Breast and cervical cancer screening programme implementation in 16 countries.

OBJECTIVES: There is a continuing need to monitor and evaluate the impact of organized screening programmes on cancer incidence and mortality. We report results from a programme assessment conducted within the International Cancer Screening Network (ICSN) to understand the characteristics of cervical screening programmes within countries that have established population-based breast cancer screening programmes. METHODS: In 2007-2008, we asked 26 ICSN country representatives to complete a web-based survey that included questions on breast and cervical cancer screening programmes. We summarized information from 16 countries with both types of organized programmes. RESULTS: In 63% of these countries, the organization of the cervical cancer screening programme was similar to that of the breast cancer screening programme in the same country. There were differences in programme characteristics, including year established (1962-2003 cervical; 1986-2002 breast) and ages covered (15-70+ cervical; 40-75+ breast). Adoption of new screening technologies was evident (44% liquid-based Pap tests; 13% human papillomavirus (HPV)-triage tests cervical; 56% digital mammography breast). There was wide variation in participation rates for both programme types (<4-80% cervical; 12-88% breast), and participation rates tended to be higher for cervical (70-80%) than for breast (60-70%) cancer screening programmes. Eleven ICSN member countries had approved the HPV vaccine and five more were considering its use in their organized programmes. CONCLUSION: Overall, there were similarities and differences in the organization of breast and cervical cancer screening programmes among ICSN countries. This assessment can assist established and new screening programmes in understanding the organization and structure of cancer screening programmes.

"Learning together, growing with family": the implementation and evaluation of a family support programme

The "Learning together, growing with family" programme is targeted to at-risk parents and children from 6 to 11 years old, with a preventive focus on promoting positive parent-child relationships. In this study, we examined the quality of the programme implementation and its influence on the programme results in a sample of 425 parents and 138 facilitators drawn from the first trial. Mixed methods were used, consisting of: parental self-reports on parenting dimensions, professionals' records on parental attendance and appraisals on six topics of the implementation process, and focus group discussions in which facilitators reported on the initial steps of the implementation. Results showed a high quality of implementation with respect to the group facilitator and the programme organization factors, followed by the coordination with services and the support facilities offered to participants and, finally, by the factors of fidelity and prior organization steps. Results of the focus groups confirmed that the prior steps were challenging and offered the more effective strategies. Better quality in the implementation factors predicted better parenting styles and parental competencies after the programme, as well as a higher attendance rate. In sum, this study demonstrates the importance of good implementation in at-risk contexts and provides some clues as to the key elements that moderate programme effectiveness.

Best practices of international double degree programmes. Case of Russian and European universities

The purpose of the Master’s thesis research is to study and disseminate the best practices of international double Master’s degree programmes organization, implementation and development. The given research is focused on two main areas: motivation of higher education institutions to start double degree programmes and best practices of double degree programme design and implementation from the perspective of building joint curriculum and organizing balanced mobility and development of existing programmes in terms of increasing their quality and attractiveness. This is a case study of the double degree programmes between Russian and European universities. The study findings reveal good developments in the field of double degree cooperation between Russian and European universities and a high motivation from both parties. The research depicts different models of building a joint curriculum and organizing academic mobility. The following areas could be outlined as development points for double degree programmes: - Personal interest and commitment of organizers of double degree programmes; - Comprehensive agreement between partners on different aspects and practicalities of the double degree programme implementation; - Promotion towards more balanced student participation and two-way mobility; - Foreign language skills improvement for students and university staff; - Joint strategy and actions in marketing and quality assurance; - Involvement of international companies; - Wider usage of e-learning technology.

Die Wirkungen von Extensivierungs- und Vertragsnaturschutzprogrammen auf die Entwicklung einer "gerade noch aktuellen Agrarlandschaft"

