700 resultados para Prioritization of interventions
Resumo:
Digital technologies have profoundly changed not only the ways we create, distribute, access, use and re-use information but also many of the governance structures we had in place. Overall, "older" institutions at all governance levels have grappled and often failed to master the multi-faceted and multi-directional issues of the Internet. Regulatory entrepreneurs have yet to discover and fully mobilize the potential of digital technologies as an influential factor impacting upon the regulability of the environment and as a potential regulatory tool in themselves. At the same time, we have seen a deterioration of some public spaces and lower prioritization of public objectives, when strong private commercial interests are at play, such as most tellingly in the field of copyright. Less tangibly, private ordering has taken hold and captured through contracts spaces, previously regulated by public law. Code embedded in technology often replaces law. Non-state action has in general proliferated and put serious pressure upon conventional state-centered, command-and-control models. Under the conditions of this "messy" governance, the provision of key public goods, such as freedom of information, has been made difficult or is indeed jeopardized.The grand question is how can we navigate this complex multi-actor, multi-issue space and secure the attainment of fundamental public interest objectives. This is also the question that Ian Brown and Chris Marsden seek to answer with their book, Regulating Code, as recently published under the "Information Revolution and Global Politics" series of MIT Press. This book review critically assesses the bold effort by Brown and Marsden.
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Die Förderung regelmäßiger Bewegungs- und Sportaktivitäten bei älteren Menschen gewinnt zunehmend an Bedeutung. Für eine effiziente Bewegungs- und Sportförderung werden zielgruppenspezifische Maßnahmen gefordert. Sportbezogene Motive und Ziele von Älteren werden aktuell selten systematisch in die Konzeption von Interventionen miteinbezogen, wenngleich sie für das Wohlbefinden und die Aufrechterhaltung des Sportverhaltens eine zentrale Rolle einnehmen. Das bereits bestehende BMZI ermöglicht die Individualdiagnose von Motiven und Zielen im Freizeit- und Gesundheitssport bei Personen im mittleren Erwachsenenalter. Der vorliegende Beitrag zielt auf eine Adaption des Fragebogens für Menschen im höheren Erwachsenenalter. Das BMZI-HEA deckt mit insgesamt 27 Items folgende Motive und Ziele ab: Figur/Aussehen, Kontakt, Wettkampf/Leistung, Alltagskompetenz/Gesundheit, Positive Bewegungserfahrungen, Kognitive Funktionsfähigkeit, Stimmungsregulation. Der Fragebogen wurde an drei Stichproben explorativ und konfirmatorisch überprüft. Der globale Modell-Fit des BMZI-HEA ist als zufriedenstellend zu beurteilen. Die erwartungskonformen Zusammenhänge mit der Selbstkonkordanz verweisen auf eine gute Konstruktvalidität des Instruments. Das BMZI-HEA empfiehlt sich als ökonomisches Instrument für die Individualdiagnose der psychischen Handlungsvoraussetzungen für das Sporttreiben von Menschen im höheren Erwachsenenalter.
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Due to its extraordinary biodiversity and rapid deforestation, north-eastern Madagascar is a conservation hotspot of global importance. Reducing shifting cultivation is a high priority for policy-makers and conservationists; however, spatially explicit evidence of shifting cultivation is lacking due to the difficulty of mapping it with common remote sensing methods. To overcome this challenge, we adopted a landscape mosaic approach to assess the changes between natural forests, shifting cultivation and permanent cultivation systems at the regional level from 1995 to 2011. Our study confirmed that shifting cultivation is still being used to produce subsistence rice throughout the region, but there is a trend of intensification away from shifting cultivation towards permanent rice production, especially near protected areas. While large continuous forest exists today only in the core zones of protected areas, the agricultural matrix is still dominated by a dense cover of tree crops and smaller forest fragments. We believe that this evidence makes a crucial contribution to the development of interventions to prevent further conversion of forest to agricultural land while improving local land users' well-being.
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In my thesis I looked at Cold War interventionism by America. In the Post WWII period, many countries were searching for freedom from colonial rule, and many were attracted to the idea of communism or socialism. In this context of a destabilized world and power struggle between the U.S.A and the U.S.S.R., revolutions often became points of interests and parts of this larger power play. Any type of revolution was a destabilization, in a system that was unstable at best, and peace between the powers rested precariously on the idea of “Mutually Assured Destruction.” I would like to look more specifically, at the Latin American Region, which seemed full of upheaval, and was an area of much intervention, especially during the Reagan Administration. This administration had varying goals and conflicts about the region. The large amount of interventionism in the 1980s was in part a response to the Vietnam War, which was seen as an American failure, since prevention of communism did not occur. Following this, American strength needed to be shown again in the international stage, especially in Latin America, due to its close proximity to America. I would like to explore the intervention in Grenada and see if it followed a pattern of intervention in the region. This will be contrasted with the case of Nicaragua, which seemed more typical of interventions in the region. The causes of intervention in the region as well as the reasons these interventions took such different courses will be explored and investigated.
