949 resultados para Program Design
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Cash transfers targeted to poor people, but conditional on some behavior on their part, such as school attendance or regular visits to health care facilities, are being adopted in a growing number of developing countries. Even where ex-post impact evaluations have been conducted, a number of policy-relevant counterfactual questions have remained unanswered. These are questions about the potential impact of changes in program design, such as benefit levels or the choice of the means-test, on both the current welfare and the behavioral response of household members. This paper proposes a method to simulate the effects of those alternative program designs on welfare and behavior, based on microeconometrically estimated models of household behavior. In an application to Brazil’s recently introduced federal Bolsa Escola program, we find a surprisingly strong effect of the conditionality on school attendance, but a muted impact of the transfers on the reduction of current poverty and inequality levels.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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STEPanizer is an easy-to-use computer-based software tool for the stereological assessment of digitally captured images from all kinds of microscopical (LM, TEM, LSM) and macroscopical (radiology, tomography) imaging modalities. The program design focuses on providing the user a defined workflow adapted to most basic stereological tasks. The software is compact, that is user friendly without being bulky. STEPanizer comprises the creation of test systems, the appropriate display of digital images with superimposed test systems, a scaling facility, a counting module and an export function for the transfer of results to spreadsheet programs. Here we describe the major workflow of the tool illustrating the application on two examples from transmission electron microscopy and light microscopy, respectively.
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Drawing on theories of technical communication, rhetoric, literacy, language and culture, and medical anthropology, this dissertation explores how local culture and traditions can be incorporated into health-risk-communication-program design and implementation, including the design and dissemination of health-risk messages. In a modern world with increasing global economic partnerships, mounting health and environmental risks, and cross-cultural collaborations, those who interact with people of different cultures have “a moral obligation to take those cultures seriously, including their social organization and values” (Hahn and Inhorn 10). Paradoxically, at the same time as we must carefully adapt health, safety, and environmental-risk messages to diverse cultures and populations, we must also recognize the increasing extent to which we are all becoming part of one, vast, interrelated global village. This, too, has a significant impact on the ways in which healthcare plans should be designed, communicated, and implemented. Because communicating across diverse cultures requires a system for “bridging the gap between individual differences and negotiating individual realities” (Kim and Gudykunst 50), both administrators and beneficiaries of malaria-treatment-and-control programs (MTCPs) in Liberia were targeted to participate in this study. A total of 105 people participated in this study: 21 MTCP administrators (including designers and implementers) completed survey questionnaires on program design, implementation, and outcomes; and 84 MTCP beneficiaries (e.g., traditional leaders and young adults) were interviewed about their knowledge of malaria and methods for communicating health risks in their tribe or culture. All participants showed a tremendous sense of courage, commitment, resilience, and pragmatism, especially in light of the fact that many of them live and work under dire socioeconomic conditions (e.g., no electricity and poor communication networks). Although many MTCP beneficiaries interviewed for this study had bed nets in their homes, a majority (46.34 percent) used a combination of traditional herbal medicine and Western medicine to treat malaria. MTCP administrators who participated in this study rated the impacts of their programs on reducing malaria in Liberia as moderately successful (61.90 percent) or greatly successful (38.10 percent), and they offered a variety of insights on what they might do differently in the future to incorporate local culture and traditions into program design and implementation. Participating MTCP administrators and beneficiaries differed in their understanding of what “cultural incorporation” meant, but they agreed that using local indigenous languages to communicate health-risk messages was essential for effective health-risk communication. They also suggested that understanding the literacy practices and linguistic cultures of the local people is essential to communicating health risks across diverse cultures and populations.
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Technical communication certificates are offered by many colleges and universities as an alternative to a full undergraduate or graduate degree in the field. Despite certificates’ increasing popularity in recent years, however, surprisingly little commentary exists about them within the scholarly literature. In this work, I describe a survey of certificate and baccalaureate programs that I performed in 2008 in order to develop basic, descriptive data on programs’ age, size, and graduation rates; departmental location; curricular requirements; online offerings; and instructor status and qualifications. In performing this research, I apply recent insights from neosophistic rhetorical theory and feminist critiques of science to both articulate, and model, a feminist-sophistic methodology. I also suggest in this work that technical communication certificates can be theorized as a particularly sophistic credential for a particularly sophistic field, and I discuss the implications of neosophistic theory for certificate program design and administration.
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This article examines the predictors of placement following IFPSfor a sample of child mental health service recipients and their families. Risk and protective factors vary depending on the time frame under consideration. Immediately following service, children 's level of Social/Legal functioning, a previous group home placement, and the presence of mental health problems for other family members increase risk of placement, while the number of follow-up services serves to lessen risk. Three to six months after service, the presence of a child behavior presenting problem and a projected placement in foster care serve as protective factors, while two service targets, alcohol monitoring and time management, serve to increase risk. Appropriate use of results for program design and for structuring access to services is discussed.
