Optimal dietary patterns designed from local foods to achieve maternal nutritional goals.

Science.gov (United States)

Raymond, Jofrey; Kassim, Neema; Rose, Jerman W; Agaba, Morris

2018-04-04

Achieving nutritional requirements for pregnant and lactating mothers in rural households while maintaining the intake of local and culture-specific foods can be a difficult task. Deploying a linear goal programming approach can effectively generate optimal dietary patterns that incorporate local and culturally acceptable diets. The primary objective of this study was to determine whether a realistic and affordable diet that achieves nutritional goals for rural pregnant and lactating women can be formulated from locally available foods in Tanzania. A cross sectional study was conducted to assess dietary intakes of 150 pregnant and lactating women using a weighed dietary record (WDR), 24 h dietary recalls and a 7-days food record. A market survey was also carried out to estimate the cost per 100 g of edible portion of foods that are frequently consumed in the study population. Dietary survey and market data were then used to define linear programming (LP) model parameters for diet optimisation. All LP analyses were done using linear program solver to generate optimal dietary patterns. Our findings showed that optimal dietary patterns designed from locally available foods would improve dietary adequacy for 15 and 19 selected nutrients in pregnant and lactating women, respectively, but inadequacies remained for iron, zinc, folate, pantothenic acid, and vitamin E, indicating that these are problem nutrients (nutrients that did not achieve 100% of their RNIs in optimised diets) in the study population. These findings suggest that optimal use of local foods can improve dietary adequacy for rural pregnant and lactating women aged 19-50 years. However, additional cost-effective interventions are needed to ensure adequate intakes for the identified problem nutrients.

Academic Optimism, Organizational Citizenship Behaviors, and Student Achievement at Charter Schools

Science.gov (United States)

Guvercin, Mustafa

2013-01-01

The purpose of this study was to examine the relationship among academic optimism, Organizational Citizenship Behaviors (OCBs), and student achievement in college preparatory charter schools. A purposeful sample of elementary school teachers from college preparatory charter schools (N = 226) in southeast Texas was solicited to complete the…

Designing optimal food intake patterns to achieve nutritional goals for Japanese adults through the use of linear programming optimization models.

Science.gov (United States)

Okubo, Hitomi; Sasaki, Satoshi; Murakami, Kentaro; Yokoyama, Tetsuji; Hirota, Naoko; Notsu, Akiko; Fukui, Mitsuru; Date, Chigusa

2015-06-06

Simultaneous dietary achievement of a full set of nutritional recommendations is difficult. Diet optimization model using linear programming is a useful mathematical means of translating nutrient-based recommendations into realistic nutritionally-optimal food combinations incorporating local and culture-specific foods. We used this approach to explore optimal food intake patterns that meet the nutrient recommendations of the Dietary Reference Intakes (DRIs) while incorporating typical Japanese food selections. As observed intake values, we used the food and nutrient intake data of 92 women aged 31-69 years and 82 men aged 32-69 years living in three regions of Japan. Dietary data were collected with semi-weighed dietary record on four non-consecutive days in each season of the year (16 days total). The linear programming models were constructed to minimize the differences between observed and optimized food intake patterns while also meeting the DRIs for a set of 28 nutrients, setting energy equal to estimated requirements, and not exceeding typical quantities of each food consumed by each age (30-49 or 50-69 years) and gender group. We successfully developed mathematically optimized food intake patterns that met the DRIs for all 28 nutrients studied in each sex and age group. Achieving nutritional goals required minor modifications of existing diets in older groups, particularly women, while major modifications were required to increase intake of fruit and vegetables in younger groups of both sexes. Across all sex and age groups, optimized food intake patterns demanded greatly increased intake of whole grains and reduced-fat dairy products in place of intake of refined grains and full-fat dairy products. Salt intake goals were the most difficult to achieve, requiring marked reduction of salt-containing seasoning (65-80%) in all sex and age groups. Using a linear programming model, we identified optimal food intake patterns providing practical food choices and

WFH: closing the global gap--achieving optimal care.

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Skinner, Mark W

2012-07-01

For 50 years, the World Federation of Hemophilia (WFH) has been working globally to close the gap in care and to achieve Treatment for All patients, men and women, with haemophilia and other inherited bleeding disorders, regardless of where they might live. The WFH estimates that more than one in 1000 men and women has a bleeding disorder equating to 6,900,000 worldwide. To close the gap in care between developed and developing nations a continued focus on the successful strategies deployed heretofore will be required. However, in response to the rapid advances in treatment and emerging therapeutic advances on the horizon it will also require fresh approaches and renewed strategic thinking. It is difficult to predict what each therapeutic advance on the horizon will mean for the future, but there is no doubt that we are in a golden age of research and development, which has the prospect of revolutionizing treatment once again. An improved understanding of "optimal" treatment is fundamental to the continued evolution of global care. The challenges of answering government and payer demands for evidence-based medicine, and cost justification for the introduction and enhancement of treatment, are ever-present and growing. To sustain and improve care it is critical to build the body of outcome data for individual patients, within haemophilia treatment centers (HTCs), nationally, regionally and globally. Emerging therapeutic advances (longer half-life therapies and gene transfer) should not be justified or brought to market based only on the notion that they will be economically more affordable, although that may be the case, but rather more importantly that they will be therapeutically more advantageous. Improvements in treatment adherence, reductions in bleeding frequency (including microhemorrhages), better management of trough levels, and improved health outcomes (including quality of life) should be the foremost considerations. As part of a new WFH strategic plan

Financing and funding health care: Optimal policy and political implementability.

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Nuscheler, Robert; Roeder, Kerstin

2015-07-01

Health care financing and funding are usually analyzed in isolation. This paper combines the corresponding strands of the literature and thereby advances our understanding of the important interaction between them. We investigate the impact of three modes of health care financing, namely, optimal income taxation, proportional income taxation, and insurance premiums, on optimal provider payment and on the political implementability of optimal policies under majority voting. Considering a standard multi-task agency framework we show that optimal health care policies will generally differ across financing regimes when the health authority has redistributive concerns. We show that health care financing also has a bearing on the political implementability of optimal health care policies. Our results demonstrate that an isolated analysis of (optimal) provider payment rests on very strong assumptions regarding both the financing of health care and the redistributive preferences of the health authority. Copyright © 2015 Elsevier B.V. All rights reserved.

Intersectoral cooperation in the sphere of public health care: ways of optimization

Directory of Open Access Journals (Sweden)

Natan G. Korshever

2017-08-01

Material and Methods — There were analyzed the normative legal field of public health care, the results of anonymous survey of 838 physicians – health care organizers including 34 experts, and of 6,106 persons not engaged in medical professions. Results — There were established the list and significance of 37 health determinants; the effect produced on them by 23 state and public sectors engaged in health care; characteristics of these sectors’ interaction. There were substantiated 38 informative vectors for evaluating the effectiveness of intersectoral cooperation in the sphere of public health care – 22 simple (each representing a single informative criterion and 16 complex (consisting of several, from 3 to 12 informative criteria. There was developed an automatic multi-vector method for assessing success in intersectoral cooperation in the sphere of public health care in a territorial formation (formations, and there was designed an appropriate technology of optimization, including the primary multi-vector analysis, purposeful correction and dynamic evaluation. Conclusion — Public health care optimization is a process which should be carried out with regard to hierarchic interaction of the engaged sectors and peculiarities of their influence on health determinants, multi-vector evaluation of intersectoral cooperation efficacy aimed to substantiate and choose such administrative decisions which prove to be the best from the viewpoint of resulting effective achievements. The obtained materials may be realized in everyday practice of public health care.

Physiological geroscience: targeting function to increase healthspan and achieve optimal longevity.

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Seals, Douglas R; Justice, Jamie N; LaRocca, Thomas J

2016-04-15

Most nations of the world are undergoing rapid and dramatic population ageing, which presents great socio-economic challenges, as well as opportunities, for individuals, families, governments and societies. The prevailing biomedical strategy for reducing the healthcare impact of population ageing has been 'compression of morbidity' and, more recently, to increase healthspan, both of which seek to extend the healthy period of life and delay the development of chronic diseases and disability until a brief period at the end of life. Indeed, a recently established field within biological ageing research, 'geroscience', is focused on healthspan extension. Superimposed on this background are new attitudes and demand for 'optimal longevity' - living long, but with good health and quality of life. A key obstacle to achieving optimal longevity is the progressive decline in physiological function that occurs with ageing, which causes functional limitations (e.g. reduced mobility) and increases the risk of chronic diseases, disability and mortality. Current efforts to increase healthspan centre on slowing the fundamental biological processes of ageing such as inflammation/oxidative stress, increased senescence, mitochondrial dysfunction, impaired proteostasis and reduced stress resistance. We propose that optimization of physiological function throughout the lifespan should be a major emphasis of any contemporary biomedical policy addressing global ageing. Effective strategies should delay, reduce in magnitude or abolish reductions in function with ageing (primary prevention) and/or improve function or slow further declines in older adults with already impaired function (secondary prevention). Healthy lifestyle practices featuring regular physical activity and ideal energy intake/diet composition represent first-line function-preserving strategies, with pharmacological agents, including existing and new pharmaceuticals and novel 'nutraceutical' compounds, serving as potential

Physiological geroscience: targeting function to increase healthspan and achieve optimal longevity

Science.gov (United States)

Justice, Jamie N.; LaRocca, Thomas J.

2015-01-01

Abstract Most nations of the world are undergoing rapid and dramatic population ageing, which presents great socio‐economic challenges, as well as opportunities, for individuals, families, governments and societies. The prevailing biomedical strategy for reducing the healthcare impact of population ageing has been ‘compression of morbidity’ and, more recently, to increase healthspan, both of which seek to extend the healthy period of life and delay the development of chronic diseases and disability until a brief period at the end of life. Indeed, a recently established field within biological ageing research, ‘geroscience’, is focused on healthspan extension. Superimposed on this background are new attitudes and demand for ‘optimal longevity’ – living long, but with good health and quality of life. A key obstacle to achieving optimal longevity is the progressive decline in physiological function that occurs with ageing, which causes functional limitations (e.g. reduced mobility) and increases the risk of chronic diseases, disability and mortality. Current efforts to increase healthspan centre on slowing the fundamental biological processes of ageing such as inflammation/oxidative stress, increased senescence, mitochondrial dysfunction, impaired proteostasis and reduced stress resistance. We propose that optimization of physiological function throughout the lifespan should be a major emphasis of any contemporary biomedical policy addressing global ageing. Effective strategies should delay, reduce in magnitude or abolish reductions in function with ageing (primary prevention) and/or improve function or slow further declines in older adults with already impaired function (secondary prevention). Healthy lifestyle practices featuring regular physical activity and ideal energy intake/diet composition represent first‐line function‐preserving strategies, with pharmacological agents, including existing and new pharmaceuticals and novel �

Translational Geroscience: Emphasizing function to achieve optimal longevity

Science.gov (United States)

Seals, Douglas R.; Melov, Simon

2014-01-01

Among individuals, biological aging leads to cellular and organismal dysfunction and an increased risk of chronic degenerative diseases and disability. This sequence of events in combination with the projected increases in the number of older adults will result in a worldwide healthcare burden with dire consequences. Superimposed on this setting are the adults now reaching traditional retirement ages--the baby boomers--a group that wishes to remain active, productive and physically and cognitively fit as they grow older. Together, these conditions are producing an unprecedented demand for increased healthspan or what might be termed “optimal longevity”—to live long, but well. To meet this demand, investigators with interests in the biological aspects of aging from model organisms to human epidemiology (population aging) must work together within an interactive process that we describe as translational geroscience. An essential goal of this new investigational platform should be the optimization and preservation of physiological function throughout the lifespan, including integrative physical and cognitive function, which would serve to increase healthspan, compress morbidity and disability into a shorter period of late-life, and help achieve optimal longevity. To most effectively utilize this new approach, we must rethink how investigators and administrators working at different levels of the translational research continuum communicate and collaborate with each other, how best to train the next generation of scientists in this new field, and how contemporary biological-biomedical aging research should be organized and funded. PMID:25324468

Optimising the introduction of multiple childhood vaccines in Japan: A model proposing the introduction sequence achieving the highest health gains.

Science.gov (United States)

Standaert, Baudouin; Schecroun, Nadia; Ethgen, Olivier; Topachevskyi, Oleksandr; Morioka, Yoriko; Van Vlaenderen, Ilse

2017-12-01

Many countries struggle with the prioritisation of introducing new vaccines because of budget limitations and lack of focus on public health goals. A model has been developed that defines how specific health goals can be optimised through immunisation within vaccination budget constraints. Japan, as a country example, could introduce 4 new pediatric vaccines targeting influenza, rotavirus, pneumococcal disease and mumps with known burden of disease, vaccine efficacies and maximum achievable coverages. Operating under budget constraints, the Portfolio-model for the Management of Vaccines (PMV) identifies the optimal vaccine ranking and combination for achieving the maximum QALY gain over a period of 10 calendar years in children optimal sequence of vaccine introduction (mumps [1st], followed by influenza [2nd], rotavirus [3rd], and pneumococcal [4th]). With exactly the same budget but without vaccine ranking, the total QALY gain can be 20% lower. The PMV model could be a helpful tool for decision makers in those environments with limited budget where vaccines have to be selected for trying to optimise specific health goals. Copyright © 2017 GlaxoSmithKline Biologicals SA. Published by Elsevier B.V. All rights reserved.

