Population, health, and nutrition : annual operational review for fiscal 1992

Population, health, and nutrition (PHN) lending decreased in fiscal 1992 from the record levels of fiscal 1991, in both the amount and the number of operations. Lending amounted to $961.6 million for 16 projects, compared with$1,567.6 million for 28 projects in fiscal 1991. This temporary dip in PHN lending is attributable largely to pipeline factors. Fiscal 1993 lending is projected to recapture if not exceed the fiscal 1991 level, and projections for fiscal 1993 and fiscal 1995 are for a continued increase in lending volume. PHN projects approved in fiscal 1992 have been responsive to the World Bank's objective of poverty alleviation. Collectively, fiscal 1992 projects cover the essential features of good poverty work but the depth and quality of poverty work varies across projects. Drawing from the good practices observed and lessons recorded in this year's portfolio, the review offers the following suggestions, among others, for strengthening PHN interventions to alleviate poverty: poverty information and monitoring must be accompanied by dissemination and sensitization activities to strengthen national understanding of poverty-related issues and national commitment to resolving them through the proper policy; community involvement in project design and development requires clearly defined and carefully designed institutional and procedural mechanisms, and a concerted effort to make them work; it is essential that PHN sector work identify poor and vulnerable groups and assess their needs and demands for basic health, family planning, and nutrition services; and even the most demand-driven project designs targeted to clearly identified poverty groups require promotional activities to ensure that these groups participate in and benefit from project initiatives. Health lending is now a decade old, and many innovations in PHN lending have emerged only in the past four or five years. This review demonstrates that good practices and new and promising ideas - well worth emulating - are scattered across PHN work. Overall, PHN work is moving in the right direction and the quality of work is generally seen to be improving. Welcome trends (which should be encouraged and reinforced) include serious attention to the poorest, most vulnerable populations, growing consideration of the demand of target groups, and increased attention to monitoring and evaluation of sector performance.Health Monitoring&Evaluation,Health Economics&Finance,Banks&Banking Reform,Poverty Monitoring&Analysis,Urban Services to the Poor

Addressing health inequalities in Latin America: the role of social protection

After more than a decade of progress in various areas of social development, since 2015 poverty has increased, labor market indicators have deteriorated, and the reduction of income inequality has stagnated in Latin America. These trends are of concern as they can affect health indicators and exacerbate profound health inequalities. This situation demands integrated policy responses that can create synergies between different sectors. There is growing recognition of the role of social protection in the eradication of poverty and the reduction of inequality. Various social protection mechanisms buffer against the costs of accessing health services directly and indirectly. By expanding coverage and universal access, promotion and prevention actions in health and nutrition, and fundamentally, the fight against poverty, inequality, and exclusion, social protection plays a fundamental role in guaranteeing the right to health and overcoming inequalities in this area. The reduction of inequalities in health should be a priority for all countries, and a way forward in that direction is to promote the construction and strengthening of universal social protection systems. RESUMEN Después de más de una década de avances en diversos ámbitos del desarrollo social, desde 2015 en América Latina se registran aumentos en la pobreza, deterioros en indicadores del mercado laboral y un estancamiento en la reducción de la desigualdad del ingreso. Estas tendencias son preocupantes ya que pueden perjudicar los indicadores de salud y exacerbar las profundas desigualdades en salud. Esta situación demanda respuestas integradas de políticas, capaces de crear sinergias entre diferentes sectores. Existe un creciente reconocimiento sobre el rol de la protección social en la erradicación de la pobreza y la reducción de la desigualdad. Los diversos mecanismos de protección social aminoran los costos de acudir a servicios de salud de manera directa e indirecta. Mediante la expansión de la cobertura y el acceso universal, las acciones de promoción y prevención en salud y nutrición, y de manera fundamental, la lucha contra la pobreza, la desigualdad y la exclusión, la protección social juega un papel ineludible para la garantía del derecho a la salud y la superación de desigualdades en esta área. La reducción de las desigualdades en salud debe ser una prioridad para todos los países y un camino para avanzar en esa dirección es promover la construcción y el fortalecimiento de sistemas de protección social universales

A comparative investigation of the indications for renal replacement therapy and the optimal timing for commencing the therapy

