Promoting universal access to health services in post-conflict situations : what role can large scale cash transfer programmes play for better outcomes ?

11 p.Making well-informed decisions about how best to achieve MDGs depends on the ability of public policy makers in accessing the best available evidence about what is known to work and what could be potential benefits, and ways to integrate solutions into complex and often under-resourced health systems. Conditional cash transfer programmes have been largely explored as a policy for improving the education and health outcomes of poor children in developing countries as well as a tool for long-term poverty alleviation; but needs to be appropriate to the context and both fiscally and politically affordable. In DRC, the crisis and conflicts of the past decades severely affected the health status of the population and degraded the health system. Consequently, efforts in reducing infant and under-five morbidity and mortality are seriously hampered by widespread poverty and economic deregulation. The aim of this paper is to question the feasibility and affordability of cash transfer compared to 2 alternatives: an outreach health and nutrition programme with a behavioral change communication component and the elimination of basic health care user fees. The results show that children health outcomes may instead be driven by the equal distribution of quality services through outreach health and nutrition programmes (20% to real GDP) than a large scale health-oriented conditional cash transfer (25.9% to real GDP). A number of issues is outlined with regard to the country's socio-economic and political context : (i) health-oriented conditional cash transfer cannot operate in DRC due to supply-side constraints and lack of health supply strategy, logistics and engineering ; (ii) targeting is somewhat time consuming and irrelevant in such context with a headcount averaging 77% ; (iii) outcomes of a geographic focused cash transfer programme could be expected on improvement of nutritional status, but less on the rise of health demand and would be difficult to scale-up

Socioeconomic inequalities in child and maternal health care in Cameroon

http://onlineresearchjournals.org/JSS/pdf/2012/nov/Nkwenkeu%20et%20al..pdfInternational audienceIn developing economies, a number of investigations have highlighted the fact that the increase in health expenditure will only contribute to poverty reduction if such expenditure is efficient and if access to health services becomes more equitable. This paper measured inequality trends in maternal and child health services access and use in Cameroon where health policies were redirected in the 90s. Using data from Demographic and Health Surveys (1991, 1998 and 2004), the relationship between socio-economic status and health inequalities was assessed. Concentration Index and an accurate estimate built from the capability theory were used to measure inequality trends in socio-economic status. The results show that the policies and interventions have been more effective in reaching the better-off than the worst-off. Increase in total health care access and use were detected for both variables (DPT3 and assistance at delivery) with concentration Index showing improved movements through equal distribution. This observation was contradicted by Lorenz curve for assistance at delivery. Trend differentials observed from health index reveal a significant correlation between health outcomes, deprivation and geographic affiliation. Health services access and use are determined by both socio-economic status and a number of factors including resource allocation and contextual factors. In such context, improvements in the monitoring of healthcare distribution is important to be carry out at both national and sub-national levels, especially in countries that have undergone decentralization and where socio-cultural factors may greatly differ from one region to another

Socioeconomic inequalities in child and maternal health care in Cameroon

http://onlineresearchjournals.org/JSS/pdf/2012/nov/Nkwenkeu%20et%20al..pdfInternational audienceIn developing economies, a number of investigations have highlighted the fact that the increase in health expenditure will only contribute to poverty reduction if such expenditure is efficient and if access to health services becomes more equitable. This paper measured inequality trends in maternal and child health services access and use in Cameroon where health policies were redirected in the 90s. Using data from Demographic and Health Surveys (1991, 1998 and 2004), the relationship between socio-economic status and health inequalities was assessed. Concentration Index and an accurate estimate built from the capability theory were used to measure inequality trends in socio-economic status. The results show that the policies and interventions have been more effective in reaching the better-off than the worst-off. Increase in total health care access and use were detected for both variables (DPT3 and assistance at delivery) with concentration Index showing improved movements through equal distribution. This observation was contradicted by Lorenz curve for assistance at delivery. Trend differentials observed from health index reveal a significant correlation between health outcomes, deprivation and geographic affiliation. Health services access and use are determined by both socio-economic status and a number of factors including resource allocation and contextual factors. In such context, improvements in the monitoring of healthcare distribution is important to be carry out at both national and sub-national levels, especially in countries that have undergone decentralization and where socio-cultural factors may greatly differ from one region to another

Les enjeux du processus d'institutionnalisation des indicateurs de bien-être territorialisés : le cas de l'expérience grenobloise

