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The health-care system in Ghana is similar to those in other developing countries and access to health services for remote communities is extremely limited. In July, 2010, the Government of Ghana launched the national e health strategy. A number of international organizations have initiated various pilot projects, including disseminating and collecting data, education initiatives and telemedicine. In addition, several institutions and organizations are dedicated to the promotion of e-health and a range of Web-based health consultancy services have begun. The main objective of this study is to provide an overview of eHealth activities in Ghana. It was a daunting task, not least because of the need to gather information on eHealth projects and initiatives in Ghana, as there is no existing repository of such information. Through literature search in Africa journals online, Hinari, Medline, Google.com, Journal of Telemedicine and e-Health, Journal of Telemedicine and Telecare, Journal of Medical Internet Research and Interaction with eHealth experts, followed up with some of the authors' for directions to other projects, and following the references in some articles. A total of twenty-two (22) pilot projects have been identified in Ghana. Mobile devices in use range from PDAs to simple phones and smart phones. The key findings of this research are that there are about 22 eHealth project at various stages of implementation in Ghana. Some of these projects have wind up and others are still being implemented. Mobile devices in use range from PDAs to simple mobile phones and smart phones. Most of the projects have been donor initiated. Data collection started in March 2010 to June 2013. Although eHealth seems to have a limited role in Ghana at present, there is growing interest in the opportunities it may offer in terms of improving the delivery and access to services, especially in remote locations. Recommendations for further research are provided.

[EN] The European rabbit (Oryctolagus cuniculus L.) is a key prey species in Mediterranean ecosystems that has declined in its natural ranges as a result of diseases and loss of habitat. This situation has led to the production of wild rabbits in enclosures in which they can acclimate and breed. The efficiency of these enclosures as extensive breeding systems is defined by their population growth rate (PGR). The aim of this study is to analyse the effect of rabbit abundance on the PGR. This has been done by creating general linear models to explain autumn and spring PGR with the use of rabbit abundance estimates, enclosure size, aerial predation and previous PGR as possible explanatory variables. Rabbit abundance and enclosure size negatively affected the autumn PGR, while only rabbit abundance affected the spring PGR in the best-fit models. It is suggested that maintaining rabbit densities at fewer than 30 rabbits per hectare might help to optimise the efficiency inside enclosures. ; L.R.A. was supported by a grant from the University of Córdoba. Our English was reviewed by Sally Newton. This work is funded by the Andalusia Autonomous Environmental Government through a project for the conservation of the Cinereous Vulture in Córdoba province. ; Ruiz-Aizpurua, L.; Guerrero-Casado, J.; Carpio, AJ.; Tortosa, FS. (2014). High rabbit abundance proves detrimental to the population growth rate in European rabbit (Oryctolagus cuniculus L.) extensive breeding enclosures. World Rabbit Science. 22(3):179-186. doi:10.4995/wrs.2014.1668. ; SWORD ; 179 ; 186 ; 22 ; 3 ; Branco, M., Ferrand, N., & Monnerot, M. (2000). Phylogeography of the European rabbit (Oryctolagus cuniculus) in the Iberian Peninsula inferred from RFLP analysis of the cytochrome b gene. Heredity, 85(4), 307-317. doi:10.1046/j.1365-2540.2000.00756.x ; Burnham K.P., Anderson D.R. 2002. Model Selection and Multimodel Inference: A Practical Information-Theoretic Approach. 2nd ed. Springer, New York, USA, 488. ; Junta de Andalucía. 2003. Dehesas de Sierra ...

