Elementary Teachers\u27 Commitment Declines: Antecedents, Processes, and Outcomes

This qualitative study examines the organizational, social, and personal factors that may influence elementary teachers\u27 declining commitments. Our findings suggest that when the teachers under study felt unsuccessful, that is, when they experienced low feelings of efficacy and low feelings of community, teachers\u27 commitments\u27 shifted or declined. However, the impact of negative teaching experiences on commitments is far from uniform. Rather the teachers\u27 commitments declined as a function of the teachers\u27 understandings of their perceived failures

Factors Related to Community Mobilization and Continued Involvement in a Community-Based Effort To Enhance Adolescents\u27 Sexual Behaviour

Purpose: This article describes and proposes a model of the factors that influenced community members\u27 initial mobilization, continuing effort, or lack of involvement in a community based-intervention on adolescents\u27 sexual health in Nova Scotia, Canada. Design: This study was conducted within the constructivist paradigm and guided by the principles of grounded theory. Methods: Factors related to community members\u27 initial and continued involvement were explored using analyses of the contents of in-depth interviews and written documentation through pattern identification, clustering of conceptual groupings, identification of relationships between variables, constant comparisons, and theoretical memos. Subjects: Respondents included 14 participants, the 12 members of the Board of Directors and two paid staff (i.e., the project coordinator and the health centre nurse). Results: Specific personal, community-related, and organizational factors have influenced community members\u27 involvement in the project. These factors were grouped into an explanatory model

Childhood Physical Abnormalities following Paternal Exposure to Sulfur Mustard Gas in Iran: a Case-Control Study

BACKGROUND:Mustard gas, a known chemical weapon, was used during the Iran-Iraq war of 1980-1988. We aimed to determine if exposure to mustard gas among men was significantly associated with abnormalities and disorders among progenies.METHODS:Using a case-control design, we identified all progenies of Sardasht men (exposed group, n = 498), who were born at least nine months after the exposure, compared to age-matched controls in Rabat, a nearby city (non-exposed group, n = 689). We conducted a thorough medical history, physical examination, and appropriate paraclinical studies to detect any physical abnormality and/or disorder. Given the presence of correlated data, we applied Generalized Estimating Equation (GEE) multivariable models to determine associations.RESULTS:The overall frequency of detected physical abnormalities and disorders was significantly higher in the exposed group (19% vs. 11%, Odds Ratio [OR] 1.93, 95% Confidence Interval [CI], 1.37-2.72, P = 0.0002). This was consistent across sexes. Congenital anomalies (OR 3.54, 95% CI, 1.58-7.93, P = 0.002) and asthma (OR, 3.12, 95% CI, 1.43-6.80, P = 0.004) were most commonly associated with exposure. No single abnormality was associated with paternal exposure to mustard gas.CONCLUSION:Our study demonstrates a generational effect of exposure to mustard gas. The lasting effects of mustard gas exposure in parents effects fertility and may impact child health and development in the long-term

Coopération politique et intégration régionale en Arctique : naissance, développement et critique d’une région

Dans cet article, nous montrons que la coopération politique instituée « par le haut » en Arctique à la fin de la Guerre froide a mené à une intégration régionale institutionnelle. Cette dernière s’est centrée autour de la protection de l’environnement, qui paraît cependant être avant tout un prétexte politique. Nous comprenons en effet la région comme un outil politique, utilisé par les États circumpolaires pour restreindre de plus en plus le périmètre de décision régional. En retour, ce modèle de gouvernance fermée est remis en cause par de nouveaux acteurs, en particulier fédéraux (Québec) mais aussi étatiques internationaux ou autochtones, qui tentent d’élargir les limites de la région avec de nouvelles formes de gouvernance plus ouvertes. Les stratégies des acteurs qui dessinent une gouvernance multiniveau et enchevêtrée forment une région par intersection aux limites floues et contestées.In this paper, we aim that it is the political cooperation driven "from above" in the post-Cold War era that has led to visible regional institutional integration in the Arctic. This institutional integration stems from the Arctic state's desire to protect the environment as a pretext for political cooperation. In a context of increased politicization of the region due to the consequences of climate change, the construction of the Arctic region becomes indeed a way for the Arctic states to gradually pushed out indigenous organizations and external actors from the decision-making bodies. In return, this model of closed governance is challenged by those who are trying to broaden the boundaries of the region with new and more open forms of governance. Political actors at different scales thus converge to build regional governance that is not only multilevel, but also entangled and creates a region with fuzzy borders

Does ratification of human-rights treaties have effects on population health?

