Suchergebnisse

1. Introduction -- 2. Aims and concepts -- 3. Simple random sampling -- 4. Efficiency, economy and logistics -- 5. Prediction from spatial classifications -- 6. Sampling from designed experiments -- 7. Sampling for regression and calibration -- 8. Nested sampling and analysis -- 9. Geostatistics : model-based prediction.

Regulatory approvals for cardiovascular polypills are increasing rapidly across more than 30 countries. The evidence clearly shows polypills improve adherence and cardiovascular disease risk factors for patients with indications for use of polypill components—ie, those with established cardiovascular disease or at high risk. However, the implementation of polypills into clinical practice has many challenges. The clinical trials literature provides insights into the clinical impact of a polypill strategy, including cost-effectiveness, safety of use, substantial improvement in adherence, and better risk factor control than usual care. Despite the clear need for such a strategy and the available clinical data backing up the use of the polypill in different patient populations, challenges to widespread implementation, such as an absence of government reimbursement and poor physician uptake (identified from on the ground experience in countries following commercial rollout), have greatly obstructed real-world implementation. Obtaining the full public health benefit of polypills will require education, advocacy, endorsement, and implementation by key global agencies such as WHO and national clinical bodies, as well as endorsement from governments.

"Often regarded as one of life's few certainties, death is both instantly familiar to us and deeply mysterious. Death is everywhere, yet few of us take the time to consider its significance in shaping human lives. This book addresses the difficult, complex, sensitive subject of death from a unique point of view. Drawing on insights from philosophers across the ages, the authors argue that death is a matter of profound educational importance. Paying particular attention to thinkers in the existentialist tradition, Philosophy, Death and Education shows that our understanding of death can play a key role in determining what, how and why we teach and learn. Death exerts an influence, often unnoticed, on our commitments and priorities, our ideals and relationships. A thoughtful examination of death, the authors suggest, can help us to see ourselves in a new light, and in so doing, allow us to better appreciate what others have to offer"--

A regional survey of the forests in north-eastern New South Wales recorded eight species of nocturnal forest birds and nine species of arboreal marsupials from 291 sites. Three major environmental gradients accounting for the distribution of these species in north-eastern New South Wales were identified: elevation, forest type (wet forest types having a dense mesic understorey or dry forest types having an open or sparse understorey), and logging intensity. Characteristic assemblages of species were associated with each end of these three gradients. A core group of species occurred across a wide range of environmental conditions, including logged and unlogged forest. Most species occurred with similar frequency in logged and unlogged forest. Implications for forest management are discussed.

AbstractThe environmental implications of implementing the requirement for treatment of coastal sewage prior to discharge, which were put forward in an EC draft Directive on municipal waste‐water treatment, are examined. In order to establish the current situation, the results of a national survey of coastal and estuarine sewage discharges are presented. A review of the impact of sewage discharges on the marine environment is presented in conjunction with an assessment of the impact of sewage‐treatment processes on the land and in the air. These aspects are integrated into overall conclusions about net environmental impact. Finally, a decision‐tree approach to the assignment of priority to additional action required at individual locations is developed.

Background: Authorizing health care providers other than physicians to prescribe medicines (i.e., non-medical prescribing, NMP) has been used to improve access to healthcare in many countries. This paper aimed to identify the scope of policies facilitating NMP worldwide and investigate the relationship of such policies with a country's physician to population ratio and economic status. Methods: A hierarchical search strategy was used. First, we compiled a list of countries and territories (n = 216) based upon World Bank record. Then, we collected relevant information for each country by using country name combined with key terms in PubMed, Google, and World Health Organization (WHO) country pharmaceutical profiles. Countries' socio-economic status and physician to population ratio were determined using data from the World Bank. Results: Legislation allowing NMP was found for 117 of 216 (54%) countries and territories. The most prevalent policy identified was that of autonomous prescribing authority (59%). Countries with low or high incomes and those with low or high physician to population ratios (3/1000) had the highest concentration of policies for NMP rights. Conclusion: Despite the varied scope of relevant policies, NMP has been implemented in countries of varied income levels and physician to population ratios. Future research is warranted to empirically examine its impact on access to care.

Highlights: - Despite clinical evidence of its effectiveness in secondary prevention of cardiovascular disease, uptake of fixed dose combination therapy (FDCs) for CVD has been poor. - A symposium was held bringing together stakeholders on this issue, including from academia, government and NGOs. - The conclusion made was that what is now needed to improve implementation of FDCs is country-specific health systems analyses to design appropriate implementation strategies. - Implementation strategies must look beyond listing on the WHO Essential Medicines List to consider approaches to improving FDC availability, accessibility, affordability, and adherence. - Strategies might include incorporation of FDCs into the WHO HEARTS technical package, simplified treatment and monitoring algorithms, decentralisation of medicine dispensing and task-sharing for treatment management.