Community Health Workers: A Holistic Solution for Individual and Community Health

Community Health Workers (CHWs) go by many names, including outreach workers, patient navigators, peer health educators, and lay health advocates. CHWs help people overcome obstacles by accompanying them through treatment, monitoring needs for food and housing, leading education campaigns and empowering community members to take charge of their own health. As members of the communities they serve, CHWs establish relationships of trust with those they serve, bridging the gap between the clinic and community. Community Health Workers embrace a holistic conception of health, working not only in health care, but also with the social determinants of health such as poverty, education, and housing

Forum Shopping For Stale Claims: Statutes of Limitations and Conflict of Laws

This article, however, has a modest goal. It will not argue for rationality or for a new interests analysis, as some scholars have done, or for consistency or for the adoption of one or the other of the proposed solutions. It will review the interstate and international aspects of statutes of limitations and examine the unique role of statute havens focusing not on criticism, but prediction. The most recent decisions by the United States, New Hampshire and Mississippi Supreme Courts indicate that discussion of what will, or what could, happen may be more valuable than discussion of what should happen in the area of statutes of limitations and the conflict of laws. The conclusion this paper will reach can be stated simply: Forum shopping for statutes of limitations will continue as long as each state has the constitutional power to apply its own statute of limitations as it wishes

The Impact of Dietary Egg Intake on Metabolic Health in Food Insecure Households

Food Insecurity (FI) is defined as a condition in which individuals lack access to adequate food due to limited financial resources. FI is estimated to impact 12% of households in United States. Adults and children who experience FI are an increased risk for developing metabolic disease such as type 2 diabetes, obesity, hypertension, and cardiovascular disease. The negative health outcomes associated with FI are multi-factorial, however, many of them may be caused by limited nutritional intake and poor diet quality. Efforts to better understand the obstacles food insecure populations face is critical in order to improve nutrient intake and minimize the negative health outcomes involved. Dietary intake of eggs may serve as applicable solution for FI families who are challenged by limited nutritional intake. Eggs contain a variety of nutrients that support metabolic health. For instance, eggs are a complete source of high quality protein. Diets abundant in high quality protein are shown to improve body composition, nutrient intake, and markers of cardiometabolic health. In addition, eggs contain sixteen vitamins and minerals, and are one of the few sources of naturally occurring vitamin D. Furthermore, eggs are cost-efficient. When comparing the relationship between foods based on calories and unit cost, the energy cost of eggs is significantly less when compared to other animal protein foods such as meat, poultry and fish. However, dietary intake of eggs is controversial in-regards to cardiovascular health and it is unclear whether or not regular and long-term consumption is appropriate. Therefore, the objective of this thesis was to determine if habitual egg intake improves body composition, cardiometabolic markers, and nutrient status is adults and children from food insecure household

Occasional Paper No. 089-1: Employment of Black and Hispanic Police Officers, 1983-1988: A Follow-up Study

Police departments in the 50 largest cities in the United States made uneven progress in the employment of black and Hispanic officers between 1983 and 1988. Nearly half (45 percent) of the big-city police departments made significant progress in the employment of black officers. Seventeen percent, however, reported a decline in the percentage of black officers. A similar pattern exists in the employment of Hispanic police officers. Forty-two percent of the departments reported significant increases in the percentage of Hispanic officers employed. Nearly 11 percent (10.6 percent) reported a decline, however, while 17.0 percent reported no change. Affirmative action plans appear to play a significant role in police employment trends. Nearly two-thirds (63.8 percent) of the police departments reported operating under an affirmative action plan at some· point during the last five years. Twenty-three of the affirmative action plans were court-ordered, and seven were voluntary. Nineteen of the affirmative action plans covered the employment of both black and Hispanic officers; 11 covered only the recruitment of black officers. No departments reported plans covering only Hispanic officers

WORM - A NEW OPEN ROAD LINE SOURCE MODEL FOR LOW WIND SPEED CONDITIONS

Emission from road traffic constitutes one of the most important sources of air pollution in urban areas. This paper describes a newly developed air pollution dispersion model for open roads and highways called WORM (Weak Wind Open Road Model), and give some results using this model during low wind speed and (strongly) stable atmospheric conditions at Nordbysletta in Norway, during a 3-4 months period in the winter/spring of 2002

South African Regulatory Authority: The Impact of Reliance on the Review Process Leading to Improved Patient Access

