Evaluation of an implementation strategy for a World Health Organization (WHO) public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

Aim: This paper aims to evaluate a strategy for the implementation of public health policy recommendations from the World Health Organization’s (WHO) report “International Perspectives on Spinal Cord Injury” in Romania. More specifically, it seeks to: a) evaluate implementation actions with a focus on a number of people reached and status of completion at 12 months follow-up; b) describe implementation activities undertaken in the course of one year, and; c) evaluate perceived barriers and facilitators of implementation at 12 months follow-up. Methods: A cross-sectional design was adopted with two surveys administered in 2014/15 among key implementers in Romania. The questionnaires contained open-ended, multiple choice and 5-point Likert scale questions. Results on the implementation status, implementation activities performed and self-reported barriers and facilitators were analysed and reported using descriptive statistics. Results: Implementation completion rate was 75%, with 4390 persons directly or indirectly benefiting from the implementation-related activities listed in the final implementation plan reporting. A broad range of implementation experiences was reported. Most common activity types were delivery of services, technical trainings, implementation coordination and development meetings. Most useful tools and processes were the Romanian language version summary of the report, educational meetings, and local consensuses processes. Reported outcomes included the direct output produced, evidence of services provided, and individual or organizational level impact. Most barriers were named for the policymakers and academia as stakeholder groups and most facilitating influences for the private sector, with dependence of policymakers on constituency interest scoring highest barrier and the general availability of European Commission and European Structural Funds highest facilitator. Conclusion: The surveys proved to be both feasible and useful tools to expand our understanding of implementation and to supplement the more standard used implementation strategies at country level

Evaluation of an implementation strategy for a World Health Organization (WHO) public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

Aim: This paper aims to evaluate a strategy for the implementation of public health policy recommendations from the World Health Organization’s (WHO) report “International Perspectives on Spinal Cord Injury” in Romania. More specifically, it seeks to: a) evaluate implementation actions with a focus on a number of people reached and status of completion at 12 months follow-up; b) describe implementation activities undertaken in the course of one year, and; c) evaluate perceived barriers and facilitators of implementation at 12 months follow-up.Methods: A cross-sectional design was adopted with two surveys administered in 2014/15 among key implementers in Romania. The questionnaires contained open-ended, multiple choice and 5-point Likert scale questions. Results on the implementation status, implementation activities performed and self-reported barriers and facilitators were analysed and reported using descriptive statistics.Results: Implementation completion rate was 75%, with 4390 persons directly or indirectly benefiting from the implementation-related activities listed in the final implementation plan reporting. A broad range of implementation experiences was reported. Most common activity types were delivery of services, technical trainings, implementation coordination and development meetings. Most useful tools and processes were the Romanian language version summary of the report, educational meetings, and local consensuses processes. Reported outcomes included the direct output produced, evidence of services provided, and individual or organizational level impact. Most barriers were named for the policymakers and academia as stakeholder groups and most facilitating influences for the private sector, with dependence of policymakers on constituency interest scoring highest barrier and the general availability of European Commission and European Structural Funds highest facilitator.Conclusion: The surveys proved to be both feasible and useful tools to expand our understanding of implementation and to supplement the more standard used implementation strategies at country level. 

Paschaplegiker? Hilfe- und Ausweichverhalten gegenüber Rollstuhlfahrern an öffentlichen Orten: eine empirische Beobachtungsstudie in der Stadt Luzern

"Mit Hilfe einer quantitativen und qualitativen Inhaltsanalyse, die auf einer Videobeobachtung basiert, wurde das Hilfe- und Ausweichverhalten von Passanten gegenüber einem sich in einer vermeintlichen Problemsituation befindenden Rollstuhlfahrer untersucht. Lediglich 28 von 541 Passanten sprachen den Rollstuhlfahrer an, von denen wiederum 13 Hilfsangebote machten. Nicht nur die Passanten, die vorübergingen, hielten unüblich große Abstände zum Rollstuhlfahrer, sondern auch dessen Gesprächspartner. Ein weiteres Hauptergebnis liegt in der Entdeckung eines 'Ansteckungseffekts', der darin besteht, dass sich Passanten offenbar erst trauen, den Rollstuhlfahrer anzusprechen, wenn dies bereits jemand vor ihnen gemacht hat." (Autorenreferat)"Help and avoidance behaviors of pedestrians towards a wheelchair user in a seemingly problematic situation were observed and videotaped. A quantitative as well as qualitative content analysis was performed. Only 28 of 541 pedestrians contacted the wheelchair user. Of these13 offered help. Pedestrians passing the wheelchair user as well as dialogue partners positioned themselves in an unusually large distance to the wheelchair user. We also discovered a kind of 'contagion effect'. When one pedestrian had contacted the wheelchair user others followed immediately within the same time interval. A by-stander effect could not be confirmed." (author's abstract