Achieve real gender equality for adolescent health | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-11-03

Nov 3, 2016 ... Achieve real gender equality for adolescent health ... yet limited access to sexual and reproductive health services is preventing women and girls ... forms of sexual violence, trafficking, and abuse and gender discrimination.

Optimal number of tests to achieve and validate product reliability

International Nuclear Information System (INIS)

Ahmed, Hussam; Chateauneuf, Alaa

2014-01-01

The reliability validation of engineering products and systems is mandatory for choosing the best cost-effective design among a series of alternatives. Decisions at early design stages have a large effect on the overall life cycle performance and cost of products. In this paper, an optimization-based formulation is proposed by coupling the costs of product design and validation testing, in order to ensure the product reliability with the minimum number of tests. This formulation addresses the question about the number of tests to be specified through reliability demonstration necessary to validate the product under appropriate confidence level. The proposed formulation takes into account the product cost, the failure cost and the testing cost. The optimization problem can be considered as a decision making system according to the hierarchy of structural reliability measures. The numerical examples show the interest of coupling design and testing parameters. - Highlights: • Coupled formulation for design and testing costs, with lifetime degradation. • Cost-effective testing optimization to achieve reliability target. • Solution procedure for nested aleatoric and epistemic variable spaces

Optimizing Health Care Environmental Hygiene.

Science.gov (United States)

Carling, Philip C

2016-09-01

This article presents a review and perspectives on aspects of optimizing health care environmental hygiene. The topics covered include the epidemiology of environmental surface contamination, a discussion of cleaning health care patient area surfaces, an overview of disinfecting health care surfaces, an overview of challenges in monitoring cleaning versus cleanliness, a description of an integrated approach to environmental hygiene and hand hygiene as interrelated disciplines, and an overview of the research opportunities and challenges related to health care environmental hygiene. Copyright © 2016 Elsevier Inc. All rights reserved.

Faculty Sense of Academic Optimism and Its Relationship to Students' Achievement in Well Performing High Schools

Science.gov (United States)

Cromartie, Michael Tyrone

2013-01-01

The aim of this study was to determine the organizational characteristics and behaviors that contribute to sustaining a culture of academic optimism as a mechanism of student achievement. While there is a developing research base identifying both the individual elements of academic optimism as well as the academic optimism construct itself as…

Optimism predicts positive health in repatriated prisoners of war.

Science.gov (United States)

Segovia, Francine; Moore, Jeffrey L; Linnville, Steven E; Hoyt, Robert E

2015-05-01

"Positive health," defined as a state beyond the mere absence of disease, was used as a model to examine factors for enhancing health despite extreme trauma. The study examined the United States' longest detained American prisoners of war, those held in Vietnam in the 1960s through early 1970s. Positive health was measured using a physical and a psychological composite score for each individual, based on 9 physical and 9 psychological variables. Physical and psychological health was correlated with optimism obtained postrepatriation (circa 1973). Linear regressions were employed to determine which variables contributed most to health ratings. Optimism was the strongest predictor of physical health (β = -.33, t = -2.73, p = .008), followed by fewer sleep complaints (β = -.29, t = -2.52, p = .01). This model accounted for 25% of the variance. Optimism was also the strongest predictor of psychological health (β = -.41, t = -2.87, p = .006), followed by Minnesota Multiphasic Personality Inventory-Psychopathic Deviate (MMPI-PD; McKinley & Hathaway, 1944) scores (β = -.23, t = -1.88, p = .07). This model strongly suggests that optimism is a significant predictor of positive physical and psychological health, and optimism also provides long-term protective benefits. These findings and the utility of this model suggest a promising area for future research and intervention. (c) 2015 APA, all rights reserved).

Mitigating India's health woes: Can health insurance be a remedy to achieve universal health coverage?

Directory of Open Access Journals (Sweden)

B Savitha

2016-01-01

Full Text Available A low level of public investments in preventive health facilities and medical care facilities and health professionals has given rise to poor health status for an average Indian. Insufficient government funding for health care, inadequate and ineffective health financing mechanisms, poor delivery of health care, especially in public facilities, and excessive reliance on unregulated high-cost private providers have contributed to the poor accomplishment of Millennium Development Goals, especially in the informal sector. Sustainable Development Goals (SDGs consider health to be one of the important objectives to be achieved by all the nations in the world. This paper reappraises the current status, unmet needs, challenges, and the way forward to implement and achieve universal health coverage (UHC in India by thrusting the focus on three elements (pillars of universal access to health services. Despite seven decades of independence, India does still face the formidable challenge of providing health services to its population at an affordable cost. One of the major obstacles in reaching universal coverage and universal health entitlement of every Indian citizen has been the absence of effective health financing mechanism that promotes affordable access to weaker and vulnerable sections of the society. In this respect, health insurance certainly does have the potential to expedite the process of UHC if various stakeholders work in cohesion under the government stewardship. In rural India, the health infrastructure and workforce are inadequate to serve the unserved and underserved population. Hence, the government should invest in public health facilities while promoting pan-India health insurance to ensure and guarantee easy access and affordability for its citizens. The way forward should not only be centered on financial protection, but also to have renewed emphasis on restructuring the health-care system, ensuring the adequate availability of

A Blueprint for Innovation to Achieve Health System Transformation.

Science.gov (United States)

Snowdon, Anne W

2017-01-01

Global health systems are challenged by escalating costs and growing demands for care created by the demands of aging populations and rising rates of chronic illness which place unsustainable pressure on health systems to meet population health needs. To overcome these challenges, transformational change is needed to strengthen health system performance and sustainability. Innovation is widely viewed as the strategy to drive transformational change in health systems; yet to date, innovation has lacked a clearly defined focus or agenda to achieve transformation. An actionable innovation agenda is needed to achieve transformational change for health systems. The key conditions for success as an innovation strategy are examined, including clearly defined innovation objectives, key milestones, and actionable steps every system stakeholder must pursue in order to guide the innovation agenda and ultimately accelerate the transformational changes needed for a sustainable healthcare system that delivers value to populations.

Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

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Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

2014-02-01

Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Pro-health role of optimism among people with mental disorders

Directory of Open Access Journals (Sweden)

Karolina Potempa

2014-12-01

Full Text Available Aim: Many scientific reports indicate that optimism positively affects our psychophysical well-being. The main purpose of the conducted research was to verify whether optimism is a predictor of health-oriented resources also in patients with paranoid schizophrenia, depressive disorders and depressive schizoaffective disorders. The following health-oriented factors were evaluated in the study: health behaviour, life satisfaction, social functioning and coping with stress. Furthermore, we have verified whether there were any differences related to the level of optimism and health-oriented factors between individuals with mental disorders and a control group. Methods: The following tools were used in the study: Optimism Questionnaire, Health-Related Behaviour Inventory, Coping Inventory for Stressful Situations, Satisfaction with Life Scale, Social and Occupational Functioning Assessment Scale, Beck Depression Inventory. Results: Effects of optimism on some of the health-oriented factors were observed in patients with mental disorders as well as in healthy individuals. Significant differences in the level of health-oriented resources between the study population and controls were reported. Conclusions: The study suggests that generalisation of the conclusions regarding healthy population to individuals with mental disorders should be done with caution. Further research is needed to investigate the health behaviour determinants in patients with mental disorders.

An exercise in nostalgia: Nostalgia promotes health optimism and physical activity.

Science.gov (United States)

Kersten, Mike; Cox, Cathy R; Van Enkevort, Erin A

2016-10-01

Previous research has shown that nostalgia, a sentimental longing for the past, leads to greater feelings of optimism, with other work demonstrating that optimistic thinking (general & health-orientated) is associated with better physical and psychological health. Integrating these two lines of research, the current studies examined whether nostalgia-induced health optimism promotes attitudes and behaviours associated with better physical well-being. Participants, in three experiments, were randomly assigned to write about either a nostalgic or ordinary event. Following this, everyone completed a measure of health optimism (Studies 1-3), measures of health attitudes (Study 2) and had their physical activity monitored over the course of 2 weeks (Study 3). The results revealed that, in comparison to control conditions, nostalgic reverie led to greater health optimism (Studies 1-3). Further, heightened health optimism following nostalgic reflection led to more positive health attitudes (Study 2), and increased physical activity over a two-week period (i.e. Fitbit activity trackers; Study 3). These findings highlight the importance of nostalgia on health attitudes and behaviours. Specifically, this work suggests that nostalgia can be used as a mechanism to increase the importance, perceived efficacy and behaviour associated with better physical health.

Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

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Fusheini, Adam; Eyles, John

2016-10-07

Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

The Role of a Provider-Sponsored Health Plan in Achieving Scale and Integration.

Science.gov (United States)

Johnson, Steven P

2016-01-01

In pursuit of two primary strategies-to become an integrated delivery network (IDN) on the local level and to achieve additional overall organizational scale to sustain operations-Health First, based in Rockledge, Florida, relies on the success of its provider-sponsored health plan (PSHP) as a critical asset. For Health First, the PSHP serves as an agent for holding and administering financial risk for the health of populations. In addition, we are learning that our PSHP is a critical asset in support of integrating the components of our care delivery system to manage that financial risk effectively, efficiently, and in a manner that creates a unified experience for the customer.Health First is challenged by continuing pressure on reimbursement, as well as by a substantial regulatory burden, as we work to optimize the environments and tools of care and population health management. Even with strong margins and a healthy balance sheet, we simply do not have the resources needed to bring an IDN robustly to life. However, we have discovered that our PSHP can be the vehicle that carries us to additional scale. Many health systems do not own or otherwise have access to a PSHP to hold and manage financial risk. Health First sought and found a not-for-profit health system with complementary goals and a strong brand to partner with, and we now provide private-label health plan products for that system using its strong name while operating the insurance functions under our license and with our capabilities.

Optimizing the efficacy of multimedia consumer health information.

Science.gov (United States)

Monkman, Helen; Kushniruk, Andre W

2015-01-01

Using two or more communication methods (e.g., text, narration, pictures, animation, video) is known as multimedia. Multimedia has been used in a broad range of domains. Not surprisingly, multimedia is gaining popularity in the field of consumer health information as its benefits are being recognized. However, there is a large body of evidence in the cognitive literature that could be used to inform and optimize multimedia presentation of consumer health information. This paper outlines the Cognitive Theory of Multimedia Learning (CTML) and presents the application of this model for consumer health informatics. The CTML is a valuable resource for the development and revision of consumer health information to optimize its efficacy. Current research on multimedia and consumer health information is described. Finally, the outstanding opportunities to leverage the CTML for consumer health information are discussed.

Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

Science.gov (United States)

Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

2014-01-01

Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

Optimal Sensor Selection for Health Monitoring Systems

Science.gov (United States)

Santi, L. Michael; Sowers, T. Shane; Aguilar, Robert B.

2005-01-01

Sensor data are the basis for performance and health assessment of most complex systems. Careful selection and implementation of sensors is critical to enable high fidelity system health assessment. A model-based procedure that systematically selects an optimal sensor suite for overall health assessment of a designated host system is described. This procedure, termed the Systematic Sensor Selection Strategy (S4), was developed at NASA John H. Glenn Research Center in order to enhance design phase planning and preparations for in-space propulsion health management systems (HMS). Information and capabilities required to utilize the S4 approach in support of design phase development of robust health diagnostics are outlined. A merit metric that quantifies diagnostic performance and overall risk reduction potential of individual sensor suites is introduced. The conceptual foundation for this merit metric is presented and the algorithmic organization of the S4 optimization process is described. Representative results from S4 analyses of a boost stage rocket engine previously under development as part of NASA's Next Generation Launch Technology (NGLT) program are presented.

Assessment of health risk due to PM 10 using fuzzy linear membership kriging with particle swarm optimization

International Nuclear Information System (INIS)

Singh, Jeetendra B.; Reddy, Vijay S.; Jana, Soumya; De, Swades

2013-01-01

Air quality is an important determinant of individual as well as broader well-being. Major pollutants include gasses as well as assorted suspended particulate matter (PM). In this paper, we focus on PM10, which are a collection of particles with median aerodynamic diameter less than 10 μm that remains suspended in the air for long periods. PM10, usually consist of smoke, dirt and dust particles, as well as spores and pollen, could easily be inhaled deep into lung. As a result, high outdoor PM10 concentration poses significant health hazard, and accurate modeling and prediction of health risk due to PM10 assume importance in pollution and public health management. In this backdrop, we propose an improved health risk assessment technique, and demonstrate its efficacy using widely used California PM10 database. At the heart of the proposed method lies indicator kriging, a well-known risk estimation technique. However, improved assessment of subjective health risk is achieved by posing the problem in a fuzzy setting, and optimizing the associated membership functions. In particular, we employ particle swarm optimization (PSO) algorithm, which has been motivated by natural behavior of organisms such as fish-schooling and bird flocking, and proven effective in various optimization contexts. We apply the fuzzy PSO membership grade kriging technique to predict the PM10 spatial distribution over the entire California state. (orig.)

