Columbia Baptist Association

https://scholarlycommons.obu.edu/arbaptrec/1046/thumbnail.jp

1995 Columbia Football Association Media Guide

https://digitalcommons.cwu.edu/cwu_athletics_media_guides/1062/thumbnail.jp

Land Use Framework Element of the CRAG Regional Plan

The Land Use Framework Element is an element of the Regional Plan pursuant to Regional Objective II and to Section 3 of the Rules Adopting and Implementing the CRAG Goals and Objectives

Investment Promotion Agencies and Sustainable FDI: Moving toward the Fourth Generation of Investment Promotion

In April and May 2010, CCSI supported WAIPA to conduct its annual survey. This report, Investment Promotion Agencies and Sustainable FDI: Moving toward the Fourth Generation of Investment Promotion, benchmarks the responses of IPAs regarding sustainable FDI and its four dimensions (economic development, environmental sustainability, social development, governance) and finds, among other things, that these are unevenly addressed by investment promotion strategies and investment incentives. The report also draws attention to the desirability of attracting sustainable FDI, rather than focusing on volume of investment alone. In 2017, CCSI also helped the World Association of Investment Promotion Agencies (WAIPA) to conduct its annual survey on FDI and sustainable development among WAIPA member investment promotion agencies (IPAs). The report, The Role of IPAs in Advancing Sustainable Development, finds that that IPAs recognize both the crucial role of FDI in advancing the Sustainable Development Goals (SDGs), and the role of IPAs for facilitating that sustainable development

Motion of Fred T. Korematsu Center for Law and Equality, Columbia Legal Services, and Washington Defender Association for Leave to File Amicus Curiae Brief in Support of Respondent

State of Washington v. Marvin Le

The devil is in the details: trends in avoidable hospitalization rates by geography in British Columbia, 1990–2000

BACKGROUND: Researchers and policy makers have focussed on the development of indicators to help monitor the success of regionalization, primary care reform and other health sector restructuring initiatives. Certain indicators are useful in examining issues of equity in service provision, especially among older populations, regardless of where they live. AHRs are used as an indicator of primary care system efficiency and thus reveal information about access to general practitioners. The purpose of this paper is to examine trends in avoidable hospitalization rates (AHRs) during a period of time characterized by several waves of health sector restructuring and regionalization in British Columbia. AHRs are examined in relation to non-avoidable and total hospitalization rates as well as by urban and rural geography across the province. METHODS: Analyses draw on linked administrative health data from the province of British Columbia for 1990 through 2000 for the population aged 50 and over. Joinpoint regression analyses and t-tests are used to detect and describe trends in the data. RESULTS: Generally speaking, non-avoidable hospitalizations constitute the vast majority of hospitalizations in a given year (i.e. around 95%) with AHRs constituting the remaining 5% of hospitalizations. Comparing rural areas and urban areas reveals that standardized rates of avoidable, non-avoidable and total hospitalizations are consistently higher in rural areas. Joinpoint regression results show significantly decreasing trends overall; lines are parallel in the case of avoidable hospitalizations, and lines are diverging for non-avoidable and total hospitalizations, with the gap between rural and urban areas being wider at the end of the time interval than at the beginning. CONCLUSION: These data suggest that access to effective primary care in rural communities remains problematic in BC given that rural areas did not make any gains in AHRs relative to urban areas under recent health sector restructuring initiatives. It remains important to continue to monitor the discrepancy between them as a reflection of inequity in service provision. In addition, it is important to consider alternative explanations for the observed trends paying particular attention to the needs of rural and urban populations and the factors influencing local service provision

Managing health professional migration from sub-Saharan Africa to Canada: a stakeholder inquiry into policy options

BACKGROUND: Canada is a major recipient of foreign-trained health professionals, notably physicians from South Africa and other sub-Saharan African countries. Nurse migration from these countries, while comparatively small, is rising. African countries, meanwhile, have a critical shortage of professionals and a disproportionate burden of disease. What policy options could Canada pursue that balanced the right to health of Africans losing their health workers with the right of these workers to seek migration to countries such as Canada? METHODS: We interviewed a small sample of émigré South African physicians (n = 7) and a larger purposive sample of representatives of Canadian federal, provincial, regional and health professional departments/organizations (n = 25); conducted a policy colloquium with stakeholder organizations (n = 21); and undertook new analyses of secondary data to determine recent trends in health human resource flows between sub-Saharan Africa and Canada. RESULTS: Flows from sub-Saharan Africa to Canada have increased since the early 1990s, although they may now have peaked for physicians from South Africa. Reasons given for this flow are consistent with other studies of push/pull factors. Of 8 different policy options presented to study participants, only one received unanimous strong support (increasing domestic self-sufficiency), one other received strong support (increased health system strengthening in source country), two others mixed support (voluntary codes on ethical recruitment, bilateral or multilateral agreements to manage flows) and four others little support or complete rejection (increased training of auxiliary health workers in Africa ineligible for licensing in Canada, bonding, reparation payments for training-cost losses and restrictions on immigration of health professionals from critically underserved countries). CONCLUSION: Reducing pull factors by improving domestic supply and reducing push factors by strengthening source country health systems have the greatest policy traction in Canada. The latter, however, is not perceived as presently high on Canadian stakeholder organizations' policy agendas, although support for it could grow if it is promoted. Canada is not seen as "actively' recruiting" ("poaching") health workers from developing countries. Recent changes in immigration policy, ongoing advertising in southern African journals and promotion of migration by private agencies, however, blurs the distinction between active and passive recruitment

