[Better use of the capacity of universities. 5th plan for university building].
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Education↗
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Results for “Capacity Building”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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[A comparison between the heat transmission indexes of the most common building materials and their gamma ray absorbing capacity (Preliminary report)].
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Construction Materials↗
Using technical assistance to strengthen tobacco control capacity: evaluation findings from the Tobacco Technical Assistance Consortium.
Immediately following the Master Settlement Agreement of 1998 and the corresponding growth of new and existing tobacco control programs, it became clear that tobacco prevention and control organizations required technical assistance to help them carry out their missions. The Tobacco Technical Assistance Consortium (TTAC) was established at the Rollins School of Public Health in 2001 to provide tailored technical assistance services to meet the needs of the expanded workforce and to build tobacco control capacity. To understand whether and how TTAC's technical assistance enhanced capacity, TTAC conducted an evaluation of its services through semi-structured telephone interviews with the primary contacts and one to two additional informants for each of 48 technical assistance services provided over an 18-month period. The majority of respondents reported they had increased knowledge and skills in tobacco control, strengthened leadership skills, developed or strengthened partnerships with other tobacco control organizations, and changed the way they practice tobacco control following the assistance. More modest improvements were noted in the areas of increased organizational support and policy change at the local or state level.
Education, Public Health Professional↗
[Interdisciplinary health research].
Health care professionals are increasingly called upon to work collaboratively. This commentary discusses our experience at the Summer Institute on Interdisciplinary Health Research, which aimed to increase the capacity of future Canadian researchers to work with health professionals from other disciplines. We discuss, in particular, our small group experience--the challenges we faced, and how we were able to resolve the internal conflicts that occurred. We also discuss the conditions necessary to engage in interdisciplinary work and offer suggestions to improve future initiatives to build interdisciplinary research capacity.
Canada↗
Recruitment strategies for studying dementia in later life among diverse cultural groups.
This article provides conceptual and theoretical guidance on approaches to enhance recruiting and retaining diverse populations in dementia research by using a sociocultural perspective and constructivist approach. Informed by this conceptual and theoretical guidance, the article also discusses some of the major barriers to recruitment with ideas on how to address these barriers. Further discussion is provided on building community relations and capacity, and strategies to increase the level of participation in dementia care research. The article ends with best strategies for addressing barriers to recruitment and retention, building community relations and capacity, and increasing participation in research projects.
Age Factors↗
Hydrogen storage in nanostructured carbons by spillover: bridge-building enhancement.
The hydrogen storage capacity in nanostructured carbon materials can be increased by atomic hydrogen spillover from a supported catalyst. A simple and effective technique was developed to build carbon bridges that serve to improve contact between a spillover source and a secondary receptor. In this work, a supported catalyst (Pd-C) served as the source of hydrogen atoms via dissociation and primary spillover and AX-21 or single-walled carbon nanotubes (SWNTs) were secondary spillover receptors. By carbonizing a bridge-forming precursor in the presence of the components, the hydrogen adsorption amount was increased by a factor of 2.9 for the AX-21 receptor and 1.6 for the SWNT receptor at 298 K and 100 kPa. Similar results were obtained at 10 MPa, indicating that the enhancement factor is a weak function of pressure. The AX-21 receptor with carbon bridges had the highest absolute capacity of 1.8 wt % at 298 K and 10 MPa. Reversibility was demonstrated through desorption and readsorption at 298 K. The bridge-building process appears to be receptor specific, and optimization may yield even greater enhancement. Using this technique, enhancements in storage of up to 17-fold on other carbon-based materials have been observed and will be reported elsewhere shortly.
Journal Article↗
The Fresno County Refugee Health Volunteer Project: a case study in cross-cultural health care delivery.
