Investigating the Sustainability of Outcomes in a Chronic Disease Treatment Programme

This study examines trends in chronic disease outcomes from initiation of a specialised chronic disease treatment programme through to incorporation of programme activities into routine service delivery. We reviewed clinical records of 98 participants with confirmed renal disease or hypertension in a remote indigenous community health centre in Northern Australia. For each participant the review period spanned an initial three years while participating in a specialised cardiovascular and renal disease treatment programme and a subsequent three years following withdrawal of the treatment programme. Responsibility for care was incorporated into the comprehensive primary care service which had been recently redeveloped to implement best practice care plans. The time series analysis included at least six measures prior to handover of the specialised programme and six following handover. Main outcome measures were trends in blood pressure (BP) control, and systolic and diastolic BP. We found an improvement in BP control in the first 6-12 months of the programme, followed by a steady declining trend. There was no significant difference in this trend between the pre- compared to the post-programme withdrawal period. This finding was consistent for control at levels below 130/80 and 140/90, and for trends in mean systolic and diastolic BP. Investigation of the sustainability of programme outcomes presents major challenges for research design. Sustained success in the management of chronic disease through primary care services requires better understanding of the causal mechanisms related to clinical intervention, the basis upon which they can be 'institutionalised' in a given context, and the extent to which they require regular revitalisation to maintain their effect

On attracting investment to Russian economy

Modern conditions of economic systems development have necessitated more precise directions of investment process for the economic growth to accelerate. The precipitous fall of oil prices that occurred in the second half of 2014 weighed heavily on foreign direct investment flows to oilexporting countries. The problem of attracting investment is one of the key problems of economic development. The aim of this study is to analyze and evaluate the shifts in the structure of investments, the study of the structure of investments to the Russian economy. Structural changes result from differences in the growth rate of the elements forming an economic system. An integral coefficient has been used for evaluation of structural changes. Multiple regression was used to analyze the impact of various factors on the change in structure of investment. The regression coefficients in the model give quantitative assessment of the pace of change in the structure as it depends on a specific factor. The model estimation shows that the variables “share of investments in manufacturing” (positive influence) and “share of investments in the health, physical culture, education” (negative influence) have the largest t-values. Hence, these two factors influence the structural changes in investments most strongly The evaluation and analysis of the structural shifts may lead to conclusions regarding the efficiency of the structure investment and adjustment of the economic policy

Social work-generated evidence in traumatic brain injury from 1975 to 2014: a systematic scoping review

The International Network for Social Workers in Acquired Brain Injury (INSWABI) commissioned a systematic scoping review to ascertain the social work-generated evidence base on people with traumatic brain injury (TBI) of working age. The review aimed to identify the output, impact and quality of publications authored by social workers on this topic. Study quality was evaluated through assessment frameworks drawn from the United Kingdom National Service Framework for Long-Term Conditions. In the 40-year period from 1975 to 2014, 115 items were published that met the search criteria (intervention studies, n = 10; observational studies, n = 52; literature reviews, n = 6; expert opinion or policy analysis, n = 39; and others, n = 8). The publications could be grouped into five major fields of practice: families, social inclusion, military, inequalities and psychological adjustment. There was a significant increase in the number of publications over each decade. Impact was demonstrated in that the great majority of publications had been cited at least once (80.6%, 103/115). Articles published in rehabilitation journals were cited significantly more often than articles published in social work journals. A significant improvement in publication quality was observed across the four decades, with the majority of studies in the last decade rated as high quality

Requerimento propondo construir a futura capital federal sem ônus para os cofres públicos, desde que o governo, autorizado por lei, contrate os proponentes diretamente ou a empresa que organizarem, nos termos da proposta oferecida

Descrição do item documental.Documento pertence ao Arquivo da Câmara dos Deputados.Consta a proposta para a construção da futura capital federal