Evaluation of the Electronic Logistics Management Information System as Improvements for Availability of Essential Medicines in Health Centre and Dispensaries: Case Study at Rombo District Council.

Despite the implementation of the eLMIS in Tanzania, the availability of essential medicine in public health facilities still remains challenging. The study was to evaluate the progress of eLMIS towards improving the availability of essential medicines. Specific objectives study are: To assess the coverage and the use of the eLMIS at public health facility specifically at health centre and dispensaries, to assess the knowledge of the staffs dealing with health commodities on the use of eLMIS at their facilities, to assess the knowledge of the councils managers dealing with health commodities on the use of eLMIS information for decision making in improving the availability of health commodities at the facilities. The evaluation of the eLMIS was performed using a formative evaluation process, using a blend of quantitative data collected in 25 visited health care facilities and qualitative data gathered in district health offices. 59 health care workers were interviewed and 5 respondent from; district health office was interviewed. The collected quantitative data were analysed using SPSS and presented into descriptive data analysis tools. The study findings shows that, the eLMIS has improved data visibility from the facilities, data use by councils managers and hence has improved the availability of essential medicine where by the average availability for selected public health facilities is 96%, while training to health care workers managing health commodities is 100%. To sustain the availability of essential medicines, strengthening eLMIS is essential but there is a need for a government of Tanzania to increase the budget for essential medicine, employ pharmaceutical personnel, and improve financial management. Keywords: Evaluation, Electronic Logistics, Essential Medicines in Health Centre

Neue Handlungslogiken

Die gesellschaftlichen Transformationen zu einer Nachhaltigen Entwicklung erfordern neue Handlungslogiken und Verhaltensveränderungen. Diese gilt es zu analysieren und im Sinne einer transformativen Forschung zu beeinflussen. Welche Anknüpfungspunkte gibt es für die Nachhaltigkeits ökonomik und welche neuen Forschungsfragen ergeben sich daraus

A quasi-experimental study to mobilize rural low-income communities to assess and improve the ecological environment to prevent childhood obesity

Citation: Peters, P., Gold, A., Abbott, A., Contreras, D., Keim, A., Oscarson, R., . . . Mobley, A. R. (2016). A quasi-experimental study to mobilize rural low-income communities to assess and improve the ecological environment to prevent childhood obesity. Bmc Public Health, 16, 7. doi:10.1186/s12889-016-3047-4Background: The Ecological Model of Childhood Overweight focuses on characteristics that could affect a child's weight status in relation to the multiple environments surrounding that child. A community coaching approach allows community groups to identify their own strengths, priorities and identity. Little to no research currently exists related to community-based efforts inclusive of community coaching in creating environmental change to prevent childhood obesity particularly in rural communities. Methods: A quasi-experimental study will be conducted with low-income, rural communities (n = 14) in the North Central region of the United States to mobilize capacity in communities to create and sustain an environment of healthy eating and physical activity to prevent childhood obesity. Two rural communities within seven Midwestern states (IN, KS, MI, OH, ND, SD, WI) will be randomly assigned to serve as an intervention or comparison community. Coalitions will complete assessments of their communities, choose from evidence-based approaches, and implement nutrition and physical activity interventions each year to prevent childhood obesity with emphasis on policy, system or environmental changes over four years. Only intervention coalitions will receive community coaching from a trained coach. Outcomes will be assessed at baseline, annually and project end using previously validated instruments and include coalition self-assessments, parental perceptions regarding the built environment, community, neighborhood, and early childhood environments, self-reflections from coaches and project staff, ripple effect mapping with coalitions and, final interviews of key stakeholders and coaches. A mixed-methods analysis approach will be used to evaluate if Community Coaching enhances community capacity to create and sustain an environment to support healthy eating and physical activity for young children. ANOVA or corresponding non-parametric tests will be used to analyze quantitative data relating to environmental change with significance set at P < .05. Dominant emergent themes from the qualitative data will be weaved together with quantitative data to develop a theoretical model representing how communities were impacted by the project. Discussion: This project will yield data and best practices that could become a model for community development based approaches to preventing childhood obesity in rural communities