ThesisEnd stage renal disease (ESRD) is a major health problem resulting in conside rably increased morbidity and mortality, in decreased qual ity of life and in high costs from renal replacement therapy (RRT) . There are almost a million people that owe their lives to dialys is and currently there is a 5 yea r survival rate of chronic renal failure (CRF) patients . Today optimization of dialys is must guarantee the full time restitution t o . society of a totally rehab ilitated individual. This study a ims at investigating the indications for commencing RRT and the optima l timing for commencing the therapy , derived from comparative investigations , and incorporat ing factors affecting renal failure patients. It includes the benefits of screening high risk individua ls for renal d isease, and the benefits of managing factors affecting renal function to pro long the pretreatment phase . It also looks at the effectiveness and opt imal timing for commencing a pre-end stage renal disease (PESRD) program, and considers whether there is patient imp rovement in patients managed before development of renal failure . Finally the study aims at investigating a way to reduce the financial aspect related to treatment. The research was twofold. First ly it involved a screening of 100 indiv iduals at tht: risk of chronic kidney disease (CKD), whereby a serum creat in ine va lue was taken and the glomerular filtration rate (OFR) calculated . Secondly it incorporated a biochemical and clinical assessment of 95 CRF patients , a month prior to RRT, at commencement of RRT, at I month and 3 months after RRT. The screening revealed a mean creatin ine for males 128.45 flmollL and for females 108 .99 flmollL. Twen ty-four percent (24%) of patien ts had a OFR of between 30 - 59 , 6% of patients had a OFR of between 15 29, and 3% of pat ients had a OFR of < 15 ml / minlI.73m2. T his strongly ind icates the need to screen individua ls at risk for renal failure . The second part of the study revealed that at commencement the mean OFR was 6.7 ml/ minlI .73m2, uremia , malnutrition, anemia, hyperparathyroid ism, hyperphosphatemia, and other electro lyte imbalances were present , all predisposing a patient to a poor clinical outcome , an inc rease in morbidity and mortal ity, and a dec rease in the qual ity of life. From the investigation of patients commencing dialysis it was determined that the optimal timing for commenc ing RRT was at the first clin ical evidence of deterioration in the presence of uremia and / o r malnutrit ion despite medical in tervention . It was found that RRT should not be postponed until creatinine falls within mandated range , as postponement adversely affects the patient, and th

A comparative investigation of the indications for renal replacement therapy and the optimal timing for commencing the therapy

ThesisEnd stage renal disease (ESRD) is a major health problem resulting in conside rably increased morbidity and mortality, in decreased qual ity of life and in high costs from renal replacement therapy (RRT) . There are almost a million people that owe their lives to dialys is and currently there is a 5 yea r survival rate of chronic renal failure (CRF) patients . Today optimization of dialys is must guarantee the full time restitution t o . society of a totally rehab ilitated individual. This study a ims at investigating the indications for commencing RRT and the optima l timing for commencing the therapy , derived from comparative investigations , and incorporat ing factors affecting renal failure patients. It includes the benefits of screening high risk individua ls for renal d isease, and the benefits of managing factors affecting renal function to pro long the pretreatment phase . It also looks at the effectiveness and opt imal timing for commencing a pre-end stage renal disease (PESRD) program, and considers whether there is patient imp rovement in patients managed before development of renal failure . Finally the study aims at investigating a way to reduce the financial aspect related to treatment. The research was twofold. First ly it involved a screening of 100 indiv iduals at tht: risk of chronic kidney disease (CKD), whereby a serum creat in ine va lue was taken and the glomerular filtration rate (OFR) calculated . Secondly it incorporated a biochemical and clinical assessment of 95 CRF patients , a month prior to RRT, at commencement of RRT, at I month and 3 months after RRT. The screening revealed a mean creatin ine for males 128.45 flmollL and for females 108 .99 flmollL. Twen ty-four percent (24%) of patien ts had a OFR of between 30 - 59 , 6% of patients had a OFR of between 15 29, and 3% of pat ients had a OFR of < 15 ml / minlI.73m2. T his strongly ind icates the need to screen individua ls at risk for renal failure . The second part of the study revealed that at commencement the mean OFR was 6.7 ml/ minlI .73m2, uremia , malnutrition, anemia, hyperparathyroid ism, hyperphosphatemia, and other electro lyte imbalances were present , all predisposing a patient to a poor clinical outcome , an inc rease in morbidity and mortal ity, and a dec rease in the qual ity of life. From the investigation of patients commencing dialysis it was determined that the optimal timing for commenc ing RRT was at the first clin ical evidence of deterioration in the presence of uremia and / o r malnutrit ion despite medical in tervention . It was found that RRT should not be postponed until creatinine falls within mandated range , as postponement adversely affects the patient, and the survival of dialysis patients depends on their condition at the time dialysis is first initiated. Postponing treatment was found to have adverse effects on patients commencing RRT, with an increase in the number of acute hemodialysis (AHD) sessions and increase in the number of access. Patients managed prior to commencement of RRT and patients commencing dialys is at a higher GFR experienced fewer complications, when compared to patients who commenced dialysis later. There is an improvement in patient outcome in patients managed prior to the commencement of RRT and it is beneficial to manage factors affecting renal function in order to prolong the pre-treatment phase . The PESRD educational program is an effective component in the management of kidney disease and initiating a PESRD program early in the course of kidney disease is advantageous to the patient. The financial costs related to renal replacement are extremely high, and can be reduced allowing more patients to be treated for the same amount of money. From the results obtained from the study it is clear that effective PESRD management and early commencement of RRT in dialysis patients leads to an improved qual ity of life, and a decline in complications experienced