Assessment of health risk due to PM 10 using fuzzy linear membership kriging with particle swarm optimization

Energy Technology Data Exchange (ETDEWEB)

Singh, Jeetendra B.; Reddy, Vijay S.; Jana, Soumya [Indian Institute of Technology, Hyderabad (India). Dept. of Electrical Engineering; De, Swades [Indian Institute of Technology, Delhi (India). Dept. of Electrical Engineering

2013-07-01

Air quality is an important determinant of individual as well as broader well-being. Major pollutants include gasses as well as assorted suspended particulate matter (PM). In this paper, we focus on PM10, which are a collection of particles with median aerodynamic diameter less than 10 {mu}m that remains suspended in the air for long periods. PM10, usually consist of smoke, dirt and dust particles, as well as spores and pollen, could easily be inhaled deep into lung. As a result, high outdoor PM10 concentration poses significant health hazard, and accurate modeling and prediction of health risk due to PM10 assume importance in pollution and public health management. In this backdrop, we propose an improved health risk assessment technique, and demonstrate its efficacy using widely used California PM10 database. At the heart of the proposed method lies indicator kriging, a well-known risk estimation technique. However, improved assessment of subjective health risk is achieved by posing the problem in a fuzzy setting, and optimizing the associated membership functions. In particular, we employ particle swarm optimization (PSO) algorithm, which has been motivated by natural behavior of organisms such as fish-schooling and bird flocking, and proven effective in various optimization contexts. We apply the fuzzy PSO membership grade kriging technique to predict the PM10 spatial distribution over the entire California state. (orig.)

The Bangladesh paradox: exceptional health achievement despite economic poverty.

Science.gov (United States)

Chowdhury, A Mushtaque R; Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina; Hussain, Zakir; Chen, Lincoln C

2013-11-23

Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

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Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

2014-01-01

It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

Effects of optimism on recovery and mental health after a tornado outbreak.

Science.gov (United States)

Carbone, Eric G; Echols, Erin Thomas

2017-05-01

Dispositional optimism, a stable expectation that good things will happen, has been shown to improve health outcomes in a wide range of contexts, but very little research has explored the impact of optimism on post-disaster health and well-being. Data for this study come from the Centers for Disease Control and Prevention's Public health systems and mental health community recovery (PHSMHCR) Survey. Participants included 3216 individuals living in counties affected by the April 2011 tornado outbreak in Mississippi and Alabama. This study assesses the effect of dispositional optimism on post-disaster recovery and mental health. Dispositional optimism was found to have a positive effect on personal recovery and mental health after the disaster. Furthermore, it moderated the relationship between level of home damage and personal recovery as well as the relationship between home damage and post-traumatic stress disorder (PTSD), with stronger effects for those with increased levels of home damage. The utility of screening for optimism is discussed, along with the potential for interventions to increase optimism as a means of mitigating adverse mental health effects and improving the recovery of individuals affected by disasters and other traumatic events.

Optimal achieved blood pressure in acute intracerebral hemorrhage: INTERACT2.

Science.gov (United States)

Arima, Hisatomi; Heeley, Emma; Delcourt, Candice; Hirakawa, Yoichiro; Wang, Xia; Woodward, Mark; Robinson, Thompson; Stapf, Christian; Parsons, Mark; Lavados, Pablo M; Huang, Yining; Wang, Jiguang; Chalmers, John; Anderson, Craig S

2015-02-03

To investigate the effects of intensive blood pressure (BP) lowering according to baseline BP levels and optimal achieved BP levels in patients with acute intracerebral hemorrhage (ICH). INTERACT2 was an open, blinded endpoint, randomized controlled trial in 2,839 patients with ICH within 6 hours of onset and elevated systolic BP (SBP) (150-220 mm Hg) who were allocated to receive intensive (target SBP <140 mm Hg within 1 hour, with lower limit of 130 mm Hg for treatment cessation) or guideline-recommended (target SBP <180 mm Hg) BP-lowering treatment. Outcome was physical function across all 7 levels of the modified Rankin Scale at 90 days. Analysis of the randomized comparisons showed that intensive BP lowering produced comparable benefits on physical function at 90 days in 5 subgroups defined by baseline SBP of <160, 160-169, 170-179, 180-189, and ≥190 mm Hg (p homogeneity = 0.790). Analyses of achieved BP showed linear increases in the risk of physical dysfunction for achieved SBP above 130 mm Hg for both hyperacute (1-24 hours) and acute (2-7 days) phases while modest increases were also observed for achieved SBP below 130 mm Hg. Intensive BP lowering appears beneficial across a wide range of baseline SBP levels, and target SBP level of 130-139 mm Hg is likely to provide maximum benefit in acute ICH. This study provides Class I evidence that the effect of intensive BP lowering on physical function is not influenced by baseline BP. © 2014 American Academy of Neurology.

Healthful School Living: Environmental Health in the School.

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Rowe, Daryl E.

1987-01-01

Environmental health, as it relates to schools, is defined. Site, chemical, biological, and physical health hazards are identified. Recommendations and precautions to help achieve optimal health, safety, and comfort are presented. Resources are noted. (Author/MT)

Achieving universal health coverage in small island states: could importing health services provide a solution?

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Walls, Helen; Smith, Richard

2018-01-01

Background Universal health coverage (UHC) is difficult to achieve in settings short of medicines, health workers and health facilities. These characteristics define the majority of the small island developing states (SIDS), where population size negates the benefits of economies of scale. One option to alleviate this constraint is to import health services, rather than focus on domestic production. This paper provides empirical analysis of the potential impact of this option. Methods Analysis was based on publicly accessible data for 14 SIDS, covering health-related travel and health indicators for the period 2003–2013, together with in-depth review of medical travel schemes for the two highest importing SIDS—the Maldives and Tuvalu. Findings Medical travel from SIDS is accelerating. The SIDS studied generally lacked health infrastructure and technologies, and the majority of them had lower than the recommended number of physicians in a country, which limits their capacity for achieving UHC. Tuvalu and the Maldives were the highest importers of healthcare and notably have public schemes that facilitate medical travel and help lower the out-of-pocket expenditure on medical travel. Although different in approach, design and performance, the medical travel schemes in Tuvalu and the Maldives are both examples of measures used to increase access to health services that cannot feasibly be provided in SIDS. Interpretation Our findings suggest that importing health services (through schemes to facilitate medical travel) is a potential mechanism to help achieve universal healthcare for SIDS but requires due diligence over cost, equity and quality control. PMID:29527349

The contracting round: achieving health gain or financial balance?

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McCarthy, M

1998-12-01

In the 1991 National Health Service reforms, health authorities became responsible for the health of their resident population, and they contract for health services from NHS providers - trusts and primary care services. A case study in Camden and Islington, an inner London health district, during 1996-1997 shows that contracting was directed more towards achieving financial balance than health objectives. Reasons include the inflationary effect of competition within an internal market, the power of administrators in decision-making within the health authority, and lack of adequate financial accounting in the NHS to relate costs to health outcomes. The introduction of programme budgets for districts would provide more cost-effective use of the nation's resources.

Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

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Lan, Jesse Yu-Chen

2017-12-01

The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

Results of a workplace health campaign: what can be achieved?

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Leyk, Dieter; Rohde, Ulrich; Hartmann, Nadine D; Preuß, Philipp A; Sievert, Alexander; Witzki, Alexander

2014-05-02

Effective health promotion in the workplace is now essential because of the rising health-related costs for businesses, the increasing pressure arising from international competition, prolonged working lives, and the aging of the work force. The basic problem of prevention campaigns is that the target groups are too rarely reached and sustainable benefits too rarely achieved. In 2011, we carried out a broad-based health and fitness campaign to assess how many personnel could be motivated to participate in a model study under nearly ideal conditions. 1010 personnel were given the opportunity to participate in various kinds of sports, undergo sports-medicine examinations, attend monthly expert lectures, and benefit from nutritional offerings and Intranet information during work hours. Pseudonymized questionnaires were used to classify the participants according to their exercise behavior as non-active, not very active, and very active. The participants' subjective responses (regarding, e.g., health, exercise, nutrition, and the factors that motivated them to participate in sports or discouraged them from doing so) were recorded, as were their objective data (measures of body size and strength). The duration of the study was one year. 490 of the 1010 personnel (48.5%, among whom 27.2% were nonactive, 44.1% not very active, and 28.7% very active) participated in the initial questionnaire and testing. By the end of the study, this figure had dropped to 17.8%; diminished participation affected all three groups to a comparable extent. A comparison of dropouts and non-dropouts revealed that older age was a stable predictor for drop-out (bivariate odds ratio [OR] 1.028, p = 0.006; multivariate OR 1.049, p = 0.009). The study participants reported beneficial effects on their health and health awareness, performance ability, psychological balance, stress perception, exercise and dietary behavior. Even under optimal conditions and with high use of staff resources, this model

Health transformation plan: Goals achievement in Nemazee hospital

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Ali Akbar Ahmadi

2016-01-01

Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

The roles of veterinary, medical and environmental professionals to achieve ONE HEALTH

Directory of Open Access Journals (Sweden)

Mahendra Pal

2014-12-01

Full Text Available According to the WHO- “Health is a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity”. The good health is the fundamental right of all the people on earth. The concept of ‘One Medicine’ coined by Calvin W. Schwabe evolves towards ’One Health’ which comprises collaborative efforts of multiple disciplines to achieve perfect health of people, animals, and our environment. ‘One Health’ deals with the challenges at the intersection of animal, human and environment health including the infectious diseases, the global food crises, and climate change due to global warming. The cordial and active association of various disciplines such as medicine, veterinary, public health, environment, wildlife, ecology, and food hygiene is highly emphasized in order to achieve the goal of ‘One Health’. This mini-review describes brief history of ‘one health’, the roles of veterinary, medical and environmental professionals, and developing collaboration with various concern professionals to achieve ‘one health’. In addition, the selected achievements of ‘one health’ in the past 10 years have been described along with the challenges ahead for the successful implementation of such concept.

Optimal health insurance contract : can moral hazard increase indemnity ?

OpenAIRE

Bien, Franck; Alary, David

2006-01-01

In this note, we generalize the results obtained by Barday and Lesur (2005) by considering a bivariated non separable utility function. We characterize optimal health insurance contracts. Moreover, we show that under moral hazard a sufficiently high risk aversion implies that the optimal coverage and the optimal preventive effort are higher than with perfect information.

Can biosimilars help achieve the goals of US health care reform?

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Boccia, Ralph; Jacobs, Ira; Popovian, Robert; de Lima Lopes, Gilberto

2017-01-01

The US Patient Protection and Affordable Care Act (ACA) aims to expand health care coverage, contain costs, and improve health care quality. Accessibility and affordability of innovative biopharmaceuticals are important to the success of the ACA. As it is substantially more difficult to manufacture them compared with small-molecule drugs, many of which have generic alternatives, biologics may increase drug costs. However, biologics offer demonstrated improvements in patient care that can reduce expensive interventions, thus lowering net health care costs. Biosimilars, which are highly similar to their reference biologics, cost less than the originators, potentially increasing access through reduced prescription drug costs while providing equivalent therapeutic results. This review evaluates 1) the progress made toward enacting health care reform since the passage of the ACA and 2) the role of biosimilars, including the potential impact of expanded biosimilar use on access, health care costs, patient management, and outcomes. Barriers to biosimilar adoption in the USA are noted, including low awareness and financial disincentives relating to reimbursement. The evaluated evidence suggests that the ACA has partly achieved some of its aims; however, the opportunity remains to transform health care to fully achieve reform. Although the future is uncertain, increased use of biosimilars in the US health care system could help achieve expanded access, control costs, and improve the quality of care.

Anger and health in dementia caregivers: exploring the mediation effect of optimism.

Science.gov (United States)

López, J; Romero-Moreno, R; Márquez-González, M; Losada, A

2015-04-01

Although previous studies indicate a negative association between caregivers' anger and health, the potential mechanisms linking this relationship are not yet fully understood. The aim of this study was to explore the potential mediating role of optimism in the relationship between anger and caregivers' physical health. Dementia caregivers (n = 108) were interviewed and filled out instruments assessing their anger (reaction), optimism and health (vitality). A mediational model was tested to determine whether optimism partially mediated the relationship between anger and vitality. Angry reaction was negatively associated with optimism and vitality; optimism was positively associated with vitality. Finally, the relationship between angry reaction and vitality decreased when optimism was entered simultaneously. A non-parametric bootstrap approach confirmed that optimism significantly mediated some of the relationship between angry reaction and vitality. These findings suggest that low optimism may help explain the association between caregivers' anger and reduced sense of vitality. The results provide a specific target for intervention with caregivers. Copyright © 2013 John Wiley & Sons, Ltd.

Flux consumption optimization and the achievement of 1 MA discharges on NSTX

International Nuclear Information System (INIS)

Menard, J.; LeBlanc, B.; Sabbagh, S.A.

2001-01-01

The spherical tokamak (ST), because of its slender central column, has very limited volt-second capability relative to a standard aspect ratio tokamak of similar plasma cross-section. Recent experiments on the National Spherical Torus Experiment (NSTX) have begun to quantify and optimize the ohmic current drive efficiency in a MA-class ST device. Sustainable ramp-rates in excess of 5MA/sec during the current rise phase have been achieved on NSTX, while faster ramps generate significant MHD activity. Discharges with I P exceeding 1MA have been achieved in NSTX with nominal parameters: aspect ratio A=1.3-1.4, elongation κ=2-2.2, triangularity δ=0.4, internal inductance l i =0.6, and Ejima coefficient C E =0.35. Flux consumption efficiency results, performance improvements associated with first boronization, and comparisons to neoclassical resistivity are described. (author)

Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka.

