Improving Health and Building Human Capital Through an Effective Primary Care System

To improve population health, one must put emphasis on reducing health inequities and enhancing health protection and disease prevention, and early diagnosis and treatment of diseases by tackling the determinants of health at the downstream, midstream, and upstream levels. There is strong theoretical and empirical evidence for the association between strong national primary care systems and improved health indicators. The setting approach to promote health such as healthy schools, healthy cities also aims to address the determinants of health and build the capacity of individuals, families, and communities to create strong human and social capitals. The notion of human and social capitals begins to offer explanations why certain communities are unable to achieve better health than other communities with similar demography. In this paper, a review of studies conducted in different countries illustrate how a well-developed primary health care system would reduce all causes of mortalities, improve health status, reduce hospitalization, and be cost saving despite a disparity in socioeconomic conditions. The intervention strategy recommended in this paper is developing a model of comprehensive primary health care system by joining up different settings integrating the efforts of different parties within and outside the health sector. Different components of primary health care team would then work more closely with individuals and families and different healthy settings. This synergistic effect would help to strengthen human and social capital development. The model can then combine the efforts of upstream, midstream, and downstream approaches to improve population health and reduce health inequity. Otherwise, health would easily be jeopardized as a result of rapid urbanization

Business not as usual: how multisectoral collaboration can promote transformative change for health and sustainable development.

• We present a model of enabling fac-tors for effective multisectoral collabo-ration for improvements in health and sustainable development. • Drive change: assess whether desired change is better off achieved by mul-tisectoral collaboration; drive forward collaboration by mobilising a critical mass of policy and public attention. • Define: frame the problem strategi-cally and holistically so that all sec-tors and stakeholders can see the benefits of collaboration and contri-bution to the public good• Design: create solutions relevant to context, building on existing mecha-nisms, and leverage the strengths of diverse sectors for collective impact. • Relate: ensure resources for multi-sectoral collaboration mechanisms, including for open communication and deliberation on evidence, norms, and innovation across all components of collaboration. • Realise: learn by doing, and adapt with regular feedback. Remain open to redefining and redesigning the collaboration to ensure relevance, effectiveness, and responsiveness to change. • Capture success: agree on success markers, using qualitative and quan-titative methods to monitor results regularly and comprehensively, and learn from both failures and successes to inform action and sustain gains

Thermal morphological characterization and tensile strength properties of poly vinyl alcohol (PVOH) and cassava starch blends

El presente estudio tuvo como finalidad estudiar la morfología y propiedades térmicas y mecánicas de mezclas de polialcohol vinílico (PVOH) y almidón de yuca (St). Para esto se prepararon formulaciones con PVOH 99% hidrolizado, PVOH 88% hidrolizado, almidón de yuca y glicerol industrial. Con cada uno de los PVOH utilizados se prepararon mezclas con proporciones PVOH/St de 100/0, 80/20, 60/40, 40/60, 20/80 y 0/100. La apariencia de las películas varió desde la mayor transparencia y brillo de las películas de los dos tipos de PVOH utilizados, hasta la opacidad de las películas de almidón. En general la apariencia de las películas obtenidas a partir de las diferentes proporciones de PVOH/St, varió de acuerdo con la composición. Algunas de las formulaciones presentaron separación de fases en las películas. Las micrografías electrónicas de barrido de las películas fracturadas en frío, mostraron superficies de fractura que variaron de acuerdo con la composición de la mezcla. Las películas de PVOH y sus mezclas mostraron superficies de fractura tipo escisión con marcas de playa que disminuyeron a medida que aumentaba la proporción de almidón en la mezcla. Los difractogramas de rayos x de las películas, mostraron patrones típicos de materiales semicristalinos y amorfos, se obtuvieron porcentajes de cristalinidad que variaron entre 7,3% para el almidón puro y 22,5% para el PVOH 99% hidrolizado puro. Al analizar las propiedades de tensión se encontraron deformaciones de alrededor de 4% para el almidón puro y 105% para el PVOH 99% hidrolizado, así mismo los esfuerzos máximos variaron desde 15 MPa para el PVOH 88% puro y 60MPa para mezclas PVOH/St, obtenidas con PVOH 99% hidrolizado. Por otro lado, se observó que el módulo, el esfuerzo de fluencia, el esfuerzo máximo y el esfuerzo de ruptura disminuyen y las deformaciones aumentan cuando se introduce el plastificante en el sistema de mezcla. En el análisis térmico se observó que el PVOH 99% presenta un pico endotérmico angosto y profundo al rededor de 225ºC, mientras que el PVOH 88% hidrolizado presento un pico endotérmico de menor profundidad en 195ºC, por su parte el almidón presentó un pico endotérmico ancho y profundo alrededor de 140ºC. Los termogramas de las mezclas presentaron los picos correspondientes a cada uno de los materiales que las conformaban. Los espectros infrarrojos permitieron tener indicios de que las interacciones entre las moléculas de los polímeros se dan de manera similar para los materiales puros y para las mezclas, ya que el pico correspondiente a los grupos hidroxilos no cambió de posición para ninguna de las formulaciones. / Abstract. Blends of poly(vinyl alcohol) (PVOH) and cassava starch(St) were prepared using PVOH 99% and 88% degree of hydrolysis and glycerin as plasticizer. The proportions of PVOH/St blends were 100/0, 80/20, 60/40, 40/60; 20/80 and 0/100.The morphological characterization was carried out by using scanning electronic microscopy and X- ray diffraction. Cleavage fracture surfaces in microscopy images and crystalline peaks in the X-ray diffraction patterns were found. The degree of crystallinity was calculated by X-ray patterns and was 23% for pure PVOH99 and 7% for St. Stress – strain plots for the PVOH99 formulations behavior was similar to the pure St, while films prepared with PVOH88 had modulus and strain that were in between the pure materials properties. This could be explained by better interactions between the components in PVOH88/St than PVOH99/St blends. The characteristic endothermic melting peak for the pure PVOH99 was found around 225 ºC and for PVOH88 appeared at about 195ºC. The pure St DSC curves, shown a deep and wide endothermic peak around 140 ºC. Similar performance was seen in the past and it has been attributed to a loose of molecular order of the amylopectin helix through helix – coil transition. Differences in OH stretching peak signal in FTIR could be attributed to a different interaction between the OH group and the surrounding groups. In this case, it is notorious the difference in the IR spectrum of pure PVOH88 and its blends. This could be originated by the effect OH interactions.Magister en Ingeniería – Materiales y ProcesosMaestrí