Health Inequalities Intervention Toolkit

This Health Inequalities Intervention Toolkit, developed jointly by the Association of Public Health Observatories and the Department of Health, focuses on improving life expectancy and infant mortality rates, especially in disadvantaged areas. Based on local authority boundaries, it is designed to assist evidence-based local service planning and commissioning, including Joint Strategic Needs Assessments. The Toolkit does this by providing information on the diseases, which are causing low life expectancy in individual areas, enabling good local priority setting. The Toolkit was originally designed to support achievement of the national Public Service Agreement target to: "Reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth." Although the PSA target has now ended, the Toolkit should still be useful to the NHS and local government, supporting planning to narrow inequalities in life expectancy and infant mortality

Health Inequalities Intervention Tool (2011)

The Health Inequalities Intervention Tool has been commissioned by the Department of Health through the Association of Public Health Observatories (APHO). The tool is designed to assist commissioners in Spearhead Primary Care Trusts (PCTs) with their Local Delivery Planning (LDP) and commissioning and to assist Spearhead Local Authorities (LAs) with the delivery of Local Area Agreements (LAAs). It highlights key issues for Spearhead PCTs and LAs to consider in order to achieve the life expectancy element of the Government's Public Service Agreement (PSA) on health inequalities by 2010

Utilization of needs assessments by decision makers: A comparative analysis of assessment methods

The major purpose of this study was to ascertain how needs assessment findings and methodologies are accepted by public decision makers in the U.S. Virgin Islands. To accomplish this, the following five different needs assessments were executed: (1) population survey; (2) key informants survey; (3) community forum; (4) rates-under-treatment (RUT); and (5) social indicators analysis. The assessments measured unmet needs of older persons regarding transportation, in-home care, and socio-recreation services, and determined which of the five methodologies is most costly, time consuming, and valid.^ The results of a five-way comparative analysis was presented to public sector decision makers who were surveyed to determine whether they are influenced more by needs assessment findings, or by the methodology used, and to ascertain the factors that lead to their acceptance of needs assessment findings and methodologies.^ The survey results revealed that acceptance of findings and methodology is influenced by the congruency of the findings with decision makers' goals and objectives, feasibility of the findings, and credibility of the researcher.^ The study also found that decision makers are influenced equally by needs assessment findings and methodology; that they prefer population surveys, although they are the most expensive and time consuming of the methodologies; that different types of needs assessments produce different results; and, that needs assessment is an essential program planning tool. Executive decision makers are found to be influenced more by management factors than by legal and political factors, while legislative decision makers are influenced more by legal factors. Decision makers overwhelmingly view their leadership style as democratic.^ A typology of the five needs assessments, highlighting their strengths and weaknesses, is offered as a planning guide for public decision makers. ^

Utilization of needs assessments by decision makers : a comparative analysis of assessment methods

The major purpose of this study was to ascertain how needs assessment findings and methodologies are accepted by public decision makers in the U. S. Virgin Islands. To accomplish this, the following five different needs assessments were executed: (1) population survey; (2) key informants survey; (3) community forum; (4) rates-under-treatment (RUT); and (5) social indicators analysis. The assessments measured unmet needs of older persons regarding transportation, in-home care, and sociorecreation services, and determined which of the five methodologies is most costly, time consuming, and valid. The results of a five-way comparative analysis was presented to public sector decision makers who were surveyed to determine whether they are influenced more by needs assessment findings, or by the methodology used, and to ascertain the factors that lead to their acceptance of needs assessment findings and methodologies. The survey results revealed that acceptance of findings and methodology is influenced by the congruency of the findings with decision makers' goals and objectives, feasibility of the findings, and credibility of the researcher. The study also found that decision makers are influenced equally by needs assessment findings and methodology; that they prefer population surveys, although they are the most expensive and time consuming of the methodologies; that different types of needs assessments produce different results; and, that needs assessment is an essential program planning tool. Executive decision makers are found to be influenced more by management factors than by legal and political factors, while legislative decision makers are influenced more by legal factors. Decision makers overwhelmingly view their leadership style as democratic. A typology of the five needs assessments, highlighting their strengths and weaknesses is offered as a planning guide for public decision makers.