Human-rights treaties indicate a country's commitment to human rights. Here, we assess whether ratification of human-rights treaties is associated with improved health and social indicators. Data for health (including HIV prevalence, and maternal, infant, and child [<5 years] mortalities) and social indicators (child labour, human development index, sex gap, and corruption index), gathered from 170 countries, showed no consistent associations between ratification of human-rights treaties and health or social outcomes. Established market economy states had consistently improved health compared with less wealthy settings, but this was not associated with treaty ratification. The status of treaty ratification alone is not a good indicator of the realisation of the right to health. We suggest the need for stringent requirements for ratification of treaties, improved accountability mechanisms to monitor compliance of states with treaty obligations, and financial assistance to support the realisation of the right to health

Differences in need for antihypertensive drugs among those aware and unaware of their hypertensive status: a cross sectional survey

BACKGROUND: Lack of antihypertensive use among hypertensive individuals is a major public health problem. It remains unclear as to how much of this lack of treatment is because of failure to diagnose hypertension or failure to initiate drug treatment for those with a diagnosis of hypertension. The primary aim of this study was to determine the proportion of those untreated individuals who would be recommended to start drug therapy for control of blood pressure among those aware or unaware of their diagnosis of hypertension. METHODS: The Canadian Heart Health Surveys (1986 – 1992), a national, cross-sectional descriptive survey (n = 23 129), was used to determine the proportion of individuals who were untreated, yet satisfied the 2004 Canadian hypertension guidelines for initiating drug therapy. Patients were divided into subgroups of those aware and unaware of having a diagnosis of hypertension according to self reported awareness from the survey. RESULTS: Of those with untreated hypertension (= 140/90 mmHg), only 37% were aware of their diagnosis. 74% of untreated individuals aware of their diagnosis of hypertension would require drug therapy, compared to 57% of those who were unaware. Of those >65 years of age, 52% of aware individuals needed drug therapy whereas only 34% of unaware elderly would need drug treatment. CONCLUSION: In both unaware and aware subgroups, the majority of patients with untreated hypertension would benefit from antihypertensive drug therapy according to the 2004 Canadian Hypertension recommendations. The proportion of untreated patients that still need drug therapy was higher among those who were aware compared to those who were unaware. This finding suggests that the major gap in hypertension control may be in initiating drug therapy rather than in diagnosing hypertension. Further studies are needed to confirm these results to ultimately help strategize public health efforts in controlling hypertension

Heart and Stroke Foundation of Ontario (HSFO) high blood pressure strategy's hypertension management initiative study protocol

<p>Abstract</p> <p>Background</p> <p>Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community.</p> <p>Methods</p> <p>This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru ^®automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs) and 1 Community Health Centre (CHC) and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150 community pharmacists across the 11 communities throughout the province of Ontario. The 11 primary care sites will be divided into immediate and delayed groups based on geography and the use of an electronic versus a traditional chart patient record.</p> <p>Discussion</p> <p>Initial consideration was given to randomizing the groups, however, for a number of reasons, this was deemed to not be possible. In order to ensure that the sites in the immediate intervention and delayed intervention groups are not different from each other, the sites will be assigned to the intervention groups manually to ensure a distribution of the variables as evenly as possible.</p> <p>Given that HSFO approached this particular group of health care providers to participate in a program relating to hypertension, this may have heightened their awareness of the issue and affected their management of patients with hypertension. Thus, data will be collected to allow an assessment of previous practice patterns and determine any impact of the Hawthorne Effect.</p> <p>Trial registration</p> <p>Clinicaltrials.gov NCT00425828</p

Should active recruitment of health workers from sub-Saharan Africa be viewed as a crime?

[No abstract available]Articl

Water and sanitation infrastructure for health: The impact of foreign aid

<p>Abstract</p> <p>Background</p> <p>The accessibility to improved water and sanitation has been understood as a crucial mechanism to save infants and children from the adverse health outcomes associated with diarrheal disease. This knowledge stimulated the worldwide donor community to develop a specific category of aid aimed at the water and sanitation sector. The actual impact of this assistance on increasing population access to improved water and sanitation and reducing child mortality has not been examined.</p> <p>Methods</p> <p>We performed a country-level analysis of the relationship between water and sanitation designated official development assistance (WSS-ODA) per capita, water and sanitation coverage, and infant and child mortality in low-income countries as defined by the World Bank. We focused our inquiry to aid effectiveness since the establishment of the Millennium Development Goals (MDGs).</p> <p>Results</p> <p>Access to improved water has consistently improved since 2002. Countries receiving the most WSS-ODA ranged from odds ratios of 4 to 18 times more likely than countries in the lowest tertile of assistance to achieve greater gains in population access to improved water supply. However, while there were modestly increased odds of sanitation access, these were largely non-significant. The countries with greatest gains in sanitation were 8-9 times more likely to have greater reductions in infant and child mortality.</p> <p>Conclusions</p> <p>Official development assistance is importantly impacting access to safe water, yet access to improved sanitation remains poor. This highlights the need for decision-makers to be more intentional with allocating WSS-ODA towards sanitation projects.</p