La propuesta del número 22 de la revista Relaciones Internacionales era "indagar, exponer o aclarar las teorías de Relaciones Internacionales que se elaboran desde y en el Sur". En este artículo se cuestiona la idea —implícita en la propuesta— de que la fractura Norte–Sur sea la más apropiada para entender las dinámicas y la evolución de la disciplina y la teoría de las Relaciones Internacionales en el mundo. Partiendo de la constatación de que el desarrollo institucional de la disciplina de las Relaciones Internacionales y la contribución a la teoría de un país del Norte como España es bien menor que el de un país del Sur como Brasil, se defiende una interpretación Centro-Periferia de la disciplina. De acuerdo con ella, la teoría de las Relaciones Internacionales se produce en un Centro casi exclusivamente confinado a los Estados Unidos, con una menor participación del Reino Unido y otros países del Norte y Centro de Europa. La Periferia de las Relaciones Internacionales es, desde esta perspectiva, bastante más amplia que lo denotado por el concepto de Sur o Sur Global. Estableciendo seguidamente un diálogo con los trabajos publicados en el número 22 sobre las Relaciones Internacionales en Brasil (especialmente el de Daniel Jatobá y, en menor medida el de María Elena Lorenzini y María Gisela Pereyra Doval), se hacen algunas consideraciones sobre la recepción de la Teoría de las Relaciones Internacionales en Brasil, entendiendo que pueden tener alguna utilidad para reflexionar, en general, sobre algunos de los dilemas que supone la transmisión de la teoría de las RI en la Periferia. Por último, se aboga por una estrategia de inserción internacional de las ideas basada en el diálogo y en un rigor metodológico ajeno a cualquier moda, ya sea mainstream o alternativa.

Background: As many patients with severe mental illness (SMI) who have complex needs are difficult to engage, outreach mental health services are needed to engage them into treatment. The extent to which these services exist in large European cities is unknown. Methods: Experts in 29 European countries were sent a structured questionnaire containing two case vignettes of difficult-to-engage patients (a first-episode psychosis patient and a homeless chronic schizophrenia patient). The type and quality of outpatient care was assessed and related to several national indices. Results: The questionnaire was returned by experts from 22 countries (76%) representing 92% of the EU population. Six countries (21%) had a systematic method for detecting difficult-to-engage patients. The most important route whereby such patients entered the mental health system was through informal care; the most important reasons for entering it were the level of psychiatric symptoms, nuisance and violence. Assertive outreach was available in nine countries (41%), with coverage ranging from a few teams (sometimes for a specific target group) to most of the country. The case vignettes showed that outpatient care for these difficult-to-engage patients varied widely. In seven (30%) of the 22 countries, a hospital would take no action if such patients who had been admitted voluntarily discharged themselves prematurely. On a scale of 0–10, the experts' mean scores regarding the quality of outpatient care for patients with SMI in general were 5.2 (SD = 1.9) and 3.2 (SD = 2.2) in difficult-to-engage ones. Explorative analyses showed that the quality of outpatient care for difficult-to-engage patients was associated with gross national income and the number of psychiatrists per capita. Conclusions: Outpatient mental health services for difficult-to-engage SMI patients varied widely among European countries; experts judged their overall quality to be poor. It is now important to achieve consensus on a minimum European standard for the quality of care for such patients.

[EN] The sharing of research data is a hot topic at the international level, especially due to the development of e-science, based on collaborative working methods that use technology in an intensive manner. The amount of digital data and of its sharing is growing fast, and a lack of proper management could limit the potential benefits to stakeholders (researchers, governments and public funding agencies, research managers and libraries, and finally the publishing sector). The aim of this review is first to place the sharing of electronic research data in the context of its appearance and of open environments; secondly, it describes the life cycle model of data preservation; finally, it describes several initiatives dealing with methodologies and technologies. In parallel, international developments and highlights needs that exist in Spain are described. ; [ES] El intercambio de datos de investigación es un tema candente debido a la expansión de los métodos de trabajo colaborati- vos con un uso intensivo de tecnología (e-ciencia). El volumen y el intercambio de datos electrónicos están aumentando con rapidez, y si no se tratan correctamente sus beneficios no llegarán a sus potenciales interesados (investigadores, gobiernos y organismos de financiación públicos, directores de investigación y bibliotecas, sector editorial.). Este trabajo revisa su aparición y los movimientos de acceso abierto, describe un modelo de ciclo de vida para la preservación de datos, y revisa las iniciativas que tratan sobre metodologías y tecnologías. De forma paralela se presentan los avances internacionales y las necesidades españolas. ; Millán González, L.; Saorín, T.; Ferrer Sapena, A.; Alexandre Benavent, R.; Peset Mancebo, MF. (2013). Gestión de datos de investigación: infraestructuras para su difusión. El profesional de la información. 22(4):415-423. http://hdl.handle.net/10251/38129 ; S ; 415 ; 423 ; 22 ; 4