Position Statement Community Needs Assessments & Health Improvement Planning, April 2016

The Iowa Department of Public Health urges hospitals and local boards of health to collaborate in completing a comprehensive community health needs assessment and health improvement plan. The department will be flexible in its reporting requirements for local CHNA & HIP processes to support integration with hospitals.

MANAGING STRATEGIC CHANGE:New Business Models Applying Wireless Technology as a Source of Competitive Edge

The diffusion of mobile telephony began in 1971 in Finland, when the first car phones, called ARP1 were taken to use. Technologies changed from ARP to NMT and later to GSM. The main application of the technology, however, was voice transfer. The birth of the Internet created an open public data network and easy access to other types of computer-based services over networks. Telephones had been used as modems, but the development of the cellular technologies enabled automatic access from mobile phones to Internet. Also other wireless technologies, for instance Wireless LANs, were also introduced. Telephony had developed from analog to digital in fixed networks and allowed easy integration of fixed and mobile networks. This development opened a completely new functionality to computers and mobile phones. It also initiated the merger of the information technology (IT) and telecommunication (TC) industries. Despite the arising opportunity for firms' new competition the applications based on the new functionality were rare. Furthermore, technology development combined with innovation can be disruptive to industries. This research focuses on the new technology's impact on competition in the ICT industry through understanding the strategic needs and alternative futures of the industry's customers. The change speed inthe ICT industry is high and therefore it was valuable to integrate the DynamicCapability view of the firm in this research. Dynamic capabilities are an application of the Resource-Based View (RBV) of the firm. As is stated in the literature, strategic positioning complements RBV. This theoretical framework leads theresearch to focus on three areas: customer strategic innovation and business model development, external future analysis, and process development combining these two. The theoretical contribution of the research is in the development of methodology integrating theories of the RBV, dynamic capabilities and strategic positioning. The research approach has been constructive due to the actual managerial problems initiating the study. The requirement for iterative and innovative progress in the research supported the chosen research approach. The study applies known methods in product development, for instance, innovation process in theGroup Decision Support Systems (GDSS) laboratory and Quality Function Deployment (QFD), and combines them with known strategy analysis tools like industry analysis and scenario method. As the main result, the thesis presents the strategic innovation process, where new business concepts are used to describe the alternative resource configurations and scenarios as alternative competitive environments, which can be a new way for firms to achieve competitive advantage in high-velocity markets. In addition to the strategic innovation process as a result, thestudy has also resulted in approximately 250 new innovations for the participating firms, reduced technology uncertainty and helped strategic infrastructural decisions in the firms, and produced a knowledge-bank including data from 43 ICT and 19 paper industry firms between the years 1999 - 2004. The methods presentedin this research are also applicable to other industries.