Beginning in 1979, Fresno County received a 2nd dramatic influx of Southeast Asian refugees. There are now approximately 20,000 of these refugees, including the largest population of Hmong in the US. This community includes about 2000 Cambodian, 14,000 Hmong, and 4000 Lowland Lao. Altogether, Southeast Asian refugees comprise nearly 10% of the population of Fresno. These demographics provide the backdrop for significant problems in health care service delivery. Some barriers include: 1) stress, loss, dislocation, poverty, illness, and unemployment that are part of the refugee experience; 2) language differences; 3) cultural isolation; and 4) cultural beliefs and practices whose spiritual, wholistic, and natural forms of care often run contrary to the West's scientific, specialized, and technological treatment modalities. The Health Department began to recognize some difficulties related to health services for refugees and developed a strategy to combat these. This strategy was named the Refugee Health Volunteer Project and its goal was to enable individuals, families, and community groups to better meet their own health care needs. Goals were to be met by 1st creating a community-based health promotion network to 1) identify health needs, 2) communicate health information, 3) train community health volunteers, and 4) build a greater capacity for self-care that would last beyond the end of the program. The program's goal would also be met by overcoming the access problems with the service system by 1) communicating community-identified needs, 2) identifying specific barriers in the service system, 3) initiating broad participation among service providers in designing more accessible approaches to service delivery, and 4) improving coordination between service providers. Significant progress has been made in a very short time. The Project demonstrates that a fairly common, bureaucratic organization can be responsive to extremely unique community needs. The project is demonstrating the effectiveness of a network approach as a model for service delivery to ethnic communities experiencing language and cultural barriers to health care. The project staff have served as a catalyst for initiatives which are creating ways in which the broader health delivery system can be more accessible to refugee clients. What is emerging is an approach to health empowerment that builds on the strengths, skills, knowledge, and experience of community people and those organizations which support their efforts.
Americas↗
Total and respirable dust in swine confinement buildings: the benefit of respiratory protective masks and effect of recirculated air.
Caretakers and pigs in dusty environments inhale particles and toxic gases which can cause subclinical illness. We determined the reduction in sampled dust elicited by respiratory masks mounted on glass funnels. Open-faced filters or British cyclones were sampled to measure quantities of dust which the masks had trapped. Respiratory masks reduced the sampled total suspended particulates (open-faced filters) by > or = 75% with NIOSH/MSHA certified protectant (2-tie) masks and > or = 50% with NIOSH/MSHA non-certified comfort (1-tie) masks. Respirable particulates (British cyclones) were reduced by > or = 45% with NIOSH/MSHA certified protectant (2-tie) masks. These data suggest properly worn respiratory protective masks afford significant protection against both total suspended and respirable particulates in swine confinement facilities. Penetration of 3-25% of total aerosol mass through masks allowing only 1% penetration of a silica aerosol with an aerodynamic diameter of 0.6-1.0 microns suggested that measurable portions of the aerosol mass in these confinement houses behaved as if they were less than 1 micron in diameter. Because of the small size of the aerosol, NIOSH/MSHA certified respiratory protective masks should be worn when working in those facilities. We also studied concentrations of ammonia, endotoxin and total and respirable dust particles to determine effects of a recirculation fan which increased the nominal air flow capacity of the building by 10%. Recirculated air had minimal effects on ammonia, total airborne endotoxin or total particulate mass.(ABSTRACT TRUNCATED AT 250 WORDS)
Air Conditioning↗
The Childhood Cancer and Leukemia International Consortium (CLIC): Expanding global collaboration in pediatric cancer etiology research.
Childhood cancers are rare, but incidence has risen modestly in countries with robust registration, partly reflecting improved diagnosis. In high-income countries, cancer is the leading cause of disease-related death in children. Marked inequities in incidence, survival, and research capacity underscore the need for large-scale collaboration to identify environmental, genetic, and contextual determinants of risk. The Childhood Cancer and Leukemia International Consortium (CLIC) was established in 2007 to study the etiology of childhood leukemia and later expanded in 2019 to include other childhood cancers, principally solid tumors. CLIC pools harmonized, individual-level data from case-control and cohort studies, obtained through interviews, record linkage (insurance claims, registries), or geographic information systems, and integrates germline genomic data where available. Membership has grown from 13 studies in 9 countries to 57 studies in 21 countries; recruitment spans the early 1960s to the present and encompasses approximately 150,000 cases across all tumor types and 300,000 controls with clinical, demographic, and exposure data, centralized via harmonized data dictionaries at the Data Coordination Center, established in 2014 at the International Agency for Research on Cancer, and supported by a secure analysis platform. Pooled analyses across diverse populations have implicated parental age, prenatal vitamin or folic acid use, mode of delivery, fetal growth, selected congenital anomalies, occupational or household exposures (e.g., pesticides), paternal smoking, and markers of early-life immune modulation (e.g., breastfeeding, daycare attendance) in leukemia risk, informing carcinogen evaluation and prevention. The integration of genetic ancestry and germline susceptibility data is clarifying ancestry-related differences in leukemia biology and outcomes, while confirming risk loci with population-specific effects. CLIC is now adding polygenic risk scores and exposomic data to refine etiologic subtyping and identify modifiable pathways, while broadening representation from underserved regions through partnership-building and capacity-strengthening.
Humans↗
Implementing and using quality measures for children's health care: perspectives on the state of the practice.
