• Title/Summary/Keyword: Backsliding

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Improvement and Backsliding after Chronic-disease Self-management Education in Japan: One-year Cohort Study

  • Park, Min Jeong
    • The Korean Journal of Rehabilitation Nursing
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    • v.20 no.1
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    • pp.42-51
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    • 2017
  • Purpose: In people who have chronic diseases, disabilities, and rehabilitation needs, self-management education can improve health and health-related behavior, and it can reduce the utilization of healthcare services. The purpose of this research was to assess the long-term effects of chronic-disease self-management education in Japan. Methods: This study included 184 adults living with various chronic medical conditions who participated in the Chronic Disease Self-Management Program (CDSMP) in Japan. Data were collected before the program began, and then collected 3 more times over 1 year. Results: Healthcare-service utilization was low at baseline, and it did not change. Self-evaluated health status, health-related distress, coping with symptoms, communication with doctors, and self-efficacy to manage symptoms all improved after the program. However, there was backsliding in all of the outcomes that had improved. Conclusion: Some benefits of this program can last for at least 1 year, but interventions to prevent attenuation may be needed. For economic evaluations, research should focus on populations with higher baseline levels healthcare-service utilization, including use of rehabilitation services. Also, more attention should be focused on the longer-term decay or persistence of the program's benefits, particularly regarding on preventing and reducing disabilities and with regard to rehabilitation needs.

Myanmar Libraries after the 'Opening Up'

  • Bradley, Fiona
    • Journal of Information Science Theory and Practice
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    • v.5 no.4
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    • pp.49-67
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    • 2017
  • This article assesses the recent development of libraries in Myanmar and efforts to build the sector's capacity leading up to and after the first democratic elections held in the country in nearly 50 years, at the end of 2015. Cyclone Nargis in 2008 is viewed as a 'framing event' (Birkland, 1998) that led to national legal and policy reforms, an increase in national and international projects to support development of Myanmar libraries, and the strengthening of local actors including the Myanmar Library Association to coordinate and lead development activities. Although in need of modernisation, networking, and professional skills, the existence of a widespread number of all library types across the country provides an important foundation for further development. The current status and readiness of libraries is explored in the broader context of the rapid leap from limited to more widely available access to information and technology. The article finds that there is great potential for libraries in Myanmar to support the continued transition to democracy as evidenced by the role of libraries and access to information in other countries that have transitioned. Remaining challenges include the potential of backsliding on national reforms, and the need for significant investments in infrastructure and skills. Libraries must be transformed to meet the changing needs of information users in a young democracy.

Characteristics of Post 2020 Architect and Application of Differentiation in the Post 2020 Regime (신기후체제 설계의 특징과 신기후체제에서 차별화 적용 방안)

  • Lee, Sangyun;Choi, Dohyun
    • Journal of Environmental Policy
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    • v.14 no.3
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    • pp.95-118
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    • 2015
  • The 2015 Agreement, an initial architect of the Post-2020 Regime, is expected to be adopted at the twenty-first session of the Conference of Parties to be held in Paris in 2015. We discussed key characteristics of the Post-2020 Regime and applications of differentiation which is most contentious issue in the Post-2020 negotiation. In the Post-2020 Regime, automatic ambition increases of Parties could be accomplished through applications of the circular nature of Intented Nationally Determined Contributions (INDC) as well as the progression of mitigation efforts. In terms of differentiation, it would be better to advocate a new method to applying differentiation in the Post-2020 Regime taking into account our own national circumstances. Specifically, promotion of self-differentiation which fits nearly with the philosophy of INDC could be an alternative. In order to promote self-differentiation, rules to apply self-differentiation needs to be devised, and the purpose of such rules should be the ambition increase.

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