Draft U.S. Pacific Marine Mammal Stock Assessments: 2009

Under the 1994 amendments to the Marine Mammal Protection Act (MMPA), the National Marine Fisheries Service (NMFS) and the U.S. Fish and Wildlife Service (USFWS) are required to publish Stock Assessment Reports for all stocks of marine mammals within U.S. waters, to review new information every year for strategic stocks and every three years for non-strategic stocks, and to update the stock assessment reports when significant new information becomes available. This report presents stock assessments for 13 Pacific marine mammal stocks under NMFS jurisdiction, including 8 “strategic” stocks and 5 “non-strategic” stocks (see summary table). A new stock assessment for humpback whales in American Samoa waters is included in the Pacific reports for the first time. New or revised abundance estimates are available for 9 stocks, including Eastern North Pacific blue whales, American Samoa humpback whales, five U.S. west coast harbor porpoise stocks, the Hawaiian monk seal, and southern resident killer whales. A change in the abundance estimate of Eastern North Pacific blue whales reflects a recommendation from the Pacific Scientific Review Group to utilize mark-recapture estimates for this population, which provide a better estimate of total population size than the average of recent line-transect and mark-recapture estimates. The ‘Northern Oregon/Washington Coast Stock’ harbor porpoise stock assessment includes a name change (‘Oregon’ is appended to ‘Northern Oregon’) to reflect recent stock boundary changes. Changes in abundance estimates for the two stocks of harbor porpoise that occur in Oregon waters are the result of these boundary changes, and do not reflect biological changes in the populations. Updated information on the three stocks of false killer whales in Hawaiian waters is also included in these reports. Information on the remaining 50 Pacific region stocks will be reprinted without revision in the final 2009 reports and currently appears in the 2008 reports (Carretta et al. 2009). Stock Assessments for Alaskan marine mammals are published by the National Marine Mammal Laboratory (NMML) in a separate report. Pacific region stock assessments include those studied by the Southwest Fisheries Science Center (SWFSC, La Jolla, California), the Pacific Islands Fisheries Science Center (PIFSC, Honolulu, Hawaii), the National Marine Mammal Laboratory (NMML, Seattle, Washington), and the Northwest Fisheries Science Center (NWFSC, Seattle, WA). Northwest Fisheries Science Center staff prepared the report on the Eastern North Pacific Southern Resident killer whale. National Marine Mammal Laboratory staff prepared the Northern Oregon/Washington coast harbor porpoise stock assessment. Pacific Islands Fisheries Science Center staff prepared the report on the Hawaiian monk seal. Southwest Fisheries Science Center staff prepared stock assessments for 9 stocks. The stock assessment for the American Samoa humpback whale was prepared by staff from the Center for Coastal Studies, Hawaiian Islands Humpback National Marine Sanctuary, the Smithsonian Institution, and the Southwest Fisheries Science Center. Draft versions of the stock assessment reports were reviewed by the Pacific Scientific Review Group at the November 2008, Maui meeting. The authors also wish to thank those who provided unpublished data, especially Robin Baird and Joseph Mobley, who provided valuable information on Hawaiian cetaceans. Any omissions or errors are the sole responsibility of the authors. This is a working document and individual stock assessment reports will be updated as new information on marine mammal stocks and fisheries becomes available. Background information and guidelines for preparing stock assessment reports are reviewed in Wade and Angliss (1997). The authors solicit any new information or comments which would improve future stock assessment reports. These Stock Assessment Reports summarize information from a wide range of sources and an extensive bibliography of all sources is given in each report. We strongly urge users of this document to refer to and cite original literature sources rather than citing this report or previous Stock Assessment Reports. If the original sources are not accessible, the citation should follow the format: [Original source], as cited in [this Stock Assessment Report citation].

Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study

Objective To evaluate if two different measures of synovial activation, baseline Hoffa synovitis and effusion synovitis, assessed by MRI, predict cartilage loss in the tibiofemoral joint at 30 months follow-up in subjects with neither cartilage damage nor tibiofemoral radiographic osteoarthritis of the knee. Methods Non-contrast-enhanced MRI was performed using proton density-weighted fat-suppressed sequences in the axial and sagittal planes and a short tau inversion recovery sequence in the coronal plane. Hoffa synovitis, effusion synovitis and cartilage status were assessed semiquantitatively according to the WORMS scoring system. Included were knees that had neither radiographic osteoarthritis nor MRI-detected tibiofemoral cartilage damage at the baseline visit. The presence of Hoffa synovitis was defined as any grade = 2 (range 0-3) and effusion synovitis as any grade = 2 (range 0-3). Logistic regression was performed to examine the relation of the presence of either measure to the risk of cartilage loss at 30 months adjusting for other potential confounders. Results Of 514 knees included in the analysis, the prevalence of Hoffa synovitis and effusion synovitis at the baseline visit was 8.4% and 10.3%, respectively. In the multivariable analysis, baseline effusion synovitis was associated with an increased risk of cartilage loss. No such association was observed for baseline Hoffa synovitis. Conclusions Baseline effusion synovitis, but not Hoffa synovitis, predicted cartilage loss. The findings suggest that effusion synovitis, a reflection of inflammatory activity including joint effusion and synovitic thickening, may play a role in the future development of cartilage lesions in knees without osteoarthritis.

