1,671 research outputs found

    Training competent and effective Primary Health Care Workers to fill a void in the outer islands health service delivery of the Marshall Islands of Micronesia

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    BACKGROUND: Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities. In an effort to remedy the effectiveness of health care delivery to these islands, a program to train mid-level health care workers (Hospital Assistants) was developed and implemented by the Ministry of Health in conjunction with the hospital in Majuro, the capital city of the Marshall Islands. METHODS: A physician instructor with experience and expertise in primary health care in these regions conducted the program. The curriculum included training in basic health science, essentials of endemic disorders and their clinical management appropriate to the outer islands. Emphasis was given to prevention and health promotion as well as to the curative aspects. For clinical observation, the candidates were assigned to clinical departments of the Majuro hospital for 1 year during their training, as assistants to the nursing staff. This paper discusses the details of the training, the modalities used to groom the candidates, and an assessment of the ultimate effectiveness of the program. RESULTS: Out of 16 boys who began training, 14 candidates were successful in completing the program. In 1998 a similar program was conducted exclusively for women under the auspices of Asian Development Bank funding, hence women were not part of this program. CONCLUSION: For developing countries of the Pacific, appropriately trained human resources are an essential component of economic progress, and the health workforce is an important part of human resources for sustainable progress and development

    Open Design: Contributions, Solutions, Processes and Projects

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    Open design is a catchall term for various on- and offline design and making activities. It can be used to describe a type of design process that allows for (is open to) the participation of anybody (novice or professional) in the collaborative development of something. As well as this, it can mean the distribution and unrestricted use of design blueprints and documentation for the use by others. In this paper, the authors highlight various aspects of open and collaborative design and argue for the use of new terms that address what is open and when. A range of design projects and online platforms that have open attributes are then explored, whereby these terms are applied. In terms of design, the focus is specifically on the design of physical things rather than graphical, software or system design

    Early Economic Evaluation of Diagnostic Technologies: Experiences of the NIHR Diagnostic Evidence Co-operatives

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    Diagnostic tests are expensive and time-consuming to develop. Early economic evaluation using decision modeling can reduce commercial risk by providing early evidence on cost-effectiveness. The National Institute for Health Research Diagnostic Evidence Co-operatives (DECs) was established to catalyze evidence generation for diagnostic tests by collaborating with commercial developers; DEC researchers have consequently made extensive use of early modeling. The aim of this article is to summarize the experiences of the DECs using early modeling for diagnostics. We draw on 8 case studies to illustrate the methods, highlight methodological strengths and weaknesses particular to diagnostics, and provide advice. The case studies covered diagnosis, screening, and treatment stratification. Treatment effectiveness was a crucial determinant of cost-effectiveness in all cases, but robust evidence to inform this parameter was sparse. This risked limiting the usability of the results, although characterization of this uncertainty in turn highlighted the value of further evidence generation. Researchers evaluating early models must be aware of the importance of treatment effect evidence when reviewing the cost-effectiveness of diagnostics. Researchers planning to develop an early model of a test should also 1) consult widely with clinicians to ensure the model reflects real-world patient care; 2) develop comprehensive models that can be updated as the technology develops, rather than taking a “quick and dirty” approach that may risk producing misleading results; and 3) use flexible methods of reviewing evidence and evaluating model results, to fit the needs of multiple decision makers. Decision models can provide vital information for developers at an early stage, although limited evidence mean researchers should proceed with caution

    Split-time AI : using estrus detection aids to optimize timed artificial insemination (2016)

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    New July 2016.Includes bibliographical reference

    Split-time Al : using estrus detection aids to optimize timed artificial insemination (2018)

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    Timed AI pregnancy rates can be optimized through use of a split-time AI approach following administration of the 14-day CIDR-PG protocol for heifers and the 7-day COSynch + CIDR protocol for mature cows. Using split-time AI, insemination of non-estrous females is delayed until 20 to 24 hours after the scheduled time for fixed-time AI. Estrotect estrus detection aids applied at the time of PG administration allow producers to determine the estrous status of females and inseminate at the optimal time.Includes bibliographical reference

    Physical Conditions in the Ionized Gas of 30 Doradus

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    We present a mid-infrared spectroscopic data cube of the central part of 30 Doradus, observed with Spitzer's IRS and MIPS/SED mode. Aromatic dust emission features and emission lines from molecular and atomic hydrogen are detected but not particularly strong. The dominant spectral features are emission lines from moderately ionized species of argon, neon, and sulphur, which are used to determine the physical conditions in the ionized gas. The ionized gas excitation shows strong variations on parsec scales, some of which can plausibly be associated with individual hot stars. We fit the ionic line strengths with photoionization and shock models, and find that photoionization dominates in the region. The ionization parameter U traces the rim of the central bubble, as well as highlighting isolated sources of ionization, and at least one quiescent clump. The hardness of the ionizing radiation field T_rad reveals several "hot spots" that are either the result of individual very hot stars or trace the propagation of the diffuse ionizing field through the surrounding neutral cloud. Consistent with other measurements of giant molecular hydrogen regions, log(U) ranges between -3 and -0.75, and T_rad between 30000 and 85000K.Comment: 32 pages, 26 figures, ApJ accepted. A version with high-resolution images can be found at http://www.astro.virginia.edu/~ged3j/indebetouw20090125.pd
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