Population, health, and nutrition : annual operational review for fiscal 1992

Population, health, and nutrition (PHN) lending decreased in fiscal 1992 from the record levels of fiscal 1991, in both the amount and the number of operations. Lending amounted to $961.6 million for 16 projects, compared with$1,567.6 million for 28 projects in fiscal 1991. This temporary dip in PHN lending is attributable largely to pipeline factors. Fiscal 1993 lending is projected to recapture if not exceed the fiscal 1991 level, and projections for fiscal 1993 and fiscal 1995 are for a continued increase in lending volume. PHN projects approved in fiscal 1992 have been responsive to the World Bank's objective of poverty alleviation. Collectively, fiscal 1992 projects cover the essential features of good poverty work but the depth and quality of poverty work varies across projects. Drawing from the good practices observed and lessons recorded in this year's portfolio, the review offers the following suggestions, among others, for strengthening PHN interventions to alleviate poverty: poverty information and monitoring must be accompanied by dissemination and sensitization activities to strengthen national understanding of poverty-related issues and national commitment to resolving them through the proper policy; community involvement in project design and development requires clearly defined and carefully designed institutional and procedural mechanisms, and a concerted effort to make them work; it is essential that PHN sector work identify poor and vulnerable groups and assess their needs and demands for basic health, family planning, and nutrition services; and even the most demand-driven project designs targeted to clearly identified poverty groups require promotional activities to ensure that these groups participate in and benefit from project initiatives. Health lending is now a decade old, and many innovations in PHN lending have emerged only in the past four or five years. This review demonstrates that good practices and new and promising ideas - well worth emulating - are scattered across PHN work. Overall, PHN work is moving in the right direction and the quality of work is generally seen to be improving. Welcome trends (which should be encouraged and reinforced) include serious attention to the poorest, most vulnerable populations, growing consideration of the demand of target groups, and increased attention to monitoring and evaluation of sector performance.Health Monitoring&Evaluation,Health Economics&Finance,Banks&Banking Reform,Poverty Monitoring&Analysis,Urban Services to the Poor

Creating a new education paradigm to prepare nurses for the 21st Century

Nurse educators are accountable to keep baccalaureate education responsive to the ever changing healthcare delivery environment. The changing context of healthcare delivery requires focusing on population health and social determinants, providing interprofessional, team-based care, advancing innovation, and preparing practice ready baccalaureate nursing graduates. To be practice ready, nursing graduates must be agile and think and reason on their feet due to increasing care complexity beyond the hospital walls, changing care needs of individuals and families, advancing technology, shifting settings of care delivery, and managing multiple transitions. The purpose of this paper is to consider these healthcare changes and share a new baccalaureate nursing curriculum that radically shifts the paradigm from caring for patients to caring for people, and transforms from a diseased-based, acute care focused curriculum to one promoting a culture of health and multiple new and emerging roles of registered nurses

Population, health, and nutrition : fiscal 1991 sector review

The theme of this year's annual sector review blends two special topics: poverty alleviation and the development of management and institutional capacity. Based on a review of project experience, both within and outside of the population, health and nutrition (PHN) sector, this report distills lessons that should assist task managers in the design and implementation of interventions to develop poverty-sensitive management and institutional capacity in the PHN sector. The Bank's ability to strengthen institutions, especially those needed to alleviate poverty, are constrained by the number and the skills mix of PHN staff, by the absence of standards and guidelines for analyzing and addressing institutional and management issues, and by too little time to spend on institutional and management issues. Therefore, the sector review recommends : a) improving the sector staff not only in numbers but in access to guidelines and training; b) revising Bank priorities and practices to ensure that enough time is spent on supervision and on upstream diagnostic work; c) grounding PHN policies in a macroeconomic and multisectoral framework oriented toward growth with poverty reduction, together with a sound strategy for building institutions and the capacity to implement and manage policy; and d) seeking more creative use of Bank instruments through a review and assessment of the best use of lending instruments for PHN sector interventions.Banks&Banking Reform,Poverty Assessment,Urban Services to the Poor,Health Monitoring&Evaluation,Health Economics&Finance

Cambodia!

Join Professor Denise Brown to learn about the temples built in 12th Century Siem Reap of modern Cambodia. Originally built as a Hindu temple by the Khmer Empire and later used by Buddhist monks, the temples are architectural marvels that have survived industrialization, war, and attempts by the surrounding jungle to reclaim them. Professor Brown will discuss her journey to the Angkor sites and to other temples in Bangkok, Thailand

Peru: Lima to Machu Picchu to the Amazon Forest!

