Private Sector Programs Research Articles

Descriptive Analysis of University Enrollment Trends in Colombia between 2014 and 2022

During the study period between 2014 and 2022, a 9.5% increase in the number of university students enrolled in Colombia was observed, with a total of 419,940 new enrollees. The objective of this research was to analyze trends and cycles in university enrollments, focusing on the impact of the COVID-19 pandemic and the growth of the virtual modality. The methodology included analyzing data from the National Higher Education Information System (SNIES) and performing calculations to evaluate variations in enrollments over the years. The results allowed visualizing the enrollment cycles between private and official sector universities, highlighting that the pandemic generated a significant decrease in enrollments in 2020, mainly affecting private universities. An increase in the gap between enrollment in the official and private sector was observed, with the latter losing ground. The virtual modality experienced exponential growth in the last 8 years and as a result of the pandemic became an important factor in the university enrollment market, especially in graduate programs in the private sector and undergraduate programs in the formal sector. In summary, the study reveals the transformation of the university enrollment landscape in Colombia, due to changes in student preferences between sector and mode of study. These findings may be valuable for decision making in educational institutions and provide a deeper understanding of trends in higher education in the Colombian context.

Faktor-Faktor Yang Mempengaruhi Nilai Konstruksi Di Indonesia Dengan Regresi Poisson dan Regresi Binomial Negatif

Abstract. The construction sector is one of the drivers of national economic growth, contributing 10.6% to the National GDP. The capitalization value of the construction sector continues to increase from year to year due to an increase in the industrial sector in the private sector and infrastructure acceleration programs launched by the government in several provinces. However, this has led to a lack of equitable distribution of infrastructure development in several other provinces. To help the government carry out equitable infrastructure development, which can then help the national economy, an analysis is needed to find out what factors affect the construction value of each province in Indonesia. The relationship between the value of the construction and the factors that influence it can be determined by regression analysis. The regression analysis method used in this study is Poisson regression and negative binomial regression. Negative binomial regression is performed specifically to overcome overdispersion in Poisson regression. After the analysis, the results of the factors that have a statistical influence on the value of construction in Indonesia (NK) are the number of workers in each province (JTK) and the number of construction companies in each province (JP) with a pseudo R2 value of 0.978 or 97.8%.
 

PQA measures to expand beyond dispensing and claims data

The shift to quality-based incentives continues to emerge in pharmacy. The Pharmacy Quality Alliance (PQA) is currently working to develop pharmacy measures for A1C and blood pressure reporting; adherence to medications for hypertension, high cholesterol, and diabetes treatment; and antidepressant medication management. These are important measures that address chronic, high-cost, and high-burden diseases, PQA noted. According to Lynn Pezzullo, RPh, senior director of quality innovation at PQA, there’s a strong interest in these measures not only from payers, but also because pharmacists are able to directly improve their patients’ health in these areas. The measures, once completed, will be appropriate to use in value-based plan pharmacy agreements. PQA’s work on these new measures began in 2020, a continuation of work on pharmacy measures that started in 2019. Their efforts were in response to interest from members and policymakers who wanted to better evaluate pharmacy quality as well as assess pharmacist-provided care and pharmacy-based services. “Multistakeholder groups have helped in the prioritization and development of these measures,” said Pezzullo. Moving to an outcomes-based system of care means developing clinical measures to assess whether patients are meeting specified clinical goals. PQA got its start in 2006 developing performance measures that center on addressing the appropriate and safe use of medications. The work began with measures for the Medicare Part D prescription drug program. Within Medicare Part D, the Medicare star ratings program awards quality bonus payments within the Medicare Advantage program on the basis of how well health plans execute a set of performance measures. Five PQA measures are included in the Medicare Part D star ratings program. There are three types of PQA measures: ▪Performance measures▪Monitoring measures▪Quality improvement indicatorsOnly PQA performance measures can be used in accountability programs and only for the intended level of attribution.PQA measures are grouped into four domains: ▪Adherence▪Appropriate medication use▪Medication safety▪Medication management servicesPQA has two measure sets focused on opioids and specialty medications. Most PQA measures are for evaluating health plan performance and quality improvement. PQA also has a set of pharmacy measures for evaluating pharmacy performance and quality improvement. There are three types of PQA measures: ▪Performance measures▪Monitoring measures▪Quality improvement indicators Only PQA performance measures can be used in accountability programs and only for the intended level of attribution. PQA measures are grouped into four domains: ▪Adherence▪Appropriate medication use▪Medication safety▪Medication management services PQA has two measure sets focused on opioids and specialty medications. Most PQA measures are for evaluating health plan performance and quality improvement. PQA also has a set of pharmacy measures for evaluating pharmacy performance and quality improvement. However, PQA measures are beginning to be used in other sectors, including state-based and private sector programs. Overall, 15 PQA measures are used across CMS’ quality programs and more are used in state and regional quality programs. “Our measures we develop can be used beyond Medicare Part D,” said Pezzullo. This is especially true as more pharmacists move away from dispensing and toward providing patient care services. Even so, the new PQA pharmacy measures in development align with CMS’s star ratings program as well as CMS’s Healthcare Effectiveness data and Information Set (HEDIS) measures, which are a set of standardized performance measures that provide purchasers and consumers with information to compare health plan performance. PQA’s foundational measures rely on prescription claims data. But in the shift to value-based care, the performance measures being developed by PQA are based on pharmacy data that expand beyond dispensing and claims data. “Health plans recognize that pharmacists improve patients’ outcomes,” said Pezzullo. For example, pharmacists can close gaps in care by administering appropriate immunizations to patients and improve clinical measures such as A1C levels. “Improving patients’ health outcomes is a goal for all stakeholders across health care,” Pezzullo said. PQA aims to complete development of these pharmacy measures and have them available for use by early 2022 and 2023.

