What can a participatory approach to evaluation contribute to the field of integrated care?

© 2017 BMJ Publishing Group. All rights reserved. Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground. In this paper we present a methodological approach, based on the principles of participatory research, that attempts to address this challenge. Participatory approaches are characterised by a desire to use social science methods to solve practical problems and a commitment on the part of researchers to substantive and sustained collaboration with relevant stakeholders. We describe how we applied an emerging practical model of participatory research, the researcher-in-residence model, to evaluate a large-scale integrated care programme in the UK. We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits of rigorously evaluating their work, by providing insights for local stakeholders that they were either not familiar with or had not fully considered in relation to the development and implementation of the programme and by challenging established mindsets and norms. While there is still much to learn about the benefits and challenges of applying participatory approaches in the health sector, we demonstrate how using such approaches have the potential to help practitioners integrate care more effectively in their daily practice and help progress the academic study of integrated care

AN OPTIMAL CORN ROOTWORM SCOUTING PROGRAM FOR IMPROVED PROFITABILITY OF AREAWIDE PEST MANAGEMENT IN THE EASTERN CORN BELT

Economic analyses show that without cost reductions, Areawide Pest Management for corn rootworm control is not cost effective in Illinois/Indiana where a variant form of the western corn rootworm exists. This paper examines strategies for reducing scouting/costs and determining the minimal scouting effort necessary to maintain effective adult suppression.Crop Production/Industries,

Adoption of Transgenic Crops by Smallholder Farmers in Entre Rios, Argentina

This is a study of the adoption of transgenic crops by 120 smallholder farmers interviewed in July 2005 in the communities of San Jose de Feliciano and La Paz in the Entre Rios Province of Argentina. Logistic regression results indicate that access to a planter is essential for smallholders to adopt Bt corn, while adopters of Roundup Ready soybeans have larger farms, access to credit, availability of all essential machinery, more years of schooling, and are primarily located in the La Paz community.transgenic crops, technology adoption, Bt corn, Roundup Ready soybeans, biotechnology, Argentina, smallholders, Farm Management, Research and Development/Tech Change/Emerging Technologies,

Limited Resource Families and Child Health Status: A Case Study in Montero, Bolivia

Child malnutrition is a problem that poses social and economic costs to individuals, households, communities, and nations, like Bolivia. Childhood malnutrition can be reduced through effective policy and health interventions such as those of the Consejo de Salud Rural Andino (CSRA) in Montero, Bolivia. The CSRA is a non-profit, private organization that operates three health care clinics in Montero, Bolivia. Low-income mothers and their children are provided with free or minimal-cost public health education and basic pre- and post natal medical services . Three separate clinic areas serve three different populations in terms of child nutritional status and demographic and socioeconomic characteristics. Effectiveness and priority intervention points for reducing childhood malnutrition can be identified by a thorough understanding of socio-economic and demographic characteristics as they relate to child nutrition status. Survey data were collected from 180 women with children under the age of five living in the CSRA clinic coverage area. Data focused on child health, nutrition, anthropometric data, and household socioeconomic and demographic characteristics. Multivariate regression analysis was used to explain child nutrition status as indicated by anthropometric indices. The regression models included child-specific, maternal, and household factors. Regression models were estimated for three anthropometric indices: weight-for-age, height-for-age, and weight-for-height. CSRA initiatives were found to have made a positive contribution to child and maternal health care. However, child malnutrition remains which is inversely associated with critical demographic and socioeconomic characteristics of the various households such as maternal education and household income and wealth.Health Economics and Policy,

SOYBEAN PRODUCTION COSTS: AN ANALYSIS OF THE UNITED STATES, BRAZIL, AND ARGENTINA

U.S. farmers' share of world soybean exports has declined, while Brazil and Argentina are gaining. There is much debate concerning the competitive advantage of U.S. versus Latin American soybean producers. A detailed analysis of soybean production costs under different systems and technologies in the United States, Argentina, and Brazil was conducted.Crop Production/Industries,

MANAGING THE CORN ROOTWORM VARIANT: EMPIRICAL RESULTS FROM AN INDIANA FARMER SURVEY

The emergence of a corn rootworm "variant" has reduced the effectiveness of a corn-soybean rotation in some areas of Indiana. This research identifies potential control alternatives. Empirical results suggest that younger, more educated managers of larger farms would be the most likely to adopt transgenic corn for rootworm control.areawide pest management, corn rootworms, technology adoption, transgenic corn, Crop Production/Industries,

Studies on the use of sulfites to control shrimp melanosis (Blackspot) (Presented at the 11th Annual Meeting of the Tropical and Subtropical Fisheries Technological Conference of the Americas, January 14, 1986, Tampa, Florida)

Shrimp melanosis, commonly known as 'blackspot' is a harmless but objectionable surface dicoloration caused by polyphenoloxidase enzyme systems which remain active during refrigeration or ice storage. In the early 1950's sulfiting agents, particularily sodium bisulfite was first introduced to prevent or inhibit melanosis, thus yielding a more valuable harvest (1). Such use of sulfites was 'prior sanctioned1 by the U.S. Food and Drug Administration (FDA) in 1956 (2). More recent FDA decisions reaffirmed this practice, (3) but continuing regulatory scrutiny could restrict or eliminate the application of sulfite on shrimp. The regulatory action is prompted by an increasing concern for adverse 'allergic' reactions most common amongst hyper-(sulfite) sensitive asthmatics. Thus work was initiated to find alternatives to replace or reduce the amount of sulfites required to inhibit shrimp melanosis. This work would screen for possible alternatives which would require subsequent verification with field tests and statistical evaluations. (21pp.

TECHNOLOGICAL CHANGE AND LABOR'S RELATIVE SHARE: THE MECHANIZATION OF U.S. COTTON PRODUCTION

Research and Development/Tech Change/Emerging Technologies,

Three-dimensional imaging of direct-written photonic structures

Third harmonic generation microscopy has been used to analyze the morphology of photonic structures created using the femtosecond laser direct-write technique. Three dimensional waveguide arrays and waveguide-Bragg gratings written in fused-silica and doped phosphate glass were investigated. A sensorless adaptive optical system was used to correct the optical aberrations occurring in the sample and microscope system, which had a lateral resolution of less than 500 nm. This non-destructive testing method creates volume reconstructions of photonic devices and reveals details invisible to other linear microscopy and index profilometry techniques.Comment: 8 pages, 3 color figures, 2 hyper-linked animation