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de Silva, Amala; Ranasinghe, Thushara; Abeykoon, Palitha

2016-09-01

With state-funded health care that is free at the point of delivery, a sound primary health-care policy and widespread health-care services, Sri Lanka seems a good example of universal health coverage. Yet, health transition and disparities in provision and financing threaten this situation. Sri Lanka did well on the Millennium Development Goal health indicators, but the Sustainable Development Goal (SDG) for health has a wider purview, which is to "ensure healthy lives and promote well-being for all at all ages". The gender gap in life expectancy and the gap between life expectancy and healthy life expectancy make achievement of the health SDG more challenging. Although women and children do well overall, the comparative health disadvantage for men in Sri Lanka is a cause for concern. From a financing perspective, high out-of-pocket expenditure and high utilization of the private sector, even by those in the lowest income quintile, are concerns, as is the emerging "third tier", where some individuals accessing state health care that is free at the point of delivery actually bear some of the costs of drugs, investigations and surgery. This cost sharing is resulting in catastrophic health expenditure for individuals, and delays in and non-compliance with treatment. These concerns about provision and financing must be addressed, as health transition will intensify the morbidity burden and loss of well-being, and could derail plans to achieve the health SDG.

[Actively promote nutrition and health surveillance, achieve the national nutrition and health goals].

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Ding, Gangqiang; Zhao, Wenhua; Chen, Junshi

2016-03-01

The results of Chinese Nutrition and Health Surveillance (2010-2012) showed that the anemia prevalence in China reduced significantly compared with 2002, and people's nutrition and health status have improved. Unbalanced diet still exist, such as low intake of vegetables and fruits, and high intake of salt. The serum total cholesterol level and the prevalence of hypercholesterolemia and borderline high cholesterolemia were high among urban adults, and more attention should be paid for high serum total cholesterol level among older adults. These results are significant to the development of nutrition and health intervention strategy, carry out nutrition intervention and the achievement of national nutrition and health goals.

Constrained Optimization Methods in Health Services Research-An Introduction: Report 1 of the ISPOR Optimization Methods Emerging Good Practices Task Force.

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Crown, William; Buyukkaramikli, Nasuh; Thokala, Praveen; Morton, Alec; Sir, Mustafa Y; Marshall, Deborah A; Tosh, Jon; Padula, William V; Ijzerman, Maarten J; Wong, Peter K; Pasupathy, Kalyan S

2017-03-01

Providing health services with the greatest possible value to patients and society given the constraints imposed by patient characteristics, health care system characteristics, budgets, and so forth relies heavily on the design of structures and processes. Such problems are complex and require a rigorous and systematic approach to identify the best solution. Constrained optimization is a set of methods designed to identify efficiently and systematically the best solution (the optimal solution) to a problem characterized by a number of potential solutions in the presence of identified constraints. This report identifies 1) key concepts and the main steps in building an optimization model; 2) the types of problems for which optimal solutions can be determined in real-world health applications; and 3) the appropriate optimization methods for these problems. We first present a simple graphical model based on the treatment of "regular" and "severe" patients, which maximizes the overall health benefit subject to time and budget constraints. We then relate it back to how optimization is relevant in health services research for addressing present day challenges. We also explain how these mathematical optimization methods relate to simulation methods, to standard health economic analysis techniques, and to the emergent fields of analytics and machine learning. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

Science.gov (United States)

Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

2014-01-01

Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

Public Health Achievements and Challenges: Symposium of the University of Mostar Faculty of Health Studies.

Science.gov (United States)

Ravlija, Jelena; Vasilj, Ivan; Babic, Dragan; Marijanovic, Inga

2017-05-01

Public health is an important area of health care that reflects the readiness of the state and society to provide the welfare of all citizens through the promotion of health and the preservation of a healthy environment - factors that directly affect the health of the population. The field of public health is very broad and its concept is changing over time, being defined in a narrower and wider sense. In short, public health is a science and practice that aims at ensuring the conditions in which people can preserve and improve their health and prevent health damage. The third millennium brings its specifics, needs and priorities according to challenges public health is faced by in the twenty-first century: the economic crisis, rising inequality, population aging, rising rates of chronic diseases, migration, urbanization, ecosystem change, climate change, etc. The role of public health is to protect, improve health, prevent diseases and injuries. Such a public health approach implies a multisectoral work focusing on "wider health determinants", and within this activity experts from various medical and non-medical profiles, whose field of public health is concerned, can be found. The development of inter-departmental co-operation skills contributes to a better understanding of health professionals and professionals of other profiles, and facilitates common, synergistic actions in addressing public health problems in the community. Symposium on Public Health Achievements and Challenges organized by the University of Mostar Faculty of Health Studies is just another indication of the obligation, the need and the desire for professional and scientific contribution to the fight for better health. Our faculty has so far organized other numerous symposia, and the aim of this symposium is to present public health achievements and challenges in our surrounding in order to protect, improve health, prevent diseases and injuries in a modern way.

SU-G-BRC-01: A Data-Driven Pre-Optimization Method for Prediction of Achievability of Clinical Objectives in IMRT

Energy Technology Data Exchange (ETDEWEB)

Ranganathan, V; Kumar, P [Philips India Limited, Bangalore, Karnataka (India); Bzdusek, K [Philips, Fitchburg, WI (United States); Das, J Maria [Sanjay Gandhi PG Inst Med Scienes, Lucknow (India)

2016-06-15

Purpose: We propose a novel data-driven method to predict the achievability of clinical objectives upfront before invoking the IMRT optimization. Methods: A new metric called “Geometric Complexity (GC)” is used to estimate the achievability of clinical objectives. Here, GC is the measure of the number of “unmodulated” beamlets or rays that intersect the Region-of-interest (ROI) and the target volume. We first compute the geometric complexity ratio (GCratio) between the GC of a ROI (say, parotid) in a reference plan and the GC of the same ROI in a given plan. The GCratio of a ROI indicates the relative geometric complexity of the ROI as compared to the same ROI in the reference plan. Hence GCratio can be used to predict if a defined clinical objective associated with the ROI can be met by the optimizer for a given case. Basically a higher GCratio indicates a lesser likelihood for the optimizer to achieve the clinical objective defined for a given ROI. Similarly, a lower GCratio indicates a higher likelihood for the optimizer to achieve the clinical objective defined for the given ROI. We have evaluated the proposed method on four Head and Neck cases using Pinnacle3 (version 9.10.0) Treatment Planning System (TPS). Results: Out of the total of 28 clinical objectives from four head and neck cases included in the study, 25 were in agreement with the prediction, which implies an agreement of about 85% between predicted and obtained results. The Pearson correlation test shows a positive correlation between predicted and obtained results (Correlation = 0.82, r2 = 0.64, p < 0.005). Conclusion: The study demonstrates the feasibility of the proposed method in head and neck cases for predicting the achievability of clinical objectives with reasonable accuracy.

[Psychological benefits of physical activity for optimal mental health].

Science.gov (United States)

Poirel, Emmanuel

Mental health is a worldwide public health concern, as can be seen from the WHO's comprehensive mental health action plan 2013-2020 which was adopted by the 66th World Health Assembly. According to the Mental health commission of Canada (2012), one in five Canadians will personally experience a mental illness in their lifetime, and the WHO shows that mental illness represents the second most prevalent risk of morbidity after heart disease. Physical activity certainly provides an answer to this problem. Physical activity has been shown to improve physical health but it is also one of the most natural and accessible means to improve mental health. The aim of the present article is to propose a biopsychosocial model on the basis of a literature review on the psychological benefits of physical activity. In view of the findings we assume that physical activity increases mental well-being and optimal mental health as opposed to poor mental health. Hence, physical activity provides a state of well-being that enables individuals to realize their own potential, and that helps to cope with the normal stresses of life or adversity. The model certainly opens the way for research and new hypothesis, but it also aims at the promotion of the benefits of physical activity on psychological well-being for optimal mental health.

What research impacts do Australian primary health care researchers expect and achieve?

Directory of Open Access Journals (Sweden)

Reed Richard L

2011-11-01

Full Text Available Abstract Background Funding for research is under pressure to be accountable in terms of benefits and translation of research findings into practice and policy. Primary health care research has considerable potential to improve health care in a wide range of settings, but little is known about the extent to which these impacts actually occur. This study examines the impact of individual primary health care research projects on policy and practice from the perspective of Chief Investigators (CIs. Methods The project used an online survey adapted from the Buxton and Hanney Payback Framework to collect information about the impacts that CIs expected and achieved from primary health care research projects funded by Australian national competitive grants. Results and Discussion Chief Investigators (CIs provided information about seventeen completed projects. While no CI expected their project to have an impact in every domain of the framework used in the survey, 76% achieved at least half the impacts they expected. Sixteen projects had published and/or presented their work, 10 projects included 11 doctorate awards in their research capacity domain. All CIs expected their research to lead to further research opportunities with 11 achieving this. Ten CIs achieved their expectation of providing information for policy making but only four reported their research had influenced policy making. However 11 CIs achieved their expectation of providing information for organizational decision making and eight reported their research had influenced organizational decision making. Conclusion CIs reported that nationally funded primary health care research projects made an impact on knowledge production, staff development and further research, areas within the realm of influence of the research team and within the scope of awareness of the CIs. Some also made an impact on policy and organizational decision-making, and on localized clinical practice and service

How to achieve a collaborative approach in health promotion: preferences and ideas of users of mental health services.

Science.gov (United States)

Pals, Regitze Anne Saurbrey; Hempler, Nana Folmann

2018-02-12

Collaborative approaches to consensus building or decision-making are beneficial in health-promoting activities targeting users of mental health services (users). However, little is known about how to achieve a collaborative approach in practice. The purpose of this study was to explore: (1) users' preferences and ideas related to achieving a collaborative approach in health-related communication and (2) perspectives of healthcare and social work professionals and family members on users' ideas and preferences. Data were collected through interactive workshops with users (n = 15), professionals (n = 21) and users' family members (n = 12). Data were analysed using systematic text condensation. Users provided three recommendations for establishing a collaborative approach in communication about health: (1) involving users in deciding the agenda and setting for health-promoting activities; (2) exchanging knowledge between users and professionals about health and values; and (3) exploring users' motivation for change. Users and professionals had diverging perceptions of the value of establishing a collaborative approach. Professionals regarded relationship building and health promotion as separate phenomena, whereas users perceived relationship building as inherently health promoting. Family members of users requested specific guidance and support with regard to clarifying and fulfilling the best possible support role as a family member. The findings suggest that a collaborative approach in health promotion may be difficult to achieve without a focus on professional development for healthcare and social work professionals. © 2018 Nordic College of Caring Science.

Integrating epidemiology, psychology, and economics to achieve HPV vaccination targets.

Science.gov (United States)

Basu, Sanjay; Chapman, Gretchen B; Galvani, Alison P

2008-12-02

Human papillomavirus (HPV) vaccines provide an opportunity to reduce the incidence of cervical cancer. Optimization of cervical cancer prevention programs requires anticipation of the degree to which the public will adhere to vaccination recommendations. To compare vaccination levels driven by public perceptions with levels that are optimal for maximizing the community's overall utility, we develop an epidemiological game-theoretic model of HPV vaccination. The model is parameterized with survey data on actual perceptions regarding cervical cancer, genital warts, and HPV vaccination collected from parents of vaccine-eligible children in the United States. The results suggest that perceptions of survey respondents generate vaccination levels far lower than those that maximize overall health-related utility for the population. Vaccination goals may be achieved by addressing concerns about vaccine risk, particularly those related to sexual activity among adolescent vaccine recipients. In addition, cost subsidizations and shifts in federal coverage plans may compensate for perceived and real costs of HPV vaccination to achieve public health vaccination targets.

Organizational attributes that assure optimal utilization of public health nurses.

Science.gov (United States)

Meagher-Stewart, Donna; Underwood, Jane; MacDonald, Mary; Schoenfeld, Bonnie; Blythe, Jennifer; Knibbs, Kristin; Munroe, Val; Lavoie-Tremblay, Mélanie; Ehrlich, Anne; Ganann, Rebecca; Crea, Mary

2010-01-01

Optimal utilization of public health nurses (PHNs) is important for strengthening public health capacity and sustaining interest in public health nursing in the face of a global nursing shortage. To gain an insight into the organizational attributes that support PHNs to work effectively, 23 focus groups were held with PHNs, managers, and policymakers in diverse regions and urban and rural/remote settings across Canada. Participants identified attributes at all levels of the public health system: government and system-level action, local organizational culture of their employers, and supportive management practices. Effective leadership emerged as a strong message throughout all levels. Other organizational attributes included valuing and promoting public health nursing; having a shared vision, goals, and planning; building partnerships and collaboration; demonstrating flexibility and creativity; and supporting ongoing learning and knowledge sharing. The results of this study highlight opportunities for fostering organizational development and leadership in public health, influencing policies and programs to optimize public health nursing services and resources, and supporting PHNs to realize the full scope of their competencies.

Quantitative Guidance for Stove Usage and Performance to Achieve Health and Environmental Targets.