Modelling optimal location for pre-hospital helicopter emergency medical services

<p>Abstract</p> <p>Background</p> <p>Increasing the range and scope of early activation/auto launch helicopter emergency medical services (HEMS) may alleviate unnecessary injury mortality that disproportionately affects rural populations. To date, attempts to develop a quantitative framework for the optimal location of HEMS facilities have been absent.</p> <p>Methods</p> <p>Our analysis used five years of critical care data from tertiary health care facilities, spatial data on origin of transport and accurate road travel time catchments for tertiary centres. A location optimization model was developed to identify where the expansion of HEMS would cover the greatest population among those currently underserved. The protocol was developed using geographic information systems (GIS) to measure populations, distances and accessibility to services.</p> <p>Results</p> <p>Our model determined Royal Inland Hospital (RIH) was the optimal site for an expanded HEMS – based on denominator population, distance to services and historical usage patterns.</p> <p>Conclusion</p> <p>GIS based protocols for location of emergency medical resources can provide supportive evidence for allocation decisions – especially when resources are limited. In this study, we were able to demonstrate conclusively that a logical choice exists for location of additional HEMS. This protocol could be extended to location analysis for other emergency and health services.</p

Classificatory multiplicity: intimate partner violence diagnosis in emergency department consultations

Aims and Objectives The aim of this research was to explore the naming, or classification, of physical assaults by a partner as ‘intimate partner violence’ during emergency department consultations. Background Research continues to evidence instances when intimate partner physical violence is ‘missed’ or unacknowledged during emergency department consultations. Methods Theoretically this research was approached through complexity theory and the sociology of diagnosis. Research design was an applied, descriptive and explanatory, multiple-method approach that combined: qualitative semi-structured interviews with service users (n=8) and emergency department practitioners (n=9), and qualitative and quantitative document analysis of emergency department health records (n=28). Results This study found that multiple classifications of intimate partner violence were mobilised during emergency department consultations and that these different versions of intimate partner violence held different diagnostic categories, processes, and consequences. Conclusion The construction of different versions of intimate partner violence in emergency department consultations could explain variance in people’s experiences and outcomes of consultations. The research found that the classificatory threshold for ‘intimate partner violence’ was too high. Strengthening systems of diagnosis (identification and intervention) so that all incidents of partner violence are named as ‘intimate partner violence’ will reduce the incidence of missed cases and afford earlier specialist intervention to reduce violence and limit its harms. Relevance to Clinical Practice This research found that identification of and response to intimate partner violence, even in contexts of severe physical violence, was contingent. By lowering the classificatory threshold so that all incidents of partner violence are named as ‘intimate partner violence’, practitioners could make a significant contribution to reducing missed intimate partner violence during consultations and improving health outcomes for this population. This research has relevance for practitioners in any setting where service-user report of intimate partner violence is possible.   SUMMARY BOX What does this paper contribute to wider global community? • Identification of and response to intimate partner violence, even in contexts of severe physical violence was found to be contingent. • Classification of intimate partner violence was connected to: legal duty to respond statutory frameworks of risk of harms; socio-cultural discourses about what counts as intimate partner violence; and health care practitioners’ perceptions of usual modes of disclosure. • Connecting all reports of partner perpetrated violence to intimate partner violence identification and intervention will reduce missed cases in health consultations and mobilise earlier intervention to reduce violence and limit its harms. • The sociology of diagnosis is a valuable conceptual tool for examining variance in identification and response for a wide range of determinants of health of concern for nurses and allied professions

Local public health workers' perceptions toward responding to an influenza pandemic

BACKGROUND: Current national preparedness plans require local health departments to play an integral role in responding to an influenza pandemic, a major public health threat that the World Health Organization has described as "inevitable and possibly imminent". To understand local public health workers' perceptions toward pandemic influenza response, we surveyed 308 employees at three health departments in Maryland from March – July 2005, on factors that may influence their ability and willingness to report to duty in such an event. RESULTS: The data suggest that nearly half of the local health department workers are likely not to report to duty during a pandemic. The stated likelihood of reporting to duty was significantly greater for clinical (Multivariate OR: 2.5; CI 1.3–4.7) than technical and support staff, and perception of the importance of one's role in the agency's overall response was the single most influential factor associated with willingness to report (Multivariate OR: 9.5; CI 4.6–19.9). CONCLUSION: The perceived risk among public health workers was shown to be associated with several factors peripheral to the actual hazard of this event. These risk perception modifiers and the knowledge gaps identified serve as barriers to pandemic influenza response and must be specifically addressed to enable effective local public health response to this significant threat