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This dissertation examined the impact of acculturation and the influence of the family (specifically parenting practices) on Hispanic youth's sexual behavior and reproductive health and is presented in the form of three papers. In the first paper, we assessed the reliability and validity of the Bicultural Acculturation Scale/Language Proficiency (BAS/LP) subscale for use among Hispanic middle school-aged youth. The purpose of the second paper was to examine the associations between initiation of vaginal intercourse, parental monitoring, and parent-child communication while controlling for acculturation and other recognized covariates. Finally, the purpose of the third dissertation paper was to examine HPV vaccine knowledge, attitudes, and acceptability among Hispanic mothers and girls using strategic focus groups. The three papers will jointly extend the knowledge about Hispanic youth and their parents regarding both sexual initiation and uptake of the HPV vaccine. In addition, findings from the papers can inform the development of interventions for Hispanic youth and their parents to delay sexual initiation and increase HPV vaccine uptake.^
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Effective communication; whether from an interpersonal, mass media, or global perspective, is a critical component in public health. It is an essential conduit in increasing public awareness of available health resources, potential health hazards and related disease prevention strategies, and in delivering better health care. Within this context, available literature asserts doctor-patient communication as central to healthcare delivery. It has been shown to affect patient health outcomes, satisfaction with care, adherence to treatment recommendations, and even understanding of medical information. While research supports the essential imperative of interventions aimed at teaching doctors and patients the communication skills necessary for a successful and meaningful medical interaction, most interventions to date, focus on teaching these communication skills to doctors and seem to rely, largely, on mass media for providing patients with the information needed to increase communication efficacy. This study sought to fill a significant gap in the doctor-patient communication literature by reviewing the context of the doctor-patient exchange in the medical interaction, the implications of this exchange in resulting care of the patient, and the potential improvements to practice through interventions aimed at improving the communication exchange. Closing with an evaluation of a patient-centered communication intervention, the “How to Talk to Your Doctor” (HTTTYD) program that combines previously identified optimal strategies for improving communication between doctors and patients, this study examined the patients’ perspective of their potential as better communicators in the medical interaction. ^ Specific Aims, Hypotheses or Questions (Aim I) To examine the context of health communication within a public health framework and its relation to health care delivery. (Aim II) To review doctor-patient communication as a central focus within health care delivery and the resulting implications to patient care. (Aim III) To assess the utility of interventions to improve doctor-patient communication. Specifically, to evaluate the effectiveness of a patient-centered community education intervention, the “How to Talk to Your Doctor” (HTTTYD) program, aimed at improving patient communication efficacy.^
Resumo:
Purpose: To examine the effect of obesity and gestational weight gain on heart rate variability (HRV), oxygenation (HbO 2 and SpO2), hemoglobin A1c (HbA1c) and the frequency of pregnancy complications in obese (O) and non-obese (NO) women.^ Design: The study was an observational comparison study with a repeated measures design. ^ Setting: The setting was a low risk prenatal, university clinic located in a large southeastern metropolitan city. ^ Sample: The sample consisted of a volunteer group of 41 pregnant women who were observed at the three time points of 20, 28, and 36 weeks gestation. ^ Analysis: Analysis included general linear modeling with repeated measures to test for group differences with changes over time on vagal response, HbA1c, and oxygenation. Odds ratios were computed to compare the frequency of birth outcomes. ^ Findings: The interaction effect of time between O and NO women on HbO2 was significant. The mean HP, RSA, and HbO2 changed significantly over time within the NO women. The mean HbA 1c increased significantly over time within the O women. Women with excess gestational weight gain had significantly lower heart period than women with weight gain within the IOM recommendations. Obese women were more likely to have Group B streptococcal infections, gestational hypertension, give birth by cesarean or instrument assistance, and have at least one postnatal event. ^ Conclusions: Monitoring HRV, oxygenation, and HbA1c using minimally invasive measures may permit early identification of alterations in autonomic response. Implementation of interventions to promote vagal tone may help to reduce risks for adverse perinatal outcomes related to obesity. Future studies should examine the effect of obesity on the vagal response and perinatal outcomes. ^
