抽象目标在低收入和中等收入国家(LMIC)中,糖尿病的负担正在增加。很少有研究探讨了LMIC中糖尿病患者的护理途径。这项研究评估了危地马拉农村糖尿病成年人的护理轨迹。Design A qualitative investigation was conducted as part of a population-based study assessing incidence and risk factors for chronic kidney disease in two rural sites in Guatemala.807个个体的随机样本对两个部位的糖尿病进行了血红蛋白A1C(HBA1C)筛查。Based on results from the first 6 months of the population study, semistructured interviews were performed with 29 adults found to have an HbA1c≥6.5% and who reported a previous diagnosis of diabetes.访谈探索了通往糖尿病护理的途径和经历。Detailed interview notes were coded using NVivo and used to construct diagrams depicting each participant's pathway to care and use of distinct healthcare sectors.Results Participants experienced fragmented care across multiple health sectors (97%), including government, private and non-governmental sectors.The majority of participants sought care with multiple providers for diabetes (90%), at times simultaneously and at times sequentially, and did not have longitudinal continuity of care with a single provider.Many participants experienced financial burden from out-of-pocket costs associated with diabetes care (66%) despite availability of free government sector care.Participants perceived government diabetes care as low-quality due to resource limitations and poor communication with providers, leading some to seek care in other health sectors.Conclusions This study highlights the fragmented, discontinuous nature of diabetes care in Guatemala across public, private and non-governmental health sectors.Strategies to improve diabetes care access in Guatemala and other LMICs should be multisectorial and occur through strengthened government primary care and innovative private and non-governmental organisation care models.
– – Environmental Impacts – a Driver for Using Alternative Energy – – Alternative Energy and Carbon Reduction – – Solar Energy – – Wind Energy – – Hydropower – – Geothermal Energy – – Waste-to-Energy Systems – – Fuel Cells – An Example of Hydrogen Applications – – Hybrid Alternative Energy Systems – – Creative Energy Storage Applications – – Alternative Energy Strategies for Buildings – – Transportation Systems – – Governmental Alternative Energy Programs – – Financial Approaches and Incentives for替代能源 - - 替代能量的未来 - 生物质
– Introduction to Alternative Energy – Environmental Impacts – Alternative Energy & Carbon Reduction – Solar Energy – Wind Energy – Hydropower – Geothermal Energy – Waste to Energy – Fuel Cells – Hybrid Alternative Energy Systems (Hybrid Renewables) – Creative Energy Storage Applications – Alternative Energy Strategies for Buildings – Bio-fuels & Transportation Systems – Governmental Alternative Energy Programs – Financial Approaches & Incentives for Alternative Energy – The Future of Alternative Energy – Resources &代表考试
11。It shall be the sole responsibility of the owner(s), their successors or assigns, (and/or their contractor, their successors or assigns, as applicable) to pursue any negotiations, obtain any agreements and/or permits, etc., from all necessary owners, private and/or governmental agencies in charge of properties and/or rights-of-way adjacent to this project, that may be required to do any work (construction, access, modifications, grading,排水,结构,道路等)直接侵占这些相邻的属性和通行权,无论是否在这些计划上显示或描述了这项工作。
当前的研究表明,沿海湿地,尤其是盐木和海草床,比森林和其他陆地栖息地更高的碳含量要高得多。鉴于气候变化的加速影响,评估不同栖息地类型的二氧化碳隔离潜力并量化其对温室气体减少的贡献的兴趣越来越大。At the latest Trilateral Governmental Conference in 2022, the Trilateral Governmental Council decided to ‘investigate the role of the ecosystem service value of carbon sequestration by typical Wadden Sea habitats like seagrass beds and salt marshes and their contribution to the EU greenhouse gas reduction targets whilst preserving the Outstanding Universal Value' ( CWSS, 2023 , see also SIMP ).代表科学,自然保护或管理的专家之间的信息交换是更好地了解Wadden Sea中CO 2隔离的当前知识状态的关键,并评估该地区有助于减少温室气体的潜力。本网络研讨会应是获得可用信息概述的第一步,同时还为专家提供了讨论的机会,例如知识差距,对CO 2进行三边评估的机会和/或管理措施对Wadden Sea中CO 2隔离的潜在影响。我们计划从正在进行的项目上进行多次演讲,理想情况下涵盖了不同的瓦登海栖息地类型,然后在突破小组中进行时间讨论关键主题,使所有参与者有机会为讨论做出贡献。
While DOE's response to Governor Kotek's letter assures a commitment to transparency and future public involvement, the effectiveness of these commitments will depend on their implementation. Transportation of Hanford tank waste through Oregon is our top issue and concern. The inherent risks of transporting treated tank waste liquids, the yet-to- be-determined plans for waste transportation methods and routes, and the uncertainty whether there will be any task-and-route-specific NEPA process are issues that require thorough public information-sharing and input, prior to decision-making. As additional preliminary decisions are made, timely outreach to and input from governmental entities, and Tribal governments potentially impacted by proposed transportation routes will be an important component of a decision process that is open and transparent.
