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PubMed2003

Empowerment through community building: Diabetes Today in the Pacific.

The goal of Diabetes Today, a program of the Centers for Disease Control and Prevention (CDC), is to develop coalitions and train coalition members in assessment, planning, and evaluation to address diabetes in their communities. CDC established the Pacific Diabetes Today Resource Center (PDTRC) in 1998 to tailor the program for Pacific Islander communities in Hawaii, American Samoa, Guam, the Commonwealth of the Northern Marianas Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and Palau. PDTRC's work is guided by the principles of community building and the goal of empowering coalitions to take action around diabetes. Culturally appropriate strategies are used to gain access to the community, transfer knowledge and skills, build coalitions, and provide technical assistance. Evidence of empowerment is seen in increased individual competence, enhanced community capacity, reduced barriers, and improved supports to address diabetes. To maintain the gains of community building in the Pacific, three factors appear critical: an engaged leader, a host agency for the coalition, and continuing access to technical assistance and funds.

Centers for Disease Control and Prevention, U.S.↗
PubMed2002

Impact of soil movement on carbon sequestration in agricultural ecosystems.

Recent modeling studies indicate that soil erosion and terrestrial sedimentation may establish ecosystem disequilibria that promote carbon (C) sequestration within the biosphere. Movement of upland eroded soil into wetland systems with high net primary productivity may represent the greatest increase in storage capacity potential for C sequestration. The capacity of wetland systems to capture sediments and build up areas of deposition has been documented as well as the ability of these ecosystems to store substantial amounts of C. The purpose of our work was to assess rates of sediment deposition and C storage in a wetland site adjacent to a small first-order stream that drains an agricultural area. The soils of the wetland site consist of a histosol buried by sediments from the agricultural area. Samples of deposited sediments in the riparian zone were collected in 5 cm increments and the concentration of 137Cs was used to determine the 1964 and 1954 deposition layers. Agricultural activity in the watershed has caused increased sediment deposition to the wetland. The recent upland sediment is highly enriched in organic matter indicating that large amounts of organic C have been sequestered within this zone of sediment deposition. Rates of sequestration are much higher than rates that have occurred over the pre-modern history of the wetland. These data indicate the increased sedimentation rates in the wetland ecosystem are associated with increased C sequestration rates.

Agriculture↗
PubMed2006

Potential contributions to disability theorizing and research from positive pyschology.

PURPOSE: Within the context of taking the perspectives of disabled individuals themselves more seriously, it is imperative that researchers and practitioners accord due primacy to the experiential worlds and everyday lived experiences of individuals with disabilities. Based on the premise that theoretical groundedness (along with methodological rigour) is integral to sound research, it is argued that the existing body of knowledge regarding the lived experiences of individuals with disabilities may be complemented by a conceptual placing of understandings of disability in relation to a prominent theoretical pathway at the moment, namely, the interdisciplinary emphasis on human strengths and wellness. METHOD: A critical engagement with key conceptualizations of disability entailed a focus on the development, strengths, and challenges of medical, social and psychologically based conceptualizations of disability. RESULTS AND CONCLUSION: The existing body of knowledge around disability may be extended and complemented by key concepts regarding human health/wellness from the field of Positive Psychology. Positive Psychology's keynote contribution to the study of disability and rehabilitation entails directing researchers and practitioners to the aim of building, reinforcing and extending disabled individuals' strengths and capacities in order to optimize their functioning in all areas of life, and thereby promote wellness.

Cerebral Palsy↗
PubMed2001

The Integration of Genomics into Public Health Research, Policy and Practice in the United States.

Objectives: To examine the opportunities for and responsibilities of the public health community in bridging the gap between gene discovery and the application of genetic information to improve health and prevent disease. Methods: We developed genetics-related definitions for the core functions and essential services of public health. We combined these definitions with a visual model to create one possible 'blueprint' for integrating genomics into public health activities. Results: The proposed blueprint and accompanying examples illustrate the important role for genomics throughout public health research, policy and practice. Further refinement and implementation of this blueprint represents an ambitious public health leadership agenda. Conclusions: Opportunities for immediate action include strategic planning for the integration of genomics across programs, developing genomics competencies among health professionals, enhancing surveillance and epidemiologic capacity to aid evidence-based policy making, building partnerships and seeking input from stakeholders and incorporating information about genomics into health communications. Copyright 2001 S. Karger AG, Basel

Journal Article↗
PubMed1991

Safety considerations in the psychiatric setting.