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Cancer patients increasingly request alternative therapies such as imagery techniques and support groups. Although research suggests evidence of enhanced psychosocial functioning with supportive group therapy and enhanced immune function with imagery techniques, studies are anecdotal or limited to case studies or descriptive reports. The efficacy of these alternative therapies should be validated by randomized, controlled trials and the mechanisms of action mediating immune function and outcome examined.^ In a 12-month pilot study, we evaluate the feasibility of conducting a controlled study with clinical trial methodology to test the effects of imagery/relaxation and support on quality of life, emotional well-being, and immune function for women after breast cancer. Using a randomized pre-post test design with three intervention waves, we assigned women (n = 47) to either standard care (n = 15), standard care plus 6-weekly support sessions (n = 16) or imagery/relaxation sessions (n = 16).^ The primary aim of this pilot study is to determine the feasibility of conducting a clinical trial of alternative therapies in a clinical care setting. Secondary aims are to determine parameter estimates for the effects of the two treatment groups on quality of life, coping, social support, and immune function and describe methodology issues related to trials of alternative therapies.^ The research provides direction for future studies of alternative therapies by describing the recruitment, clinical trial experience, and related methodology issues. The study extends previous work by differentiating the effects of support group from mental imagery among outpatient groups who are homogeneous regarding cancer type and treatment stage. The study provides data for future longitudinal studies of disease progression by differentiating the effectiveness of interventions designed to enhance quality of life, coping, social support, and immune function and subsequently, alter the clinical course of disease. ^
Resumo:
This study was designed to test the theoretical predictors of personal efficacy expectations among family medicine resident physicians for helping their patients change thirteen high risk health behaviors. A survey questionnaire was sent to 781 family medicine residents in the six state south central region. The response rate was 60 percent. The hypothesized relationship between lower levels of difficulty and higher personal efficacy expectations was supported by the data. Effort was a significant predictor of perceived self efficacy for health behaviors considered less difficult to change. Situational support did not prove to be a significant predictor for many of the health behaviors. Rate and pattern of success were consistent and significant predictors of perceived self efficacy for helping patients change all thirteen of the health behaviors. Modeling of effective methods by faculty was a significant predictor of efficacy expectations for several but not all of the behaviors. Personal modeling was a significant predictor of perceived efficacy for helping patients change behaviors related to alcohol misuse and exercise. The respondents personally modeled positive health behaviors more consistently than their older colleagues or the general population.^ The results of this study lend substantially to the usefulness of the cognitive-behavioral theory of perceived self efficacy and provide a mechanism for assessing the predictors of personal efficacy expectations of family medicine resident physicians. The findings are expected to have direct implications for faculty to institute systematic programs of interventions designed to increase residents' perceptions of efficacy in facilitating more positive health behaviors among their patients. ^
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The topic of occupational health and safety (OHS) has been investigated for many years and continues to be a concept often researched today. Generally speaking OHS research has been centered around food safety, construction safety, transportation safety, fire safety, drug and alcohol testing, health and medical management, and industrial hygiene to name a few. However, the concept of OHS concerning female commercial sex workers (FCSWs) has rarely been investigated, often neglected, seldom discussed and is lacking in sound research. Although regarded as the "oldest profession", commercial sex work (CSW) has consistently been ignored, disregarded and under-researched due to the illegality and stigmatization of prostitution. This paper reviews occupational safety and health issues faced by FCSWs in Tema and Accra, Ghana, through in-depth interviews, visits to women's homes, field work, informal conversations and participant observations with FCSWs over a period of two months. Facets of OHS that emerged among FCSWs included sexually transmissible infections, risks associated with harassment and violence from police and clients, alcohol and drug use, irregular hospital visits and/or lack of hospital visits, immigration issues, legal and policing risks. We argue that CSW be viewed as an occupation in great need of interventions to reduce workplace risks and improve the health and safety of FCSWs^
Resumo:
Mucho ofthe towns of Mendoza have been working for years with a methodology built with traditional zoningand code of permitted uses,not permitted or conditional. With these instrument sexpectthe presentation of private enter prisesto assess whether it complies with these regulationsto authorize the works.These agencies have a plan with zoning and code application shave already considered planning. This form of work, shows clearly the lack of actions to drive urban developmentsin the department, initiatives on the issue only limited to astatic situation, waiting for proposal sand external actions,not being able to see the advantagesand /or contribution saccom panying the Land Use Plan. Une of the important elements to considerin the Plan process, is the incorporation of participatory stage allows, consensus and guidanceto policy makers, community in territorial actions. For this way are designed and constructed public works, to address concerns of the population and in some cases,works that will produce community supportat election time. A look at the performance of Cities hall suchas Granada City Council, Churriana de la Vega and Jun, you can observe that the planning can be done other wise, as articulated action from the same organism. In principle determining zoning and uses of spaceis integral to the Land Use Planand that it further comprises the development proposals,the lines of action and prioritization of programs and projects. These local governants, which manage a municipality, working withdy namic planning councilasit implements the proposed urban development, agricultural, commercial and industrialin its territory and build public work saccording to plan. Since 2009,the province has a Law of Zoningand Land Use demanded Municipal Land Management Plans, but three years after the enactmentof the 18 only has aplan.Thisis due to two reasons:the policy makersdo not understand the multiplicity of elements and facets of a plan covering the other,the plans are perceived as a limitation on their actions , a fact not willing to accept. The dissemination of know ledge and the, new ways toaddress the Land Use Planning and management of conflicts generated by the unprecedented growthwith incompatible usesin these cities that the component swhich will requirel and manager stoimplement aplanning Plans. Tusa dinámica risión Fromm te municipalitos in thais contexto de can tal abur innovación and a newway of governing
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La tesis estudia una serie de intervenciones gestadas en el ámbito judicial que se ocuparon de regular la vida de niños y jóvenes acusados de delinquir. Nominados como 'menores', se trataba de un sector de la población que se encontraba fuera de los marcos normativos previstos por la definición moderna de la infancia y la juventud. En este sentido, el objetivo principal de la investigación es presentar una primera aproximación a tres aspectos vinculados a la construcción social de la minoridad en la provincia de Buenos Aires en el período comprendido entre 1930 y 1943. En primer lugar, pensar la transformación de la forma de concebir los delitos cometidos por los niños y jóvenes y de juzgar sus transgresiones, iniciada en la década de 1920 y consolidada en la década de 1930. En segundo lugar, pensar la configuración de ideas punitivas estructuradas sobre la educación como un elemento clave para reemplazar el castigo tradicional para este sector de la población. En tercer lugar, pensar la centralidad conferida a la familia en dichas ideas y en las prácticas judiciales, que la erigían como una estrategia de solución y como la causa principal del peligro diagnosticado
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Los microemprendimientos productivos surgen en la última década como una opción alternativa para el tratamiento de la problemática laboral de los jóvenes en América Latina. En este trabajo realizamos una discusión sobre el alcance y las características de este tipo de intervenciones, analizando sus potencialidades y sus limitaciones en contextos con elevados índices de pobreza y mercados de trabajo deprimidos. En el texto, luego de realizar una breve revisión del estado del arte sobre el tema, presentamos los avances de un estudio en el que analizamos los primeros resultados de un programa implementado, hace algunos años, en la Ciudad de Resistencia (Provincia del Chaco) con dicho objetivo
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Las dos primeras ediciones de Potpourri. Silbidos de un vago aparecieron en octubre y noviembre de 1882; la tercera se publicó en diciembre del 83. Para la segunda, salvo la corrección de cinco erratas, el autor no introdujo ningún cambio. Sí lo hizo para la publicación de la tercera; el más importante: el agregado de un prólogo. En cuanto al resto del texto, el tipo de intervenciones -sustituciones léxicas y modificaciones formales que en ocasiones involucran transformaciones semánticas, ajustes que benefician la coherencia de la trama y la legibilidad- revela una preocupación evidente por el detalle
Resumo:
Objetivos: este trabajo tiene como objetivo analizar los niveles de actividad fisicas en estudiantes de escuelas secundarias y estudiantes universitarios; estimar su percepción del entorno contruído en relación con la actividad física, y evaluar la relación entre la educación física y el entorno contruído. Metodología: Se aplicó un estudio sociológico trasversal con diseño no experimental. Se completaron el cuestionario internacional de actividad física y el cuestionario de caraterísticas de entorno contruído con una muestra de 1.862 alumnos de escuelas secundarias y universidad en Granada, España. Resultados: los alumnos de la escuela secundaria fueron significativamente más activos que los estudiantes universitarios, quienes alcanzaron niveles insuficientes de actividad física. Sin embargo, consideraron Granada un buen contexto para hacer ejercicio al aire libre. No se encontraron relaciones entre los niveles de actividad física y el entorno contruído. Conclusión: la discrepancia de resultados entre los niveles de actividad física y la percepción del entorno contruído sugieren la necesidad de intervenciones focalizadas en hacer que los jóvenes se den cuenta de las posibilidades que el medio les ofrece para ejercitarse. En consecuencia, el medio puede tener un impacto en la salud al mismo tiempo que los jóvenes aprenden a respetarlo