The Experts below are selected from a list of 128715 Experts worldwide ranked by ideXlab platform
Marie K. Harder - One of the best experts on this subject based on the ideXlab platform.
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perceived key elements of a successful residential food waste sorting program in urban apartments stakeholder views
Journal of Cleaner Production, 2016Co-Authors: D Y Xu, M P R Gordon, N K L Robinson, Marie K. HarderAbstract:A large, successful, residential food waste sorting (recycling) program in urban high-density housing was studied to elicit perceptions of the key elements of its success. An embedded mixed-methods approach was used with rigorous quantitative measures of weights and compositions of the waste to confirm the success of the program, combined with in-depth semi-structured interviews of stakeholders to reveal their opinions of the elements key for success. The program produced a 70% food waste capture rate slowly decreasing to 45% over 54 weeks, with <1% contamination. The key elements for success were found to relate to clarification of roles and responsibilities, and the usefulness of a ‘broker’ (here, an NGO (Non-Governmental Organisation)) to co-develop new boundaries for stakeholder responsibilities. Residents first needed to be convinced of the serious intention of the local government to implement the policy, but then viewed waste sorting as a civic duty. This is different to the moderator of “authority’ in earlier studies. The use of volunteers to demonstrate and interact on a personal level with residents was seen as a key element. The three month period of volunteer involvement was seen as key to good habit forming.
Ahmed El-gohary - One of the best experts on this subject based on the ideXlab platform.
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Role of a sentinel surveillance system in the context of global surveillance of infectious diseases
Lancet Infectious Diseases, 2004Co-Authors: Isao Arita, Miyuki Nakane, Kazunobu Kojima, Namiko Yoshihara, Takashi Nakano, Ahmed El-goharyAbstract:Summary In some nation states, sustained integrated global epidemiological surveillance has been weakened as a result of political unrest, disinterest, and a poorly developed infrastructure due to rapidly increasing global inequality. The emergence of severe acute respiratory syndrome has shown vividly the importance of sensitive worldwide surveillance. The Agency for Cooperation in International Health, a Japanese Non-Governmental Organisation, has developed on a voluntary basis a sentinel surveillance system for selected target infectious diseases, covering South America, Africa, and Asia. The system has uncovered unreported infectious diseases of international importance including cholera, plague, and influenza; current trends of acute flaccid paralysis surveillance in polio eradication; and prevalence of HIV, syphilis, hepatitis B, and hepatitis C in individual areas covered by the sentinels. Despite a limited geographical coverage, the system seems to supplement disease information being obtained by global surveillance. Further development of this sentinel surveillance system would be desirable to contribute to current global surveillance efforts, for which, needless to say, national surveillance and alert system takes principal responsibility.
Angelica Ullauri - One of the best experts on this subject based on the ideXlab platform.
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scaling up art adherence clubs in the public sector health system in the western cape south africa a study of the institutionalisation of a pilot innovation
Globalization and Health, 2018Co-Authors: Hayley Macgregor, Andrew Mckenzie, Tanya Jacobs, Angelica UllauriAbstract:In 2011, a decision was made to scale up a pilot innovation involving ‘adherence clubs’ as a form of differentiated care for HIV positive people in the public sector antiretroviral therapy programme in the Western Cape Province of South Africa. In 2016 we were involved in the qualitative aspect of an evaluation of the adherence club model, the overall objective of which was to assess the health outcomes for patients accessing clubs through epidemiological analysis, and to conduct a health systems analysis to evaluate how the model of care performed at scale. In this paper we adopt a complex adaptive systems lens to analyse planned Organisational change through intervention in a state health system. We explore the challenges associated with taking to scale a pilot that began as a relatively simple innovation by a Non-Governmental Organisation. Our analysis reveals how a programme initially representing a simple, unitary system in terms of management and clinical governance had evolved into a complex, differentiated care system. An innovation that was assessed as an excellent idea and received political backing, worked well whilst supported on a small scale. However, as scaling up progressed, challenges have emerged at the same time as support has waned. We identified a ‘tipping point’ at which the system was more likely to fail, as vulnerabilities magnified and the capacity for adaptation was exceeded. Yet the study also revealed the impressive capacity that a health system can have for catalysing novel approaches. We argue that innovation in largescale, complex programmes in health systems is a continuous process that requires ongoing support and attention to new innovation as challenges emerge. Rapid scaling up is also likely to require recourse to further resources, and a culture of iterative learning to address emerging challenges and mitigate complex system errors. These are necessary steps to the future success of adherence clubs as a cornerstone of differentiated care. Further research is needed to assess the equity and quality outcomes of a differentiated care model and to ensure the inclusive distribution of the benefits to all categories of people living with HIV.