The treatment gap for mental disorders in adults enrolled in HIV treatment programmes in South Africa: a cohort study using linked electronic health records.

Mental disorders are common in people living with HIV (PLWH) but often remain untreated. This study aimed to explore the treatment gap for mental disorders in adults followed-up in antiretroviral therapy (ART) programmes in South Africa and disparities between ART programmes regarding the provision of mental health services. We conducted a cohort study using ART programme data and linked pharmacy and hospitalisation data to examine the 12-month prevalence of treatment for mental disorders and factors associated with the rate of treatment for mental disorders among adults, aged 15-49 years, followed-up from 1 January 2012 to 31 December 2017 at one private care, one public tertiary care and two pubic primary care ART programmes in South Africa. We calculated the treatment gap for mental disorders as the discrepancy between the 12-month prevalence of mental disorders in PLWH (aged 15-49 years) in South Africa (estimated based on data from the Global Burden of Disease study) and the 12-month prevalence of treatment for mental disorders in ART programmes. We calculated adjusted rate ratios (aRRs) for factors associated with the treatment rate of mental disorders using Poisson regression. In total, 182 285 ART patients were followed-up over 405 153 person-years. In 2017, the estimated treatment gap for mental disorders was 40.5% (95% confidence interval [CI] 19.5-52.9) for patients followed-up in private care, 96.5% (95% CI 95.0-97.5) for patients followed-up in public primary care and 65.0% (95% CI 36.5-85.1) for patients followed-up in public tertiary care ART programmes. Rates of treatment with antidepressants, anxiolytics and antipsychotics were 17 (aRR 0.06, 95% CI 0.06-0.07), 50 (aRR 0.02, 95% CI 0.01-0.03) and 2.6 (aRR 0.39, 95% CI 0.35-0.43) times lower in public primary care programmes than in the private sector programmes. There is a large treatment gap for mental disorders in PLWH in South Africa and substantial disparities in access to mental health services between patients receiving ART in the public vs the private sector. In the public sector and especially in public primary care, PLWH with common mental disorders remain mostly untreated.

Bridging the Digital Divide: What Has Not Worked But What Just Might

America has spent billions trying to close the Digital Divide, but adoption disparities along many dimensions persist. The COVID pandemic has rekindled the strong interest in broadband adoption, with many in Congress now proposing to spend billions more to shrink the adoption gap. In this POLICY PAPER, we first offer an economic analysis of how best to spend broadband subsidies. As might be expected, the analysis prescribes that money should be spent where it is most effective (per dollar) at increasing adoption. Second, we offer an empirical analysis of past broadband adoption programs by quantifying the effect of several programs established by the American Reinvestment and Recovery Act of 2009. Applying a Difference-in-Differences model to Census data on adoption, we find no positive effect on home broadband adoption from programs funded by the Broadband Technology Opportunity Program (“BTOP”). Third, we discuss the potential benefits of direct subscriber subsidies considering the successful private sector programs offering low-cost broadband plans to low-income and other qualifying households. Direct subsidies to end-users will increase adoption, but surveys and empirical evidence prescribe sober expectations on their effectiveness at achieving universal adoption. Subsidizing broadband infrastructure deployment in unserved areas is a direct approach to increase broadband adoption, but even so the costs in some regions may outweigh the benefits.