Cameras in the Hands of Indigenous Youth: Participation, Films, and Nutrition in India

Background: Indigenous communities in India have diets that do not fulfill all of their minimum nutritional requirements. Given the unaffordability of healthy diets, these communities rely on common-pool resources to make up for shortfalls in food. Yet, such foods are devalued as “backward,” and accessing them is regulated by unequal gendered roles. Objectives: To explore the central role of community participation in documenting and transmitting indigenous knowledge about the role of locally available foods in improving dietary diversity. Methods: Through a participatory action research approach, 10 Santhal youth were trained to make films about a range of locally available foods and other issues of concern to them (Santhal/Santal is a native ethnic group in India). These films were broadcast on a YouTube channel and screened locally. A thematic content analysis of 49 films was undertaken, alongside interviews with the filmmakers and focus group discussions with viewers who attended 4 film screenings. Results: A majority of the films produced drew on intergenerational and indigenous knowledge about edible plants, insects, and rodents; skills in foraging and preparing food; awareness of the benefits of the food; and sustainability issues across the traditional food systems. The filmmakers initially focused on responding to community needs and showcasing Santhal cultural practices. Their later films began to reflect on aspects of their culture that needed to be preserved, revived, or modified. Audiences noted the relatability and relevance of the provided information, generated ideas and priority themes for further documentation, and expressed the need for revival and modification of certain cultural food practices. Conclusion: A participatory filmmaking process in the context of community nutrition can enable participants to question unequal power relations by enabling the most marginalized to voice their own perspectives with the support of cameras and filmmaking skills

HSCI2012: proceedings of the 9th International Conference on Hands-on Science

Including 1st Childrens’ Summit on Hands-on Science & Environmental Education. The core topic of the 9th Hands-on Science Conference are “Science Education, Environment and Society" and "Reconnecting Society with Nature through Hands-on Science”.Livro que reúne os trabalho extensos aceites para publicação nos proceedings da 9th HSCI conferenc