OBJECTIVE: The objective of this study was to identify issues, obstacles, and priorities related to implementing and using child health care quality measures from the perspectives of 4 groups: 1) funders of quality-measurement development and implementation; 2) developers of quality measures; 3) users of quality measures (including Medicaid and the State Children's Health Insurance Program, employer coalitions, and consumer groups); and 4) health plans and providers (in their role as both subjects and users of quality measures). METHODS: A series of semistructured interviews was conducted with approximately 40 opinion leaders drawn from these 4 groups. The interviews were conducted by telephone between September and December of 2001. Major topic areas covered in the interviews were similar across the groups. Topic areas included 1) strategic vision and/or objectives for funding, developing, or using quality measures for children's health care; 2) a brief summary of the specific quality measures funded, developed, or used; 3) issues and challenges facing funders and developers of measures; 4) major successes achieved; 5) obstacles to implementation and use of measures; and 6) priority needs for future funding. RESULTS: Leaders from all 4 groups acknowledge the importance of developing a robust set of quality measures that can serve multiple objectives and multiple audiences. Standardization of measures is viewed as a critical feature related to all objectives. An assessment of specific quality measures funded, developed, or used by strategic objective shows a high correlation between the uses intended by funders and developers and the actual applications of the various users. The most commonly cited measures across all groups are the Consumer Assessment of Health Plans Survey and Health Plan Employer Data and Information Set, followed by the Child and Adolescent Health Measurement Initiative and special topic studies to support quality-improvement applications (eg, asthma, diabetes, etc). The major issues and challenges cited in common among funders and developers are 1) the lack of trained capacity in the field to conduct needed research and development, and 2) the difficulty in generating sustained interest and support among funders because of the complexity of quality-measurement issues, competing funding priorities in the face of limited funds available to allocate, and the lack of clear and compelling evidence that quality measurement and improvement actually result in better outcomes for children. The 3 most common successes cited across all 4 groups are 1) the growing consensus and collaboration among diverse stakeholder groups involved in measurement development and implementation; 2) the increasing collection and use of specific measures; and 3) early documentation of tangible results in terms of improved quality of care. Specific measurement tools cited as successes by funders and developers include the Medicaid Health Plan Employer Data and Information Set, Consumer Assessment of Health Plans Survey, the Child and Adolescent Health Measurement Initiative, and Rand QA Tools. The most important obstacle reported across all groups is the lack of a strong and compelling "business case" that clearly demonstrates the benefits of quality measurement relative to the costs of implementation. Strongly related to this barrier is the cost of implementing and using measures without a sustainable source of financing as well as the absence of strong public awareness and political support for children's health care quality measurement. Another major barrier cited is the lack of coordination among funders, which prevents the field from developing a unified approach to addressing the numerous technical, political, and administrative issues also cited at length by the leaders interviewed. The 5 top needs for future funding identified across all 4 groups follow directly from the major obstacles that they reported: 1) develop the business case for children's health care quality measurement and improvement based on rigorous cost-bigorous cost-benefit analysis and documentation of quantifiable successes; 2) develop new measures to fill the gaps in critical areas (including adolescent health care, behavioral health, and chronic conditions) that can be applied at the hospital and ambulatory care provider levels; 3) invest in building needed research capacity, a trained pool of users of quality measures, and the capacity among providers to understand and use quality-improvement methods and tools; 4) invest in developing an information infrastructure that will support the efficient collection and use of measures for multiple purposes, including clinical practice, quality measurement, and quality improvement; and 5) develop increased public awareness and support for quality measurement based on improved strategies for communicating with consumers, purchasers, providers, and policy makers. CONCLUSIONS: Several implications are suggested by these perspectives for the future direction of quality measurement in children's health care. First, to meet the funding needs identified, many funders must improve coordination to reduce the noise and fragmentation generated by numerous competing or redundant activities. Improved coordination among funders will help assure maximum impact and the efficient use of scarce resources. Second, the importance attached to standardization of measures by both users and developers may conflict at times with the need for innovation and flexibility. Child health quality leaders will need to manage this tension between standardization and innovation to maintain an appropriate balance between the benefits of both. Finally, many of the obstacles identified are not unique to children's health care. Child health quality leaders will need to determine to what extent their efforts to overcome these obstacles can be successfully undertaken independently as opposed to in concert with groups concerned about other populations and sectors in the health care system.
Child↗
Improving the nutritional resource environment for healthy living through community-based participatory research.