Food Intake of Kansans Over 80 Years of Age Attending Congregate Meal Sites

As the population of the United States continues to age, it has become increasingly more important to recognize the food intake and eating habits of older adults. The objective of this study was to describe the food group intake, factors predicting food group intake, and the food choices of community-dwelling Kansans, 80 years of age and older who participate in congregate meal programs. Participants completed a short questionnaire querying demographic information, current health status, and dietary supplement use. Participants (n = 113) were then followed up via telephone to complete two 24-hour diet recalls. Data were analyzed to determine adequacy of food group intake and mean intake. Regression analyses were used to determine factors predicting intake and frequency analysis established food typically consumed. Female participants were significantly more likely to consume more fruit servings than males. Intake was low for all five of the food groups, especially dairy. Chronic health conditions and dietary supplement use were consistently predictive factors of the amount of each food group consumed

Calcium-fortified beverage supplementation on body composition in postmenopausal women

BACKGROUND: We investigated the effects of a calcium-fortified beverage supplemented over 12 months on body composition in postmenopausal women (n = 37, age = 48–75 y). METHODS: Body composition (total-body percent fat, %Fat(TB); abdominal percent fat, %Fat(AB)) was measured with dual energy x-ray absorptiometry. After baseline assessments, subjects were randomly assigned to a free-living control group (CTL) or the supplement group (1,125 mg Ca(++)/d, CAL). Dietary intake was assessed with 3-day diet records taken at baseline and 12 months (POST). Physical activity was measured using the Yale Physical Activity Survey. RESULTS: At 12 months, the dietary calcium to protein ratio in the CAL group (32.3 ± 15.6 mg/g) was greater than the CTL group (15.2 ± 7.5 mg/g). There were no differences from baseline to POST between groups for changes in body weight (CAL = 0.1 ± 3.0 kg; CTL = 0.0 ± 2.9 kg), %Fat(TB )(CAL = 0.0 ± 2.4%; CTL = 0.5 ± 5.4%), %Fat(AB )(CAL = -0.4 ± 8.7%; CTL = 0.6 ± 8.7%), or fat mass (CAL = 1.3 ± 2.6 kg; CTL = 1.3 ± 2.7 kg). CONCLUSION: These results indicate that increasing the calcium to protein ratio over two-fold by consuming a calcium-fortified beverage for 12 months did not decrease body weight, body fat, or abdominal fat composition in postmenopausal women

Components of an Anticancer Diet: Dietary Recommendations, Restrictions and Supplements of the Bill Henderson Protocol

The use of complementary and alternative medicines including dietary supplements, herbals and special diets to prevent or treat disease continues to be popular. The following paper provides a description of an alternative dietary approach to the self-management and treatment of cancer, the Bill Henderson Protocol (BHP). This diet encourages daily intake of raw foods, a combination of cottage cheese and flaxseed oil and a number of supplements. Some foods and food groups are restricted (e.g., gluten, meat, dairy). Early background theory that contributed to the protocol’s development is presented as is a summary of relevant evidence concerning the anti-cancer fighting properties of the individual components. Supplement intake is considered in relation to daily recommended intakes. Challenges and risks to protocol adherence are discussed. As with many complementary and alternative interventions, clear evidence of this dietary protocol’s safety and efficacy is lacking. Consumers of this protocol may require guidance on the ability of this protocol to meet their individual nutritional needs

Vordenker einer nachhaltigen Gesellschaft : Karl Polanyi und die "Große Transformation"

Der oft nur begriffliche Rückgriff auf Karl Polanyis Analyse der "Großen Transformation" greift zu kurz. Ein konsequenterer Blick darauf kann der Transformationsforschung neue Impulse geben