Safety in the psychiatric setting involves many aspects of facility design, renovation, operations, training, and administrative control. Through the application of a systematic hazard-control program, risks may be identified and action taken to reduce or eliminate the potential for accidental or self-inflicted injuries. This paper addresses specific aspects of the hazard-control process and its application at The Sheppard and Enoch Pratt Hospital, Baltimore, Maryland.

Baltimore↗
PubMed2003

[Intervention in dyslexic disorders: phonological awareness training].

Taking into account the systems for the treatment of brain information when drawing up a work plan allows us to recreate processing routines that go from multisensory perception to motor, oral and cognitive production, which is the step prior to executive levels of thought, bottom-up and top-down processing systems. In recent years, the use of phonological methods to prevent or resolve reading disorders has become the fundamental mainstay in the treatment of dyslexia. The work is mainly based on phonological proficiency, which enables the patient to detect phonemes (input), to think about them (performance) and to use them to build words (output). Daily work with rhymes, the capacity to listen, the identification of phrases and words, and handling syllables and phonemes allows us to perform a preventive intervention that enhances the capacity to identify letters, phonological analysis and the reading of single words. We present the different therapeutic models that are most frequently employed. Fast For Word (FFW) training helps make progress in phonematic awareness and other linguistic skills, such as phonological awareness, semantics, syntax, grammar, working memory and event sequencing. With Deco-Fon, a programme for training phonological decoding, work is carried out on the auditory discrimination of pure tones, letters and consonant clusters, auditory processing speed, auditory and phonematic memory, and graphophonological processing, which is fundamental for speech, language and reading writing disorders. Hamlet is a programme based on categorisation activities for working on phonological conceptualisation. It attempts to encourage the analysis of the segments of words, syllables or phonemes, and the classification of a certain segment as belonging or not to a particular phonological or orthographical category. Therapeutic approaches in the early phases of reading are oriented towards two poles based on the basic mechanisms underlying the process of learning to read, the grapheme phoneme transformation process and global word recognition. The interventionalist strategies used at school are focused on the use of cognitive strategy techniques. The purpose of these techniques is to teach pupils practical strategies or resources aimed at overcoming specific deficiencies.

Child↗
PubMed2006

General practice research and research skill needs--attitudes of GP supervisors.

BACKGROUND: General practice research is an important learning area in general practice registrar training. General practitioner supervisors have a central role in registrar training. Registrar training in Tasmania has the added component of a research project. Little is known about supervisors' research attitudes, confidence to support registrar research projects, and research skill needs. METHOD: A postal survey was sent to all 40 GP supervisors with General Practice Training Tasmania. RESULTS: Response rate was 90% (n=36): 33% were interested in becoming involved in general practice research; 53% wanted to improve their research skills; and 55% did not feel confident supporting a registrar with a research project. Those supervisors who were confident were more likely to have previous research involvement. DISCUSSION: There is potential for increasing research capacity in GP supervisors. It is important to build the confidence of supervisors in their support of general practice registrars engaged in research projects.

Adult↗
PubMed2005

Blueprint for a greener city: growth need not cost the earth.