Erfolgskontrollen für Agrarumweltprogramme bezogen sich bisher meistens auf einzelne Flächen oder auf programmbezogene, großräumige Evaluationen. Es wurde jedoch kaum untersucht, wie sich die Maßnahmen auf die Entwicklung einzelner Naturräume auswirken. Auch gab es keine Studien, welche die Wechselwirkungen zwischen den Beweggründen der Landnutzer auf der ei-nen- sowie Landnutzung und Vegetation auf der anderen Seite interpretierten. Die Dissertation Wirkungen von Extensivierungs- und Vertragsnaturschutzprogrammen auf die Entwick-lung einer »gerade noch aktuellen Agrarlandschaft« hat diese Lücke geschlossen. Sie erklärt, welche Bedeutung die hessischen Programme HELP und HEKUL für den hohen Anteil naturschutzfachlich wertvollen Grünlands im Rommeroder Hügel-land westlich des Meißner haben. Untersuchungsgegenstand waren die Grünlandvegetation und die landwirtschaftlichen Betriebe mit ihren Menschen und deren Beweggründen. Diese Inhalte er-forderten eine Vorgehensweise, die sowohl sozialwissenschaftliche als auch naturwissenschaftliche Methoden einbindet, um Bezüge zwischen Betrieben und Grünlandvegetation zu er-kennen. Umfangreiche pflanzensoziologische Untersuchungen und Interviews der Betriebsleiter waren Grundlage für eine Schlagdatenbank und weitergehende Auswertungen. Die Interpretation vegetationskundlicher Erhebungen im Kontext betrieblicher Entscheidungen und Beweggründe erforderte es, althergebrachte Ansätze in neuer Form zu verknüpfen. Die Bewertung der Programmwirkungen stützte sich auf die Schlagdatenbank und auf vier Szena-rien zur zukünftigen Gebietsentwicklung bei unterschiedlichen Programmfortschreibungen. Zur Darstellung von Erhebungen und Ergebnissen entstand eine Vielzahl thematischer Karten. Der überdurchschnittlich hohe Anteil naturschutzfachlich bedeutsamer Grünlandtypen auf den Programmflächen und die Interpretation der Szenarien belegten eine hohe Wirksamkeit von HELP und HEKUL im Gebiet. Nicht nur auf den Vertragsnaturschutzflächen des HELP, sondern auch auf dem HEKUL-Grünland sind naturschutzfachlich bedeutende Vegetationstypen überproportional vertreten. Die vier Szenarien ließen erkennen, dass eine Beschränkung des HELP auf Schutzgebiete, eine Abschaffung der HEKUL-Grünlandextensivierung oder gar eine ersatzlose Strei-chung beider Programme zu erheblichen Verschlechterungen der naturschutzfachlichen Situation führen würde. Gleichzeitig war festzustellen, dass es ohne die landwirtschaftlich schwierigen natur-räumlichen Verhältnisse sowie eine eher großteilige Agrarstruktur mit überdurchschnittlich flächen-starken und wirtschaftlich stabilen Vollerwerbsbetrieben keine so deutlichen Programmwirkungen gegeben hätte. Auch die Tatsache, dass viele Landwirte eine intensive Landwirtschaft aus innerer Überzeugung ablehnen und mit einer erheblich geringeren Stickstoffintensität wirtschaften als es HEKUL verlangt, wirkte verstärkend. Die große Bedeutung individueller Beweggründe einzelner Betriebsleiter wurde auch in den engen Beziehungen einzelner Grünland-Pflanzengesellschaften zu bestimmten Betriebstypen und sogar einzelnen Höfen sichtbar, deren Beschreibung und Interpretation wichtige Erkenntnisse zu den so-zioökonomischen Voraussetzungen verschiedener Vegetationstypen lieferte. Für die zukünftige Entwicklung der hessischen Agrarumweltförderung empfiehlt die Dissertation eine Einführung und bevorzugte Anwendung ergebnisorientierter Honorierungsverfahren, eine bessere Berücksichtigung des gering gedüngten Grünlands über eine differenzierte Förderung sehr extensiver Düngeregime, eine stärkere Modularisierung des Gesamtprogramms und eine Durchführung aller Maßnahmen im Vertragsverfahren. Die betriebszweigbezogene Grünlandextensivierung sollte zukünftig in Kulissen angeboten werden, in denen ein verstärktes Wechseln von Betrieben in die Mindestpflege nach DirektZahlVerpflV zu erwarten ist.

Análisis del arrendamiento como alternativa en la política de vivienda de interés social en Colombia. Lecciones y reflexiones aprendidas a partir de la experiencia de Sudáfrica

Los esfuerzos de la presente investigación se concentran en el cumplimiento del objetivo principal, el cual consiste en analizar el arrendamiento como un programa que puede ser incorporado en la política de vivienda en Colombia, para dar respuesta de forma transitoria y/o temporal de alojamiento a los hogares con ingresos iguales o inferiores a dos salarios mínimos, ya que actualmente la política sectorial no incorpora esta forma tenencia de la vivienda para ofertar soluciones habitacionales. El arrendamiento tiene rasgos interesantes e importantes de destacar, tales como que él mismo constituye una forma de tenencia de vivienda eminentemente urbana. Además, es un mercado al que acuden todos los estratos socioeconómicos, por lo cual no es un mercado segregado. Igualmente, al relacionar ésta tenencia con el territorio y por ende con la economía espacial, se puede decir que no existe segregación socio-espacial muy pronunciada frente a la distribución urbana de la tenencia de la vivienda en arrendamiento. En este sentido, la tenencia de la vivienda en forma de arrendamiento se presenta en todo el territorio urbano de Cali, Medellín y Bogotá.

