Suchergebnisse

US-Experten belegen akribisch das Wirken der Diagnosefalle: Durch die Errungenschaften der modernen Medizintechnik würden Millionen Menschen ohne Symptome zu Patienten gemacht und wegen Krankheiten behandelt, die sie auf keine Weise beeinträchtigt hätten. (Uwe-Friedrich Obsen)

This report describes grid-interactive efficient buildings in the context of state and local government interests; highlights trends, challenges and opportunities for demand flexibility; provides an overview of valuation and performance assessments for demand flexibility; and outlines actions that state and local governments can take, in concert with utilities, regional grid operators, and building owners, to advance demand flexibility.

This issue brief is for local governments that are well-positioned to participate in a commercial property assessed clean energy (C-PACE) program but are looking to inform a decision about whether to join or create a program. This resource addresses two specific barriers these local governments may face regarding C-PACE programs: (1) uncertainty about the likelihood of tax foreclosure on properties in default of C-PACE payments and the risks local governments bear, and (2) uncertainty about the staff labor commitment associated with administering the program, including the execution of the special tax assessment process.

Most energy efficiency measures produce energy savings that vary over the course of a year. The value of the hourly electricity savings also varies over the course of a year because the cost of generating, transmitting and distributing electricity during peak demand periods may be significantly higher than during off-peak, or lower load, hours. But many planning and program activities across the United States are missing this important element. A variety of trends are changing the electricity system, including increased adoption of other distributed energy resources, electrification of buildings and vehicles, and relative costs for natural gas-fired and renewable energy generation. Knowing when energy efficiency occurs and the value of the energy or demand savings to the electricity system—the time-sensitive value of efficiency—provides public utility commissions, utilities and other decision makers with key information needed to procure the optimal amount of energy efficiency for their system. The report begins with a discussion of our approach to determining use cases and examples, and then examines the need for time-sensitive efficiency data. Next, it examines five use cases in which states, independent system operators/regional transmission operators (ISOs/RTOs), utilities, and efficiency program administrators consider the TSV-EE: (1) energy efficiency program planning and evaluation, (2) distribution system planning, (3) electricity resource planning (4) electricity rate design, and (5) state and local government activities. The report concludes with areas for future research on the time-sensitive value of efficiency.

This report reviews the status of agricultural extension in Ethiopia, Kenya, Mauritius, Somalia, Sudan and Uganda). While significant progress has been achieved in Kenya and Mauritius, internal strife in the other countries has held back major efforts to strengthen the role and performance of agricultural extension. The review attempts to draw lessons from the experience gained so far and explores the key issues that need to be resolved during the design and implementation of future extension projects in East Africa. (DÜI-Hff)

Health research tends to be deficit-based by nature; as researchers we typically quantify or qualify absence of health markers or presence of illness. This can create a narrative with far reaching effects for communities already subject to stigmatization. In the context of Indigenous health research, a deficit-based discourse has the potential to contribute to stereotyping and marginalization of Indigenous Peoples in wider society. This is especially true when researchers fail to explore the roots of health deficits, namely colonization, Westernization, and intergenerational trauma, risking conflation of complex health challenges with inherent Indigenous characteristics. In this paper we explore the incompatibility of deficit-based research with principles from several ethical frameworks including the Tri-Council Policy Statement (TCPS2) Chapter 9, OCAP® (ownership, control, access, possession), Inuit Tapiriit Kanatami National Inuit Strategy on Research, and Canadian Coalition for Global Health Research (CCGHR) Principles for Global Health Research. Additionally we draw upon cases of deficit-based research and stereotyping in healthcare, in order to identify how this relates to epistemic injustice and explore alternative approaches. ; La recherche en santé a tendance à être basée sur les déficits; en tant que chercheurs, généralement nous quantifions ou qualifions l'absence de marqueurs de santé ou la présence d'une maladie. Cela peut créer un récit ayant des effets d'une grande portée pour les communautés déjà victimes de stigmatisation. Dans le contexte de la recherche en santé autochtone, un discours basé sur les déficits peut contribuer aux stéréotypes et à la marginalisation des peuples autochtones dans une société élargie. C'est particulièrement vrai lorsque les chercheurs ne parviennent pas à explorer les racines des déficits de santé, à savoir la colonisation, l'occidentalisation et les traumatismes intergénérationnels, au risque de confondre des problèmes de santé complexes avec des caractéristiques autochtones inhérentes. Dans cet article, nous explorons l'incompatibilité de la recherche basée sur les déficits avec les principes de plusieurs cadres éthiques, y compris le chapitre 9 de l'Énoncé de politique des trois Conseils (EPTC2), les principes PCAP® (propriété, contrôle, accès, possession), la Stratégie nationale sur la recherche inuite Inuit Tapiriit Kanatami et les principes de la Coalition canadienne pour la recherche en santé mondiale (CCRSM). En outre, nous nous appuyons sur des cas de recherche basée sur les déficits et le stéréotypage dans le domaine des soins de santé, dans le but d'identifier leur lien avec l'injustice épistémique et d'explorer des approches alternatives.