SB 16 /a NON-MAJOR PARTY VOTERS IN PRIMARY ELECTIONS (FIGUEROA/WIRTH) SB 36 /a SENSITIVE PERSONAL INFORMATION NONDISCLOSURE (SEDILLO LOPEZ/PARAJÓN) SB 124 /a SUPERINTENDENT OF INSURANCE SUBPOENAS (DUHIGG/SZCZEPANSKI) HB 386 GOVERNMENTAL ACCOUNTING CLASS & COMPENSATION (HERNANDEZ JF) HB 405志愿消防员SVC。和培训(冈萨雷斯/德拉克鲁兹)HB 468州国旗(Murphy/Dow)HB 493 HB 493公共财务责任法案(Borrego)您被邀请参加Zoom Webinar!从PC,Mac,iPad或Android加入:https://us02web.zoom.us.us.us/j/89282948977电话一-Tap: +17193594580,,89282948977#US 8977
增援保障网络 – 机遇与挑战 主持人:» 德国联合保障与支持服务负责人 Martin Schelleis 中将 介绍:» 西门子数字工业软件航空航天与国防战略及营销副总裁 Todd Tuthill 小组成员:» 荷兰布伦瑟姆盟军联合部队司令部 (JFC) DCOS 支持 Stefan Linus Fix 少将 » 德国联邦国防军后勤司令部司令 Gerald Funke 少将 » ESG 后勤总监、ESG 业务领域保障与后勤负责人 Stephan Heitz » Governmental Services AS WilNor 首席执行官 Vidar Hole » 达索系统高级总监 Enrico Scharlock » 第 21 战区保障司令部指挥官 James M. Smith 少将
a p reface to p ublic i nformation h和book book the Act。《德克萨斯公共信息法》(《公共信息法》或“法案”)授予公众要求访问政府信息的权利。以下是该法规定的基本程序,权利和责任的描述。提出请求。当一个人向政府机构提交书面请求时,该法案将触发。请求必须询问已经存在的记录或信息。该法案不需要政府机构来创建新信息,进行法律研究或回答问题。在准备请求时,一个人可能想询问政府机构可用哪些信息。向请求者收取费用。一个人可以要求查看信息,获取信息的副本,或两者兼而有之。如果要求提供信息副本,则政府机构可能会为这些副本收取费用。如果要求仅是为了检查信息的机会,则通常政府机构可能不会向请求者征收指控。但是,在某些有限情况下,政府机构可能会向获取信息征收指控。政府机构对副本或获取信息的所有指控都必须遵守总检察长办公室(“ OAG”)规定的规则,除非另一项法规授权政府机构设定自己的指控。该法案的例外。尽管该法案使大多数政府信息向公众提供,但存在一些例外。问题或投诉。联邦机构。如果可能适用异常,并且政府机构希望扣留信息,则政府机构通常必须在收到公开记录请求的十个工作日内,请将此事转介给OAG,以裁定是否适用异常。如果OAG规定了例外情况,则政府机构将不会发布信息。如果政府机构不正确地发布信息,则该法案授权该法案或OAG提起民事诉讼,以迫使政府机构发布该信息。要到达OAG的公开政府热线,请致电免费电话(877)673-6839(877-OPEN TEX)。热线工作人员可以回答有关使用和遵守该法案的适当程序的问题,并可以协助政府机构和要求政府机构提供信息的人。热线工作人员还审查了有关涉嫌违反该法案的书面投诉。如果投诉涉及指控,请通过(888)672-6787(888-Orcosts)与OAG的成本免费电话联系,或转发书面投诉。对该法案的某些违规行为可能涉及可能的刑事处罚。这些违法行为必须报告给适当的县检察官或刑事地方检察官。该法案不适用于联邦政府或其任何部门或机构。如果您正在寻求联邦政府的信息,则适当的法律是《联邦信息自由法》(“ FOIA”)。FOIA的规则和程序与《公共信息法》的规则和程序不同。