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The purpose of this comparative analysis of CHIP Perinatal policy (42 CFR § 457) was to provide a basis for understanding the variation in policy outputs across the twelve states that, as of June 2007, implemented the Unborn Child rule. This Department of Health and Human Services regulation expanded in 2002 the definition of “child” to include the period from conception to birth, allowing states to consider an unborn child a “targeted low-income child” and therefore eligible for SCHIP coverage. ^ Specific study aims were to (1) describe typologically the structural and contextual features of the twelve states that adopted a CHIP Perinatal policy; (2) describe and differentiate among the various designs of CHIP Perinatal policy implemented in the states; and (3) develop a conceptual model that links the structural and contextual features of the adopting states to differences in the forms the policy assumed, once it was implemented. ^ Secondary data were collected from publicly available information sources to describe characteristics of states’ political system, health system, economic system, sociodemographic context and implemented policy attributes. I posited that socio-demographic differences, political system differences and health system differences would directly account for the observed differences in policy output among the states. ^ Exploratory data analysis techniques, which included median polishing and multidimensional scaling, were employed to identify compelling patterns in the data. Scaled results across model components showed that economic system was most closely related to policy output, followed by health system. Political system and socio-demographic characteristics were shown to be weakly associated with policy output. Goodness-of-fit measures for MDS solutions implemented across states and model components, in one- and two-dimensions, were very good. ^ This comparative policy analysis of twelve states that adopted and implemented HHS Regulation 42 C.F.R. § 457 contributes to existing knowledge in three areas: CHIP Perinatal policy, public health policy and policy sciences. First, the framework allows for the identification of CHIP Perinatal program design possibilities and provides a basis for future studies that evaluate policy impact or performance. Second, studies of policy determinants are not well represented in the health policy literature. Thus, this study contributes to the development of the literature in public health policy. Finally, the conceptual framework for policy determinants developed in this study suggests new ways for policy makers and practitioners to frame policy arguments, encouraging policy change or reform. ^
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Healthcare for the Homeless—Houston (HHH) received a research grant from The Medallion Foundation, Inc. in March 2006 to pilot The Jail Inreach Project, an intensive “inreach” initiative to assess the impact of providing continuity of mental and primary health care services for homeless individuals who suffer from mental illness and/or substance abuse being released from jail. This pilot project was initiated by HHH, in collaboration with the Harris County Sheriff’s Office and the Mental Health Mental Retardation Authority of Harris County (MHMRA). Those who are flagged as “frequent flyers” and who are diagnosed with a mental illness are referred to the Jail Inreach Project. In order to maximize the effectiveness of the discharge plan, case managers offer the option of meeting the client at the time of release and bring them to the HHH clinic located four blocks from the jail. Participation in both the program and the option for direct release to the care of a case manager are voluntary.^ The purpose of this study is to determine the outcomes of the Jail Inreach Project and addresses the following objectives: (1) to evaluate the characteristics of inmates that chose to be released from jail to the direct care of an HHH case manager versus those who opt for self release and (2) to determine the number and percent of inmates that are linked to services and relationship with type of release (direct versus indirect), (3) to determine if there is a relationship between outcomes and characteristics and (4) to determine what outcomes are a function of release, controlling for characteristics. Statistical analysis, including frequencies, cross tabulations, chi-square and logistical regression, found that those who opt for self release are six times less likely to be successfully linked to services and that gender is the most significant predictor of choosing self release. Men are far more likely to opt for self release than women engaged in this program. These findings help inform policy and program design and development that addresses the difference in service utilization and successful linkage to services post-incarceration. Successful linkage to services, thus continuity of and access to care, further impact the effects of the revolving door phenomenon of mentally ill homeless individuals cycling between the streets, jails and hospital emergency centers.^
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This study evaluates the effectiveness of the Children and Youth Projects' Adolescent Family Life Program, a comprehensive program serving pregnant and parenting adolescents in the economically disadvantaged area of West Dallas. The underlying question asked is what are the relative contributions of the comprehensive, school-linked Adolescent Family Life (AFL) Program compared with the Maternal Health and Family Planning Program (MHFPP), a categorical provider of family planning and reproductive services, towards meeting the immediate and intermediate term needs of adolescent mothers. Also addressed are the protective effects of participation in the Dallas Independent School District Health Special Program, a segregated school for pregnant adolescents.^ A cohort of 339 West Dallas adolescent mothers who delivered babies during a two-year period, 1986 through 1987, are monitored by linking records from Parkland Hospital, the primary provider to hospital services to indigent women in Dallas, the Dallas Independent School District, and the prenatal care providers, the AFL and MHFP Programs. Information is collected on each teen describing her demographic, fertility, service utilization and educational characteristics.^ The study tests the hypothesis that adolescents receiving services from the comprehensive AFL program will be less likely to have a repeat birth and to discontinue school during the 24 month study period, compared with categorical provider clients. Although the study finds that there are no statistically significant differences in repeat deliveries, using survival analysis, or in school continuation between programs, important findings are revealed about the ethnic differences. Black and Hispanic fertility and educational behaviors are compared, and their implications for program design and evaluation discussed. ^
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While most professionals do not dispute the fact that evaluation is necessary to determine whether agencies and practitioners are truly providing services that meet clients’ needs, information regarding consistent measures on service effectiveness in human service organizations is sparse. A national survey of 250 not-for-profit family service organizations in the United States (52.8% return rate) yielded results relevant to client identified needs and agency effectiveness measures in serving today’s families. On an open-ended survey item, 52.3% agencies indicated that poverty represented the most pressing problem among today’s families because other psychological needs also take priority. Over two thirds of these agencies used multiple methods to evaluate their services. Clients’ feedback and outcome measures are the most popular methods. The findings reveal agencies' difficulties in determining what or who decides if the most appropriate services are being provided for the target population. Limited data collected on outcomes and impact may impose additional difficulties in program design and planning.
