strategies toward adaptation to the variabilities associated with climate change. The Government should ensure that these programs be carried out to the optimal levels for reasons described above. The ―no-regrets approach‖ which intimates that measures will be beneficial with or without climate change should be adopted. A study on the Costs of Inaction for the Caribbean in the face of climate change listed Grenada among the countries which would experience significant impacts on GDP between now and 2100 without adaptation interventions. Investment in the water sector is germane to building Grenada‘s capacity to cope with the multivariate impact of changes in the parameters of climate.

An assessment of the economic impact of climate change on the tourism sector in Aruba

In this study, an attempt is made to assess the economic impact of climate change on Aruba. This study has three main objectives. The first is to examine the factors that influence the demand and supply of tourism in Aruba. The second is to forecast the cost of climate change to the tourism sector until 2050 under the A2 and B2 climate scenarios with the Business as Usual (BAU) as a comparator climate scenario, and the third is to estimate the cost of adaptation and mitigation strategies that can be undertaken by Aruba to address climate change in the tourism sector.

Characteristics of physical activity programs in the Brazilian primary health care system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Information flows and environments in business contexts: the meat sector case of Salmanca/Spain

Organizational environments are related to hierarchic levels existing in a determined organization, and they influence in the formal and informal flows origin and in their monitoring and/or extinction. Informational environments are a result of organizational environments, of which focus is information and knowledge. Information flows are a fundamental element to informational environments, in a way that there´s no informational environments if there´s no information flows. Informational flows are natural reflections from their environments, in terms of content and in the way they occur. This qualitative and quantitative research was developed in three stages, in a way to allow the comprehension of the phenomena related to information and knowledge environments and information flows that occur in the meat sector from the Province of Salamanca, Spain. We used Laurence Bardin´s ‘Analysis of Content’, more specifically the ‘Categorical Analysis’ technique to data analysis. As data collection procedure we accomplished a field research, applying a questionnaire as an intentional sample of the meat industries segment from the Province of Salamanca, Spain. From data tabulation and analysis, we infer that information environments and flows are relevant to these companies business development, as well as we emphasized the need of information and knowledge management deployment, in a way to insure organizational processes quality, industrial chain production and companies competition to conquer potential markets.

The Everyday Life in Public Health Research: a theoretical and methodological framework

The aim of this paper is to present some reflections on possibilities to investigate everyday life by examining ways of life, so as to broaden perspectives to the field of research in public health, in light of the fact that the study of daily ways of life involves the analysis of trajectories that contextualize routines, interactions and meanings of life. This allows the social researcher in the health field to have, based on a theoretical framework, a flexible methodology that offers mobility in the choice of the technique that best favors the understanding of the issue to be investigated. We have here, as a conceptual reference, the idea of everyday life investigated from interactive processes and contexts, as opposed to a categorial objectification between subject and object. In this context, from the theoretical reflection, we take, as the research's empirical reference, the waiting room of the outpatient clinic of the Osteoarticular Metabolism Department of a Health Care Unit in the city of Fortaleza/, Northeastern Brazil, in order to foster an interpretive understanding of the daily routine that involves the life and health situations of women with osteoporosis.

Antenatal depression strongly predicts postnatal depression in primary health care

Objective: To estimate the association between antenatal and postnatal depression and to examine the role of socioeconomic conditions in the risk of postnatal depression. Methods: A prospective cohort study, conducted between May 2005 and January 2006, with 831 pregnant women recruited from primary care clinics in the public sector in the city of Sao Paulo, Brazil. The presence of antenatal and postnatal depression was measured with the Self Report Questionnaire (SRQ-20). Sociodemographic and socioeconomic characteristics and obstetric information were obtained through a questionnaire. Crude and adjusted risk ratios (RR), with 95% CI, were calculated using a Poisson regression. Results: The prevalence of postnatal depressive symptoms was 31.2% (95% CI: 27.8-34.8%). Among the 219 mothers who had depressive symptoms, nearly 50% had already shown depressive symptoms during pregnancy. Women who had antenatal depression were 2.4 times more likely to present with postnatal depression than were women who did not have such symptoms during pregnancy. In the multivariate analysis, higher scores for assets (RR: 0.76, 95% CI 0.61-0.96), higher education (RR: 0.75 95% CI 0.59-0.96), daily contact with neighbors (RR: 0.68, 95% CI 0.51-0.90) and antenatal depression (RR: 2.44, 95% CI 1.93-3.08) remained independently associated with postnatal depression. Conclusions: Antenatal and postnatal depression are highly prevalent in the primary care setting.