Direct primary care-Where does integrated behavioral health fit?

Primary care is increasingly viewed as key to growing health system market share in value-based purchasing strategies for both public- and private-sector programs. Yet not all primary care physicians are interested in becoming part of large multispecialty practices or working in employed arrangements. Instead, a growing number of physicians are launching independent direct primary care (DPC) practices in order to maintain professional autonomy, mitigate burnout, and ensure long-term meaningful engagement with patients and families. Given that the typical size of a DPC care team is small, what does this mean for integrating behavioral health? As primary care evolves under various payment and delivery models, the integration of behavioral health services will require adaptability based on practice size, scope of practice, patient acuity, and payment model. Indeed, advocates of integrated behavioral health can "skate to where the puck is going to be"1 by familiarizing themselves with innovations in primary care, such as the DPC model. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Challenges and opportunities to livestock breeding programmes in India.

Animal breeding in India has a long and chequered history. High pressure on agricultural land and increasing human population opened a new opportunity for the livestock and poultry sector as a promising food industry. Productivity of livestock in India is low due to less coverage of livestock under structured breeding programmes, inadequate nutrition and its entanglement with several socio-economic issues. A bottom-up approach to breeding policy formulation addressing local needs is required with assured flow of investments. Cattle slaughter is banned in India; hence, a legal policy to curb widespread indiscriminate mating is required which may incur substantial financial and infrastructural burdens for castration of stray males and strengthening of cow rehabilitation centres. Genetic evaluation of indigenous cattle with progeny testing (PT) requires substantial financial support, without affecting the already existing PT for exotic cattle breeds used in the local cross-breeding programmes and PT of new genotypes obtained from crosses of exotic and local breeds of cattle and for purebred buffaloes. Small ruminants need special attention due to their socio-economic importance in rural and often highly disadvantaged communities and because they are the second most important meat-producing species after poultry. Genetic improvement of small ruminants should be accompanied by attention to shrinking grazing resources which would require strong political will together with financial support. The outreach of breeding programmes for small ruminants is currently limited; there is also a lack of linkage between the market and producers that discourages farmers from adopting clear breeding objectives like improvement in growth rate, as animals are seldom sold on weight basis. Apart from government agencies, involvement of private sector, non-government organizations, local co-operatives, self-help groups and self-sustainable community-based breeding programmes can strengthen market linkages. Strengthening of the existing infrastructure along with technical input and skilled manpower is essential for achieving the breeding objectives.

A multi-country study of the economic burden of dengue fever: Vietnam, Thailand, and Colombia

BackgroundDengue fever is a major public health concern in many parts of the tropics and subtropics. The first dengue vaccine has already been licensed in six countries. Given the growing interests in the effective use of the vaccine, it is critical to understand the economic burden of dengue fever to guide decision-makers in setting health policy priorities.Methods/Principal findingsA standardized cost-of-illness study was conducted in three dengue endemic countries: Vietnam, Thailand, and Colombia. In order to capture all costs during the entire period of illness, patients were tested with rapid diagnostic tests on the first day of their clinical visits, and multiple interviews were scheduled until the patients recovered from the current illness. Various cost items were collected such as direct medical and non-medical costs, indirect costs, and non-out-of-pocket costs. In addition, socio-economic factors affecting disease severity were also identified by adopting a logit model. We found that total cost per episode ranges from $141 to $385 for inpatient and from $40 to $158 outpatient, with Colombia having the highest and Thailand having the lowest. The percentage of the private economic burden of dengue fever was highest in the low-income group and lowest in the high-income group. The logit analyses showed that early treatment, higher education, and better knowledge of dengue disease would reduce the probability of developing more severe illness.Conclusions/SignificanceThe cost of dengue fever is substantial in the three dengue endemic countries. Our study findings can be used to consider accelerated introduction of vaccines into the public and private sector programs and prioritize alternative health interventions among competing health problems. In addition, a community would be better off by propagating the socio-economic factors identified in this study, which may prevent its members from developing severe illness in the long run.