Take a trip to one of the most interesting countries of South America, Peru. From its arid coast and largest city, Lima, through the Andes Mountains to Machu Picchu and the Sacred Valley, and beyond the Andes to the tropical forests and rivers that are tributaries of the great Amazon river. Explore the culture and cuisine of this amazing country

Anatomical curve identification

Methods for capturing images in three dimensions are now widely available, with stereo-photogrammetry and laser scanning being two common approaches. In anatomical studies, a number of landmarks are usually identified manually from each of these images and these form the basis of subsequent statistical analysis. However, landmarks express only a very small proportion of the information available from the images. Anatomically defined curves have the advantage of providing a much richer expression of shape. This is explored in the context of identifying the boundary of breasts from an image of the female torso and the boundary of the lips from a facial image. The curves of interest are characterised by ridges or valleys. Key issues in estimation are the ability to navigate across the anatomical surface in three-dimensions, the ability to recognise the relevant boundary and the need to assess the evidence for the presence of the surface feature of interest. The first issue is addressed by the use of principal curves, as an extension of principal components, the second by suitable assessment of curvature and the third by change-point detection. P-spline smoothing is used as an integral part of the methods but adaptations are made to the specific anatomical features of interest. After estimation of the boundary curves, the intermediate surfaces of the anatomical feature of interest can be characterised by surface interpolation. This allows shape variation to be explored using standard methods such as principal components. These tools are applied to a collection of images of women where one breast has been reconstructed after mastectomy and where interest lies in shape differences between the reconstructed and unreconstructed breasts. They are also applied to a collection of lip images where possible differences in shape between males and females are of interest

Carstairs Scores for Scottish Postcode Sectors, Datazones and Output Areas from the 2011 Census

Carstairs deprivation scores, originally created in 1981, provide a measure of material deprivation. Four census variables (male unemployment, no car ownership, overcrowding and low social class) were used in the creation of the score. As near as possible the same four variables have been used to update Carstairs scores decennially, despite changes to the definition of some of the variables over time. Researchers at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow have now updated Carstairs scores for 2011 for Scottish postcode sectors and for the first time datazones and output areas

Temporal trends in satellite-derived erythemal UVB and implications for ambient sun exposure assessment

Ultraviolet radiation (UVR) has been associated with various health outcomes, including skin cancers, vitamin D insufficiency, and multiple sclerosis. Measurement of UVR has been difficult, traditionally relying on subject recall. We investigated trends in satellite-derived UVB from 1978 to 2014 within the continental United States (US) to inform UVR exposure assessment and determine the potential magnitude of misclassification bias created by ignoring these trends. Monthly UVB data remotely sensed from various NASA satellites were used to investigate changes over time in the United States using linear regression with a harmonic function. Linear regression models for local geographic areas were used to make inferences across the entire study area using a global field significance test. Temporal trends were investigated across all years and separately for each satellite type due to documented differences in UVB estimation. UVB increased from 1978 to 2014 in 48% of local tests. The largest UVB increase was found in Western Nevada (0.145 kJ/m2 per five-year increment), a total 30-year increase of 0.87 kJ/m2. This largest change only represented 17% of total ambient exposure for an average January and 2% of an average July in Western Nevada. The observed trends represent cumulative UVB changes of less than a month, which are not relevant when attempting to estimate human exposure. The observation of small trends should be interpreted with caution due to measurement of satellite parameter inputs (ozone and climatological factors) that may impact derived satellite UVR nearly 20% compared to ground level sources. If the observed trends hold, satellite-derived UVB data may reasonably estimate ambient UVB exposures even for outcomes with long latency phases that predate the satellite record

Social Workers\u27/Case Manager\u27s Knowledge Deficits of Adults with Precomorbid Attention Disorders

There is a lack of knowledge about how to provide services for adults with attention deficit hyperactivity disorders (ADHD) among healthcare professionals, particularly for adults with precomorbid ADHD. The purpose of this qualitative, multiple case study was to explore the knowledge deficits of social workers and case managers regarding adults with precomorbid ADHD and their perception of obstacles in providing medication and counseling referrals. Participants\u27 perceptions of obstacles was assessed through the framework of social problem-solving theory. The sample included 10 participants: 6 case managers and 4 social workers. There were three codes that represented participants\u27 perceptions of knowledge deficits regarding adults with precomorbid ADHD, training, precomorbidity, and comorbidity. The theme knowledge deficits emerged from participants\u27 responses of needing more training about adults with precomorbid ADHD. There were also three codes that represented participants\u27 perceptions of obstacles providing referrals which included medication and counseling, referrals, and challenges. The theme perceptions of obstacles emerged from participant responses regarding clients\u27 resistance to services as a significant challenge. According to study results, knowledge deficits in participants were less likely to be detected when participants were asked questions about adults with ADHD and comorbidity. Participants found it easier to identify and provide referrals for adults with ADHD with cooccurring (comorbid) disorders. Social workers and case managers can use the results of this study to increase their knowledge about how to provide referrals for adults with ADHD as the only disorder