Support Activities Research Articles

On the scope of mechanochemical activation: The case of Cu/ZnO catalytic systems

ZnO was submitted to different conditions of high-energy ball milling to thoroughly study the outcome of mechanochemical activation. Structural modifications led to a decrease in crystallite size and an increase in micro-strain and specific surface area (SBET) with milling time. Different copper amounts were added on pristine (reference) and activated support by incipient wetness impregnation. Cu deposited over activated support showed an enhanced metal-support interaction since part of Cu2+ could be introduced into milled ZnO lattice, replacing Zn2+ ions and/or locating in lattice interstitials. Moreover, further analyses suggested an electron transfer from activated support to metal, generating a mixture of Cu2O–CuO species, particularly at the interface between metal and support. N2O chemisorption studies gave Cu particle sizes of 1.3, 1.9 and 3.5 nm (for 0.2, 0.5 and 1 wt% Cu, respectively) and thus a good metal dispersion over ZnO was achieved. Hence, support's activation by milling process showed to be an excellent approach to improve both metal-support interaction and metal dispersion of supported catalysts.

Evaluating Uptake of Evidence-Based Interventions in 355 Clinics Partnering With the Colorectal Cancer Control Program, 2015-2018.

Purpose and ObjectivesColorectal cancer screening rates remain suboptimal in the US. The Colorectal Cancer Control Program (CRCCP) of the Centers for Disease Control and Prevention (CDC) seeks to increase screening in health system clinics through implementation of evidence-based interventions (EBIs) and supporting activities (SAs). This program provided an opportunity to assess the uptake of EBIs and SAs in 355 clinics that participated from 2015 to 2018.Intervention ApproachThe 30 funded awardees of CRCCP partnered with clinics to implement at least 2 of 4 EBIs that CDC prioritized (patient reminders, provider reminders, reducing structural barriers, provider assessment and feedback) and 4 optional strategies that CDC identified as SAs (small media, professional development and provider education, patient navigation, and community health workers).Evaluation MethodsClinics completed 3 annual surveys to report uptake, implementation, and integration and perceived sustainability of the priority EBIs and SAs.ResultsIn our sample of 355 clinics, uptake of 4 EBIs and 2 SAs significantly increased over time. By year 3, 82% of clinics implemented patient reminder systems, 88% implemented provider reminder systems, 82% implemented provider assessment and feedback, 76% implemented activities to reduce structural barriers, 51% implemented provider education, and 84% used small media. Most clinics that implemented these strategies (>90%) considered them fully integrated into the health system or clinic operations and sustainable by year 3. Fewer clinics used patient navigation (30%) and community health workers (19%), with no increase over the years of the study.Implications for Public HealthClinics participating in the CRCCP reported high uptake and perceived sustainability of EBIs that can be integrated into electronic medical record systems but limited uptake of patient navigation and community health workers, which are uniquely suited to reduce cancer disparities. Future research should determine how to promote uptake and assess cost-effectiveness of CRCCP interventions.

Factors That Support Sustainability of Health Systems Change to Increase Colorectal Cancer Screening in Primary Care Clinics: A Longitudinal Qualitative Study.

From 2015 to 2020, the Centers for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP) supported 30 awardees in partnering with primary care clinics to implement evidence-based interventions (EBIs) and supporting activities (SAs) to increase colorectal cancer (CRC) screening. This study identified factors that facilitated early implementation and sustainability within partner clinics. We conducted longitudinal qualitative case studies of four CRCCP awardees and four of their partner clinics. We used the Consolidated Framework for Implementation Research (CFIR) to frame understanding of factors related to implementation and sustainability. A total of 41 semi-structured interviews were conducted with key staff and stakeholders exploring implementation practices and facilitators to sustainability. Qualitative thematic analysis of interview transcripts identified emerging themes across awardees and clinics. Qualitative themes related to six CFIR inner setting constructs-structural characteristics, readiness for implementation, networks and communication, culture, and implementation climate-were identified. Themes related to early implementation included conducting readiness assessments to tailor implementation, providing moderate funding to clinics, identifying clinic champions, and coordinating EBIs and SAs with existing clinic practices. Themes related to sustainability included the importance of ongoing electronic health record (EHR) support, clinic leadership support, team-based care, and EBI and SA integration with clinic policies, workflows, and procedures. Findings help to inform future scale-up of and decision-making within CRC screening programs and other chronic disease prevention programs implementing EBIs and SAs within primary care clinics and also highlight factors that maximize sustainability within these programs.