Increasing family planning in Myanmar: the role of the private sector and social franchise programs

BackgroundThis study examines the influence of clinical social franchise program on modern contraceptive use.MethodsThis was a cross-sectional survey of contraceptive use among 2390 currently married women across 25 townships in Myanmar in 2014. Social franchise program measures were from programmatic records.ResultsMultivariable models show that women who lived in communities with at least 1-5 years of a clinical social franchise intrauterine device (IUD) program had 4.770 higher odds of using a modern contraceptive method compared to women living in communities with no IUD program [CI: 3.739-6.084]. Townships where the reproductive health program had existed for at least 10 years had 1.428 higher odds of reporting modern method use compared to women living in townships where the programs had existed for less than 10 years [CI: 1.016-2.008].ConclusionsThis study found consistent and robust evidence for an increase in family planning methods over program duration as well as intensity of social franchise programs.

Coverage of private sector community midwife services in rural Punjab, Pakistan: development and demand.

BackgroundIn 2007, the Government of Pakistan introduced a new cadre of community midwives (CMWs) to address low skilled birth attendance rates in rural areas; this workforce is located in the private-sector. There are concerns about the effectiveness of the programme for increasing skilled birth attendance as previous experience from private-sector programmes has been sub-optimal. Indonesia first promoted private sector midwifery care, but the initiative failed to provide universal coverage and reduce maternal mortality rates.MethodsA clustered, stratified survey was conducted in the districts of Jhelum and Layyah, Punjab. A total of 1,457 women who gave birth in the 2 years prior to the survey were interviewed. χ2 analyses were performed to assess variation in coverage of maternal health services between the two districts. Logistic regression models were developed to explore whether differentials in coverage between the two districts could be explained by differential levels of development and demand for skilled birth attendance. Mean cost of childbirth care by type of provider was also calculated.ResultsOverall, 7.9% of women surveyed reported a CMW-attended birth. Women in Jhelum were six times more likely to report a CMW-attended birth than women in Layyah. The mean cost of a CMW-attended birth compared favourably with a dai-attended birth. The CMWs were, however, having difficulty garnering community trust. The majority of women, when asked why they had not sought care from their neighbourhood CMW, cited a lack of trust in CMWs’ competency and that they wanted a different provider.ConclusionsThe CMWs have yet to emerge as a significant maternity care provider in rural Punjab. Levels of overall community development determined uptake and hence coverage of CMW care. The CMWs were able to insert themselves into the maternal health marketplace in Jhelum because of an existing demand. A lower demand in Layyah meant there was less ‘space’ for the CMWs to enter the market. To ensure universal coverage, there is a need to revisit the strategy of introducing a new midwifery workforce in the private sector in contexts of low demand and marketing the benefits of skilled birth attendance.

Transport demand management - Impacts on congestion alleviation and road safety enhancement in urban areas

