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Articles 2641 - 2670 of 4956
Full-Text Articles in Public Health
Understanding Youth Sexual And Reproductive Health-Seeking Behaviors In Ethiopia: Implications For Youth-Friendly Service Programming, The Evidence Project
Understanding Youth Sexual And Reproductive Health-Seeking Behaviors In Ethiopia: Implications For Youth-Friendly Service Programming, The Evidence Project
Reproductive Health
In Ethiopia, significant attention has been given to improving youth sexual and reproductive health (SRH) services, including the establishment of youth-friendly services (YFS). Yet high rates of child marriage, unmet need for family planning, and adolescent childbearing persist, particularly in rural areas where over 84 percent of the population lives. Reaching rural youth with timely SRH information and services that are relevant to their varying ages and life stages remains a challenge. The Evidence Project is examining the coverage and reach of public and NGO-supported youth SRH services in several rural regions of Ethiopia. As this activity brief notes, the …
Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, The Evidence Project
Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, The Evidence Project
Reproductive Health
In 2008, the Government of India launched the National Health Insurance program, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in urban and rural areas to access a range of private health services. Enrolled families can access packages of services from RSBY-participating private hospitals, including family planning (FP) and other reproductive health (RH) services. Despite the availability of insurance coverage, poor families’ utilization of RSBY for FP/RH services is believed to be negligible. The Evidence Project is conducting a study in three cities in Uttar Pradesh to better understand the factors affecting utilization of RSBY …
The Raise Health Initiative For Workers, Companies, And Communities, The Evidence Project
The Raise Health Initiative For Workers, Companies, And Communities, The Evidence Project
Reproductive Health
RAISE Health is an initiative to improve the health of factory and farm workers (women and men) in developing countries through changes in global and corporate policies and workplace practices. Effective management of workplace health is good for companies and workers alike, resulting in better health and morale, better labor-management relations, empowerment of women, and better use of company health investments. Worker health is typically one of the most neglected areas in business operations. As this activity brief notes, RAISE Health is a major activity of the USAID-funded Evidence Project. The goal of the initiative is to utilize the existing …
Standard Days Method Of Contraception: Evidence On Use, Implementation, And Scale Up, Kelsey Wright, Hiba Iqteit, Karen Hardee
Standard Days Method Of Contraception: Evidence On Use, Implementation, And Scale Up, Kelsey Wright, Hiba Iqteit, Karen Hardee
Reproductive Health
In 2002, an article in Contraception reported on a trial for a new method of contraception, the Standard Days Method (SDM). SDM is a fertility awareness-based family planning (FP) method that identifies the eighth through nineteenth days of a woman’s menstrual cycle as the fertile window. SDM users abstain or use barrier methods during their fertile periods to prevent pregnancy. The trial established a first-year method failure rate of 5 per 100 woman years with correct use, and 12 per 100 women for typical use. Over the decade since the publication of the original efficacy trial, the Georgetown University Institute …
Rights-Based Family Planning: 10 Resources To Guide Programming, Jan Kumar, Karen Hardee
Rights-Based Family Planning: 10 Resources To Guide Programming, Jan Kumar, Karen Hardee
Reproductive Health
The FP2020 goal of providing FP services to 120 million more women and girls that emerged from the 2012 London Summit on Family Planning refocused attention on the need to ensure that FP programs respect, protect, and fulfill human rights. The current challenge is how to operationalize human rights in existing FP programs and new projects. This resource guide reviews ten key resources available to guide programming—FP2020: Rights and Empowerment Principles for Family Planning; Ensuring Human Rights in the Provision of Contraceptive Information and Services, Ensuring Human Rights Within Contraceptive Service Delivery: Implementation Guide; Voluntary Family Planning Programs that Respect, …
Anneau Vaginal À La Progesterone: Appel A L'Action Pour Combler Les Ecarts Importants Dans La Planification Familiale Postnatal, Population Council
Anneau Vaginal À La Progesterone: Appel A L'Action Pour Combler Les Ecarts Importants Dans La Planification Familiale Postnatal, Population Council
