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Outside the Cage: Exploring Everyday Interactions between Government Workers and Residents in a Place-Based Health Initiative  [PDF]
Naomi Sunderland
Advances in Applied Sociology (AASoci) , 2013, DOI: 10.4236/aasoci.2013.31008
Abstract: This paper presents an ethnographic case study of the daily lived experience of place by government health and community workers in a place-based chronic disease initiative (PBI) located in a disadvantaged peri-urban area in Australia. The case study focused on the place at which the PBI staff members interfaced with the community informally as opposed to the deliberate interactions described in the formal community engagement strategy. Subtle social phenomena, such as social positioning and the contrasting cultures of bureaucracy and community, generated outcomes that were the antithesis of those sought by the PBI. If these characteristics of place are not attended to during the development of PBIs, we risk recreating existing social divides and jeopardizing the potential of these initiatives to build community capacity. This case study provides an important conceptual-theoretical understanding of the place-based approach, which can augment existing empirical studies of place. The findings are also relevant for those who are exploring the physical co-location of diverse professional groups in socially disadvantaged neighbourhoods. It also exposes the inherent complexity of place and the futility of poorly designed bureaucratic responses.

The role of the applied epidemiologist in armed conflict
Sharon M McDonnell, Paul Bolton, Nadine Sunderland, Ben Bellows, Mark White, Eric Noji
Emerging Themes in Epidemiology , 2004, DOI: 10.1186/1742-7622-1-4
Abstract: We conducted a literature review and consultation of a convenience sample of practitioners of applied epidemiology with experience in conflict areas.The health programs designed to prevent and mitigate conflict are in their early stages of implementation and the evaluation measures for success are still being defined. The practice of epidemiology in conflict must occur within a larger humanitarian and political context to be effective. The skills required extend beyond the normal epidemiological training that focuses on the valid collection and interpretation of data and fall into two general categories: (1) Conducting a thorough assessment of the conflict setting in order to design more effective public health action in conflict settings, and (2) Communicating effectively to guide health program implementation, to advocate for needed policy changes and to facilitate interagency coordination. These are described and illustrated using examples from different countries.In 2004 it is estimated that there are 95 violent conflicts worldwide [1,2]. The profound consequences to the well-being of communities from these conflicts are disproportionately distributed. Ninety percent of those who die in war are civilians, half are female, and more children will die or be disabled than soldiers [2-9]. Prior to the 1990s, humanitarian assistance in the context of active violence was the domain of emergency medical services; public health and epidemiology focused on refugees and displaced populations [3,6,10,11]. As war became endemic in certain areas, primarily civil and geographically less demarcated, the international public health community was pressured to provide prevention and primary health services to the indigenous population as well [12,13]. The pervasiveness of war and the magnitude of its effects have led public health experts to advocate for directed strategies to prevent and mitigate its effects on communities [2,4,5,12-14]. These strategies are described in the WHO
Increasing leadership capacity for HIV/AIDS programmes by strengthening public health epidemiology and management training in Zimbabwe
Donna S Jones, Mufuta Tshimanga, Godfrey Woelk, Peter Nsubuga, Nadine L Sunderland, Shannon L Hader, Michael E St Louis
Human Resources for Health , 2009, DOI: 10.1186/1478-4491-7-69
Abstract: The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions.The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes.Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes.The last several years have seen a remarkable increase in funding for global health [1-3]. Most of these new resources for global health come tightly linked to addressing specific disease problems, e.g. immunizable diseases or HIV/AIDS. Despite the important accomplishments of this approach, it has been increasingly recognized that this vertical funding and its accompanying structure does not automatically address and may worsen the underlying issues that severely reduce the capacity to respond to each disease [4-6]. The most critical constraint to effective response is weakened infrastructure and systems of public health. The rapid expansion of programmes in such contexts can easily lead to only short-term impacts and further weakening of public health infrastructure [6].Many of these new resources may be wasted if human resource constraints are not addressed [7,8]. The clear challenges facing the public health workforce, particularly in developing countries, have been well documented [9-11]. This is a critical component of the global human resource crisis that is limiting the ability of the world to respond effec
Marcabru in Motion: ‘Dire vos vuoill ses duptanssa’ in chansonniers A and C, and in Maftre Ermengaud’s Breviari d’amor
Luke Sunderland
Glossator : Practice and Theory of the Commentary , 2011,
Abstract: The poems by Marcabru (fl. 1130-50) and Matfre Ermengaud (d. 1322) illustrate the intertextual nature of the Occitan tradition. This paper compares three versions of Marcabru's text (chansonnier A, longer version in C, and Matrfré's citation). If the version A appears "broadly biographical or personal," the version C, almost twice as long, is "less of a poem about Marcabru’s life, more of an attempt to define love in all its attractions and horrors." Finally, Matfre's Breviari uses the poem to express an opinion and then, also, to testify against itself. This epistemological meditation is at the very center of the preoccupation of both Matfre and Marcabru.