The current human use of global natural resources exceeds the long-term sustainable capacity of the planet. New and more sustainable ways of building cities and providing urban water services are needed. The Australian city of Sydney is expected to grow by more than 1 million people over the next 30 years. Water use from the Hawkesbury-Nepean River system already exceeds system capacity. Current proposals to allocate a greater proportion of low flows to meet environmental flow needs will limit urban water allocations and require the development of more efficient water and sewerage systems for new and existing urban development. This paper presents a hypothetical case study of how water supply and sewerage services might be provided for an additional 1 million people over a 25-year period. It compares traditional service provision with alternative scenarios incorporating water conservation measures, rainwater harvesting and water reuse. The paper presents both economic and environmental comparisons. The economic comparisons include valuations of environmental externalities in the form of environmental levies. It shows that the extra capital costs of water conservation, alternative water sources and water reuse scenarios are offset by operating savings and environmental benefits. Ecological footprints are reduced because of lower water diversions, discharges, energy use and CO2 emissions. The paper also discusses the implication of alternative infrastructure ownership and water pricing arrangements, and the opportunities to create incentives for additional investment in water conservation and reuse projects.

Cities↗
PubMed2003

Public health workforce: challenges and policy issues.

This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems.The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce.

Editorial↗
PubMed2006

When training is insufficient: reflections on capacity development in health promotion in Peru.

The international development community has lately recognized the programatic importance of capacity development. Despite growing attention, a consensus is still lacking on appropriate strategies and interventions to strengthen local capacity for development programs. The CHANGE Project designed and implemented a program to contribute to capacity development in health promotion in Peru between 2002 and 2005. This article discusses key lessons learned in the program. Successful capacity development requires the strengthening of institutional networks. Training activities alone are insufficient. Educational opportunities need to be integrated into strategies that aim to institutionalize competencies in specific work contexts and promote the inter-institutional linkages. The experience suggests that capacity development programs need to start by assessing challenges to make competencies effective in job performance. Projects should neither be donor-driven nor depend on individuals. Instead, they should focus on institution building, find creative ways to promote long-term sustainability of capacity development, and require long-term commitment to promote ownership and sustainability. What is needed is an approach that maximizes the impact of programs through collaboration among institutions committed to supporting and absorbing capacity, and to having mechanisms to monitor and change job performance according to the needs of staff, supervisors and other stakeholders.

Health Promotion↗
PubMed2006

The state of international collaboration for health systems research: what do publications tell?

AIM: International collaboration for health system development has been identified as a critical input to meet pressing global health needs. North-South collaboration has the potential to benefit both parties, while South-South collaboration offers promise to strengthen capacity rapidly and efficiently across developing countries. There is an emerging trend to analyze the fruits of such collaboration. This paper builds on this trend by applying an innovative concept-based bibliometric method to identify the international scope of collaboration within the field of health policy and systems research. Two key questions are addressed: to what extent are papers comparing developing countries as against reporting on single country studies? To what extent are papers in either case being produced by researchers within their respective countries or through North-South or South-South collaboration? METHODS: A total of 8,751 papers published in Medline between 1999 and 2003 with data on health systems and policies in developing countries were identified and content-analyzed using an innovative concept-based search technology. A sample of 13% of papers was used to identify the corresponding institution and countries covered. The sampled data was then analyzed by income group. RESULTS: Papers with an international, cross-country focus account for only 10% of the total. Just over a third of all papers are led by upper middle income country authors, closely followed by authors from high income countries. Just under half of all papers target low income countries. Cross-country papers are led mostly by institutions in high income countries, with 74% of the total. Only seven countries concentrate 60% of the papers led by developing country institutions. Institutions in the United States and the United Kingdom concentrate between them as many as 68% of the papers led by high income countries. Only 11% of all single-country papers and 21% of multi-country studies are the product of South-South collaboration. Health Financing is the topic with the greatest international scope, with 26% of all papers in the topic. Topics such as Costing and Cost Effectiveness, Finance, Sector Analysis and Insurance, regardless of their national or international scope, are led in 38% to 54% of cases by high income authors. CONCLUSION: While there is modest health systems research capacity in many developing countries for single country studies, capacity is severely limited for multi-country studies. While North-South collaboration is important, the number of international studies is still very limited to produce the kind of knowledge required to learn from experiences across countries. The fact that lead institutions as well as study countries are concentrated in a handful of mostly middle income countries attests to great disparities in research capacity. However, disparities in research capacity and interest are also evident in the North. It is urgent to build cross-country research capacity including appropriate forms of South-South and North-South collaboration.

Journal Article↗