Reproductive Health
L’anneau vaginal à la progestérone (AVP) est une méthode efficace et sûre de contraception pour les femmes qui allaitent. C’est une médecine prioritaire de la liste des produits médicaux essentiels de l’OMS et elle est inclue parmi les critères médicaux éligibles pour les personnels de la planification familiale. Développé par le Population Council, l’AVP est un anneau intra-vaginal qui donne une option contraceptive aux femmes qui allaitent au moins quatre fois par jour dès la quatrième semaine après l’accouchement. L’AVP apporte une nouvelle option pour réduire les besoins non-satisfaits des nouvelles mères, permet aux femmes d’espacer leurs grossesses sans problème, …
Progesterone Vaginal Ring: A Call-To-Action To Fill Critical Gaps In Post-Partum Family Planning, Population Council
Progesterone Vaginal Ring: A Call-To-Action To Fill Critical Gaps In Post-Partum Family Planning, Population Council
Reproductive Health
The progesterone vaginal ring (PVR) is a safe and effective method of contraception for lactating women. It is a priority medicine on the WHO’s Essential Medicines List and is included in the Medical Eligibility Criteria for family planning providers. Developed by the Population Council, the PVR is an intravaginal ring that provides women who breastfeed at least four times a day with a contraceptive option as early as four weeks after giving birth. The PVR provides a new option to reduce unmet need among new mothers, allow women to safely space their pregnancies, and improve the health of women and …
Willingness To Pay For Contraceptive Vaginal Rings In Senegal, Babacar Mane, Fatou Mbow, Deepa Rajamani, Nafissatou Diop, Saumya Ramarao
Willingness To Pay For Contraceptive Vaginal Rings In Senegal, Babacar Mane, Fatou Mbow, Deepa Rajamani, Nafissatou Diop, Saumya Ramarao
Reproductive Health
Contraceptive vaginal rings are an innovative category of products that have not been introduced into any sub-Saharan African country. As a result, there is little experience to guide the introductory pricing for the PVR and the one-year NES/EE CVR when it becomes available. The evidence generated by this consumer willingness to pay, and provider/procurer study has shed light on critical aspects of PVR introduction in Senegal. In general, the results generated here complement and reinforce findings from an acceptability study of the PVR and stakeholder discussions that have been occurring over the past three years. Results confirm that contraceptive vaginal …
L’Anneau Vaginal À Progestérone: Résultats De L’Étude D’Acceptabilité Au Sénégal, Babacar Mane, Papa Chimere Diaw, Nafissatou Diop, Fatou Mbow, Heather Clark, Saumya Ramarao, Deepa Rajamani
L’Anneau Vaginal À Progestérone: Résultats De L’Étude D’Acceptabilité Au Sénégal, Babacar Mane, Papa Chimere Diaw, Nafissatou Diop, Fatou Mbow, Heather Clark, Saumya Ramarao, Deepa Rajamani
Reproductive Health
Le Gouvernement du Sénégal s’est engagé dans une politique volontariste de repositionnement de la planification familiale à travers l’adoption d’un Plan d’Action National de Planification Familiale. Pour mieux adresser les besoins de contraception des femmes et réduire les taux d’abandon, le Population Council a initié le développement d’une gamme d’anneaux vaginaux; le premier produit développé était l’anneau vaginal à progestérone ou AVP, conçu pour les femmes qui allaitent en vue de prolonger la période d’aménorrhée lactationnelle et ainsi promouvoir l’espacement des naissances. Avec l’appui de la Fondation Bill & Melinda Gates, le Population Council a entrepris des activités de pré-introduction …
Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao
Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao
Reproductive Health
The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. The PVR was first registered in Chile and Peru in 1998 for use by postpartum women and has since been expanded to other Latin American countries. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Nigeria as part of a larger project that was also conducted in Kenya …
Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao
Progesterone Vaginal Ring: Results Of An Acceptability Study In Kenya, Francis Obare, Wilson Liambila, Chi-Chi Undie, Harriet Birungi, Shiphrah Kuria, Heather Clark, Deepa Rajamani, Saumya Ramarao
Reproductive Health
The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Kenya as part of a larger project that was also conducted in Nigeria and Senegal. The specific objectives of the study were to assess the factors influencing the acceptability of the method among clients, their spouses, providers, community members, …
Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council
Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council
Reproductive Health
Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.