The study examined some issues on Gender and renal replacement therapy (RRT) in Kano state. Stratified sampling technique was used to select 46 males and 26 females from Aminu Kano teaching hospital (AKTH) and Abdullah Wase or Nassarawa specialist hospital. Before embarking on data collection, ethical approval was sought and given by the ministry of health Kano state for Abdullah Wase hospital and the management of AKTH hospital. Data was derived primarily from the questionnaire administered to the selected samples, in addition hospital based records of patients were obtained from the dialysis unit of the two hospitals. The results of the study showed that both male and female patients delayed in RRT. However majority of the males and females delayed due to inadequate information(19%) and(18%) and lack of money(y25%) and (18%)for the male and female patients resulting from the low socio economic status of most of them as indicated in the tables on education and income of the respondents, Other factors that caused infrequent RRT included the long term nature of treatment (12%) and (23%), tried out alternative treatment (19%) and (18%)males and females respectively. Some of the socio economic and psychological costs of RRT were found to include cut in social spending( 22%) males and(15%) females, increased expenditure on health (17%) and( 19%) ,frequent illness (22%) and (31%), loss of job (4%)males only ,decrease in number of hours put to work (30%) and( 31%) matrimonial problems ((4%) and another ( 4%)for the males and females respectively Based on the findings of this research it is recommended that government ad stakeholders need to redefine their priorities and place health matters as a top priority in all state matters as the saying goes a healthy nation is a wealthy nation.

La tematica delle imposte sui prodotti energetici, ed in particolare sui carburanti, è sempre attuale nello scenario politico italiano per la grande quantità e varietà di interessi che ruotano attorno all'utilizzo di questi prodotti. Lo scopo di questo lavoro è quello di fornire una panoramica completa su questo tipo di imposizione e sulla sua evoluzione anche alla luce delle recentissime novità che riguardano il probabile aumento dell'aliquota iva dal 21 al 22%. Questo lavoro è suddiviso in tre parti. Nella prima parte abbiamo analizzato gli obiettivi di medio e lungo termine delle politiche comunitarie ambientali, energetiche e dei trasporti che incideranno in qualche misura anche sulle imposte sui carburanti, utilizzate sempre più spesso come strumenti di policy per indirizzare il comportamento dei consumatori. La ricostruzione normativa e storica delle imposte che gravano sui diversi tipi di carburanti in Italia ci ha permesso in seguito di approfondire la loro composizione e gli scopi della loro introduzione. In un'ottica comparativa abbiamo così confrontato le accise presenti nel contesto italiano e quelle presenti negli altri stati europei, facendo anche un confronto tra i livelli minimi d'imposizione previsti dalla normativa comunitaria e quelli presenti in Italia. Nella seconda parte di questo lavoro, attraverso l'utilizzo dei micro dati dell'Istat relativi agli anni 2002-2011 abbiamo cercato di descrivere le spese medie per questi prodotti distinguendole per tipologia familiare e per macroaree geografiche, e attraverso il sistema di domanda Almost Ideal abbiamo studiato l'elasticità della domanda dei vari tipi di beni, e particolarmente di quelli energetici, per capire come potrebbero eventualmente evolvere i consumi a seguito di variazioni di prezzo dipendenti da un aggravio delle imposte. Nella terza ed ultima parte, utilizzando i dati Istat sul consumo delle famiglie italiane abbiamo stimato l'incidenza dell'IVA pagata dalle famiglie italiane sul consumo dei carburanti distinguendole per fasce di reddito, e stimando le conseguenze di un eventuale aumento dell'aliquota dal 21% al 22%.