Post-Secular Nation; or how “Australian spirituality” privileges a secular, white, Judaeo-Christian culture
Sophie Sunderland
Transforming Cultures , 2007,
Abstract: There is no doubt that Australia is a secular nation, but there is a tendency to argue it is becoming post-secular. This raises the question of on what premises might a national spirituality be founded in a multicultural, multifaith society? One person who has attempted to answer this theory is the writer David Tacey. I endeavour to show that Tacey’s spiritual realm is in fact unmistakably coded Christian, and by extension ‘Judaeo-Christian’. Furthermore, this constructed realm cites a white, Anglo-Celtic subject associated with settler history as most in need of spiritual salvation. I argue that in effect, and instead of offering new alternatives for social change, Tacey’s version of spirituality functions to reinforce and reproduce a transcendent narrative of the dominance of Judaeo-Christianity and white Anglo-Celtic subjectivity in Australian culture.
Leadership in strategic information (LSI) building skilled public health capacity in Ethiopia
Italia V Rolle, Irum Zaidi, Jennifer Scharff, Donna Jones, Aynalem Firew, Fikre Enquselassie, Ashenafi Negash, Negussie Deyessa, Getnet Mitike, Nadine Sunderland, Peter Nsubuga
BMC Research Notes , 2011, DOI: 10.1186/1756-0500-4-292
Abstract: Trainees' skill sets increased in descriptive and analytic epidemiology, surveillance, and monitoring and evaluation (M and E). Data from the evaluation indicated that the course structure and the M and E module required revision in order to improve outcomes. Additionally, the first cohort had a high attrition rate. Overall, trainees and key stakeholders viewed LSI as important in building skilled capacity in public health in Ethiopia.The evaluation provided constructive insight in modifying the course to improve retention and better address trainees' learning needs. Subsequent course attrition rates decreased as a result of changes made based on evaluation findings.The United States (U.S.) President's Emergency Plan for AIDS Relief (PEPFAR), implemented in 2003, is a significant undertaking by the U.S. government to prevent and treat HIV-infected persons in developing countries [1]. Strategic Information (SI) is an essential element of PEPFAR that ensures quality data are used to guide programs supported by this initiative. Surveillance, monitoring and evaluation (M and E), health management information systems, planning, and reporting are the core components of SI [2]. As the second cycle of PEPFAR broadens its focus to health systems strengthening in addition to scaling up services for HIV care treatment and prevention (PEPFAR I), the effective use of SI is key for this venture to be successful. A recent review of PEPFAR I by the Institute of Medicine (IOM) supports the role of SI in HIV-related activities. The IOM report recommended that as PEPFAR goes forward there is a need for quality data to guide interventions, evidence-based decision making, and ongoing evaluations and research [2].The Centers for Disease Control and Prevention (CDC) has extensive experience in teaching the use of data for effective decision making using an applied approach that entails hands on practical training [3-5]. The use of data is central for evidence-based decisions as it leads t
Information systems on human resources for health: a global review
Patricia L Riley, Alexandra Zuber, Stephen M Vindigni, Neeru Gupta, Andre Verani, Nadine L Sunderland, Michael Friedman, Pascal Zurn, Chijioke Okoro, Heather Patrick, James Campbell
Human Resources for Health , 2012, DOI: 10.1186/1478-4491-10-7
Abstract: Our systematic search initially retrieved 11 923 articles in four languages published in peer-reviewed and grey literature. Following the selection of those articles which detailed HRIS implementation processes, reviews of their contents were conducted using two-person teams, each assigned to a national system. A data abstraction tool was developed and used to facilitate objective assessment.Ninety-five articles with relevant HRIS information were reviewed, mostly from the grey literature, which comprised 84?% of all documents. The articles represented 63 national HRIS and two regionally integrated systems. Whereas a high percentage of countries reported the capability to generate workforce supply and deployment data, few systems were documented as being used for HRH planning and decision-making. Of the systems examined, only 23?% explicitly stated they collect data on workforce attrition. The majority of countries experiencing crisis levels of HRH shortages (56?%) did not report data on health worker qualifications or professional credentialing as part of their HRIS.Although HRIS are critical for evidence-based human resource policy and practice, there is a dearth of information about these systems, including their current capabilities. The absence of standardized HRIS profiles (including documented processes for data collection, management, and use) limits understanding of the availability and quality of information that can be used to support effective and efficient HRH strategies and investments at the national, regional, and global levels.