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Concern about the growth in adolescent problem behaviours (e.g. delinquency, drug use) has led to increased interest in positive youth development, and a surge in funding for ‘after school programs.’ We evaluate the potential of youth sport programs to foster positive development, while decreasing the risk of problem behaviours. Literature on the positive and negative outcomes of youth sport is presented. We propose that youth sport programs actively work to assure positive outcomes through developmentally appropriate designs and supportive child–adult (parent/coach) relationships. We also highlight the importance of sport programs built on developmental assets (Benson, 1997 ) and appropriate setting features (National Research Council and Institute of Medicine, 2002 ) in bringing about the five ‘C’s of positive development (competence, confidence, character, connections, and compassion/caring: Lerner et al., 2000 ). An applied sport-programming model, which highlights the important roles of policy-makers, sport organizations, coaches and parents in fostering positive youth development is presented as a starting point for further applied and theoretical research.
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Illinois Lieutenant Governor Patrick Quinn responded to rising concerns about unaffordable energy for low-income Illinois residents by convening a meeting of advocates in January 2003, and challenging them to develop a better approach to energy assistance. As a result of that challenge, a working group of low-income advocates, energy policy advisors, researchers, and community leaders met and established the Illinois Affordable Energy Campaign (IAEC) to identify and recommend policy changes to the current Low Income Home Energy Assistance Program (LIHEAP). The Illinois LIHEAP program gives heating assistance to approximately 316,000 families across the state each year. This document the Affordable Energy Plan, is the result of this collaborative process. While the current LIHEAP program provides valuable and essential assistance to low-income families, the Affordable Energy Plan (AEP) improves the program design through a set of common sense reform measures that better address today's volatile energy environment. Reconstructing LIHEAP will make the program more efficient and effective; it will make energy more affordable for more LIHEAP customers; Illinois will see fewer homes disconnected from their utility services, and participants will be able to better understand and plan for their heating expenses.
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Objective. To improve quality of in-hospital care of patients with acute coronary syndromes using a multifaceted quality improvement program. Design. Prospective, before and after study of the effects of quality improvement interventions between October 2000 and August 2002. Quality of care of patients admitted between 1 October 2000 and 16 April 2001 (baseline) was compared with that of those admitted between 15 February 2002 and 31 August 2002 (post-intervention). Setting. Three teaching hospitals in Brisbane, Australia. Study participants. Consecutive patients (n = 1594) admitted to hospital with acute coronary syndrome [mean age 68 years (SD 14 years); 65% males]. Interventions. Clinical guidelines, reminder tools, and educational interventions; 6-monthly performance feedback; pharmacist-mediated patient education program; and facilitation of multidisciplinary review of work practices. Main outcome measures. Changes in key quality indicators relating to timing of electrocardiogram (ECG) and thrombolysis in emergency departments, serum lipid measurement, prescription of adjunctive drugs, and secondary prevention. Results. Comparing post-intervention with baseline patients, increases occurred in the proportions of eligible patients: (i) undergoing timely ECG (70% versus 61%; P = 0.04); (ii) prescribed angiotensin-converting enzyme inhibitors (70% versus 60%; P = 0.002) and lipid-lowering agents (77% versus 68%; P = 0.005); (iii) receiving cardiac counselling in hospital (57% versus 48%; P = 0.009); and (iv) referred to cardiac rehabilitation (17% versus 8%; P < 0.001). Conclusions. Multifaceted approaches can improve care processes for patients hospitalized with acute coronary syndromes. Care processes under direct clinician control changed more quickly than those reliant on complex system factors. Identifying and overcoming organizational impediments to quality improvement deserves greater attention.
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The Queensland Environmental Protection Agency monitored water quality at 133 sites in North Queensland waterways between Cooktown and Bundaburg from 1992 to 2001. Condition of the waterways was rated by comparing recent data with the Queensland Water Quality Guidelines. Long-term trends were analysed using a censored regression technique that incorporates the effects of flow, temperature, seasonality and allows for long-term non-linear trends. Many sites were in good condition; those in poor condition were usually impacted by point source discharges; those in moderate condition were usually impacted by agricultural land use. There were no consistent long-term trends across the whole region. Recommendations for future programs include incorporating pressure indicators, ensuring high standards of quality assurance, including covariates such as rainfall in trend assessment and continuing programs over more than 10 years to allow detection of trends due to changes in land-use. (c) 2004 Elsevier Ltd. All rights reserved.