Science.gov (United States)

Johnson, Michael A; Chiang, Ranyee A

2015-08-01

Displacing the use of polluting and inefficient cookstoves in developing countries is necessary to achieve the potential health and environmental benefits sought through clean cooking solutions. Yet little quantitative context has been provided on how much displacement of traditional technologies is needed to achieve targets for household air pollutant concentrations or fuel savings. This paper provides instructive guidance on the usage of cooking technologies required to achieve health and environmental improvements. We evaluated different scenarios of displacement of traditional stoves with use of higher performing technologies. The air quality and fuel consumption impacts were estimated for these scenarios using a single-zone box model of indoor air quality and ratios of thermal efficiency. Stove performance and usage should be considered together, as lower performing stoves can result in similar or greater benefits than a higher performing stove if the lower performing stove has considerably higher displacement of the baseline stove. Based on the indoor air quality model, there are multiple performance-usage scenarios for achieving modest indoor air quality improvements. To meet World Health Organization guidance levels, however, three-stone fire and basic charcoal stove usage must be nearly eliminated to achieve the particulate matter target (< 1-3 hr/week), and substantially limited to meet the carbon monoxide guideline (< 7-9 hr/week). Moderate health gains may be achieved with various performance-usage scenarios. The greatest benefits are estimated to be achieved by near-complete displacement of traditional stoves with clean technologies, emphasizing the need to shift in the long term to near exclusive use of clean fuels and stoves. The performance-usage scenarios are also provided as a tool to guide technology selection and prioritize behavior change opportunities to maximize impact.

Bridging miles to achieve milestones: Corporate social responsibility for primary health care.

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Gulati, Ruchie

2017-01-01

Sustainable Developmental Goals aim to provide "Good health for all". The task though immense ,requires equitable and efficient distribution of health resources to the community, reached predominantly by the Primary Health Centres. Strengthening these centres is essential to attain the goal. Adequate health financing is one of the important determinants for utilizing the optimal potential of these centres . Pooling funds from alternate financing strategies as Corporate Social Responsibility (CSR) funds may give impetus and facilitate healthcare affordability to the underserved population. This convergence of vision of corporate funding for "basic health services" may bridge the gap arising out of inadequate funding and facilitate "Good Health for all" in India.

How Academic Health Systems Can Achieve Population Health in Vulnerable Populations Through Value-Based Care: The Critical Importance of Establishing Trusted Agency.

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Wesson, Donald E; Kitzman, Heather E

2018-01-16

Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve. Health systems will need the help of community entities and individuals who have the trust of the population being served to act on behalf of the health system if they are to achieve this effective working partnership. The need for these trusted agents is particularly pertinent for vulnerable and historically underserved segments of the population. In this Invited Commentary, the authors discuss ways by which health systems might identify, engage, and leverage trusted agents to improve the health of the population through value-based care.

Understanding and benchmarking health service achievement of policy goals for chronic disease

Science.gov (United States)

2012-01-01

Background Key challenges in benchmarking health service achievement of policy goals in areas such as chronic disease are: 1) developing indicators and understanding how policy goals might work as indicators of service performance; 2) developing methods for economically collecting and reporting stakeholder perceptions; 3) combining and sharing data about the performance of organizations; 4) interpreting outcome measures; 5) obtaining actionable benchmarking information. This study aimed to explore how a new Boolean-based small-N method from the social sciences—Qualitative Comparative Analysis or QCA—could contribute to meeting these internationally shared challenges. Methods A ‘multi-value QCA’ (MVQCA) analysis was conducted of data from 24 senior staff at 17 randomly selected services for chronic disease, who provided perceptions of 1) whether government health services were improving their achievement of a set of statewide policy goals for chronic disease and 2) the efficacy of state health office actions in influencing this improvement. The analysis produced summaries of configurations of perceived service improvements. Results Most respondents observed improvements in most areas but uniformly good improvements across services were not perceived as happening (regardless of whether respondents identified a state health office contribution to that improvement). The sentinel policy goal of using evidence to develop service practice was not achieved at all in four services and appears to be reliant on other kinds of service improvements happening. Conclusions The QCA method suggested theoretically plausible findings and an approach that with further development could help meet the five benchmarking challenges. In particular, it suggests that achievement of one policy goal may be reliant on achievement of another goal in complex ways that the literature has not yet fully accommodated but which could help prioritize policy goals. The weaknesses of QCA can be

Health-Related Behaviors and Academic Achievement Among High School Students - United States, 2015.

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Rasberry, Catherine N; Tiu, Georgianne F; Kann, Laura; McManus, Tim; Michael, Shannon L; Merlo, Caitlin L; Lee, Sarah M; Bohm, Michele K; Annor, Francis; Ethier, Kathleen A

2017-09-08

Studies have shown links between educational outcomes such as letter grades, test scores, or other measures of academic achievement, and health-related behaviors (1-4). However, as reported in a 2013 systematic review, many of these studies have used samples that are not nationally representative, and quite a few studies are now at least 2 decades old (1). To update the relevant data, CDC analyzed results from the 2015 national Youth Risk Behavior Survey (YRBS), a biennial, cross-sectional, school-based survey measuring health-related behaviors among U.S. students in grades 9-12. Analyses assessed relationships between academic achievement (i.e., self-reported letter grades in school) and 30 health-related behaviors (categorized as dietary behaviors, physical activity, sedentary behaviors, substance use, sexual risk behaviors, violence-related behaviors, and suicide-related behaviors) that contribute to leading causes of morbidity and mortality among adolescents in the United States (5). Logistic regression models controlling for sex, race/ethnicity, and grade in school found that students who earned mostly A's, mostly B's, or mostly C's had statistically significantly higher prevalence estimates for most protective health-related behaviors and significantly lower prevalence estimates for most health-related risk behaviors than did students with mostly D's/F's. These findings highlight the link between health-related behaviors and education outcomes, suggesting that education and public health professionals can find their respective education and health improvement goals to be mutually beneficial. Education and public health professionals might benefit from collaborating to achieve both improved education and health outcomes for youths.

Optimism, well-being, depressive symptoms, and perceived physical health: a study among Stroke survivors.

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Shifren, Kim; Anzaldi, Kristen

2018-01-01

The investigation of the relation of positive personality characteristics to mental and physical health among Stroke survivors has been a neglected area of research. The purpose of this study was to examine the relationship between optimism, well-being, depressive symptoms, and perceived physical health among Stroke survivors. It was hypothesized that Stroke survivors' optimism would explain variance in their physical health above and beyond the variance explained by demographic variables, diagnostic variables, and mental health. One hundred seventy-six Stroke survivors (97 females, 79 males) completed the Revised Life Orientation Test, the Center for Epidemiological Studies Depression Scale, two items on perceived physical health from the 36-item Short Form of the Medical Outcomes study, and the Identity scale of the Illness Perception Questionnaire. Pearson correlations, hierarchical regression analyses, and the PROCESS approach to determining mediators were used to assess hypothesized relations between variables. Stroke survivors' level of optimism explained additional variance in overall health in regression models controlling for demographic and diagnostic variables, and mental health. Analyses revealed that optimism played a partial mediator role between mental health (well-being, depressive symptoms and total score on CES-D) variables and overall health.

Health-financing reforms in southeast Asia: challenges in achieving universal coverage.

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Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Aljunid, Syed Mohamed; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne

2011-03-05

In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged-contributory arrangements and tax-financed schemes-with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened. Copyright © 2011 Elsevier Ltd. All rights reserved.

Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey.

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Leung, Janni; Atherton, Iain; Kyle, Richard G; Hubbard, Gill; McLaughlin, Deirdre

2016-04-01

The aim of this study is to examine the association between optimism and psychological distress in women with breast cancer after taking into account their self-rated general health. Data were aggregated from the Scottish Health Survey (2008 to 2011) to derive a nationally representative sample of 12,255 women (11,960 cancer-free controls, and 295 breast cancer cases identified from linked cancer registry data). The explanatory variables were optimism and general health, and the outcome variable was symptoms of psychological distress. Logistic regression analyses were conducted, with optimism entered in step 1 and general health entered in step 2. In an unadjusted model, higher levels of optimism were associated with lower odds of psychological distress in both the control group (OR = 0. 57, 95 % CI = 0.51-0.60) and breast cancer group (OR = 0. 64, 95 % CI = 0.47-0.88). However, in a model adjusting for general health, optimism was associated with lower odds of psychological distress only in the control group (OR = 0.50, 95 % CI = 0.44-0.57), but not significantly in the breast cancer group (OR = 1.15, 95 % CI = 0.32-4.11). In the breast cancer group, poor general health was a stronger associate of psychological distress (OR = 4. 98, 95 % CI = 1.32-18.75). Results were consistent after adjusting for age, years since breast cancer diagnosis, survey year, socioeconomic status, education, marital status, body mass index, smoking status, and alcohol consumption. This research confirms the value of multicomponent supportive care interventions for women with breast cancer. Specifically, it suggests that following breast cancer diagnosis, health care professionals need to provide advice and signpost to services that assist women to maintain or improve both their psychological and general health.

Green Infrastructure Simulation and Optimization to Achieve Combined Sewer Overflow Reductions in Philadelphia's Mill Creek Sewershed

Science.gov (United States)

Cohen, J. S.; McGarity, A. E.

2017-12-01

The ability for mass deployment of green stormwater infrastructure (GSI) to intercept significant amounts of urban runoff has the potential to reduce the frequency of a city's combined sewer overflows (CSOs). This study was performed to aid in the Overbrook Environmental Education Center's vision of applying this concept to create a Green Commercial Corridor in Philadelphia's Overbrook Neighborhood, which lies in the Mill Creek Sewershed. In an attempt to further implement physical and social reality into previous work using simulation-optimization techniques to produce GSI deployment strategies (McGarity, et al., 2016), this study's models incorporated land use types and a specific neighborhood in the sewershed. The low impact development (LID) feature in EPA's Storm Water Management Model (SWMM) was used to simulate various geographic configurations of GSI in Overbrook. The results from these simulations were used to obtain formulas describing the annual CSO reduction in the sewershed based on the deployed GSI practices. These non-linear hydrologic response formulas were then implemented into the Storm Water Investment Strategy Evaluation (StormWISE) model (McGarity, 2012), a constrained optimization model used to develop optimal stormwater management practices on the watershed scale. By saturating the avenue with GSI, not only will CSOs from the sewershed into the Schuylkill River be reduced, but ancillary social and economic benefits of GSI will also be achieved. The effectiveness of these ancillary benefits changes based on the type of GSI practice and the type of land use in which the GSI is implemented. Thus, the simulation and optimization processes were repeated while delimiting GSI deployment by land use (residential, commercial, industrial, and transportation). The results give a GSI deployment strategy that achieves desired annual CSO reductions at a minimum cost based on the locations of tree trenches, rain gardens, and rain barrels in specified land

Optimization of condition-based asset management using a predictive health model

NARCIS (Netherlands)

Bajracharya, G.; Koltunowicz, T.; Negenborn, R.R.; Papp, Z.; Djairam, D.; De Schutter, B.; Smit, J.J.

2009-01-01

In this paper, a model predictive framework is used to optimize the operation and maintenance actions of power system equipment based on the predicted health sate of this equipment. In particular, this framework is used to predict the health state of transformers based on their usage. The health

Optimization of behavioral, biobehavioral, and biomedical interventions the multiphase optimization strategy (MOST)

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Collins, Linda M

2018-01-01

This book presents a framework for development, optimization, and evaluation of behavioral,  biobehavioral, and biomedical interventions.  Behavioral, biobehavioral, and biomedical interventions are programs with the objective of improving and maintaining human health and well-being, broadly defined, in individuals, families, schools, organizations, or communities.  These interventions may be aimed at, for example, preventing or treating disease, promoting physical and mental health, preventing violence, or improving academic achievement.   This volume introduces the Multiphase Optimization Strategy (MOST), pioneered at The Methodology Center at the Pennsylvania State University, as an alternative to the classical approach of relying solely on the randomized controlled trial (RCT).  MOST borrows heavily from perspectives taken and approaches used in engineering, and also integrates concepts from statistics and behavioral science, including the RCT.  As described in detail in this book, MOST consists of ...

Reconstruction after complex facial trauma: achieving optimal outcome through multiple contemporary surgeries.

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Jaiswal, Rohit; Pu, Lee L Q

2013-04-01

Major facial trauma injuries often require complex repair. Traditionally, the reconstruction of such injuries has primarily utilized only free tissue transfer. However, the advent of newer, contemporary procedures may lead to potential reconstructive improvement through the use of complementary procedures after free flap reconstruction. An 18-year-old male patient suffered a major left facial degloving injury resulting in soft-tissue defect with exposed zygoma, and parietal bone. Multiple operations were undertaken in a staged manner for reconstruction. A state-of-the-art free anterolateral thigh (ALT) perforator flap and Medpor implant reconstruction of the midface were initially performed, followed by flap debulking, lateral canthopexy, midface lift with redo canthopexy, scalp tissue expansion for hairline reconstruction, and epidermal skin grafting for optimal skin color matching. Over a follow-up period of 2 years, a good and impressive reconstructive result was achieved through the use of multiple contemporary reconstructive procedures following an excellent free ALT flap reconstruction. Multiple staged reconstructions are essential in producing an optimal outcome in this complex facial injury that would likely not have been produced through a 1-stage traditional free flap reconstruction. Utilizing multiple, sequential contemporary surgeries may substantially improve outcome through the enhancement and refinement of results based on possibly the best initial soft-tissue reconstruction.

Strategic planning as a tool for achieving alignment in academic health centers.

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Higginbotham, Eve J; Church, Kathryn C

2012-01-01

After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

Strategic Planning as a Tool for Achieving Alignment in Academic Health Centers

Science.gov (United States)

Higginbotham, Eve J.; Church, Kathryn C.

2012-01-01

After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare. PMID:23303997

The application of defaults to optimize parents' health-based choices for children.