The role of transdisciplinarity in building a decolonial bridge between science, policy, and practice

Transdisciplinary research is considered to offer contributions of science to sustainability transformations, partly because transdisciplinary approaches aim to increase the relevance, credibility, and legitimacy of scientific research by ensuring the active participation of non-academic actors in research. However, the possible impact of transdisciplinary research on decolonial sustainability science – understood as actively undoing Euro-North American centricity, dispossession, racism, and ongoing power imbalances in inequitable social-ecological systems – and simultaneous response to scientific rigor remain under debate. Thus, this article assesses the contributions of transdisciplinary research projects to decolonial sustainability science based on empirical infor ma tion. To do so, we analyze a sample of 43 development research projects of the Swiss Programme for Research on Global Issues for Development (r4d programme) in Africa, Asia, and Latin America. We found that despite significant differences in approaches, Global-North-dominated sustainability science still has far to go to achieve the decolonial potential of transdisciplinarity, enabling different actors’ participation

Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study.

We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector HIV programme to examine adherence and viral non-suppression (viral load > 400 copies/mL) of participants with (20,743, 38%) and without (33,635, 62%) mental health diagnoses. Mental health diagnoses were associated with unfavourable adherence patterns. The risk of viral non-suppression was higher among patients with organic mental disorders [adjusted risk ratio (aRR) 1.55, 95% confidence interval (CI) 1.22-1.96], substance use disorders (aRR 1.53, 95% CI 1.19-1.97), serious mental disorders (aRR 1.30, 95% CI 1.09-1.54), and depression (aRR 1.19, 95% CI 1.10-1.28) when compared with patients without mental health diagnoses. The risk of viral non-suppression was also higher among males, adolescents (15-19 years), and young adults (20-24 years). Our study highlights the need for psychosocial interventions to improve HIV treatment outcomes-particularly of adolescents and young adults-and supports strengthening mental health services in HIV treatment programmes

Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study.

OBJECTIVES: To examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART). SETTING: Sixteen government-funded health facilities in the rural Bikita district of Zimbabwe. DESIGN: Cross-sectional study. PARTICIPANTS: HIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months. OUTCOME MEASURES: The primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence. RESULTS: Out of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40-49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50-59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70). CONCLUSIONS: A substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe. TRIAL REGISTRATION NUMBER: NCT03704805

Evaluation of an implementation strategy for a World Health Organization (WHO) public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

Aim: This paper aims to evaluate a strategy for the implementation of public health policy recommendations from the World Health Organization’s (WHO) report “International Perspectives on Spinal Cord Injury” in Romania. More specifically, it seeks to: a) evaluate implementation actions with a focus on a number of people reached and status of completion at 12 months follow-up; b) describe implementation activities undertaken in the course of one year, and; c) evaluate perceived barriers and facilitators of implementation at 12 months follow-up. Methods: A cross-sectional design was adopted with two surveys administered in 2014/15 among key implementers in Romania. The questionnaires contained open-ended, multiple choice and 5-point Likert scale questions. Results on the implementation status, implementation activities performed and self-reported barriers and facilitators were analysed and reported using descriptive statistics. Results: Implementation completion rate was 75%, with 4390 persons directly or indirectly benefiting from the implementation-related activities listed in the final implementation plan reporting. A broad range of implementation experiences was reported. Most common activity types were delivery of services, technical trainings, implementation coordination and development meetings. Most useful tools and processes were the Romanian language version summary of the report, educational meetings, and local consensuses processes. Reported outcomes included the direct output produced, evidence of services provided, and individual or organizational level impact. Most barriers were named for the policymakers and academia as stakeholder groups and most facilitating influences for the private sector, with dependence of policymakers on constituency interest scoring highest barrier and the general availability of European Commission and European Structural Funds highest facilitator. Conclusion: The surveys proved to be both feasible and useful tools to expand our understanding of implementation and to supplement the more standard used implementation strategies at country level