Abstract Background Although many evidence-based diabetes prevention interventions exist, they are not easily applicable in real-life settings. Moreover, there is a lack of examples which describe the adaptation process of these interventions to practice. In this paper we present an example of such an adaptation. We adapted the SLIM (Study on Lifestyle intervention and Impaired glucose tolerance Maastricht) diabetes prevention intervention to a Dutch real-life setting, in a joint decision making process of intervention developers and local health care professionals. Methods We used 3 adaptation steps in accordance with current adaptation frameworks. In the first step, the elements of the SLIM intervention were identified. In the second step, these elements were judged for their applicability in a real-life setting. In the third step, adaptations were proposed and discussed for those elements which were deemed not applicable. Participants invited for this process included intervention developers and local health care professionals (n=19). Results In the first adaptation step, a total of 22 intervention elements were identified. In the second step, 12 of these 22 intervention elements were judged as inapplicable. In the third step, a consensus was achieved for the adaptations of all 12 elements. The adapted elements were in the following categories: target population, techniques, intensity, delivery mode, materials, organisational structure, and political and financial conditions. The adaptations either lay in changing the SLIM protocol (6 elements) or the real-life working procedures (1 element), or a combination of both (4 elements). Conclusions The positive result of this study is that a consensus was achieved within a relatively short time period (nine months) between the developers of the SLIM intervention and local health care professionals on the adaptations needed to make SLIM applicable in a Dutch real-life setting. Our example shows that it is possible to combine the perspectives of scientists and practitioners, and to find a balance between evidence-base and applicability concerns.

Kosovo 'unilaterally' declared independence in 2008. In the Advisory Opinion delivered on 22 July 2010, the ICJ opined that this declaration 'did not violate international law.' This Advisory Opinion has some critical ramifications for the future of the Cyprus question. One can easily deduce from the Court's findings that neither the declaration of independence by the TRNC nor its recognition violates any applicable rule of international law. As such the Greek Cypriot Administration as well as the international community does not have the right to impose a solution on the island against the will of the Turkish Cypriot community. In fact, given especially the process and outcome of half-a-century of negotiations and of 2004 referendum, the best solution to the impasse between the communities is to recognize two independent states on the island, namely the Greek Cypriot State and the Turkish Cypriot State, as envisaged in the Annan Plan. ; Kosovo 'unilaterally' declared independence in 2008. In the Advisory Opinion delivered on 22 July 2010, the ICJ opined that this declaration 'did not violate international law.' This Advisory Opinion has some critical ramifications for the future of the Cyprus question. One can easily deduce from the Court's findings that neither the declaration of independence by the TRNC nor its recognition violates any applicable rule of international law. As such the Greek Cypriot Administration as well as the international community does not have the right to impose a solution on the island against the will of the Turkish Cypriot community. In fact, given especially the process and outcome of half-a-century of negotiations and of 2004 referendum, the best solution to the impasse between the communities is to recognize two independent states on the island, namely the Greek Cypriot State and the Turkish Cypriot State, as envisaged in the Annan Plan.

Objective : The Accreditation Council on Graduate Medical Education, ACGME, duty hour limitations have been resisted for various reasons, including the belief that fatigue does not affect our profession's core skills duty hour limitations will affect patient safety due to increased handoffs and decreased training and patient care opportunities for residents. This paper will examine the recent evidence on fatigue and sleep deprivation in both the medical and military aviation professions. These professions have been compared and contrasted before because of their requirement for a high level of training and competence as well as their profound responsibility for the lives of others. It is our desire to highlight recent literature in both professions so that one may inform the other. Method : The authors conducted a search on MEDLINE for English-language literature from 2007-2012 for articles about the effects of fatigue on medical residents. The articles were limited to those from North American, Australian, and European programs. In addition, inclusion criteria included the measurement of physical and/or cognitive function as a reported outcome. Articles regarding military aviation were limited to those from the United States Navy. Results : The search found 157 articles on the effects of resident fatigue and 22 met inclusion criteria. Of the 22 reviewed articles, 13 showed a significant effect of fatigue on technical skills, cognitive function or medical error rates while 9 articles found no statistically significant effect. Articles involving Naval Aviation included relevant research and regulations. The review found a longstanding organizational acceptance of the effects of fatigue, accident data that reported fatigue as a causal factor in nearly 25% of aviation mishaps, and increased scientific understanding of the complex nature of fatigue when compared to medical research. Conclusions : To our knowledge, this is the first review to compare medical and aviation research and regulations regarding fatigue. T.