Background: The aims of this study were to compare the overall regulatory review timelines achieved by the South African Health Products Regulatory Authority (SAHPRA) in 2020 to the timelines historically achieved by the Medicines Control Council (MCC). This study also aimed to evaluate the regulatory review processes and the good review practices that have been implemented by SAHPRA to support the assessment of new chemical entities and generic product applications for market authorization in the business-as-usual and backlog process streams. Methods: A questionnaire was completed and verified by SAHPRA to describe the structure of the organization, the resources available, the process for regulatory review of new chemical entities and generic products and the level of implementation of good review practices and regulatory decision-making practices for market authorization. Data were collected and analyzed on the overall approval timelines for new chemical entities and generic products registered by SAHPRA in 2020 in the business-as-usual and backlog process streams. Results: A full, independent scientific review was conducted for all new chemical entities and generic product applications in the business-as-usual stream. Facilitated regulatory pathways were introduced for the review of new chemical entities and generic products in the backlog stream. As a result, the timelines for approval of applications in the backlog stream were 68% quicker for both new chemical entities and generics, using facilitated regulatory pathways, such as abridged and verification review models. Conclusion: The comparisons made through this study provided insight into the improvements that have been made through the establishment of SAHPRA and the transition in 2018 from the MCC. The re-engineered processes that have been developed and implemented by SAHPRA to address the backlog in the review of the applications for market authorization have demonstrated a decrease in the overall median approval times. The expansion of these processes into the routine review of medical products will contribute to the enhanced regulatory performance of SAHPRA and patients’ access to new medicines.Peer reviewe

Integration effectiveness between engineering teams on complex defence programs

As programs grow in size and complexity, it is necessary to form sub-teams of engineers to break down the work to manageable portions. These teams, referred to in isolation as ‘silos’, typically focus on a specialised technical discipline (software, avionics, electrical, etc.). How well teams combine their work, or horizontally integrate (illustrated in Figure 1 - A birds-eye view of horizontal integration), is a huge contributor to the success of a program, in terms of meeting the customer’s needs, within cost and schedule. The integration of teams is hugely important for Defence, due to the complexity and size of programs, as well as geographic and political challenges. This drives segregation of engineering efforts, as shown in Figure 2 - Breakdown and re-integration of a system. To realign teams in a common direction, develop an integrated product and achieve a successful program outcome, integrating factors are applied. The identification and evaluation of these integrating factors in Complex Defence Programs emerged as a gap in identified literature, and as such is the focus of my research. The purpose of research into engineering integration is to identify how programs can make the interactions between teams more efficient, in order to deliver the best possible product for Defence. In doing this, I’ve needed to define the value of integrating teams, identify what can be done to integrate teams, and evaluate the efficiency of integration efforts in aligning the direction of sub-teams on a program. This report documents these findings. The research conducted was primarily qualitative, based upon the perspectives of subject program team members. The identification of integrating factors was achieved through a review of Systems Engineering literature, and the observations recorded in interviews. The evaluation of these factors has been subjective, but surveys have been used to quantify results and identify recurring or commonly held perspectives within the industry

Regulatory Authority Evaluation of the Effectiveness and Efficiency of the ZaZiBoNa Collaborative Medicines Registration Initiative: The Way Forward

© 2022 Sithole, Mahlangu, Walker and Salek. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/Introduction: ZaZiBoNa, the work-sharing initiative in the Southern African Development Community (SADC) that has been in operation for 8 years has successfully assessed over 300 dossiers/applications, with an overall median time to recommendation of 12 months. All 16 SADC countries participate in the initiative as either active or non-active members. While the successes of ZaZiBoNa are evident, some challenges still exist. The aim of this study was to solicit the views of the participating authorities on the effectiveness and efficiency of the current operating model of the ZaZiBoNa initiative. Methods: Data were collected in 2021 using the Process, Effectiveness and Efficiency Rating (PEER) questionnaire developed by the authors. The questionnaire was completed by the focal person in each country and approved by the head of the authority. Results: ZaZiBoNa serves as a platform for work sharing, information exchange, capacity building and harmonisation of registration requirements. One of the benefits to regulators has been the improvement in the capacity to conduct assessments. Manufacturers have benefited from compiling one package (modules 2–5) for the initial submission as well as a single response package to the consolidated list of questions, which saves time and resources. Respondents were of the view that patients have benefited as the ZaZiBoNa has contributed to an improved availability and accessibility to quality-assured medicines. Some of the challenges identified were the inadequacy of resources and differences in time to the implementation of ZaZiBoNa recommendations by the individual countries. The establishment of a regional unit hosted in one of the member countries to enable centralised submission and coordination was identified as the best strategy to improve the effectiveness and efficiency of the initiative in the interim, with the long-term goal being the establishment of a regional medicines authority. Conclusion: The study identified the strengths of the ZaZiBoNa initiative as well as the opportunities for improvement. The recommendations made would further strengthen this initiative.Peer reviewedFinal Published versio