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Loeb, Katharine L; Radnitz, Cynthia; Keller, Kathleen; Schwartz, Marlene B; Marcus, Sue; Pierson, Richard N; Shannon, Michael; DeLaurentis, Danielle

2017-06-01

Optimal defaults is a compelling model from behavioral economics and the psychology of human decision-making, designed to shape or "nudge" choices in a positive direction without fundamentally restricting options. The current study aimed to test the effectiveness of optimal (less obesogenic) defaults and parent empowerment priming on health-based decisions with parent-child (ages 3-8) dyads in a community-based setting. Two proof-of-concept experiments (one on breakfast food selections and one on activity choice) were conducted comparing the main and interactive effects of optimal versus suboptimal defaults, and parent empowerment priming versus neutral priming, on parents' health-related choices for their children. We hypothesized that in each experiment, making the default option more optimal will lead to more frequent health-oriented choices, and that priming parents to be the ultimate decision-makers on behalf of their child's health will potentiate this effect. Results show that in both studies, default condition, but not priming condition or the interaction between default and priming, significantly predicted choice (healthier vs. less healthy option). There was also a significant main effect for default condition (and no effect for priming condition or the interaction term) on the quantity of healthier food children consumed in the breakfast experiment. These pilot studies demonstrate that optimal defaults can be practicably implemented to improve parents' food and activity choices for young children. Results can inform policies and practices pertaining to obesogenic environmental factors in school, restaurant, and home environments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Data driven approaches for diagnostics and optimization of NPP operation

International Nuclear Information System (INIS)

Pliska, J.; Machat, Z.

2014-01-01

The efficiency and heat rate is an important indicator of both the health of the power plant equipment and the quality of power plant operation. To achieve this challenges powerful tool is a statistical data processing of large data sets which are stored in data historians. These large data sets contain useful information about process quality and equipment and sensor health. The paper discusses data-driven approaches for model building of main power plant equipment such as condenser, cooling tower and the overall thermal cycle as well using multivariate regression techniques based on so called a regression triplet - data, model and method. Regression models comprise a base for diagnostics and optimization tasks. Diagnostics and optimization tasks are demonstrated on practical cases - diagnostics of main power plant equipment to early identify equipment fault, and optimization task of cooling circuit by cooling water flow control to achieve for a given boundary conditions the highest power output. (authors)

A Study of the Relationships between Distributed Leadership, Teacher Academic Optimism and Student Achievement in Taiwanese Elementary Schools

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Chang, I-Hua

2011-01-01

The purpose of this study was to explore the relationships between distributed leadership, teachers' academic optimism and student achievement in learning. The study targeted public elementary schools in Taiwan and adopted stratified random sampling to investigate 1500 teachers. Teachers' perceptions were collected by a self-report scale. In…

Direct and Mediated Relationships Between Participation in a Telephonic Health Coaching Program and Health Behavior, Life Satisfaction, and Optimism.

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Sears, Lindsay E; Coberley, Carter R; Pope, James E

2016-07-01

The aim of this study was to examine the direct and mediated effects of a telephonic health coaching program on changes to healthy behaviors, life satisfaction, and optimism. This longitudinal correlational study of 4881 individuals investigated simple and mediated relationships between participation in a telephonic health risk coaching program and outcomes from three annual Well-being Assessments. Program participation was directly related to improvements in healthy behaviors, life satisfaction and optimism, and indirect effects of coaching on these variables concurrently and over a one-year time lag were also supported. Given previous research that improvements to life satisfaction, optimism, and health behaviors are valuable for individuals, employers, and communities, a clearer understanding of intervention approaches that may impact these outcomes simultaneously can drive greater program effectiveness and value on investment.

The relationship of school performance and mental health: Educational achievement as indicator of psychopathology

NARCIS (Netherlands)

Tempelaar, W.M.

2017-01-01

In this thesis we explored the relationship between poor educational achievement and psychopathology. Examining the association between educational achievement and mental health problems and development of psychiatric disorders is important to investigate the potential value of educational

Changes in Optimism Are Associated with Changes in Health Over Time Among Older Adults

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Chopik, William J.; Kim, Eric S.; Smith, Jacqui

2016-01-01

Little is known about how optimism differs by age and changes over time, particularly among older adults. Even less is known about how changes in optimism are related to changes in physical health. We examined age differences and longitudinal changes in optimism in 9,790 older adults over a four-year period. We found an inverted U-shaped pattern between optimism and age both cross-sectionally and longitudinally, such that optimism generally increased in older adults before decreasing. Increases in optimism over a four-year period were associated with improvements in self-rated health and fewer chronic illnesses over the same time frame. The findings from the current study are consistent with changes in emotion regulation strategies employed by older adults and age-related changes in well-being. PMID:27114753

Changes in Optimism Are Associated with Changes in Health Over Time Among Older Adults.

Science.gov (United States)

Chopik, William J; Kim, Eric S; Smith, Jacqui

2015-09-01

Little is known about how optimism differs by age and changes over time, particularly among older adults. Even less is known about how changes in optimism are related to changes in physical health. We examined age differences and longitudinal changes in optimism in 9,790 older adults over a four-year period. We found an inverted U-shaped pattern between optimism and age both cross-sectionally and longitudinally, such that optimism generally increased in older adults before decreasing. Increases in optimism over a four-year period were associated with improvements in self-rated health and fewer chronic illnesses over the same time frame. The findings from the current study are consistent with changes in emotion regulation strategies employed by older adults and age-related changes in well-being.

Platform-dependent optimization considerations for mHealth applications

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Kaghyan, Sahak; Akopian, David; Sarukhanyan, Hakob

2015-03-01

Modern mobile devices contain integrated sensors that enable multitude of applications in such fields as mobile health (mHealth), entertainment, sports, etc. Human physical activity monitoring is one of such the emerging applications. There exists a range of challenges that relate to activity monitoring tasks, and, particularly, exploiting optimal solutions and architectures for respective mobile software application development. This work addresses mobile computations related to integrated inertial sensors for activity monitoring, such as accelerometers, gyroscopes, integrated global positioning system (GPS) and WLAN-based positioning, that can be used for activity monitoring. Some of the aspects will be discussed in this paper. Each of the sensing data sources has its own characteristics such as specific data formats, data rates, signal acquisition durations etc., and these specifications affect energy consumption. Energy consumption significantly varies as sensor data acquisition is followed by data analysis including various transformations and signal processing algorithms. This paper will address several aspects of more optimal activity monitoring implementations exploiting state-of-the-art capabilities of modern platforms.

A system dynamics optimization framework to achieve population desired of average weight target

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Abidin, Norhaslinda Zainal; Zulkepli, Jafri Haji; Zaibidi, Nerda Zura

2017-11-01

Obesity is becoming a serious problem in Malaysia as it has been rated as the highest among Asian countries. The aim of the paper is to propose a system dynamics (SD) optimization framework to achieve population desired weight target based on the changes in physical activity behavior and its association to weight and obesity. The system dynamics approach of stocks and flows diagram was used to quantitatively model the impact of both behavior on the population's weight and obesity trends. This work seems to bring this idea together and highlighting the interdependence of the various aspects of eating and physical activity behavior on the complex of human weight regulation system. The model was used as an experimentation vehicle to investigate the impacts of changes in physical activity on weight and prevalence of obesity implications. This framework paper provides evidence on the usefulness of SD optimization as a strategic decision making approach to assist in decision making related to obesity prevention. SD applied in this research is relatively new in Malaysia and has a high potential to apply to any feedback models that address the behavior cause to obesity.

The Relationship of Mental Pressure with Optimism and Academic Achievement Motivation among Second Grade Male High School Students

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Sarouni, Ali Sedigh; Jenaabadi, Hossein; Pourghaz, Abdulwahab

2016-01-01

The present study aimed to examine the relationship of mental pressure with optimism and academic achievement motivation among second grade second period male high school students. This study followed a descriptive-correlational method. The sample included 200 second grade second period male high school students in Sooran. Data collection tools in…

Millennium Development Goals: how public health professionals perceive the achievement of MDGs

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Marta Lomazzi

2014-09-01

Full Text Available Background: There have been various consultations on the Millennium Development Goals (MDGs by different groups. However, even if it is clear that the health sector has led the development success of the MDGs, only a few MDG reports consider public health experts’ points of view and these are mainly government driven. Designs: The World Federation of Public Health Associations (WFPHA has executed a global survey to consult public health professionals worldwide concerning the implementation and achievements of the MDGs.The survey was conceived by WFPHA health professionals and promulgated online. Public health professionals and organisations dealing with MDGs responded to the survey. Content analysis was conducted to analyse the data. Results: Survey participants attributed the highest importance worldwide to MDGs dealing with women, poverty and hunger reduction, and disease prevention and management. Moreover, they underlined the role of education, referring both to school children and professionals. In high and upper-middle income countries, environmental challenges also received considerable attention.Notably, respondents underlined that weak governance and unstable political situations, as well as the gap between professionals and politicians, were among the main causes that detracted from MDG achievements. Conclusion: The public health workforce felt it would be imperative to be included from the outset in the design and implementation of further goals. This implies that those professionals have to take an active part in the political process leading to a new and accountable framework.

Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitals

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Gabriele Arcidiacono

2017-01-01

Full Text Available Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design. The demand for patient-oriented and efficient health services leads to use these methodologies to improve hospital processes. In the framework, patients with similar characteristics are clustered in families to achieve homogeneous flows through the value stream. An optimization checklist is outlined as the result of the mapping between Functional Requirements and Design Parameters, with the right sequence of the steps to optimize the patient flow according to the principles of Axiomatic Design. The Axiomatic Design-based top-down implementation of Health Care evidence, according to Lean principles, results in a holistic optimization of hospital patient flows, by reducing the complexity of the system.

Family socioeconomic status, family health, and changes in students' math achievement across high school: A mediational model.

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Barr, Ashley Brooke

2015-09-01

In response to recent calls to integrate understandings of socioeconomic disparities in health with understandings of socioeconomic disparities in academic achievement, this study tested a mediational model whereby family socioeconomic status predicted gains in academic achievement across high school through its impact on both student and parent health. Data on over 8000 high school students in the U.S. were obtained from wave 1 (2009-2010) and wave 2 (2012) of the High School Longitudinal Study of 2009 (HSLS:09), and structural equation modeling with latent difference scores was used to determine the role of family health problems in mediating the well-established link between family SES and gains in academic achievement. Using both static and dynamic indicators of family SES, support was found for this mediational model. Higher family SES in 9th grade reduced the probability of students and their parents experiencing a serious health problem in high school, thereby promoting growth in academic achievement. In addition, parent and student health problems mediated the effect of changes in family SES across high school on math achievement gains. Results emphasize the importance of considering the dynamic nature of SES and that both student and parent health should be considered in understanding SES-related disparities in academic achievement. This relational process provides new mechanisms for understanding the intergenerational transmission of socioeconomic status and the status attainment process more broadly. Copyright © 2015 Elsevier Ltd. All rights reserved.

Optimization of maintenance for power system equipment using a predictive health model

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Bajracharya, G.; Koltunowicz, T.; Negenborn, R.R.; Papp, Z.; Djairam, D.; Schutter, B.D. de; Smit, J.J.

2009-01-01

In this paper, a model-predictive control based framework is proposed for modeling and optimization of the health state of power system equipment. In the framework, a predictive health model is proposed that predicts the health state of the equipment based on its usage and maintenance actions. Based

Making it local: Beacon Communities use health information technology to optimize care management.

Science.gov (United States)

Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A

2014-06-01

Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks--including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation--the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability.

HEALTH-RISK BEHAVIOUR IN REGARD OF FAMILY STRUCTURE AND ITS EFFECT ON ACADEMIC ACHIEVEMENT

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Kovács, Karolina Eszter

2018-01-01

Full Text Available The frequency of health-risk behaviours like smoking, alcohol consumption and substance use is usually higher in adolescence. In addition, its appearance is higher among students coming from non-intact families. These factors also have a strong influence on academic achievement as students from fragile families and students having these health-damaging habits tend to be less effective. According to our results, four different student clusters can be detected regarding health behaviour (traditional risk-takers, hard risk-takers, ambivalent students and risk-avoiders. Ambivalent students reached the best achievement while hard risk-takers showed the poorest efficacy. Finally, students from intact families showed better results compared to their peers from single-parent or patchwork families.

Understanding the Role of Achievements in Game-Based Learning

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Lucas Blair

2016-12-01

Full Text Available The objective of the current research was to examine whether one potentially effective gaming strategy—achievements—has a positive impact on learning in a game-based environment. An achievement in a video game is a reward or recognition earned by players for an in-game accomplishment. This paper describes a series of studies to evaluate the effects of achievement types on learning in a game designed to teach about health resources. The Game “Phone Dash” was used as the testbed for the following studies. The following questionnaires were utilized in this study: Video Game Self-Efficacy Scale (VGSES questionnaire, Relevance and Usefulness questionnaire, Game Engagement Questionnaire (GEQ, and the Intrinsic Motivation Inventory (IMI. Four studies were conducted. Results indicated that while in unison, the achievements were not as potent in motivating performance, certainly when combined they produced measurable changes in behavior. The four studies described in this paper provide important information regarding the optimal design of achievements in game-based health education. Developers of future game-based learning can use this information to enhance the potential effectiveness of their products. 

Perceived challenges to achieving universal health coverage: a cross-sectional survey of social health insurance managers/administrators in China.