Studies in constructive theology

This submission centres on substantive issues of constructive theology, and particularly on interpreting the love of God. The focus is on the multi -layered impact of a Christology of divine love, developed through five monographs (I began to look at concepts of love as key to exegesis in theology in my Ph.D. thesis, published as EXEGESIS AND METHOD IN HILARY OF POITIERS, 1978).THEOLOGY OF THE LOVE OF GOD (1980) explores concepts of the love of God as the basic structuring element of Christian theology. In engagement with interpretations of love in the tradition, and with contemporary use of concepts of faith, hope and history, it is proposed that the nature of God as love shapes every aspect of theology. This is exemplified through analysis of the relationship between creation and redemption, understood as one dynamic movement, disrupting boundaries of redemption.IN GOD IN CHRISTIAN PERSPECTIVE (1994) the enterprise is developed further. An understanding of God as a multifaceted model draws on Christology and Trinity, faith and practice in community. God is personal, self -differentiated being, transcendent, yet also immanent in the created order as hidden divine presence. The core elements -faith and revelation, divine action and Christology -are reappraised in the light of current theological proposals. Doctrines interact in a web of connection to shape Christian practice. A Christian understanding retains the basic core of unconditional love, Christologically characterised. A contemporary concept of God draws upon these core elements, and upon a retrieval of the historical traditions from which they arise. It can be articulated in language intelligible to contemporary citizens, and its consequences spelled out within the complexity of contemporary cultures.Generosity and the Christian Future (1997) carries this thesis to a further stage through engagement with the emancipatory theologies, postmodernity, and political theory. The study re- imagines the framework of the divine love conceived as generosity. The need to be as alert to potential future as to past developments, and to relate doctrine to political theory and cultural issues, is grounded in theological -more precisely kenotic-Christological argument. Attention is paid to issues of human rights, violence, gender and the power structures of the churches themselves.JOHN AND DONALD BAILLIE TRANSATLANTIC THEOLOGY (2002), built on first access to the Baillie Papers, lies at the heart of this submission. I regard the work of the Baillies as seminal to the understanding, justification and revisioning of a progressive Christian theology. This is a theological biography of the Baillie brothers. It traces in detail the interaction of their theology within the cultures in Europe and America in which they worked - notably in the circle of the `critical realists.' It sheds light on the huge influence of the Baillies in Scotland. This tradition is a trajectory against the stream today. I judge it to offer significant resources, combining conceptual plasticity with distinctive direction, for the future.THE TRANSFORNTATIVE IMAGINATION -RETHINKING INTERCULTURAL THEOLOGY (2004). This comparative study of connections between theology and culture, through the arts, the sciences, political and human rights issues, shapes reflection on the mystery of God in a postfoundational frame. Reciprocity between ethical issues and questions of transcendence is explored. This yields a reconception of theological methodologies, in which theology, and paradoxically Christology, is seen as a catalyst rather than a trump card in interdisciplinary projects -exemplified through specific instances in the humanities, the sciences and in politics.The central theme of the divine love is spelled out in two shorter studies in less technical style. THE CHURCH OF GOD (1984) comments critically on traditions of church, ministry and sacraments in denominational cultures, stressing the Christological imperative to be an always outward looking church. MAKING CHRISTIAN DECISIONS (1985) assesses Christian input into specific ethical issues. I include also the jointly produced collections Studies in Scottish Church History (2000), BELIEVING IN THE TEXT (2004), EXPLORATIONS IN THEOLOGY 8 (1981), and FIFTY KEY CHRISTIAN THINKERS (2004), together with a selection of published articles. The submission documents a project with a distinctive accent on the love of God as Christological leitmotif. It conceives theology as a generous approach to the transcendence of God and the consequences of incarnation

Women's social position and their health : a case study of the social determinants of the health of women in Khayelitsha, Cape Town, South Africa

Includes bibliographical references.This thesis examines the social determinants of women's health status, health knowledge and knowledge and use of health services in a peri-urban area, using Kbayelitsha in Cape Town, South Africa as a case study. It argues for the importance of women's health as a specific focus, looks at some trends in women's health internationally over the past two decades and reviews the main factors affecting women's health. Some key issues in women's health of special relevance to developing countries such as South Africa are discussed. There is a special focus on newly urbanised women in peri-urban areas. Against this background the results of a community-based survey, preceded by indepth interviews, and conducted amongst 659 women in Kbayelitsha in 1989 and 1990 are presented. Data collected were statistically analysed using unIvariate,, bivariate and multivariate analysis. A number of priority social and health problems are identified: poverty; poor environmental conditions; lack of education, partlcularly skills training appropriate for finding work and the subordinate social status of women. Major health concerns included reproductive tract infections, especially sexually transmitted diseases, infertility, contraceptive use and ante-natal care during pregnancy. There were inadequacies in cervical screening conducted by health services and deficiencies in respondents' knowledge of AIDS. cervical smears and where to obtain various health services . Young, newly urbanised women, living in the poorly serviced and unserviced informal housing areas were partlcularly vulnerable in their socio-economic and health status within a peri-urban African community such as Khayelitsha. They also had poorest health knowledge and least knowledge of where to acquire health services. Some recommended interventions focussing on certain of these areas are suggested. It is argued that changes in the provision of women's health services within a primary health care setting can only be part of the process of improving women's health. Improvements in women's economic status and their social status are fundamental to any initiatives to improve their health status

Determining food and nutrition literacy of community health workers in the Western Cape, South Africa

Master of Public Health - MPHObesity is one of the critical problems that threatens not only health, but the economy at a global level. Among the factors associated with obesity is less than optimum level of nutrition literacy. Nutrition literacy is more than just the food knowledge, it is a combination of other essential factors that help individuals to maintain healthy a body size. These factors include the selection and consumption of nutritious food; acquiring knowledge and skills in the areas of meal planning and preparation; as well as using and knowing how to read food labels correctly

La Salle University Undergraduate Catalog 2011-2012

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