OBJECTIVES: To build health promotion capacity among community residents through a community-based participatory model, and to apply this model to study the nutritional environment of an urban area to better understand the role of such resources in residents' efforts to live a healthy life. DESIGN: A multiphase collaborative study that inventoried selected markets in targeted areas of high African-American concentration in comparison with markets in a contrasting wealthier area with fewer African Americans. SETTING: A community study set in the Los Angeles metropolitan area. PARTICIPANTS: African-American community organizations and community residents in the target areas. INTERVENTIONS: Two surveys of market inventories were conducted. The first was a single-sheet form profiling store conditions and the availability of a small selection of healthy foods. The second provided detailed information on whether the store offered fruit, vegetables, low-fat dairy products, dried goods and other items necessary for residents to consume a nutritious diet. RESULTS: The targeted areas were significantly less likely to have important items for living a healthier life. The variety and quality of fresh fruit and vegetable produce was significantly lower in the target areas. Such products as 1% milk, skim milk, low-fat and nonfat cheese, soy milk, tofu, whole grain pasta and breads, and low-fat meat and poultry items were significantly less available. CONCLUSIONS: Healthy food products were significantly less available in the target areas. The authors conclude from these results that the health disparities experienced by African-American communities have origins that extend beyond the health delivery system and individual behaviors inasmuch as adherence to the healthy lifestyle associated with low chronic disease risk is more difficult in resource-poor neighborhoods than in resource-rich ones.
Black or African American↗
The 2001 dengue epidemic in Chennai.
UNLABELLED: Dengue is emerging as a serious public health problem in Tamil Nadu. The present surveillance system is unlikely to generate proper information on the epidemiology of the disease, which is essential for planning and development of relevant control/preventive measures against dengue. OBJECTIVE: Between November 2001 and January 2002, a descriptive study was undertaken on children with clinical dengue attending Kanchi Kamakoti Child Trust Hospital (KKCTH, a major private referral pediatric hospital in Tamil Nadu, India) to define the magnitude of dengue burden, the natural history of this disease in terms of clinical presentation, and outcome of the infections in hospitalized children (< 15) with clinical dengue. METHODS: The sera collected from patients analyzed for dengue specific IgM and IgG antibodies by IgM, IgG antibody capture enzyme linked immunosorbent assay (ELISA) using alternatively two commercial kits. World Health Organization clinical case definition was adopted to categorize the dengue confirmed children. RESULTS: Dengue was diagnosed in 74.5% (143) of the 192 hospitalized children with clinical dengue. A considerable proportion (20%) of the total dengue infections were constituted by infants less than 1 yr of age. DF [dengue fever], DHF [dengue hemorrhagic fever] and DSS [dengue shock syndrome] were diagnosed in 65%, 11.2% and 23.8% of 143 dengue confirmed patients respectively. Though severe dengue (DSS + DHF) was present in 35% of the patients, the mortality rate was low during the study period due to timely diagnosis and clinical management of the patients. CONCLUSION: In developing countries like India, building of laboratory capacity for diagnosis and combat-mode ready preparedness for the management of dengue cases in emergency situation may reduce dengue-related mortality. This can be achieved in a wider scale through an integrated approach through the community, professionals and the public health departments.
Adolescent↗
Incompatible land uses and the topology of cumulative risk.
The extensive literature on environmental justice has, by now, well defined the essential ingredients of cumulative risk, namely, incompatible land uses and vulnerability. Most problematic is the case when risk is produced by a large aggregation of small sources of air toxics. In this article, we test these notions in an area of Southern California, Southeast Los Angeles (SELA), which has come to be known as Asthmatown. Developing a rapid risk mapping protocol, we scan the neighborhood for small potential sources of air toxics and find, literally, hundreds of small point sources within a 2-mile radius, interspersed with residences. We also map the estimated cancer risks and noncancer hazard indices across the landscape. We find that, indeed, such large aggregations of even small, nondominant sources of air toxics can produce markedly elevated levels of risk. In this study, the risk profiles show additional cancer risks of up to 800 in a million and noncancer hazard indices of up to 200 in SELA due to the agglomeration of small point sources. This is significant (for example, estimates of the average regional point-source-related cancer risk range from 125 to 200 in a million). Most importantly, if we were to talk about the risk contour as if they were geological structures, we would observe not only a handful of distinct peaks, but a general "mountain range" running all throughout the study area, which underscores the ubiquity of risk in SELA. Just as cumulative risk has deeply embedded itself into the fabric of the place, so, too, must intervention seek to embed strategies into the institutions and practices of SELA. This has implications for advocacy, as seen in a recently initiated participatory action research project aimed at building health research capacities into the community in keeping with an ethic of care.
Air Pollutants↗
The embryo-forming potency of the posterior marginal zone in stages X through XII of the chick.