Background: Most births in rural Bangladesh are done at home because of barriers to access to facility-based services. To address this issue, the Bangladeshi Government piloted a demand-side financing scheme (the maternal health voucher programme) at subdistrict public health facilities in rural areas. We assessed the effect of this intervention on use of delivery care services and out-of-pocket expenses. Methods: We did a non-randomised, controlled study. We selected 22 subdistricts in Bangladesh with a probability proportional to their size: 11 intervention subdistricts took part in the demand-side financing programme and 11 control subdistricts did not. We selected 150 women from each subdistrict. From each subdistrict, three of nine unions and three villages from each union were selected through probability proportional to size and from each selected village we drew the required numbers of respondents through simple random sampling. We included women aged 18–49 years who had given birth in the previous 12 months. A baseline survey was done in 2010, and a follow-up survey was done in 2012, recording socioeconomic and demographic characteristics as well as service use and cost of services, collected with a structured questionnaire. Findings: 3300 women were surveyed (1650 in each group). Use of delivery services was 8% (126/1650) in 2010 versus 16% (263/1663) in 2012 in the intervention subdistricts and 8% (129/1650) versus 11% (178/1671) in control areas. Delivery at a public health facility in the intervention areas increased significantly compared with the control areas (p < 0·0001) and the intervention contributed to some of the change (difference in differences 5·1%). Average out-of-pocket cost in intervention areas fell for both normal births (from US$40 to $22) and caesarean births (from $115 to $80). In control areas, average out-of-pocket cost decreased slightly for normal births (from $33 to $29), but increased for caesarean births (from $118 to $125). Interpretation: To sustain the trend of use, ...

Este texto evalúa la democraticidad de la elección a gobernador de 2011 en el Estado de México con base en lo escrito al respecto por académicos y observadores electorales. Su marco teórico metodológico define la democraticidad, así como otros conceptos involucrados en ella, para establecer variables de análisis, como limpieza de la votación, libertad de la competencia, libertad del voto, apego a la ley, nivel de la deliberación y confianza de los ciudadanos en las elecciones y en sus principales protagonistas. La conclusión es que las 29 perspectivas examinadas (13 de observadores electorales y 16 de académicos) avalan, de acuerdo con el marco teórico-metodológico propuesto en este trabajo, la naturaleza democrática de la elección mencionada. Sin embargo, acerca de su calidad democrática, presentan notables discrepancias: para tres, ésta fue muy baja; para cuatro, baja; y para las 22 restantes, mediana o alta. ; Este texto evalúa la democraticidad de la elección a gobernador de 2011 en el Estado de México con base en lo escrito al respecto por académicos y observadores electorales. Su marco teórico metodológico define la democraticidad, así como otros conceptos involucrados en ella, para establecer variables de análisis, como limpieza de la votación, libertad de la competencia, libertad del voto, apego a la ley, nivel de la deliberación y confianza de los ciudadanos en las elecciones y en sus principales protagonistas. La conclusión es que las 29 perspectivas examinadas (13 de observadores electorales y 16 de académicos) avalan, de acuerdo con el marco teórico-metodológico propuesto en este trabajo, la naturaleza democrática de la elección mencionada. Sin embargo, acerca de su calidad democrática, presentan notables discrepancias: para tres, ésta fue muy baja; para cuatro, baja; y para las 22 restantes, mediana o alta.

