PNG mineral boom: Harnessing the extractive sector to deliver better health outcomes

International experience has shown that mining and resources sector participation in Public-Private Partnerships (PPPs) can realise substantial health benefits not only for the company, but also for its public sector partners and communities. This paper summarises the international experience, and presents examples of mining and resource sector participation in health care in Papua New Guinea (PNG). The extractive industries in PNG are already actively involved in health service delivery and improving health conditions in the area within which they operate. With the prospect of major economic growth in PNG comes an opportunity to further systematise and expand on the application of industry expertise to creating lasting development in the PNG health sector for the benefit of the private sector, the government and the community alike. The paper also discusses some of the challenges in further harnessing the private sector as a partner in PNG development, including i) barriers to collaboration; ii) engaging with extractive industry partners; and iii) developing relationships and trust.Public-Private Partnerships, mining, resources, health, PNG, extractive industries

An exploration of HIV testing policy and services through a social justice lens

The objective of this study was to evaluate the congruence between HIV testing policies and everyday testing practices in a small urban centre in Newfoundland and Labrador (NL). Social justice principles were used to explore the challenges associated with anonymous testing in a small urban centre and how current service delivery practices may be affecting "at-risk" populations and other test seekers who require a higher degree of confidentiality. Framed within a constructivist epistemology, qualitative description was used to determine data collection and analysis strategies. The findings are presented within an expanded social determinants of health framework, which emphasizes health inequalities as a driver of poor health outcomes. Data were collected from four testing sites using individual interviews and a document review of policy-related documents. A reflexive journal was logged throughout data collection and used for verification during analysis, which included thematizing, diagramming and coding. -- The applicable legislation was the Communicable Diseases Act, which requires name based reporting. Participants interpreted anonymous testing as being illegal according to this legislation. Findings demonstrated a history of offering anonymous testing at all testing sites and present-day practices that fit the definition of anonymous testing, but were referred to in official policy and understood by participants as being non-nominal. An alternate definition of anonymous testing is proposed where contact information is not requested or recorded and pre- and post-test counseling is delivered face-to-face. Redefining the provision of HIV testing services in this way supports the call to increase the visibility of social justice in Canadian public health policy. Eighteen recommendations are offered to guide this legislative and policy change

Conformational effects of nucleotide exchange in ras p21 proteins as studied by fluorescence spectroscopy

AbstractThe intrinsic fluorescence properties of the oncogene protein p21N-ras, p21H-ras and one of its transforming mutants, p21N-ras (Va1112), have been investigated. A mutant containing a single tryptophan at position 28 in p21H-ras (Trp28) has been specifically engineered to provide a probe of protein conformation on nucleotide binding. The proteins produced essentially similar circular dichroism spectra typical of alpha/beta proteins. A decrease in the intensity of the fluorescence emission spectrum due to tyrosine occurred on GDP/GTP nucleotide exchange in the native and mutant proteins. Selective excitation of the single tryptophan in p21 produced a decrease in fluorescence intensity which was accompanied by a blue shift in the wavelength of maximum emission on nucleotide exchange. A reduction in the residual Mg2+ ion concentration enhanced this effect

Manipulative therapy and/or NSAIDs for acute low back pain: design of a randomized controlled trial [ACTRN012605000036617]

BACKGROUND: Acute low back pain is a common condition resulting in pain and disability. Current national and international guidelines advocate general practitioner care including advice and paracetamol (4 g daily in otherwise well adults) as the first line of care for people with acute low back pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and spinal manipulative therapy (SMT) are advocated in many guidelines as second line management options for patients with acute low back pain who are not recovering. No studies have explored the role of NSAIDs and/or SMT in addition to first line management for acute low back pain. The primary aim of this study is to investigate if NSAIDs and/or SMT in addition to general practitioner advice and paracetamol results in shorter recovery times for patients with acute low back pain. The secondary aims of the study are to evaluate whether the addition of SMT and/or NSAIDs influences pain, disability and global perceived effect at 1, 2, 4 and 12 weeks after onset of therapy for patients with significant acute low back pain. METHODS/DESIGN: This paper presents the rationale and design of a randomised controlled trial examining the addition of NSAIDs and/or SMT in 240 people who present to their general practitioner with significant acute low back pain

Pathways into living alone in mid-life: diversity and policy implications

This paper adopts a life course approach to investigate the pathways into living alone in mid-life in Britain and how these vary by gender and socio-economic status. The rise in the proportion of people living alone over the past three decades has been well documented. However, much of the focus of the existing literature has been on either people living solo in young adulthood or in later life. Mid-life has received surprising little scholarly attention, despite the fact that living arrangements in mid-life are changing rapidly, and that household composition and socio-economic circumstances in the period immediately prior to retirement are strongly associated with living arrangements and associated sources of support in later life. This paper therefore aims to fill this gap. We begin with a review of previous research on living alone and present a conceptual framework of the pathways into living alone in mid-life. Data from the United Kingdom Household Longitudinal Survey (UKHLS) are used to analyse the partnership and parenthood histories and socio-economic characteristics of those currently living alone in mid-life. The findings indicate that the dissolution of a marriage with children is the dominant pathway into mid-life solo-living, but that there is also a substantial group of never partnered men living alone. These never partnered men are split between those with low and high socio-economic status. Distinguishing between different groups of individuals living alone in mid-life is important for policy as these groups of men and women will have different social and financial resources as they enter later life. Mid-life men living alone who have not had children, have no educational qualifications, are not economically active and who live in rented housing are likely to be most at risk of needing a social and economic ‘safety net’ in old age

Enhanced student learning and scholarly productivity through capstone projects

Abstract from the American Association of Colleges of Pharmacy/Association of Faculties of Pharmacy of Canada Annual Meeting, Chicago, IL, July 16-24, 2008

PACE - The first placebo controlled trial of paracetamol for acute low back pain: design of a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Clinical practice guidelines recommend that the initial treatment of acute low back pain (LBP) should consist of advice to stay active and regular simple analgesics such as paracetamol 4 g daily. Despite this recommendation in all international LBP guidelines there are no placebo controlled trials assessing the efficacy of paracetamol for LBP at any dose or dose regimen. This study aims to determine whether 4 g of paracetamol daily (in divided doses) results in a more rapid recovery from acute LBP than placebo. A secondary aim is to determine if ingesting paracetamol in a time-contingent manner is more effective than paracetamol taken when required (PRN) for recovery from acute LBP.</p> <p>Methods/Design</p> <p>The study is a randomised double dummy placebo controlled trial. 1650 care seeking people with significant acute LBP will be recruited. All participants will receive advice to stay active and will be randomised to 1 of 3 treatment groups: time-contingent paracetamol dose regimen (plus placebo PRN paracetamol), PRN paracetamol (plus placebo time-contingent paracetamol) or a double placebo study arm. The primary outcome will be time (days) to recovery from pain recorded in a daily pain diary. Other outcomes will be pain intensity, disability, function, global perceived effect and sleep quality, captured at baseline and at weeks 1, 2, 4 and 12 by an assessor blind to treatment allocation. An economic analysis will be conducted to determine the cost-effectiveness of treatment from the health sector and societal perspectives.</p> <p>Discussion</p> <p>The successful completion of the trial will provide the first high quality evidence on the effectiveness of the use of paracetamol, a guideline endorsed treatment for acute LBP.</p> <p>Trail registration</p> <p>ACTRN12609000966291.</p