Three essays in risky behaviors

A PhD Dissertation, presented as part of the requirements for the Degree of Doctor of Philosophy from the NOVA - School of Business and Economics

Iowa Department of Transportation Strategic Plan, January 2003 Through December 2006, June 2004

To provide safe and modern transportation systems and services to individuals who travel in Iowa, the Iowa Department of Transportation has identified three broad-based and far-reaching strategic goals: accessibility, responsiveness and accountability. These goals are outlined in this plan, which is aligned with the Accountable Government Act. In addition, the plan specifically addresses strategic needs to serve our customers, and to respond to trends of a growing population and the ever changing need to enhance and expand Iowa's transportation systems. This plan is a living document, and therefore, will be updated periodically.

Iowa Department of Transportation Strategic Plan Revised, January 2003 Through December 2006, June 2004

To provide safe and modern transportation systems and services to individuals who travel in Iowa, the Iowa Department of Transportation has identified three broad-based and far-reaching strategic goals: accessibility, responsiveness and accountability. These goals are outlined in this plan, which is aligned with the Accountable Government Act. In addition, the plan specifically addresses strategic needs to serve our customers, and to respond to trends of a growing population and the ever changing need to enhance and expand Iowa's transportation systems. This plan is a living document, and therefore, will be updated periodically.

Iowa Department of Transportation Strategic Plan, January 2008 through December 2012

To provide safe and modern transportation systems and services to individuals who travel in Iowa, the Iowa Department of Transportation has identified three broad-based and far-reaching strategic goals: accessibility, responsiveness and accountability. These goals are outlined in this plan, which is aligned with the Accountable Government Act. In addition, the plan specifically addresses strategic needs to serve our customers, and to respond to trends of a growing population and the ever changing need to enhance and expand Iowa's transportation systems. This plan is a living document, and therefore, will be updated periodically.

Iowa Department of Transportation Strategic Plan, 2012-2013

To provide safe and modern transportation systems and services to individuals who travel in Iowa, the Iowa Department of Transportation has identified three broad-based and far-reaching strategic goals: accessibility, responsiveness and accountability. These goals are outlined in this plan, which is aligned with the Accountable Government Act. In addition, the plan specifically addresses strategic needs to serve our customers, and to respond to trends of a growing population and the ever changing need to enhance and expand Iowa's transportation systems. This plan is a living document, and therefore, will be updated periodically.

The Evolving Mind-Body Alliance: A Handbook for Educators

This study examined anatomical and physiological connections between brain and body in relation to academic, physical, social, emotional, and behavioural benefits of physical activity in elementary schools. A handbook titled The Evolving Mind-Body Alliance: Physical Activities Incorporated Into the Ontario Science Curriculum—A Handbook for Educators, Schools, and School Boards was developed based on evidence that physical activity can benefit students academically, physically, and emotionally. Handbook activities were created for implementation into science lessons, with direct connections to the Ontario Science Curriculum (OSC), based on curriculum expectation goals and vision for science, including a majority of experiential learning and application knowledge, and because of students’ difficulty relating to science’s abstract concepts and terms. A review of literature about brain-body connection and benefits of movement in the classroom revealed that the defining features of the handbook should be (a) incorporation of physical activities that directly relate to the OSC, (b) require minimal resources to implement, and (c) provide a direct link to the OSC. Needs assessments were performed to gather the data from professionals in the field on the OSC and on the mandated daily physical activity. The handbook was reviewed by 3 teaching professionals in order to claim face validity of the document. The results of the project indicate that the handbook which was produced meets its goals of creating a product that is easy to use, practical, and effective for both educators and children in promoting the awareness of the brain-body connection and importance of learning through movement.

A Mentor’s Manifesto: Moving from legacy to Innovation

Current library trends and ongoing shifts are driven by numerous factors including macroeconomic environments, technological impacts, and institutional changes. Strategic needs are as varied as the many individual libraries and their circumstances, but the need is universal for thoughtful leadership in navigating change. While worldlows adapt to changing environments in the short term, long-term shifts require thoughtful leadership and long-range thinking. As libraries and collection management navigate continuing shifts, businesses face similar challenges; this article distills strategies' philosophical underpinnings from library and business scholarship.