Most of the world's population and economic growth is occurring in the cities. Essential as the movements of people and goods are to the economic and social aspects of urban life, they present people and their surrounding with the ever-increasing problems. As a consequence, world's cities face traffic congestion associated with imbalance of the available road space and operation vehicles, slow traffic flow, poor access to main activity centers, high transport cost, waste of time, psychological effects, decline productivity and increase discomfort. Vehicle emissions have their economic and health effects. Road accidents and their fatalities and injuries, pedestrian movements, socioeconomic impacts, inefficient road infrastructure, and unsafe design are also critical issues. To overcome urban transport problems, the UN Habitat has stressed that the conventional solutions of transport planning have proven their inefficiency during the past decades. The pattern and cost of land use, urban structure, population distribution, tight budget, stand-alone projects, lack of expertise, and other factors restrict the impose of successful road facility. Besides, maximizing road network capacity is not the only solution to tackle transport problems, due to the facts of high demand for urban road space and less supply, transport problems are accelerating at higher rate than population and economic growth, and building new road infrastructure requires long period due to complex project cycles. Introduction of the traditional traffic management measures to control vehicle operations is also proved partial solution. Transfer from private vehicles to public transport use is not fully acceptable solution by majority of the community in some countries beside lack of current public transport services. Another serious obstacle is institutional, due to involvement of several organizations in the transport sector, lack of interagency coordination, insufficient enforcement, unavailability of common policy and performance indicators, and insufficient information. Community concern about transport efficiency and the negative drawbacks has increased. Politician and government agencies face increasing pressure to protect the quality of urban environment, create livable cities, maintain the right access and run efficient and integrated transport system. At present, Transport Demand Management (TDM) is emerging as a fashionable concept among planners and decision-makers for sustainable urban development and minimizing transport drawbacks, since traditional transport techniques have reached their effective limits in most cities. The paper addressee merits of the TDM which aim to modify trip makers behavior and habits, reduce use of private vehicles (drive-alone transport), influence mode choice, minimize travel time, alleviate congestion and enhance road safety. Assessment is presented into the practical techniques of the TDM such as congestion charging, public transport priorities, sustainable road network development, ridesharing schemes, service centers, transport-land use planning, communications, restricting use of road space and vehicles, private sector programs, school programs, working hour schemes, and traffic monitoring centers. The paper also explores development conditions, programs and performance of the TDM systems in different parts of the world such as London, Singapore, Stockholm, Dubai and Victoria (Australia) which alleviated congestion, enhanced road safety, and promoted equity in transport accessibility for passengers, pedestrians, freight, community and economic viability. The paper stresses that TDM is the only sustainable approach to accommodate the ever-increasing demand for travel and tackle transport problems, as part of a comprehensive and balanced policy for today and future cities. TDM should be associated with shift in behavior, involvement of private sector, community groups and government organizations, efficient institutional capacity, action plan, and lead agency. TDM program should be linked with the national vision, transport system, development plan, and community benefits and expectations through short term and long-term strategy. Government leadership is crucial.

Public-private Partnership Approaches for Scaling up Zinc with ORS

Objectives: Based on evidence from four previous private sector programs, USAID's SHOPS project, in partnership with the Ghana Health Service, developed a strategy to maximize availability of, demand for, and use of zinc plus oral rehydration solution (ORS) for the treatment of pediatric diarrheas. This abstract describes the private sector-focused strategy for addressing high diarrhea prevalence among children under five in Ghana.
 Methods: SHOPS established a conducive policy and regulatory environment, engaging stakeholders from both sectors; collaborated with regulatory bodies to train over 10,000 chemical sellers and pharmacy staff and 350 clinicians in diarrhea management; partnered with pharmaceutical manufacturers to increase availability of quality, affordable products; developed an innovative campaign to increase awareness and demand; and partnered with NGOs to promote use through community mobilization. We conducted in-depth interviews and mystery client surveys with providers to assess reported and actual prescribing behavior.
 Results: Private sector sales of zinc tablets increased ten-fold after training providers and 300% after the media campaign, treating over 2 million children with diarrhea to date. Most (75%) providers mentioned zinc as their preferred diarrhea treatment; 65% actually prescribed zinc with ORS as treatment. Retail audits confirm over 60% of chemist shops and pharmacies carry zinc and ORS. These results are notable in that zinc was completely unknown and unavailable in Ghana prior to the initiation of the program in 2012.
 Conclusions: In a single year, significant progress in scaling up diarrhea treatment was realized through strategic partnerships with the private sector in Ghana.

Postgraduate Emergency Medicine Training in India: An Educational Partnership with the Private Sector

BackgroundEmergency medicine (EM) is a recently recognized specialty in India, still in its infancy. Local training programs are developing, but remain very limited. Private, for-profit hospitals are an important provider of graduate medical education (GME) in India, and are partnering with United States (US) universities in EM to expand training opportunities. ObjectiveOur aim was to describe current private-sector programs affiliated with a US university providing postgraduate EM training in India, the evolution and structure of these programs, and successes and challenges of program implementation. DiscussionPrograms have been established in seven cities in India in partnership with a US academic institution. Full-time trainees have required didactics, clinical rotations, research, and annual examinations. Faculty members affiliated with the US institution visit each program monthly. Regular evaluations have informed program modifications, and a local faculty development program has been implemented. Currently, 240 trainees are enrolled in the EM postgraduate program, and 141 physicians have graduated. A pilot survey conducted in 2012 revealed that 93% of graduates are currently practicing EM, 82% of those in India; 71% are involved in teaching, and 32% in research. Further investigation into programmatic impacts is necessary. Challenges include issues of formal program recognition both in India and abroad. ConclusionsThis unique partnership is playing a major early role in EM GME in India. Future steps include official program recognition, expanded numbers of training sites, and a gradual transition of training and education to local faculty. Similar partnership programs may be effective in other settings outside of India.