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This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …
Gender Considerations Along The Hiv Treatment Cascade: An Evidence Review With Priority Actions, Melanie Croce-Galis, Jill Gay, Karen Hardee, What Works Association, Population Council
Gender Considerations Along The Hiv Treatment Cascade: An Evidence Review With Priority Actions, Melanie Croce-Galis, Jill Gay, Karen Hardee, What Works Association, Population Council
Reproductive Health
This treatment brief provides policymakers and program implementers with evidence about the impact of gender dynamics on treatment access and adherence and the gender-related gaps in treatment research and programming. It also includes priority actions that can be taken to better address gender within treatment programming and raises questions for implementation science in order to achieve the global 90-90-90 goal. This brief draws from What Works for Women and Girls: Evidence for HIV Interventions and uses the WHO treatment cascade framework to identify and analyze major gender considerations in providing antiretroviral therapy to those living with HIV in low- and …
Proposed Indicators To Measure Adherence To And Effects Of Rights-Based Family Planning: Resource Guide, Kelsey Wright, Karen Hardee
Proposed Indicators To Measure Adherence To And Effects Of Rights-Based Family Planning: Resource Guide, Kelsey Wright, Karen Hardee
Reproductive Health
At the London Summit on Family Planning in 2012, the goal of expanding access to FP programs by 120 million additional women and girls by 2020 was established. This goal calls attention to the need for FP information and services to be delivered in ways that are voluntary and respect human rights. While human rights have been codified and affirmed in declarations, conventions, and treaties, operationalizing rights in FP programs is still in an early stage of development. With the recent emergence of global numeric benchmarks for FP programs, there is the risk that the focus will move away from …
Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi
Education Sector Response To Early And Unintended Pregnancy: A Policy Dialogue In Homa Bay County, Kenya, Chi-Chi Undie, Ian Mackenzie, Harriet Birungi, Stephen Barongo, Diosiana Ahindukha, Caleb Omondi
Reproductive Health
In collaboration with the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) Research Programme Consortium, the Population Council implemented a project to increase the demand for secondary school education in Homa Bay County, Kenya—an area characterized by high, unintended teenage pregnancy and female school drop-out rates. To foster awareness of the school re-entry policy, the Population Council collaborated with the Homa Bay County Department of Education (Ministry of Education) to convene a policy dialogue for all principals of public, day, girls-only, and co-educational secondary schools in the area. The policy dialogue helped to create visibility around the issue of …
Creating Conditions For Scale Up: Technical Assistance As An Implementation Research Uptake Strategy, Ian Askew
Creating Conditions For Scale Up: Technical Assistance As An Implementation Research Uptake Strategy, Ian Askew
Reproductive Health
No abstract provided.
Attitudes And Behaviors Of South African Women And Psychosocial Determinants Of Gonorrhea, Takiyah White Ndwanya
Attitudes And Behaviors Of South African Women And Psychosocial Determinants Of Gonorrhea, Takiyah White Ndwanya
Walden Dissertations and Doctoral Studies
The incidence of gonorrhea had declined since the HIV epidemic in the late 1980s, but is now increasing globally due to the emergence of antibiotic-resistant forms of this disease. In South Africa, the incidence of gonorrhea is highest among Black women due to their high co-infection rates with HIV and other sexually transmitted infections (STIs). This study examined the psychosocial determinants of gonorrhea among Black women aged 18 - 35 in the Langa township in Cape Town, South Africa. All participants had reported at least one sexual experience and at least one positive test for gonorrhea in the past two …
Falls Among Community-Dwelling Older Adults: Determining The Relationship Between Social Networks And The Risk For Falls, Smita Sikhrakar
Falls Among Community-Dwelling Older Adults: Determining The Relationship Between Social Networks And The Risk For Falls, Smita Sikhrakar
All Graduate Theses, Dissertations, and Other Capstone Projects
Falls among community-dwelling older adults is a big public health problem, which have an effect on older adults' health, independence, and quality of life. The purpose of this study was to determine the relationship between social networks and the risk for falls among community-dwelling older adults. This was a descriptive correlational study, which utilized a cross-sectional survey for the data collection. The dependent and independent variable of this study were the risk for falls among the community-dwelling older adults, and the strength and type of social networks respectively. In this study, 218 community-dwelling older adults were recruited, who were living …
The Impact Of Supply Chain Logistics Performance Index On The Control Of Neglected Tropical Diseases In Low- And Middle-Income Countries, Farouk Adams Umaru
The Impact Of Supply Chain Logistics Performance Index On The Control Of Neglected Tropical Diseases In Low- And Middle-Income Countries, Farouk Adams Umaru
Walden Dissertations and Doctoral Studies