В статье дается сравнительная оценка показателей физического развития и типовых свойств военнослужащих срочной службы. Объект исследования – военнослужащие срочной службы в возрасте 18–22 лет. В работе использовался личностный опросник "НПН-А" (нервно-психическая неустойчивость – акцентуации), разработанный К. Н. Поляковым, А. Н. Глушко и предназначен для выявления нервно-психической неустойчивости и некоторых акцентуаций характера. Выявлено, что у военнослужащих в процессе прохождения воинской службы отмечался высокий уровень нервно-психической неустойчивости (НПН), что свидетельствует о значительной выраженности соответствующего признака. Самый высокий уровень отмечался на начальном этапе прохождения воинской службы. В динамике прохождения воинской службы отмечалось достоверное снижение нервно-психической неустойчивости. В конце воинской службы отмечалось незначительное увеличение средних величин, что соответствовали уровню значительной выраженности данного признака. Городские военнослужащие хуже адаптируются к условиям прохождения воинской службы, чем сельские военнослужащие. Проведенный корреляционный анализ зависимости нервно-психической неустойчивости и ее отдельных параметров от возраста выявил низкую отрицательную зависимость. ; The article presents a comparative evaluation of physical development and typical properties of military servicemen. Object of research – military personnel of aged 18–22 years. Used in this work personal questionnaire "NPsI-A" (neuro-psychological instability – accentuation) developed by K. N. Polyakov, A. N. Glushko and designed to identify the neuro-psychological instability and some accentuation of character. Revealed that in military personnel in the military service was a high level of nervous and psychological instability (NPsI), which shows a significant expression of the corresponding feature. The highest level was observed at the initial stage of military service. In the dynamics of military service showed statistically significant reduction in neuro-psychological instability. At the end of military service, there was a small increase in the average values that corresponded to the level of expression of this great feature. The urban servicemen are worse adaptable to the conditions of military service than rural soldiers. The correlation analysis of the relationship of nervous and mental instability and its individual parameters of age showed a low negative relationship.

[ES] The thesis in this article supports physiological and anthropological foundations against the sociological and aesthetic foundations of architecture based on conventional codes. The genesis of the architectural shape is legitimised as an extension of the body in the movement involving the drawing of a generator, imprecise, approximate, emotional, stirring. The difference between the design design and the representation or presentation design is argued to be the difference between the design design and the representation or presentation design using sources and concepts such as 'degree zero', 'matrix space', 'diagram', so often used with a degree of ambiguity or imprecision and without critical assessments. Once again, we reflect on the digital code, an abstract and conventional annotation code that conveys aesthetic information as opposed to the original manual drawing that refers to the body and architectural sensitivities Trachana, A. (2013). The zero degree of architecture. EGA. Magazine for architectural graphics. 18 (22): 142-153. doi:10.4995/ega.2013.1691. — BONTA, J. P. 1977. Systems of significance in architecture. Barcelona: G. Gili. ; 142 153 18 22 ; [ES] The thesis in this article supports physiological and anthropological foundations against the sociological and aesthetic foundations of architecture based on conventional codes. The genesis of the architectural shape is legitimised as an extension of the body in the movement involving the drawing of a generator, imprecise, approximate, emotional, stirring. The difference between the design design and the representation or presentation design is argued to be the difference between the design design and the representation or presentation design using sources and concepts such as 'degree zero', 'matrix space', 'diagram', so often used with a degree of ambiguity or imprecision and without critical assessments. Once again, we reflect on the digital code, an abstract and conventional annotation code that conveys aesthetic information as opposed to the ...

This paper explores the possibilities, scope and limitations of modernization of education in Serbia in the second decade of the XXI century. Together with social and political changes that started in Serbia in the year 2000, considerable changes were initiated in the area of education as well. Modernization of education became one of the proclaimed goals of social development, and decentralization, democratization and improvement of the quality of education were defined as the basic directions for a school system reform. The experience with the specification, implementation and duration of the planned changes reveals their direct dependence on the changes that were taking place in the political government, as a result of which some changes have been partially implemented, while others have been postponed. The transitional society with a low level of socioeconomic development and newly established democratic institutions views the reform of education as an instrument of economic revival and progress and development of the civil society, the stronghold of democracy. However, both the educational system and the society as a whole are in a state of incomplete modernization, which is reflected in the chronic social crisis and stagnation that has been going on for decades. This has practically resulted in the retraditionalization of the dominant value system, whose characteristic, among others, is resistance to change. The Serbian educational system therefore finds itself in a paradoxical situation – what should change the society must also be changed itself, while society itself resists the changes that should be brought about by the modern school. The concluding part of the article discusses some possible outcomes of modernization of education in conditions of an absence of a supportive social context. ; Eduation between tradition and modernity : International symposium, Ohrid, 22-24 September, 2011 Воспитението и образованието меѓу традиционалното и современото општество : Меѓународен симпозиум, Охрид, 22-24 септември, 2011