This slide deck report identifies objectives and key indicators for state activities that advance demand flexibility in buildings — legislation, utility regulatory proceedings, executive orders and programs. It also illustrates progress to date and identifies trends, gaps, and opportunities. Part I of the report focuses on (1) demand response and (2) energy efficiency targeted to reduce peak demand or integrate with demand response. This section covers building energy codes, appliance and equipment standards, resource standards, utility planning, utility programs, advanced metering infrastructure and meter data, rate design, state programs, state energy planning, and related state policies and regulations. Part II of the report addresses traditional energy efficiency indicators, including utility and state programs, codes, and standards that support annual energy savings. See the additional links for an infographic, library of cited state documents on demand flexibility, and presentation to the NASEO-NARUC Grid-Interactive Efficient Buildings Working Group.

Qualitative health research plays a central role in exploring individuals' experiences and perceptions of wellness, illness, and healthcare services. Visual tools are increasingly used for data elicitation. An ecomap is a visual tool that applies ecosystems theory to human communities and relationships to provide an illustration of the quality of relationships. We describe the use of ecomaps in qualitative health research. Searches across eight databases identified 407 citations. We screened them in duplicate to identify 129 publications that underwent full text review and included 73 in the final synthesis. We classified and summarized data based on iterative comparisons across sources. Benefits of using ecomaps include improving rapport and engagement with study participants, facilitating iterative question development, and highlighting the social contexts of relationships. When used in conjunction with interviews, they promote data credibility through triangulation. Investigators have used ecomaps as a tool to facilitate primary and secondary analysis of data. Researchers have adapted the ecomap to meet their health research needs. Challenges to their use include additional time and training needed to complete, and potential privacy and confidentiality concerns. Ecomaps can be useful in qualitative health research to enhance data elicitation, analysis, presentation, and to augment study rigor.

The current study examined whether characteristics of adolescents (i.e., externalizing problems) and their environments (i.e., social support, adverse childhood experiences) relate to academic goal setting, appraisals, and outcomes. Adolescents (n = 99; 87% Black/African American) 13–16 years old completed baseline interviews, and 80% also completed follow‐up interviews. Adolescents with more externalizing problems set fewer academic goals, and youth with social networks characterized by greater support (and less strain) appraised their academic goals as more supported and achievable. Adolescents' appraisals of their academic goals, but not how many academic goals they had, predicted grades at follow‐up. Increasing social support (and reducing social strain) may foster adolescents' positive appraisals of their academic goals, which may promote academic achievement.

The development of refugee health policies is significant, given the increased volume of displaced persons seeking refuge in Canada and around the world. Changes to the Canadian refugee health policy, known as the Interim Federal Health Program (IFHP), limited healthcare access for refugees and refugee claimants from 2012 to 2016. In this article, we present a policy analysis using the case of the IFHP retrenchments to examine how political actors on opposing sides of the issue defined the problem using different causal story mechanisms. This analysis reveals that organized interests dramatically changed the problem definition of the IFHP reforms. Following their use of causal stories in redefining the problem, the courts declared that the reforms to refugee healthcare were a form of cruel and unusual treatment. Understanding policy strategies used by proponents of refugee healthcare coverage expansion is important for countries responding to the current, enduring refugee crisis.

In an effort to discover what can improve family planning services for recently immigrated Hispanic women and to foster cultural competence among health care providers in this arena, the authors conducted four focus groups of recently immigrated Hispanic women in a medium-sized Midwestern community. The focus group discussions covered such topics as health care, knowledge of birth control, domestic life, and economic issues in the United States. The participants demonstrated knowledge of and support for the concept of family planning and specific birth control methods. They also identified issues that challenge the use of birth control at the individual, family, system, and cultural levels.