The use of focus groups in the development of the KIDSCREEN HRQL questionnaire

There is increasing interest in the public health sector in the health-related quality of life (HRQL) of healthy children. However, most HRQL instruments are developed for children with a chronic illness. In addition, existing questionnaires are mostly based on expert opinion about what constitutes HRQL and the opinions and views of healthy children are seldom included. In the European project KIDSCREEN, a generic questionnaire was developed for children between the ages of 8 and 18 on the basis of children's opinions about what constitutes HRQL. Focus group discussions were organised in six European countries to explore the HRQL as perceived by children. There were six groups in each country, stratified by gender and age. The age groups were 8-9 years, 12-13 years, and 16-17 years, with 4-8 children in each group. Experienced moderators guided the discussions. The full discussions were audiotaped, transcribed and content-analysed. The discussions went smoothly, with much lively debate. For the youngest group, the most important aspect of their HRQL was family functioning. For both younger and older adolescents, social functioning, including the relationship with peers, was most important. Children in all groups considered physical and cognitive functioning to be less important than social functioning. These key findings were taken into account when designing the KIDSCREEN HRQL questionnaire for healthy children and adolescents, with more emphasis being placed on drawing up valid scales for family and social functioning. In addition, items were constructed using the language and lay-out preferred by the youngsters themselves. We conclude that focus groups are a useful way of exploring children's views of HRQL, showing that an emphasis should be placed on constructing valid social and family scales.

Impacts of Technology Adoption: Comparing Returns to the Farming Sector in Maine under Alternative Technology Regimes

This thesis tests if certain technology choices are associated with a reduction in the proportion of farming activities in the agro-food system in Maine. Goodman, Sorj, and Wilkinson define appropriationism as the replacement of farming sector activities by industrial inputs. Based on the concept of appropriationism, industrial fanning systems using large amounts of synthetic inputs contribute less to fanning than more agrarian systems, like organic fanning. Thus, returns to the farming sector should be greater for organic compared with conventional potato fanning in Maine since organic farming uses fewer industrial inputs. Goodman et. al. define substitutionism as the displacement of farming sector commodities and activities by industrial processes in the marketing sector. Based on the concept of substitutionism, returns to the farming sector should be greater for Lay's Classic®™ potato chips made from natural potatoes compared with Baked Lay's®™ potato crisps manufactured from processed dehydrated potatoes. Returns to the farming sector are defined as returns to the farmer or farm family from farming activities, returns to farm labor, and returns to farmers and farm labor producing inputs used on the farm. Results show absolute returns to the farming sector are less for organic compared to conventional tablestock potato farms in Maine. However as a proportion of farm revenues, large organic farms that market at least 25% of their produce to retail stores or directly to consumers do as well as conventional farms. When comparing returns as a proportion of consumer expenditures, these organic farms do better than conventional farms. Returns to the farming sector are less for organic because of yield penalties, cost of marketing services, and diseconomies of size for organic tablestock potato farms. Expanding acreage and reintegrating livestock with cropping systems may increase returns to the fanning sector. Organic farming demonstrates difficulties in providing marketing services at the farm level. Providing marketing services limits the ability to expand production to capture economies of size. Maine organic potato farmers emphasize non-monetary values such as supporting sustainable agriculture, self-sufficiency, the intrinsic value of work, and close community and family connections. Returns to the farming sector as a proportion of consumer expenditures are about three times greater for Lay's Classic®™ potato chips than for Baked Lay's®™ potato crisps, since the value that farmers receive for potatoes used to produce dehydrated potato flakes in one pound of crisps is about half of the value that farmers receive for potatoes used to make one pound of chips. However, this assumes farmers assign a cost to producing low-grade potatoes for dehydration proportionate to their value. Premium potatoes are used to produce potato chips. Low-grade potatoes are used to produce the dehydrated potato flakes used to make potato crisps. Returns to the farming sector are slightly greater for potato crisps if no costs are allocated to producing low-grade potatoes for dehydration. A shift in consumer preferences from potato chips to crisps may result in a geographical shift of potato production from Maine to the Pacific Northwest assuming no food-grade dehydration facilities are built in Maine.

Patient satisfaction in government health facilities in the state of Qatar

This study provides data which can contribute to improving services and delivering quality health care in government health facilities in the state of Qatar. To measure the satisfaction with current care of selected patients who receive care in Hamad General Hospital and the Khalifa Town Health Center in the city of Doha, a cross-sectional survey and a self-administered questionnaire were used.^ Analysis was performed on data from 444 patients on eight dimensions of patient satisfaction with medical care. These include: general satisfaction, availability of services, convenience of services, facilities, humaneness of doctors, quality of care, continuity of care, and aspects of the last visit. Patient satisfaction parameters were compared for males vs. females, for citizens vs. non-citizens, and for patients seen in the hospital vs. those seen in the health center.^ Results indicate that patients seen in the hospital were more satisfied with care than patients seen in the health center, that non-citizens were more satisfied than citizens, and that males were slightly more satisfied than females with medical services. ^