Student Profile of System Expertise Training in Private Sector and the Reasons for Choosing This Training

It is widely known that there are many schools in the private sector offering courses in Computer Technology, Computer Engineering, Information Systems and similar disciplines in addition to Universities presenting such courses. The private sector programs are extremely popular with students already studying at university as well as being of great interest to previously graduated university students. The first purpose of this study is to determine the percentage of university students who attend System Expertise (SE) education programs. Both previously graduated and presently studying students have been included. Secondly it aims to understand the reasons behind the attendance of such courses by students who are already studying a similar curriculum or have previously studied and graduated in similar and related fields.

System Expertise Training Courses In Private Sector: Can They Be Given Online?

It is widely known that there are many schools in the private sector offering courses in Computer Technology, Computer Engineering, Information Systems and similar disciplines in addition to Universities presenting such courses. The private sector programs are extremely popular with students already studying at university as well as being of great interest to previously graduated university students. The first purpose of this study is to determine the percentage of university students who attend theses education programs. Both previously graduated and presently studying students have been included. Secondly it aims to understand the reasons behind the attendance of such courses by students who are already studying a similar curriculum or have previously studied and graduated in similar and related fields. In the light of this information, some suggestions have been made about giving these courses as online.

INCUBACIÓN EMPRESARIAL EN LA UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS: UNA ESTRATEGIA PARA EFECTIVIZAR SU COMPROMISO CON EL DESARROLLO ECONÓMICO Y SOCIAL DEL PAÍS

El presente artículo trata sobre la temática de la incubación empresarial universitaria buscando generar una corriente de opinión en autoridades, docentes y estudiantes de la Facultad de Ciencias Contables en torno a la importancia y necesidad de gestionar el desarrollo del potencial emprendedor del alumnado de la carrera contable, proyectándolo como una alternativa de acción que permita: canalizar una vinculación más efectiva entre la universidad y el medio empresarial, a la vez de concebirla como una de las estrategias para cumplir con la visión institucional de compromiso con el desarrollo económico y social del país. Entre los aspectos expuestos se consideraron: la conceptualización de la incubación de empresas, su evolución y grado de desarrollo alcanzado, características e implicancias de los procesos de incubación, además de una revisión del contexto país y condiciones en el escenario socioeconómico y académico para la gestación de un programa de incubación empresarial. A modo genérico se concluye que a nivel país es actualmente escaso el número de universidades que cuentan con programas de incubación y las pocas existentes todavía mantienen un escaso nivel de difusión en cuanto a su grado de desarrollo; Brasil y México son los países latinoamericanos que mayor número de centros de incubación concentran; no obstante a nivel de Latinoamérica en términos generales, salvo escasas excepciones, la incubación empresarial todavía es un tema que se está forjando teniendo aun que superar limitaciones sobre todo en el tema de gestión e insuficiencia de recursos.

Calling upon the Genius of Private Enterprise: The Housing and Urban Development Act of 1968 and the Liberal Turn to Public-Private Partnerships

President Lyndon Johnson declared the Housing and Urban Development Act of 1968 to be “the most farsighted, the most comprehensive, the most massive housing program in all American history.” To replaceeveryslum dwelling in the country within ten years, the act turned from public housing, the government-run program started in the 1930s, toward private-sector programs using both nonprofit and for-profit companies. As a result, since its passage, for-profit businesses have developed the great majority of low-income residences in the United States. The law also helped popularize the idea of “public-private partnerships,” collaborations of government agencies and non-government entities—including for-profit companies—for social and urban improvements. Remarkably, political liberals supported the idea that private enterprise carry out social-welfare programs. This article examines the reasons that Democratic officials, liberals, and housing industry leaders united to create a decentralized, ideologically pluralistic, and redundant system for low-income housing. It shows that frustrations with the public housing program, the response to widespread violence in the nation's cities, and the popularity of corporate America pushed the turn toward the private sector. The changes in housing and urban policy made in the late 1960s, the article concludes, helped further distinguish the American welfare state and encourage the rise of neoliberalism in the United States.