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Shan, Linghan; Wu, Qunhong; Liu, Chaojie; Li, Ye; Cui, Yu; Liang, Zi; Hao, Yanhua; Liang, Libo; Ning, Ning; Ding, Ding; Pan, Qingxia; Han, Liyuan

2017-06-02

China has achieved over 96% health insurance coverage. However, universal health coverage (UHC) entails population coverage and the range of services covered and the extent to which health service costs are covered. This study aimed to determine the performance of the health insurance system in China in terms of its role in UHC and to identify challenges in the progress of UHC as perceived by health insurance managers/administrators. A cross-sectional questionnaire survey was conducted in Beijing, Ningbo, Harbin and Chongqing over the period of 2014 and 2015. A stratified cluster random sampling strategy was adopted to select study participants. A total of 1277 (64.8%) respondents who reported familiarity with the current health insurance system and the requirements of UHC provided valid data for analyses. They gave a rating on the role of the current health insurance system in achieving UHC. A multivariate logistic regression model was developed to determine the associations between the rating and the features of insurance arrangements. There was consensus among the respondents on the performance of the current health insurance system in terms of its role in UHC, regardless who they were and what responsibility they held in their organisation (ie, policy development, managing fund transactions, and so on). Overall, about 45% of the respondents believed that there is a long way to go to achieve UHC. The low rating was found to be associated with limited financial protection (OR=1.656, 95% CI 1.279 to 2.146), healthcare inequity (OR=1.607, 95% CI 1.268 to 2.037), poor portability (OR=1.347, 95% CI 1.065 to 1.703) and ineffective supervision and administration of funds (OR=1.339, 95% CI 1.061 to 1.692) as perceived by the respondents. Health insurance managers/administrators in China are pessimistic about the achievements of the current health insurance system. They are concerned about the overall lack of benefit that insurance programmes bring to members

Optimal allocation of land and water resources to achieve Water, Energy and Food Security in the upper Blue Nile basin

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Allam, M.; Eltahir, E. A. B.

2017-12-01

Rapid population growth, hunger problems, increasing energy demands, persistent conflicts between the Nile basin riparian countries and the potential impacts of climate change highlight the urgent need for the conscious stewardship of the upper Blue Nile (UBN) basin resources. This study develops a framework for the optimal allocation of land and water resources to agriculture and hydropower production in the UBN basin. The framework consists of three optimization models that aim to: (a) provide accurate estimates of the basin water budget, (b) allocate land and water resources optimally to agriculture, and (c) allocate water to agriculture and hydropower production, and investigate trade-offs between them. First, a data assimilation procedure for data-scarce basins is proposed to deal with data limitations and produce estimates of the hydrologic components that are consistent with the principles of mass and energy conservation. Second, the most representative topography and soil properties datasets are objectively identified and used to delineate the agricultural potential in the basin. The agricultural potential is incorporated into a land-water allocation model that maximizes the net economic benefits from rain-fed agriculture while allowing for enhancing the soils from one suitability class to another to increase agricultural productivity in return for an investment in soil inputs. The optimal agricultural expansion is expected to reduce the basin flow by 7.6 cubic kilometres, impacting downstream countries. The optimization framework is expanded to include hydropower production. This study finds that allocating water to grow rain-fed teff in the basin is more profitable than allocating water for hydropower production. Optimal operation rules for the Grand Ethiopian Renaissance dam (GERD) are identified to maximize annual hydropower generation while achieving a relatively uniform monthly production rate. Trade-offs between agricultural expansion and hydropower

Leadership profile: HealthAchieve 2013 Nursing Leadership Award Winner, Tiziana Rivera.

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Rivera, Tiziana

2014-03-01

Tiziana Rivera, the winner of the 2013 Nursing Leadership Award at the November HealthAchieve conference, is chief nursing executive and chief practice officer at Mackenzie Health. As such, she provides strategic leadership for the development and implementation of a shared vision for professional practice, nursing and all disciplines to promote innovative care and the development of care delivery models that will improve quality of care and population health.Prior to assuming her position at Mackenzie Health, Rivera provided strategic leadership for the Seniors' Health Program at Trillium Health Centre, where her role focused on the development of seniors' health services across the continuum of care. She has published numerous articles in refereed journals, conducted several research studies and presented her papers provincially, nationally and internationally. Rivera has a clinical appointment at the University of Toronto Faculty of Nursing, a faculty adviser position at Ryerson and an adjunct faculty position at the School of Health Sciences, York University and at the School of Health Sciences, Humber Institute of Technology and Advanced Learning.In the following Q and A, Rivera shares her thoughts on leadership in nursing and perspectives on several critical issues.

Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitals

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Arcidiacono, Gabriele; Matt, Dominik T.; Rauch, Erwin

2017-01-01

Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design. The demand for patient-oriented and efficient health services leads to use these methodologies to improve hospital processes. In the framework, patients with similar characteristics are clustered in families to achieve homogeneous flows through the value stream. An optimization checklist is outlined as the result of the mapping between Functional Requirements and Design Parameters, with the right sequence of the steps to optimize the patient flow according to the principles of Axiomatic Design. The Axiomatic Design-based top-down implementation of Health Care evidence, according to Lean principles, results in a holistic optimization of hospital patient flows, by reducing the complexity of the system. © 2017 Gabriele Arcidiacono et al.

Achieving the American dream: facilitators and barriers to health and mental health for Latino immigrants.

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Shobe, Marcia A; Coffman, Maren J; Dmochowski, Jacek

2009-01-01

Latinos are the largest minority group in the U.S. For Latino immigrants, a shift in migration from larger to smaller cities has recently occurred; the Latino immigrant population in Charlotte, North Carolina, has increased by 634% since 1990. The extent to which immigrants can achieve health and well-being is often related to employment, healthcare access, and social support. This study explored the human, social, and financial capital circumstances of Latino immigrants new to Charlotte and examined the effects of different aspects of capital on health outcomes. Findings indicate that capital is significantly associated with functional status and depression. Implications for social work are discussed.

Optimal Velocity to Achieve Maximum Power Output – Bench Press for Trained Footballers

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Richard Billich

2015-03-01

Full Text Available Optimal Velocity to Achieve Maximum Power Output – Bench Press for Trained Footballers In today’s world of strength training there are many myths surrounding effective exercising with the least possible negative effect on one’s health. In this experiment we focus on the finding of a relationship between maximum output, used load and the velocity with which the exercise is performed. The main objective is to find the optimal speed of the exercise motion which would allow us to reach the maximum mechanic muscle output during a bench press exercise. This information could be beneficial to sporting coaches and recreational sportsmen alike in helping them improve the effectiveness of fast strength training. Fifteen football players of the FK Třinec football club participated in the experiment. The measurements were made with the use of 3D cinematic and dynamic analysis, both experimental methods. The research subjects participated in a strength test, in which the mechanic muscle output of 0, 10, 30, 50, 70, 90% and one repetition maximum (1RM was measured. The acquired result values and other required data were modified using Qualisys Track Manager and Visual 3D software (C-motion, Rockville, MD, USA. During the bench press exercise the maximum mechanic muscle output of the set of research subjects was reached at 75% of maximum exercise motion velocity. Optimální rychlost pohybu pro dosažení maxima výstupního výkonu – bench press u trénovaných fotbalistů Dnešní svět silového tréninku přináší řadu mýtů o tom, jak cvičit efektivně a zároveň s co nejmenším negativním vlivem na zdraví člověka. V tomto experimentu se zabýváme nalezením vztahu mezi maximálním výkonem, použitou zátěží a rychlostí. Hlavním úkolem je nalezení optimální rychlosti pohybu pro dosažení maximálního mechanického svalového výkonu při cvičení bench press, což pomůže nejenom trenérům, ale i rekreačním sportovc

Optimization of time distribution for studying the course modules on advanced training of health care administrators

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Dorovskaya A.l.

2015-06-01

Full Text Available The research objective is rational (optimal time management in studying the course modules on Advanced Training of Health Care Administrators. Materials and methods. We conducted expert survey of 73 healthcare administrators from medical organizations of Saratov region. Branch-and-bound method was used for rescheduling the educational program. Results. Both direct and inverse problems have been solved. The direct one refers to time distribution for each module of the advanced Training of Healthcare Administrators course so that the total score is maximum and each module is marked not lower than "satisfactory". The inverse one resulted in achieving minimal time characteristics for varieties of average score. Conclusion. The offered approach allows to solve problems of managing time given for education.

Achieving Business Excellence by Optimizing Corporate Forensic Readiness

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Gojko Grubor

2017-02-01

Full Text Available In order to improve their business excellence, all organizations, despite their size (small, medium or large one should manage their risk of fraud. Fraud, in today’s world, is often committed by using computers and can only be revealed by digital forensic investigator. Not even small or medium-sized companies are secure from fraud. In the light of recent financial scandals that literary demolished not just economies of specific countries but entire world economy, we propose in this paper an optimal model of corporative computer incident digital forensic investigation (CCIDFI by using adopted mathematic model of the greed MCDM – multi-criteria decision-making method and the Expert Choice software tool for multi-criteria optimization of the CCIDFI readiness. Proposed model can, first of all, help managers of small and medium-sized companies to justify their decisions to employ digital forensic investigators and include them in their information security teams in order to choose the optimal CCIDFI model and improve forensic readiness in the computer incident management process that will result with minimization of potential losses of company in the future and improve its business quality.

Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association.

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Gorelick, Philip B; Furie, Karen L; Iadecola, Costantino; Smith, Eric E; Waddy, Salina P; Lloyd-Jones, Donald M; Bae, Hee-Joon; Bauman, Mary Ann; Dichgans, Martin; Duncan, Pamela W; Girgus, Meighan; Howard, Virginia J; Lazar, Ronald M; Seshadri, Sudha; Testai, Fernando D; van Gaal, Stephen; Yaffe, Kristine; Wasiak, Hank; Zerna, Charlotte

2017-10-01

Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health. We identify metrics to define optimal brain health in adults based on inclusion of factors that could be measured, monitored, and modified. From these practical considerations, we identified 7 metrics to define optimal brain health in adults that originated from AHA's Life's Simple 7: 4 ideal health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent with current guideline levels, and body mass index brain health but recognize that the truly ideal circumstance may be uncommon because there is a continuum of brain health as demonstrated by AHA's Life's Simple 7. Therefore, there is opportunity to improve brain health through primordial prevention and other interventions. Furthermore, although cardiovascular risks align well with brain health, we acknowledge that other factors differing from those related to cardiovascular health may drive cognitive health. Defining optimal brain health in adults and its maintenance is consistent with the AHA's Strategic Impact Goal to improve cardiovascular health of all Americans by 20% and to reduce deaths resulting from cardiovascular disease and stroke by 20% by the year 2020. This work in defining optimal brain health in adults serves to provide the AHA/American Stroke Association with a foundation for a new strategic direction going forward in cardiovascular health

Primary health care and public health: foundations of universal health systems.

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White, Franklin

2015-01-01

The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

Achieving and sustaining automated health data linkages for learning systems: barriers and solutions.

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Van Eaton, Erik G; Devlin, Allison B; Devine, Emily Beth; Flum, David R; Tarczy-Hornoch, Peter

2014-01-01

implementations required each hospital to devote more IT resources than were predicted. Cost savings did not meet projections because of the increased IT resource requirements and a different source of lowered chart review costs. CERTAIN succeeded in recruiting unaffiliated hospitals into the Automation Project to create an enhanced registry to achieve AHRQ goals. This case report describes several distinct barriers to central data aggregation for QI and CER across unaffiliated hospitals: (1) competition for limited on-site IT expertise, (2) concerns about data use for QI versus research, (3) restrictions on data automation to a defined subset of patients, and (4) unpredictable resource needs because of idiosyncrasies among unaffiliated hospitals in how EHR data are coded, stored, and made available for transmission-even between hospitals using the same vendor's EHR. Therefore, even a fully optimized automation infrastructure would still not achieve complete automation. The Automation Project was unable to align sufficiently with internal hospital objectives, so it could not show a compelling case for sustainability.

Effectiveness of increasing the frequency of posaconazole syrup administration to achieve optimal plasma concentrations in patients with haematological malignancy.

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Park, Wan Beom; Cho, Joo-Youn; Park, Sang-In; Kim, Eun Jung; Yoon, Seonghae; Yoon, Seo Hyun; Lee, Jeong-Ok; Koh, Youngil; Song, Kyoung-Ho; Choe, Pyoeng Gyun; Yu, Kyung-Sang; Kim, Eu Suk; Bang, Su Mi; Kim, Nam Joong; Kim, Inho; Oh, Myoung-Don; Kim, Hong Bin; Song, Sang Hoon

2016-07-01

Few data are available on whether adjusting the dose of posaconazole syrup is effective in patients receiving anti-cancer chemotherapy. The aim of this prospective study was to analyse the impact of increasing the frequency of posaconazole administration on optimal plasma concentrations in adult patients with haematological malignancy. A total of 133 adult patients receiving chemotherapy for acute myeloid leukaemia or myelodysplastic syndrome who received posaconazole syrup 200 mg three times daily for fungal prophylaxis were enrolled in this study. Drug trough levels were measured by liquid chromatography-tandem mass spectrometry. In 20.2% of patients (23/114) the steady-state concentration of posaconazole was suboptimal (increased to 200 mg four times daily. On Day 15, the median posaconazole concentration was significantly increased from 368 ng/mL [interquartile range (IQR), 247-403 ng/mL] to 548 ng/mL (IQR, 424-887 ng/mL) (P = 0.0003). The median increase in posaconazole concentration was 251 ng/mL (IQR, 93-517 ng/mL). Among the patients with initially suboptimal levels, 79% achieved the optimal level unless the steady-state level was increasing the administration frequency of posaconazole syrup is effective for achieving optimal levels in patients with haematological malignancy undergoing chemotherapy. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Exploration of priority actions for strengthening the role of nurses in achieving universal health coverage

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Rowaida Al Maaitah

Full Text Available ABSTRACT Objective: to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs towards the achievement of Universal Health Converge (UHC as perceived by health key informants in Jordan. Methods: an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. Results: the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. Conclusion: study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation.