13 p.Une expérimentation impulsée par des chercheurs et des professionnels des politiques publiques visant à construire des indicateurs de bien-être soutenable territorialisée à l'échelle du territoire de l'agglomération grenobloise a émergé à la croisée des considérations scientifiques sur les indicateurs alternatifs (Sen et Stiglitz (2009), Perret (2002) et Viveret (2002)) et des enjeux associés à l'enrichissement de l'observation locale face aux limites des indicateurs existants. Cette communication propose d'analyser l'expérience Indicateurs de Bien Étre Soutenable Territorialisées pour apporter une contribution à l'analyse des leviers et barrières à l'institutionnalisation des indicateurs alternatifs. Différentes questions sont soulevées : comment approcher cet objet "bien-être" par essence multidimensionnel (Sen, 2000) et transdisciplinaire ? Comment rendre compte des territoires et de la localité (Desrosières, 1994) et en même temps, disposer d'indicateurs qui ont un sens dans la perspective de comparaisons nationales voire internationales ? Comment passer de la convention à la mesure pour permettre la transformation de catégories de connaissance en catégories d'action publique et collective

Les enjeux du processus d'institutionnalisation des indicateurs de bien-être territorialisés : le cas de l'expérience grenobloise

13 p.Une expérimentation impulsée par des chercheurs et des professionnels des politiques publiques visant à construire des indicateurs de bien-être soutenable territorialisée à l'échelle du territoire de l'agglomération grenobloise a émergé à la croisée des considérations scientifiques sur les indicateurs alternatifs (Sen et Stiglitz (2009), Perret (2002) et Viveret (2002)) et des enjeux associés à l'enrichissement de l'observation locale face aux limites des indicateurs existants. Cette communication propose d'analyser l'expérience Indicateurs de Bien Étre Soutenable Territorialisées pour apporter une contribution à l'analyse des leviers et barrières à l'institutionnalisation des indicateurs alternatifs. Différentes questions sont soulevées : comment approcher cet objet "bien-être" par essence multidimensionnel (Sen, 2000) et transdisciplinaire ? Comment rendre compte des territoires et de la localité (Desrosières, 1994) et en même temps, disposer d'indicateurs qui ont un sens dans la perspective de comparaisons nationales voire internationales ? Comment passer de la convention à la mesure pour permettre la transformation de catégories de connaissance en catégories d'action publique et collective

Comparison on Well-Being, Engagement and Perceived School Climate in Secondary School Students with Learning Difficulties and Specific Learning Disorders: An Exploratory Study

none6noopenLombardi, Elisabetta; Traficante, Daniela; Bettoni, Roberta; Offredi, Ilaria; Vernice, Mirta; Sarti, DanielaLombardi, Elisabetta; Traficante, Daniela; Bettoni, Roberta; Offredi, Ilaria; Vernice, Mirta; Sarti, Daniel

Conant Gardens Neighborhood Revitalization Plan

Conant Gardens as a neighborhood and community is seeing a myriad of changes take place. A once beautiful and thriving setting is now largely viewed as urban decay. Core issues concern matters of socioeconomic decline, lack of essential services, changes in dedicated property ownership including absentee landlords and overall environmental deterioration that are altering the community's dynamic status and negatively impacting financial stability, wellness and safe environment conditions. The goal of this project is to provide the Conant Garden Neighborhood Development Corporation (CGNDC) with a plan that will be the foundation for action implementation. The plan will delineate base strategies for neighborhood stabilization (around issues of housing, open public spaces, internal road system). The strategies will also - when relevant and possible - define funding possibilities, a timeline for implementation, and strategies for replicability and scalability

De novo backbone and sequence design of an idealized α/β-barrel protein: evidence of stable tertiary structure