Developing an implementation strategy for a World Health Organization public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

AbstractAim: The World Health Organization (WHO) publishes a large number of health reports every year, containing recommendations to overcome societal and system barrier challenges toward targeting unmet health needs. One such report, the International Perspectives on Spi-nal Cord Injury (IPSCI), specifically describes the situation of persons with spinal cord in-jury. Against this backdrop, the question arises about how these recommendations can be incorporated into an implementation strategy. Therefore, the aim of this paper is to describe a phased process of developing an implementation strategy for a WHO public health report with IPSCI serving as a case example.Methods: The process to develop the implementation strategy consisted of specific phases each employing particular mechanisms. The preparatory phase was composed of a group dis-cussion to select development mechanisms. The implementation strategy development phase comprised focus-group interviews, as well as of a stakeholder dialogue. Thematic content analysis was applied to qualitative data.Results: The group discussion led to selection of specific development mechanisms. The focus group mechanism allowed key stakeholders to openly discuss implementation goals and processesand impacted the selection of the core implementation group members and the focus of the stakeholder dialogue (SD) discussion.The SD was instrumental in developing a specific implementation strategy based on the report‟s recommendations. The strategy con-sisted of a detailed implementation plan, provisions to coordinate an implementation group and expert guidance.Conclusion: The findings from the current study can inform the ongoing development of systematic, evidence-informed, participatory and stakeholder-driven processes for the devel-opment of implementation strategies for recommendations from WHO public health reports

ISPRM`S WAY FORWARD

This paper outlines approaches to developing the International Society of Physical and Rehabilitation Medicine (ISPRM) and addresses many current challenges Most importantly, these approaches provide the basis for ISPRM to develop its leadership role within the field of Physical and Rehabilitation Medicine (PRM) and in relation to the World Health Organization (WHO) and the United Nations (UN) system at large. They also address a number of specific critiques of the current situation. A positioning of ISPRM within the world architecture of the UN and WHO systems, as well as the consideration and fostering of respective emerging regional PRM societies, is central to establishing networking connections at different levels of the world society. Yearly congresses, possibly in co-operation with a regional society, based on a defined regional rotation, are suggested. Thus, frustration with the current bidding system for a biennial congress and an intermediate meeting could be overcome. Yearly congresses are also an important step towards increasing the organization`s funding base, and hence the possibility to expand the functions of ISPRM`s central office. ISPRM`s envisioned leadership role in the context of an international web of PRM journals complementing the formally defined official journal of ISPRM, regional societies and so forth, is an inclusive rather than exclusive approach that contributes to the development of PRM journals worldwide. An important prerequisite for the further development of ISPRM is the expansion and bureaucratization of its Central Office, adding professionalism and systematic allocation of resources to the strengths of the voluntary engagement of individual PRM doctors

THE POLICY AGENDA OF ISPRM

This paper suggests a comprehensive policy agenda and first steps to be undertaken by the International Society of Physical and Rehabilitation Medicine (ISPRM) in order to realize its humanitarian, professional and scientific mandates. The general aims of ISPRM, as formulated in its guiding documents, the relations with the World Health Organization (WHO) and the United Nations system, and demands of ISPRM`s constituency herein form the basis of this policy agenda Agenda items encompass contributions to the establishment of rehabilitation services worldwide and the development of PRM societies ISPRM`s possible input in general curricula in disability and rehabilitation, and in fighting discrimination against people experiencing disability are discuss. Moreover, the implementation of the International Classification of Functioning. Disability and Health (ICF) in medicine, contributions to WHO guidelines relevant to disability and rehabilitation the provision of a conceptual description of the rehabilitation strategy and the outline of a rehabilitation services matrix are seen as important agenda items of ISPRM`s external policy. With regard to its constituency and internal policy, a definition of the field of competence and a conceptual description of PRM, as well as the development of a consistent and comprehensive congress topic list and congress structure appear to be crucial items. The proposed agenda items serve as a basis for future discussions