American Heart Association Guide for Improving Cardiovascular Health at the Community Level, 2013 Update

The goal of this American Heart Association Guide for Improving Cardiovascular Health at the Community Level (AHA Community Guide) is to provide a comprehensive inventory of evidence-based goals, strategies, and recommendations for cardiovascular disease (CVD) and stroke prevention that can be implemented on a community level. This guide advances the 2003 AHA Community Guide1 and the 2005 AHA statement on guidance for implementation2 by incorporating new evidence for community interventions gained over the past decade, expanding the target audience to include a broader range of community advocates, aligning with the concepts and terminology of the AHA 2020 Impact Goals, and recognizing the contributions of new public and private sector programs involving community interventions. In recent years, expanding arrays of programs and policies have been implemented in increasingly diverse communities to provide tools, strategies, and other best practices to potentially reduce the incidence of initial and recurrent cardiovascular events. The AHA Community Guide complements the AHA statement entitled “Population Approaches to Improve Diet, Physical Activity, and Smoking Habits”3 and supports the AHA 2020 goal4 to “improve the cardiovascular health of all Americans by 20%, while reducing deaths from CVDs and stroke by 20%.” The present AHA Community Guide supports the AHA 2020 goal by identifying exemplary regional or national programs that encourage cardiovascular health behaviors and health factors (formerly addressing risk behaviors and risk factors) from which communities might acquire proven strategies, expertise, and technical assistance for improving cardiovascular health. The AHA Community Guide seeks to prevent the onset of disease (primary prevention) and to maintain optimal cardiovascular health (primordial prevention) among broader segments of the population. Prior research indicates that using public health strategies such as sodium reduction in processed foods to lower blood pressure,5–8 tobacco laws to promote smoking cessation,9–11 and modification of …

A Protocol to Evaluate Drug-Related Workplace Impairment

ABSTRACTThe dramatic increase in the use and abuse of prescription controlled substances, cannabis, and a rapidly evolving array of legal and illegal psychotropic drugs has led to a growing concern by employers about workplace impairment, incidents, and accidents. The Federal Workplace Drug Testing Programs, which serve as a template for most private sector programs, focus on a small group of illicit drugs, but disregard the wider spectrum of legal and illegal psychotropic drugs and prescription controlled substances. We propose a protocol for the evaluation of workplace impairment, based on comprehensive drug and alcohol testing at the time of suspected impairment, followed expeditiously by a comprehensive physician evaluation, including a focused medical history with an emphasis on controlled substance use, physical and mental status examinations, evaluation of employee adherence to prescription medication instructions, additional drug testing if indicated, use of collateral sources of information, and querying of state prescription monitoring databases. Finally, we propose suggestions for optimizing the evaluation of drug-related workplace impairment.

“NAEYC’s Key Attributes of Quality Preschool Programs” Applied to the Jordanian Kindergarten Context

Jordan’s education system is currently undergoing rigorous and comprehensive reform processes that focus on improving the status of educational policies and experiences for students in kindergarten through 12th grade. Kindergarten education in Jordan has been dominated until recently, by the private-sector. For the past decade, the Ministry of Education has taken initiative to provide government-funded kindergarten programs. The main objective of this research was to evaluate program practices implemented by private and public-sector programs and examine their alignment with Developmentally Appropriate Practices. Using NAEYC’s “Top 10 Signs of a Good Kindergarten Classroom” as evaluative guidelines, observational data was collected from 118 classrooms (50-private, 68-public). Demographic data were also obtained from classroom teachers; level of education, specialty, and years of experience. The results of the analysis revealed significant differences in application of the 10 NAEYC guidelines between public and private-sector programs. Ministry of Education kindergarten classroom practices were found to be closely aligned to best practices compared to private-sector programs. Also, teachers with bachelor’s degrees and those with early childhood education backgrounds outperformed their counterparts in the application of Developmentally Appropriate Practices. Years of experience yielded no significant results for this sample of teachers. Reflecting on the results of this study, several recommendations were posed.