A Review of Two Payment Schemes for Watershed Services from China and Vietnam: the Interface of Government Control and PES Theory
Vijay K. Kolinjivadi,Terry Sunderland
Ecology and Society , 2012, DOI: 10.5751/es-05057-170410
Abstract: China and Vietnam have developed some of the most ambitious payments for ecosystem services (PES) initiatives for watershed conservation and forest management. These include the Sloping Land Conversion Programme in China and pilot projects designed to implement Decision 380 and the subsequent national PES law in Vietnam. This study reviews how these two government-driven initiatives are achieving their environment and development objectives in terms of their institutional arrangements, implementation in practice, and sustainability prospects. Although it remains too soon to determine the effects of these programs on watershed services, early evidence indicates that they are resulting in vulnerable land being retired from cultivation supported, in some cases, by considerable contributions to household income. A review of these initiatives has revealed two emerging questions that are relevant within the wider discussion on PES theory: (1) What is the ideal role for government in an evolving socio-cultural and political context? (2) What are the implications of a lack of voluntary participation in government administered PES schemes? Future prospects for harnessing the substantial political commitment for watershed protection toward more strategic, flexible, and long-term sustainable outcomes hinge on the ongoing responsiveness of these governments to stakeholder needs and objectives.
Studying Heavy Metals in Sediments Layers along Selected Sites on the Lebanese Coast  [PDF]
Journal of Water Resource and Protection (JWARP) , 2010, DOI: 10.4236/jwarp.2010.21006
Abstract: Ensuring the environmental protection of the Lebanese coast requires a continues monitoring system. For this purpose, four heavy metals (Fe, Mn, Cu and Pb in the marine sediments along the Lebanese coast were selected for analysis Sampling was carried out from two sites: Beirut and Batroun. Thus, 1g of dried sample is used for digestion by wet mineralization in order to determine the concentration of the four heavy metals by atomic absorption spectrometry. The results showed that Beirut area is polluted, by Fe and Mn as well as the station Bat 2 of Batroun. For Cu and Pb, Batroun region is more polluted in the superficial layers. The analysis also showed significant difference between the sites except for Cu. A difference between depths and between particles size fractions are observed for all the parameters studied. There is no a significant difference in layer sequence except for the Pb, and neither between the repetitions of the same sample. Results showed that the values of the four metals studied do not exceed the maximum limits at both sites, but they showed increase in comparison with the analyses obtained before July 2006 conflict, which was caused by the release of large quantity of fuel-oil from Jiyeh Power Station.
Influence of production processes in quality of fermented milk "Laban" in Lebanon  [PDF]
Zeineddine Mayssoun, Nassif Nadine
Health (Health) , 2010, DOI: 10.4236/health.2010.24057
Abstract: Yoghurt (Laban) is one of the most consumed food products in Lebanon. Thus its quality has given a concern. In this study, the sensory, chemical and rheological properties of commercial and traditional samples were investigated in order to characterize this fermented milk. Hence, Laban samples were collected from 14 areas in Lebanon; especially from mountainous regions and from the capital Beirut. Forty-two samples were provided by processing industry whether at small, medium, or large scale. A statistical analysis was carried out, and thus sensory and physicochemical properties were subjected to two approaches of variance analysis. Pearson correlation coefficients between attributes were also calculated. Both, the analyses of variance and correlations were conducted using SPSS 3. The physicochemical analysis and the microbiological analysis exhibit a significant effect of the date, and the manufacturing process. Also, the instrumental data showed no significant correlation between physicochemical and microbiological parameters, which indicates that they are completely independent. Moreover, the general appreciation of descriptive sensory analysis of products display that this appreciation is not dependant on the production process. It is also noticed that some sensory characteristics can be dread by instrumental measures. This research endorses the essential role of quality control for the manufacturing of yoghurt in Lebanon.
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