At stage X a small posterior marginal zone (PM) fragment, when transplanted into similar-size hole in the lateral marginal zone, can initiate the development of an ectopic axis. The laterally transplanted PM, inhibits the regeneration of an axis at the original posterior side from the lateral section of the marginal zone (LM) inserted to replace it. At stage XI both the axis-forming and inhibitory capacities of the PM fragment become weaker and an axis-forming capacity starts to build up anterior to the PM, resulting in the formation of two primitive streaks at 90 degrees to each other. At stage XII the change of potencies exhibited at stage XI is more pronounced, the ability of the transplanted PM to promote axis formation at the new site is lost, and an axis is formed from the original posterior side of the blastoderm.
Animals↗
The Health Promoting Prison (HPP) and its imperative for nursing.
The World Health Organisation's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Prison (HPP) movement emerged. Here, an extensive review of the available prison-related health literature provides the basis for critical discussion and recommendations for nursing services and prison-related health care. The findings suggest that current prison-based nursing services are seriously neglected and woefully lacking in structure and resources. This article recommends strategies for reform that includes nurses who practice in all settings, and not just prison-based nurses. If nurses wish to be at the forefront of future HPP strategies, they must first embrace the radical health promotion reforms that are emerging from the current literature. Building sustainable group capacity into prison-based health care, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasise the health promotion role of nursing.
Clinical Competence↗
Epidemiological approach to aquatic animal health management: opportunities and challenges for developing countries to increase aquatic production through aquaculture.
Aquaculture appears to have strongest potential to meet the increasing demands for aquatic products in most regions of the world. The world population is on the increase, as is the demand for aquatic food products. Production from capture fisheries at a global level is levelling off. Potential contributions from aquaculture to local food security, livelihoods and nutrition can be highly significant, especially in many remote and resource-poor rural areas. One of the major constraints to aquaculture production is the losses due to diseases. Over the decades, the sector has faced significant problems with disease outbreaks and epidemics which caused significant economic losses. The use of sound epidemiological principles and logical and science-based approach to identify and manage risks comprise two of the most important components of an effective biosecurity program. The maintenance of effective biosecurity in aquaculture is becoming more and more essential. There will be more demand for aquatic animal epidemiologists as well as epidemiological tools/resources in the region. The use of epidemiology will significantly improve health management, risk analysis and disease control. Although there are clear limitations and complications in the use of epidemiology for controlling aquatic animal pathogens, some positive results have recently emerged from a series of studies and trials to control diseases affecting the small-scale shrimp farming sector in southern India. This paper summarises the results of one such study which emphasizes the significant benefit of close collaboration with farmers, both individually and as groups, and capacity and awareness building among them and the importance of understanding the risk factors and implementing better management practices.
Animal Husbandry↗
Community-based therapeutic care in HIV-affected populations.
Community-based therapeutic care (CTC) is a community-based model for delivering care to malnourished people. CTC aims to treat the majority of severely malnourished people at home, rather than in therapeutic feeding centres. This paper describes the potential of the CTC approach to provide effective care and support for people living with HIV and AIDS (PLWHA). CTC includes many of the components of a home-based care model for PLWHA. It provides outpatient treatment for common complications of HIV and AIDS, such as acute malnutrition and simple infections, and an energy-dense ready-to-use food that could be made with the appropriate balance of micronutrients for the HIV-infected patient. Through the de-centralisation of outpatient treatment sites, CTC improves accessibility by moving treatment closer to people's homes and helps to promote the sustainability of care by building on the capacity of existing health infrastructure and staff. The CTC model contains many features that are appropriate for the care and support of HIV-affected people and, in its present form, can provide effective physical care for many HIV-affected individuals. We are currently working to adapt the CTC model to make it more suitable for the support of PLWHA in the longer term.
AIDS-Related Opportunistic Infections↗
Basic requirements for the transfer of fermentation technologies to developing countries.
Traditional small-scale fermentation technologies offer considerable potential for stimulating development in the food industry of developing countries in light of their low cost, scalability, minimal energy and infrastructural requirements and the wide consumer acceptance of fermented products in these countries. Efficient transfer and adaptation of these technologies is, however, often limited by inadequate basic scientific knowledge of the processes involved and the lack of appropriate biological inoculants and process controls for these technologies. Basic infrastructures, such as suitably equipped laboratories with consistent working conditions, a constant supply of good quality water and reliable power supplies, are critical elements of a minimal technology base for transfer and adaptation of these technologies. Building the institutional capacity in developing countries to facilitate research and development geared toward a better understanding of the technologies applied in small-scale traditional fermentations is essential, as is the encouragement of governments to formulate supportive national policies, which promote small-scale agro-industrial development. Socioeconomic considerations play a critical role in the successful and sustainable transfer and adoption of technologies and their products in developing countries.
Developing Countries↗