Neglected tropical diseases (NTD) in low- and middle-income countries are still not on target per the World Health Organization's (WHO) elimination goal of 2020. Mass drug administration (MDA) is one of the effective strategies supported by the WHO for the control and subsequent elimination of NTD. This quantitative study explored how supply chain logistic capacity may be hampering MDA coverage in countries in which the diseases are endemic. The study examined secondary data from WHO data bank for MDA coverage, to quantify the relationship between supply chain logistics capacity, as measured by the World Bank's logistics performance index (LPIs), and …
‘‘We Can Wipe An Entire Culture’’: Fears And Promises Of Dna Biobanking Among Native Americans, Roberto Abadie, Kathleen Heaney
‘‘We Can Wipe An Entire Culture’’: Fears And Promises Of Dna Biobanking Among Native Americans, Roberto Abadie, Kathleen Heaney
Department of Sociology: Faculty Publications
This paper explores Native American perceptions on DNA biobanking. A qualitative study was conducted among self-declared Native Americans living off reservation in two Midwest cities. Findings demonstrate a paradox: Informants maintain strong hopes for the transformative power of gene-based research while voicing very particular social anxieties. Emerging genomic technologies elicit concerns over the potential for genetic stigmatization or discrimination based on race, preventing access to health insurance or employment. Frequently, social anxieties adopt the narrative form of conspiracy theories which portray powerful agents exploiting or abusing a disenfranchised population. We argue that while Native Americans do not have a monopoly …
Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart
Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart
PCOM Psychology Dissertations
Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …
Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri
Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri
DNP Projects
Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority.
Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to …
The Influence Of Participating In An International Clinical Experience During Baccalaureate Nursing Education On Interprofessional Collaboration And Teamwork For New Registered Nurses, Sherylyn Watson
Nursing Faculty Publications
An increased focus on interprofessional collaboration and teamwork in the healthcare professions had placed demands on nursing education to identify evidence based instructional strategies that bolster the interprofessional competency in prelicensure nursing education. One approach in addressing the call was to explore current educational opportunities for their effectiveness in developing interprofessional collaboration and teamwork. The popular trend in nursing education was to offer international clinical experiences that provide nursing care to impoverished people of developing countries. The current literature on these experiences had primarily focused on short-term outcomes that demonstrate personal growth of the individual, exposing opportunity for research concentrating …
An O'Neill Institute Briefing Paper: Ebola, The World Health Organization, And Beyond: Toward A Framework For Global Health Security, Lawrence O. Gostin, Eric A. Friedman, Daniel Hougendobler
An O'Neill Institute Briefing Paper: Ebola, The World Health Organization, And Beyond: Toward A Framework For Global Health Security, Lawrence O. Gostin, Eric A. Friedman, Daniel Hougendobler
Georgetown Law Faculty Publications and Other Works
The West African Ebola epidemic has demonstrated that the world remains ill-prepared to respond to infectious disease outbreaks. A host of institutions are now reviewing what went wrong, and new institutions are being considered, including an African Centers for Disease Control and Prevention and World Bank-initiated Pandemic Emergency Facility. The World Health Organization itself failed in one of its core functions by allowing a preventable infectious disease to spiral out of control in the world’s poorest region. The 68th World Health Assembly (WHA), held in May 2015, provided an opportunity for the Organization to reflect on what went wrong and …
Social Determinants Of Health Inequality And Life Expectancy Among Women Of Edo State, Nigeria, Daniel Aromeh Odekina
Social Determinants Of Health Inequality And Life Expectancy Among Women Of Edo State, Nigeria, Daniel Aromeh Odekina
Walden Dissertations and Doctoral Studies
Health inequality conflates a huge number of economic, social, and political issues. These issues, together described as social determinants, determine a population's health through influencing health status and life expectancy. The research purpose of this study was to examine how social determinants affected the life expectancy of the women of Edo State, based on secondary data from Nigeria's 2008 demographic and health survey (NDHS). The theories that guided the study were self-efficacy beliefs of the social cognitive theory and physical self-concept of the health belief model. This quantitative cross-sectional study examined the associations between socioeconomic status, nutritional status, literacy/educational attainment, …
A Needs Assessment: Barriers To Wildland Firefighter Fitness Training, Aria E. Mangan
A Needs Assessment: Barriers To Wildland Firefighter Fitness Training, Aria E. Mangan
Graduate Student Theses, Dissertations, & Professional Papers
Abstract:
Mangan, Aria, M.S, Spring 2015 Health and Human Performance
A Needs Assessment: Barriers to Wildland Firefighters Fitness Training
Chairperson: Dr. Annie Sondag
Introduction: Working on a wildland fire can be physically and mentally taxing. Given the physical demands of the job, fitness is a key component in keeping wildland firefighters (WLFFs) healthy and safe from injury. Unfortunately little is known about physical training (PT) programs of WLFFs.
