The Norwegian experience with nationwide implementation of fetal RHD genotyping and targeted routine antenatal anti‐D prophylaxis

2021 ◽  
Author(s):  
Kirsten Sørensen ◽  
Mette S. Bævre ◽  
Geir Tomter ◽  
Abid Hussain Llohn ◽  
Kristin G. Hagen ◽  
...  
Keyword(s):  
Nationwide Implementation

scholarly journals Efficient implementation of the ‘non-biopsy approach’ for the diagnosis of childhood celiac disease in the Netherlands: a national prospective evaluation 2010–2013

2021 ◽  
Author(s):  
Caroline R. Meijer ◽  
Joachim J. Schweizer ◽  
Anne Peeters ◽  
Hein Putter ◽  
M. Luisa Mearin
Keyword(s):  
Celiac Disease ◽  
The Netherlands ◽  
Clinical Presentation ◽  
Paediatric Population ◽  
Hla Typing ◽  
Newly Diagnosed ◽  
Prospective Evaluation ◽  
Espghan Guidelines ◽  
Intestinal Symptoms ◽  
Nationwide Implementation

AbstractThe aim of this study was (1) to prospectively evaluate the nationwide implementation of the ESPGHAN-guidelines for the diagnosis of celiac disease (CD), (2) to investigate the incidence and clinical presentation of diagnosed childhood CD (0–14 years) in the Netherlands, and (3) to compare the findings with national survey data from 1975 to 1990 and 1993 to 2000 using the same approach. From 2010 to 2013, all practicing paediatricians were invited to report new celiac diagnoses to the Dutch Pediatric Surveillance Unit. Data were collected via questionnaires. A total of 1107 children with newly diagnosed CD were reported (mean age, 5.8 years; range, 10 months–14.9 years; 60.5% female). After the introduction of the non-biopsy approach in 2012, 75% of the diagnoses were made according to the guideline with a significant decrease of 46.3% in biopsies. The use of EMA and HLA-typing significantly increased with 25.8% and 62.1%, respectively. The overall incidence rate of childhood CD was 8.8-fold higher than in 1975–1990 and 2.0-fold higher than in 1993–2000. During the study period, the prevalence of diagnosed CD was 0.14%, far below 0.7% of CD identified via screening in the general Dutch paediatric population. Clinical presentation has shifted towards less severe and extra-intestinal symptoms.Conclusion: ESPGHAN guidelines for CD diagnosis in children were effectively and rapidly implemented in the Netherlands. Incidence of diagnosed CD among children is still significantly rising with a continuous changing clinical presentation. Despite the increasing incidence of diagnoses, significant underdiagnosis still remains. What is Known:• Since 2000 the incidence of diagnosed childhood CD in the Netherlands has shown a steady rise.• The rise in incidence has been accompanied by a changing clinical presentation at diagnosis. What is New:• The ESPGHAN guidelines 2012 for CD diagnosis were effectively and rapidly implemented in the Netherlands.• The incidence of diagnosed childhood CD in the Netherlands has continued to rise significantly during the reported period.

Are Specifications of Signaling Systems for Emergency, School Bus, and Service Vehicles Adequate?

1979 ◽  
Vol 23 (1) ◽  
pp. 282-284
Author(s):  
David V. Post
Keyword(s):  
Light Signaling ◽  
Highway Maintenance ◽  
School Bus ◽  
Signaling Systems ◽  
Accident Data ◽  
Lighting Systems ◽  
Service Vehicles ◽  
Nationwide Implementation

Although accident data are limited, a review of the lighting requirements for special purpose vehicles including police, fire, ambulance, highway maintenance, and service vehicles, revealed that lighting systems for these vehicles are poorly specified. A lack of consistancy, rigor, and meaningfulness is evident both in legal specifications and current use of light signaling systems on emergency and non-emergency special purpose vehicles. Adoption of a proposed signaling scheme for special purpose vehicles is recommended. By nationwide implementation of such a scheme both consistancy and meaningfulness could be imparted to special purpose vehicular signaling. Rigor will have to be derived from research aimed at determining the proper parameters to produce conspicuous signal lights.

When Participation Wins Votes: Explaining the Emergence of Large-Scale Participatory Democracy

2021 ◽  
Author(s):  
Jared Abbott
Keyword(s):  
Case Studies ◽  
Political Party ◽  
Large Scale ◽  
Participatory Democracy ◽  
National Level ◽  
The Political ◽  
Political Costs ◽  
Participatory Institutions ◽  
Potential Benefits ◽  
Nationwide Implementation

Why are large-scale participatory institutions implemented in some countries but only adopted on paper in others? I argue that nationwide implementation of Binding Participatory Institutions (BPIs)––a critical subtype of participatory institutions––is dependent on the backing of a strong institutional supporter, often a political party. In turn, parties will only implement BPIs if they place a lower value on the political costs than on the potential benefits of implementation. This will be true if: 1) significant societal demand exists for BPI implementation and 2) the party’s political opponents cannot take advantage of BPIs for their own gain. I test this theory through two detailed case studies of Venezuela and Ecuador, drawing on 165 interviews with key national-level actors and grassroots activists.

scholarly journals Effect on Health Care Expenditures During Nationwide Implementation of the Diabetes Prevention Program as a Health Insurance Benefit

Diabetes Care ◽  
2019 ◽  
Vol 42 (9) ◽  
pp. 1776-1783 ◽  
Author(s):  
Ronald T. Ackermann ◽  
Raymond Kang ◽  
Andrew J. Cooper ◽  
David T. Liss ◽  
Ann M. Holmes ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Health Care Expenditures ◽  
Insurance Benefit ◽  
Nationwide Implementation

Nationwide implementation of adjunctive dexamethasone therapy for pneumococcal meningitis

Neurology ◽  
2010 ◽  
Vol 75 (17) ◽  
pp. 1533-1539 ◽  
Author(s):  
M. C. Brouwer ◽  
S. G. B. Heckenberg ◽  
J. de Gans ◽  
L. Spanjaard ◽  
J. B. Reitsma ◽  
...  
Keyword(s):  
Pneumococcal Meningitis ◽  
Dexamethasone Therapy ◽  
Nationwide Implementation

Shared decision making, a buzz-word in the Netherlands, the pace quickens towards nationwide implementation…

2017 ◽  
Vol 123-124 ◽  
pp. 69-74 ◽  
Author(s):  
Trudy van der Weijden ◽  
Heleen Post ◽  
Paul L P Brand ◽  
Haske van Veenendaal ◽  
Ton Drenthen ◽  
...  
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Nationwide Implementation

Telemental Health Services in Sri Lanka

2017 ◽  
Author(s):  
Sisira Edirippulige ◽  
Rohana B. Marasinghe
Keyword(s):  
Sri Lanka ◽  
Health Services ◽  
Healthcare Providers ◽  
Health Service Delivery ◽  
Telemental Health ◽  
Knowledge And Skills ◽  
Advanced Technologies ◽  
Resource Limited ◽  
Nationwide Implementation ◽  
Limited Setting

This chapter reviews the rare use of telemental health modalities in Sri Lanka and challenges facing nationwide implementation of these services in this resource-limited setting. As in other developing countries, cost of, and access to, appropriate infrastructure are key constraints in using such advanced technologies in health service delivery. While healthcare providers and policymakers have realized the value of telemental health as a useful tool, challenges to its implementation remain. These challenges include lack of technology, appropriate infrastructure, knowledge, and skills. This chapter will delve into discussing the current approaches to implement TMH through educating the General public and disseminating mental health services in Sri Lanka.

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