Country strategic risk and knowledge management:a proposed framework for improvement

The world is in a period of reflection about social and economic models. In particular there is a review of the capacities that countries have for improving their competitiveness. The experiences in a society are part of the process of learning and knowledge development in that society: especially in the development of communities. Risks appear continually in the process of the search for, analysis and implementation of solutions to problems. This paper discusses the issues related to the improvement of productivity and knowledge in a society, the risk that poor or even declining productivity brings to the communities and the need to develop people that support the decision making process in communities.The approach to improve the communities' development is through the design of a research programme in knowledge management based on distance learning. The research programme implementation is designed to provide value added to the decisions in communities in order to use collective intelligence, solve collective problems and to achieve goals that support local solutions. This program is organized and focused on four intelligence areas, artificial, collective, sentient and strategic. These areas are productivity related and seek to reduce the risk of lack of competitiveness through formal and integrated problem analysis. In a country such as Colombia, where different regions face varying problems to solve and there is a low level of infrastructure, the factors of production such as knowledge, skilled labour and "soft" infrastructure can be a way to develop the society.This entails using the local physical resources adequately for creating value with the support of people in the region to lead the analysis and search for solutions in the communities. The paper will describe the framework and programme and suggest how it could be applied in Colombia.

Surveillance Programme for Healthcare Associated Infections in the State of Sao Paulo, Brazil. Implementation and the first three years` results

Governmental programmes should be developed to collect and analyse data on healthcare associated infections (HAIs). This study describes the healthcare setting and both the implementation and preliminary results of the Programme for Surveillance of Healthcare Associated Infections in the State of Sao Paulo (PSHAISP), Brazil, from 2004 to 2006. Characterisation of the healthcare settings was carried out using a national database. The PSHAISP was implemented using components for acute care hospitals (ACH) or long term care facilities (LTCF). The components for surveillance in ACHs were surgical unit, intensive care unit and high risk nursery. The infections included in the surveillance were surgical site infection in clean surgery, pneumonia, urinary tract infection and device-associated bloodstream infections. Regarding the LTCF component, pneumonia, scabies and gastroenteritis in all inpatients were reported. In the first year of the programme there were 457 participating healthcare settings, representing 51.1% of the hospitals registered in the national database. Data obtained in this study are the initial results and have already been used for education in both surveillance and the prevention of HAI. The results of the PSHAISP show that it is feasible to collect data from a large number of hospitals. This will assist the State of Sao Paulo in assessing the impact of interventions and in resource allocation. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Mise en place d'un programme de prévention et de prise en charge du diabète en Suisse: le point de vue des patients et des professionnels de la santé [Implementation of a diabetes disease management program in Switzerland: patients' and healthcare professionals' point of view].

BACKGROUND: A reorganization of healthcare systems is required to meet the challenge of the increasing prevalence of chronic diseases, e.g. diabetes. In North-America and Europe, several countries have thus developed national or regional chronic disease management programs. In Switzerland, such initiatives have only emerged recently. In 2010, the canton of Vaud set up the "Diabetes Cantonal Program", within the framework of which we conducted a study designed to ascertain the opinions of both diabetic patients and healthcare professionals on the elements that could be integrated into this program, the barriers and facilitators to its development, and the incentives that could motivate these actors to participate. METHODS: We organized eight focus-groups: one with diabetic patients and one with healthcare professionals in the four sanitary areas of the canton of Vaud. The discussions were recorded, transcribed and submitted to a thematic content analysis. RESULTS: Patients and healthcare professionals were rather in favour of the implementation of a cantonal program, although patients were more cautious concerning its necessity. All participants envisioned a set of elements that could be integrated to this program. They also considered that the program could be developed more easily if it were adapted to patients' and professionals' needs and if it used existing structures and professionals. The difficulty to motivate both patients and professionals to participate was mentioned as a barrier to the development of this program however. Quality or financial incentives could therefore be created to overcome this potential problem. CONCLUSION: The identification of the elements to consider, barriers, facilitators and incentives to participate to a chronic disease management program, obtained by exploring the opinions of patients and healthcare professionals, should favour its further development and implementation.

Developing Childcare in Ireland - A Review of Progress on the Implementation of the Equal Opportunities Childcare Programme 2000 - 2006

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S�_�_olta - Final Report on the Development and Implementation of the S�_�_olta Quality Assurance Programme

This report provides an overview of the development and field testing of the S�_olta Quality Assurance Programme (QAP). It outlines the timeline, key roles and activities and draws upon evaluation data gathered at various stages of the action research and development process. It briefly describes the processes, tools, materials and the professional roles that have been developed to support implementation of the S�_olta QAP. It concludes with consideration of the context within which the S�_olta QAP will operate into the future and makes a set of recommendations to connect this research and development phase for S�_olta and the S�_olta QAP with national and international policy developments related to the improvement of the quality of early childhood care and education (ecce) in Ireland.