Global Trade Union Rights Situation Worsening

REPORT□ TRADEUNIONRIGHTSWORLDWIDE Global Trade Union Rights Situation Worsening 76 TradeUnionists Murderedin2008 Thousands of Dismissals and Arrests Repressionof Striking Workers in40 Countries Human and Trade Union Rights Department, International Trade Union Confederation For more information, contact ITUC Human and Trade Union Rights Department: tur@ituc-csi.org 2008world, ous was year according another fortrade to difficult this unionists year's and often ITUC around dangerAnnual the ous year fortradeunionistsaround the world, according tothisyear'sITUCAnnual Survey of TradeUnionRights Violations, which detailsabuses of fundamental workers' rights in 143countries. 76 tradeunionists werekilleddue to theiractionsto defendworkers'rights, and manymorewereattacked physically orsubjected toharassment, intimidation orarrest bytheauthorities . While theworldwide total ofkillings fell from 91 thepreviousyear,thenumberof killings in Colombia, whichis notorious as themostdangerous placeon earth fortrade unionists, reached49 - an increaseof 10 overtheprevious year.The upsurge in killings tookplace despiteassurances by the Administration of ColombianPresident Alvaro Uribethat thesituation was improving. Asidefrom theappalling tollinColombia, nine unionists weremurdered in Guatemala, whichin recent years hasseenanincrease inviolent attacks against tradeunionrepresentatives andmembers. Fourwerekilledin thePhilippines as wellas in Venezuela, threein Honduras, twoin Nepaland one each in Iraq,Nigeria, Panama,Tunisiaand Zimbabwe, wheretheMugaberegime continued its reignof terror againstthe country's union movement. Ina number ofinstances, governments wereeither directly or indirectly involvedin the killings. A totalof 50 seriousdeaththreats were recordedacrossseven countries as well, along with some100casesofphysical assaults across25 countries. Governments inatleastninecountries (Burma, Burundi, China,Cuba,Iran,SouthKorea,Tunisia, Turkeyand Zimbabwe) were responsiblefor imprisoning tradeunionists on accountof their legitimate activities insupport ofworking people. "Governments inevery region areclearly failing toprotect fundamental workers' rights, andinseveralcaseswerethemselves responsible forheavy repression of theserights. The factthatcertain countries, suchas Colombia, Guatemala and the Philippines appearyearafter yearonthedeathlist showsthat theauthorities are,atbest,incapable of ensuring protection and in some cases are complicitwithunscrupulous employers in the murders ", saidITUCGeneral Secretary GuyRyder. Some 7,500 cases of dismissalof workers involved intradeunionactivity wererecorded in a totalof68 countries, including 20 countries in Africa alone.Thesecases are,however, onlythe tipof theiceberg, witha greatmanymoredismissals notbeingrecorded. The country withthe worstrecordof dismissals was Turkey, where morethan2,000weredocumented andwherethe government remained intolerant ofunionactivity ingeneral. Indonesia(600) was thenexthighest, withhundreds alsodismissed inMalawi, Pakistan, TanzaniaandArgentina. In Burma,China,Laos, North Korea,Vietnam and a numberof othercountries, onlyofficial state-controlled unionswere allowedto operate whileinSaudiArabia, genuine trade unionactivityisstill effectively impossible. Heavygovernment interference in union affairs also continuedin Belarus through muchoftheyear. Theimpact oftheglobaleconomic situation on workers' rights was a prominent feature in many countries. Muchoftherepression acrossAfrica in particular involved governments reacting harshly against workers seeking to improve wagesas the globalfoodcrisis hit, withincreasing numbers of familiesunable to feed themselvesproperly. Incredibly, many oftheworst affected wereworkersintheagriculture sector itself. Later in2008,the effects oftheglobalfinancial crisis beganto hit, putting additional pressure on job security, wages andworking conditions. The trend towards increasingly harshexploitationand attacks on workers' rights intheworld's Export Processing Zones(EPZs),already a feature in previous years,worsenedin 2008.Thirty-four countries arecitedinthereport forinadequate or non-existent protection ofEPZworkers, including Albania, the Bahamas, Belize, Costa Rica, Dominican Republic,El Salvador,Guatemala, Honduras,Jamaica, Jordan, Mexico,Nicaragua, Polandand Oman.A further 22 countries aresingledoutfortheexploitation ofmigrant workers, who are oftendenied even the mostbasic of rights, andwhosesituation frequently meansthat theyare the mostvulnerable of all workers to exploitation andabuse. "Hundreds of millions of working people, in developingand in industrialised countries, are deniedthefundamental rights tofreedom ofassociation andcollective bargaining. Formany, especially thoseinprecarious employment, thisdenial wreaks havocontheir lives, as they workextremelylonghoursinhazardous orunhealthy situations withincomes so lowthat they areunabletosupportthemselves and theirhouseholdsproperly. Lackofrespect forworkers' rights has increased inequality aroundtheworld,and thatinequality helpedtrigger theglobalrecession", saidRyder. Disturbing trends in labourrights intheindustrialised countries are also evident in theSurvey, withincreasing recourseto contract labourand 'third-party' labouragencyemployment eroding incomes, conditions andrights atwork. On a more positivenote,changesin government in both Australia and in theUSAbrought thepromise of newprotections for working peopleintwocountries withextremely poorrecords inrecent years. Workers in Burkina Faso, Kenya and Mozambiquealso had some cause foroptimism, withtheadoptionofnew legislation recognising andenabling trade unionorganising, whileinthe Maldives, thecountry's new Constitution guaranteesfreedom ofassociation andtheright tostrike. INTERNATIONAL union rights Page 24 Volume 16Issue 3 2009 ...