Purpose: The purpose of this study was to examine motivators and barriers to PT in WLFFs. Personal, interpersonal, organizational and environmental factors that influence PT were identified. Strategies for overcoming barriers were …
Jessie Huey Laurence Papers - Accession 5, Jessie Huey Laurence
Jessie Huey Laurence Papers - Accession 5, Jessie Huey Laurence
Manuscript Collection
The Jessie Huey Laurence Papers primarily consist of correspondence, but also included are speeches, program notes, minutes, financial records, photographs, clippings, and scrapbooks relating to her role in the South Carolina Federation of Women’s Clubs (1928-1937); her promotion of a compulsory school attendance bill for South Carolina (1934-1936); the formation of the South Carolina Council for the Common Good (1935); Works Progress Administration (WPA) and Public Works Administration (PWA) projects in South Carolina; and her interest in the Catawba Indians of York County, as chairman of Indian Affairs Committee for the Catawba Chapter of the Daughters of the American Revolution. …
Physician Role In Enhancing Patient Communication, Tamanna Sahni
Physician Role In Enhancing Patient Communication, Tamanna Sahni
UROP Posters
Communication in the in-patient environment is crucial, and the relationship between a patient and physician enhances patient health and wellness. Patients should feel confident with their abilities to feel comfortable conversing with physicians, which would thus treat symptoms more effectively. This communication has decreased over time, hence patients are often are unable to obtain medical information from their healthcare providers. What is the relationship between psychological factors, such as self-esteem, and quality of patient-physician communication? And can physicians ensure increased patient comfort in the medical environment?
Various factors can affect the patients’ comfort with their physicians, and when addressed, these …
Let’S Talk About Sex, And What Happens When We Don’T: How Limited Sex Education In Nepal’S Government Schools Affects Women In Arranged Marriages, Isabelle Stillman
Let’S Talk About Sex, And What Happens When We Don’T: How Limited Sex Education In Nepal’S Government Schools Affects Women In Arranged Marriages, Isabelle Stillman
Independent Study Project (ISP) Collection
In Nepal’s government secondary schools, the reproductive health curriculum is often covered in a single week, and many teachers neglect to administer the lessons thoroughly due to beliefs that sex is a private matter, inappropriate or unnecessary for students. The government curriculum not only lacks detail about reproduction and intercourse, but, in the information it does include, defines male and female puberty processes, reproductive systems, sexual health, roles in family planning, and intercourse in ways that further the gender inequality so deeprooted in Nepali culture. Following secondary school, many women in Nepal are married in arranged matches, to men they …
Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin
Independent Study Project (ISP) Collection
Contextual information: At the global level, inequities exist with respect to access and quality of healthcare. Primary Health Care is a strategy to respond to these inequities. It adopts an integral concept of health that includes no only illness but also the wellbeing of a person affected by many environmental factors. It is a strategy that aims to improve access to medical care and health information through health promotion and has the goal of giving the population more control over their health. Community health workers, people from the same neighborhood in which they work promoting health, are recognized on the …