Sumana Navin - One of the best experts on this subject based on the ideXlab platform.
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Heart transplantation in India—looking back as we celebrate 25 years of the transplant law
Indian Journal of Thoracic and Cardiovascular Surgery, 2020Co-Authors: Sunil Shroff, Kriti Mittal, Sumana NavinAbstract:India’s heart transplantation programme is the number one programme in South Asia with an average heart transplantation rate of 0.2 per million population (pmp) versus the global average of 1.06 pmp (2016-2018). The deceased donation rate was 0.67 pmp in India in 2018. The law which made it possible has completed 25 years. In the first 5 years, after the law was passed, less than 50 hearts had been transplanted. The foundation for the deceased donation programme was laid through the creation of an ‘Organ Sharing Network’ in the year 2000 by Multi Organ Harvesting Aid Network (MOHAN) Foundation, a Non-Governmental Organisation in Chennai. The role of the Health Department of Tamil Nadu in streamlining the deceased donation process in 2008–2009 changed the course of the programme. The heart transplantation programme evolved due to a handful of committed hospitals from the private sector. The challenge was in the identification and certification of brain death, and this continues to be the main reason for the low donation rate. The referral government hospitals, which usually receive traumatic head injuries that result in brain death, seldom possess the infrastructure or financial autonomy to start a transplant programme. Hence, expensive transplants like heart and liver have catered to the needs of the economically affordable class mostly. To improve the donation rate will require innovative thinking by taking steps such as strengthening the national programme and creating cross-subsidy formulas in organ sharing so that the less affordable too have access to such surgeries. To showcase the success of the programme, it is also imperative to start a heart transplant outcome registry to study the short- and long-term outcomes.
Aurelio Di Pasquale - One of the best experts on this subject based on the ideXlab platform.
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assessment of the effect of larval source management and house improvement on malaria transmission when added to standard malaria control strategies in southern malawi study protocol for a cluster randomised controlled trial
BMC Infectious Diseases, 2017Co-Authors: Robert S Mccann, Henk Van Den Berg, Peter J Diggle, Michele Van Vugt, Dianne J Terlouw, Kamija S Phiri, Aurelio Di PasqualeAbstract:Due to outdoor and residual transmission and insecticide resistance, long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) will be insufficient as stand-alone malaria vector control interventions in many settings as programmes shift toward malaria elimination. Combining additional vector control interventions as part of an integrated strategy would potentially overcome these challenges. Larval source management (LSM) and structural house improvements (HI) are appealing as additional components of an integrated vector management plan because of their long histories of use, evidence on effectiveness in appropriate settings, and unique modes of action compared to LLINs and IRS. Implementation of LSM and HI through a community-based approach could provide a path for rolling-out these interventions sustainably and on a large scale. We will implement community-based LSM and HI, as additional interventions to the current national malaria control strategies, using a randomised block, 2 × 2 factorial, cluster-randomised design in rural, southern Malawi. These interventions will be continued for two years. The trial catchment area covers about 25,000 people living in 65 villages. Community participation is encouraged by training community volunteers as health animators, and supporting the Organisation of village-level committees in collaboration with The Hunger Project, a Non-Governmental Organisation. Household-level cross-sectional surveys, including parasitological and entomological sampling, will be conducted on a rolling, 2-monthly schedule to measure outcomes over two years (2016 to 2018). Coverage of LSM and HI will also be assessed throughout the trial area. Combining LSM and/or HI together with the interventions currently implemented by the Malawi National Malaria Control Programme is anticipated to reduce malaria transmission below the level reached by current interventions alone. Implementation of LSM and HI through a community-based approach provides an opportunity for optimum adaptation to the local ecological and social setting, and enhances the potential for sustainability. Registered with The Pan African Clinical Trials Registry on 3 March 2016, trial number PACTR201604001501493.