We have designed, synthesized, and characterized a 216 amino acid residue sequence encoding a putative idealized α/β-barrel protein. The design was elaborated in two steps. First, the idealized backbone was defined with geometric parameters representing our target fold: a central eight parallel-stranded β-sheet surrounded by eight parallel α-helices, connected together with short structural turns on both sides of the barrel. An automated sequence selection algorithm, based on the dead-end elimination theorem, was used to find the optimal amino acid sequence fitting the target structure. A synthetic gene coding for the designed sequence was constructed and the recombinant artificial protein was expressed in bacteria, purified and characterized. Far-UV CD spectra with prominent bands at 222 nm and 208 nm revealed the presence of α-helix secondary structures (50%) in fairly good agreement with the model. A pronounced absorption band in the near-UV CD region, arising from immobilized aromatic side-chains, showed that the artificial protein is folded in solution. Chemical unfolding monitored by tryptophan fluorescence revealed a conformational stability (ΔGH_2O) of 35 kJ/mol. Thermal unfolding monitored by near-UV CD revealed a cooperative transition with an apparent T_m of 65 °C. Moreover, the artificial protein did not exhibit any affinity for the hydrophobic fluorescent probe 1-anilinonaphthalene-8-sulfonic acid (ANS), providing additional evidence that the artificial barrel is not in the molten globule state, contrary to previously designed artificial a/ b-barrels. Finally, ^1H NMR spectra of the folded and unfolded proteins provided evidence for specific interactions in the folded protein. Taken together, the results indicate that the de novo designed α/β-barrel protein adopts a stable three-dimensional structure in solution. These encouraging results show that de novo design of an idealized protein structure of more than 200 amino acid residues is now possible, from construction of a particular backbone conformation to determination of an amino acid sequence with an automated sequence selection algorithm

Saberes e práticas de enfermeiros na realização e interpretação do eletrocardiograma

The aim of the present study was to analyze the knowledge of nurses in aspects related to the electrocardiogram exam. This is an integrative review using the BVS, PubMed and Academic Google databases. Used in conjunction with the Boolean AND operator. Twelve articles were found, 8 in Portuguese and 4 internationals. More than half of the articles indicate that nurses have a deficit in knowledge about the placement of the electrodes and the interpretation of the electrocardiographic tracing. In addition to demonstrating the relationship between time since graduation and professional experience, and improvement courses, where professionals who had undergone previous training, showed better performance. We conclude that it is essential that nurses have sufficient scientific knowledge to interpret electrocardiographic tracings. Furthermore, continuing education proved to be of fundamental importance in training and updating knowledge.O objetivo do presente estudo foi analisar o conhecimento de enfermeiros nos aspectos relacionados ao exame de eletrocardiograma. Trata-se de uma revisão integrativa através das bases BVS, PubMed e Google Acadêmico. Utilizados em conjunto com o operador booleano AND. Foram encontrados 12 artigos, sendo 8 em português e 4 internacionais. Mais da metade dos artigos apontam que os enfermeiros possuem déficit no conhecimento sobre o posicionamento dos eletrodos e a interpretação do traçado eletrocardiográfico. Além de demonstrar a relação entre o tempo de formação e experiência profissional e cursos de aperfeiçoamento, onde profissionais que haviam realizado treinamentos prévios, demonstraram melhor desempenho. Concluímos que é imprescindível que enfermeiros tenham conhecimento científico suficiente para interpretar os traçados eletrocardiográficos. Ademais, a educação continuada se mostrou de fundamental a importância na capacitação e atualização dos conhecimentos

Saberes e práticas de enfermeiros na realização e interpretação do eletrocardiograma

The aim of the present study was to analyze the knowledge of nurses in aspects related to the electrocardiogram exam. This is an integrative review using the BVS, PubMed and Academic Google databases. Used in conjunction with the Boolean AND operator. Twelve articles were found, 8 in Portuguese and 4 internationals. More than half of the articles indicate that nurses have a deficit in knowledge about the placement of the electrodes and the interpretation of the electrocardiographic tracing. In addition to demonstrating the relationship between time since graduation and professional experience, and improvement courses, where professionals who had undergone previous training, showed better performance. We conclude that it is essential that nurses have sufficient scientific knowledge to interpret electrocardiographic tracings. Furthermore, continuing education proved to be of fundamental importance in training and updating knowledge.O objetivo do presente estudo foi analisar o conhecimento de enfermeiros nos aspectos relacionados ao exame de eletrocardiograma. Trata-se de uma revisão integrativa através das bases BVS, PubMed e Google Acadêmico. Utilizados em conjunto com o operador booleano AND. Foram encontrados 12 artigos, sendo 8 em português e 4 internacionais. Mais da metade dos artigos apontam que os enfermeiros possuem déficit no conhecimento sobre o posicionamento dos eletrodos e a interpretação do traçado eletrocardiográfico. Além de demonstrar a relação entre o tempo de formação e experiência profissional e cursos de aperfeiçoamento, onde profissionais que haviam realizado treinamentos prévios, demonstraram melhor desempenho. Concluímos que é imprescindível que enfermeiros tenham conhecimento científico suficiente para interpretar os traçados eletrocardiográficos. Ademais, a educação continuada se mostrou de fundamental a importância na capacitação e atualização dos conhecimentos