Optimizing Bone Health in Duchenne Muscular Dystrophy

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Jason L. Buckner

2015-01-01

Full Text Available Duchenne muscular dystrophy (DMD is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serious sequelae adversely affect quality of life and can impact survival. The current clinical issues relating to bone health and bone health screening methods in DMD are presented in this review. Diagnostic studies, including biochemical markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry (DXA, as well as spinal imaging using densitometric lateral spinal imaging, and treatment to optimize bone health in patients with DMD are discussed. Treatment with bisphosphonates offers a method to increase bone mass in these children; oral and intravenous bisphosphonates have been used successfully although treatment is typically reserved for children with fractures and/or bone pain with low bone mass by DXA.

Are People Healthier If Their Partners Are More Optimistic? The Dyadic Effect of Optimism On Health Among Older Adults

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Kim, Eric S.; Chopik, William J.; Smith, Jacqui

2015-01-01

Objective Optimism has been linked with an array of positive health outcomes at the individual level. However, researchers have not examined how a spouse's optimism might impact an individual's health. We hypothesized that being optimistic (and having an optimistic spouse) would both be associated with better health. Methods Participants were 3,940 adults (1,970 couples) from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. Participants were tracked for four years and outcomes included: physical functioning, self-rated health, and number of chronic illnesses. We analyzed the dyadic data using the actor partner interdependence model. Results After controlling for several psychological and demographic factors, a person's own optimism and their spouse's optimism predicted better self-rated health and physical functioning (b's = .08-.25, p's optimism and health did not diminish over time. Conclusions Being optimistic and having an optimistic spouse were both associated with better health. Examining partner effects is important because such analyses reveal the unique role that spouses play in promoting health. These findings may have important implications for future health interventions. PMID:24840138

Achieving universal health coverage goals in Thailand: the vital role of strategic purchasing.

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Tangcharoensathien, Viroj; Limwattananon, Supon; Patcharanarumol, Walaiporn; Thammatacharee, Jadej; Jongudomsuk, Pongpisut; Sirilak, Supakit

2015-11-01

Strategic purchasing is one of the key policy instruments to achieve the universal health coverage (UHC) goals of improved and equitable access and financial risk protection. Given favourable outcomes of Universal Coverage Scheme (UCS), this study synthesized strategic purchasing experiences in the National Health Security Office (NHSO) responsible for the UCS in contributing to achieving UHC goals. The UCS applied the purchaser-provider split concept where NHSO, as a purchaser, is in a good position to enforce accountability by public and private providers to the UCS beneficiaries, through active purchasing. A comprehensive benefit package resulted in high level of financial risk protection as reflected by low incidence of catastrophic health spending and impoverished households. The NHSO contracted the District Health System (DHS) network, to provide outpatient, health promotion and disease prevention services to the whole district population, based on an annual age-adjusted capitation payment. In most cases, the DHS was the only provider in a district without competitors. Geographical monopoly hampered the NHSO to introduce a competitive contractual agreement, but a durable, mutually dependent relationship based on trust was gradually evolved, while accreditation is an important channel for quality improvement. Strategic purchasing services from DHS achieved a pro-poor utilization due to geographical proximity, where travel time and costs were minimal. Inpatient services paid by Diagnostic Related Group within a global budget ceiling, which is estimated based on unit costs, admission rates and admission profiles, contained cost effectively. To prevent potential under-provisions of the services, some high cost interventions were unbundled from closed end payment and paid on an agreed fee schedule. Executing monopsonistic purchasing power by NHSO brought down price of services given assured quality. Cost saving resulted in more patients served within a finite

Strategies to optimize lithium-ion supercapacitors achieving high-performance: Cathode configurations, lithium loadings on anode, and types of separator

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Cao, Wanjun; Li, Yangxing; Fitch, Brian; Shih, Jonathan; Doung, Tien; Zheng, Jim

2014-12-01

The Li-ion capacitor (LIC) is composed of a lithium-doped carbon anode and an activated carbon cathode, which is a half Li-ion battery (LIB) and a half electrochemical double-layer capacitor (EDLC). LICs can achieve much more energy density than EDLC without sacrificing the high power performance advantage of capacitors over batteries. LIC pouch cells were assembled using activated carbon (AC) cathode and hard carbon (HC) + stabilized lithium metal power (SLMP®) anode. Different cathode configurations, various SLMP loadings on HC anode, and two types of separators were investigated to achieve the optimal electrochemical performance of the LIC. Firstly, the cathode binders study suggests that the PTFE binder offers improved energy and power performances for LIC in comparison to PVDF. Secondly, the mass ratio of SLMP to HC is at 1:7 to obtain the optimized electrochemical performance for LIC among all the various studied mass ratios between lithium loading amounts and active anode material. Finally, compared to the separator Celgard PP 3501, cellulose based TF40-30 is proven to be a preferred separator for LIC.

The Effect of Resiliency Training on Mental Health, Optimism and Life Satisfaction of Female-Headed Households

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َAli Mohammad Naemi

2015-10-01

Full Text Available The aim of the study was to investigate the effect of resiliency intervention on mental health, optimism and life satisfaction of female-headed-households in the city of Sabzevar. The research was semi-experimental, with pretest-posttest and control group. Forty two women who volunteered to participate in the training program (10 sessions, each session 90 minutes and within 10 weeks were selected by available sampling and randomly assigned to experimental and control groups (each group,n = 21. Data was collected by demographic questionnaire, Goldberg General Health Questionnaire (28- GHQ, Scheier, and Carver Optimism Scale (LOT-R and Diener, Emmons, Larsen, and Griffin Satisfaction with Life Scale (SWLS. The results of co-variance analysis showed that resiliency training was effective on increasing mental health, optimism and life satisfaction. Therefore, resiliency skill training can be used as an efficient way to increase mental health, optimism and life satisfaction of female-headed households.

Social support, acculturation, and optimism: understanding positive health practices in Asian American college students.

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Ayres, Cynthia G; Mahat, Ganga

2012-07-01

This study developed and tested a theory to better understand positive health practices (PHP) among Asian Americans aged 18 to 21 years. It tested theoretical relationships postulated between PHP and (a) social support (SS), (b) optimism, and (c) acculturation, and between SS and optimism and acculturation. Optimism and acculturation were also tested as possible mediators in the relationship between SS and PHP. A correlational study design was used. A convenience sample of 163 Asian college students in an urban setting completed four questionnaires assessing SS, PHP, optimism, and acculturation and one demographic questionnaire. There were statistically significant positive relationships between SS and optimism with PHP, between acculturation and PHP, and between optimism and SS. Optimism mediated the relationship between SS and PHP, whereas acculturation did not. Findings extend knowledge regarding these relationships to a defined population of Asian Americans aged 18 to 21 years. Findings contribute to a more comprehensive knowledge base regarding health practices among Asian Americans. The theoretical and empirical findings of this study provide the direction for future research as well. Further studies need to be conducted to identify and test other mediators in order to better understand the relationship between these two variables.

The Barriers to Achieve Financial Protection in Iranian Health System: A Qualitative Study in a Developing Country.

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Naghdi, Seyran; Moradi, Tayebeh; Tavangar, Fateh; Bahrami, Giti; Shahboulaghi, Mohammadi; Ghiasvand, Hesam

2017-09-01

The move to universal health coverage and consequently health promotion is influenced by political, socio-economic and other contextual factors in a country. Iran, as a developing country with an upper-middle national income, has developed policies to achieve universal health coverage through financial protection. This study aims to investigate barriers to develop financial protection as a requirement to achieve universal health coverage. This qualitative study was conducted using 20 in-depth interviews with experts in social welfare, health insurance and financing. The framework analysis method was used to analyze the data. The results have been categorized in three major themes that were extracted from ten sub-themes. The major themes included the political, social and economic context of the country, the context and structure of healthcare system and dimensions of UHC. Achieving financial protection as a long-term objective should be considered as a priority among Iranian policy makers that requires an inter-sectoral collaboration with a defined in-charge body. Health policy makers in Iran should develop a more comprehensive benefits package for diseases and health conditions with catastrophic consequences. They also should develop a plan to cover the poor people.

Association between Optimism, Psychosocial Well Being and Oral Health: A Cross-Sectional Study.

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Thiruvenkadam, G; Asokan, Sharath; Baby John, J; Geetha Priya, P R

The aim of the study was to assess the association of optimism and psychosocial well being of school going children on their oral health status. The study included 12- to 15-year-old school going children (N = 2014) from Tamilnadu, India. Optimism was measured using the revised version of the Life Orientation Test (LOT-R). A questionnaire was sent to the parents regarding their child's psychosocial behavior which included shyness, feeling inferiority, unhappiness and friendliness. Clinical examination for each child was done to assess the DMFT score and OHI-S score. The data obtained were statistically analyzed using Pearson Chi-Square test, Mann-Whitney test and Kruskal-Wallis test with the aid of SPSS software (version 17). Odds Ratio (OR) was calculated with 95% Confidence Interval (CI). The p value ≤ 0.05 was considered statistically significant. Boys with high optimism had significantly lesser DMFT score than the boys with low optimism (p=0.001). Girls with high optimism had significantly higher DMFT score (p=0.001). In psychosocial outcomes, inferiority (p=0.002) and friendliness (p=0.001) showed significant association with DMFT score. Among the boys, children who felt less inferior (p=0.001), less unhappy (p=0.029) and more friendly (p=0.001) had lesser DMFT score. Among the psychosocial outcomes assessed, inferiority and friendliness had significant association with oral health of the children and hence, can be used as a proxy measures oral health.

Should Schools Be Optimistic? An Investigation of the Association between Academic Optimism of Schools and Student Achievement in Primary Education

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Boonen, Tinneke; Pinxten, Maarten; Van Damme, Jan; Onghena, Patrick

2014-01-01

Academic emphasis, collective efficacy, and faculty trust in students and parents (3 school characteristics positively associated with student achievement) are assumed to form a higher order latent construct, "academic optimism" (Hoy, Tarter, & Woolfolk Hoy, 2006a, 2006b). The aim of the present study is to corroborate the latent…

Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system.

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Akbari, Nahid; Ramezankhani, Ali; Pazargadi, Mehrnoosh

2013-07-01

At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the "unmet need for family planning" have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a cascade model for presenting the

Dispositional Optimism

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Carver, Charles S.; Scheier, Michael F.

2014-01-01

Optimism is a cognitive construct (expectancies regarding future outcomes) that also relates to motivation: optimistic people exert effort, whereas pessimistic people disengage from effort. Study of optimism began largely in health contexts, finding positive associations between optimism and markers of better psychological and physical health. Physical health effects likely occur through differences in both health-promoting behaviors and physiological concomitants of coping. Recently, the scientific study of optimism has extended to the realm of social relations: new evidence indicates that optimists have better social connections, partly because they work harder at them. In this review, we examine the myriad ways this trait can benefit an individual, and our current understanding of the biological basis of optimism. PMID:24630971

Achieving value for money in health: a comparative analysis of OECD countries and regional countries.

Science.gov (United States)

Çelik, Yusuf; Khan, Mahmud; Hikmet, Neşet

2017-10-01

To measure efficiency gains in health sector over the years 1995 to 2013 in OECD, EU, non-member European countries. An output-oriented DEA model with variable return to scale, and residuals estimated by regression equations were used to estimate efficiencies of health systems. Slacks for health care outputs and inputs were calculated by using DEA multistage method of estimating country efficiency scores. Better health outcomes of countries were related with higher efficiency. Japan, France, or Sweden were found to be peer-efficient countries when compared to other developed countries like Germany and United States. Increasing life expectancy beyond a certain high level becomes very difficult to achieve. Despite declining marginal productivity of inputs on health outcomes, some developed countries and developing countries were found to have lowered their inefficiencies in the use of health inputs. Although there was no systematic relationship between political system of countries and health system efficiency, the objectives of countries on social and health policy and the way of achieving these objectives might be a factor increasing the efficiency of health systems. Economic and political stability might be as important as health expenditure in improving health system goals. A better understanding of the value created by health expenditures, especially in developed countries, will require analysis of specific health interventions that can increase value for money in health. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Behavioural contracting as a tool to help patients achieve better health.

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Neale, A V

1991-12-01

Behavioural contracting is an intervention technique in which a client signs an agreement to make certain behaviour changes within a specified time, usually with explicitly defined rewards for adherence or success. Contracting is being increasingly used by health professionals to assist patients in making beneficial life style changes. This paper presents data on the outcome of behavioural contracting interventions to lower serum cholesterol and to increase exercise activity. Of 223 primary care patients enrolled in a health promotion programme, 179 met with the project health educator to improve their cardiovascular risk profile; 144 of these were classified as having 'high cholesterol' and 51 signed contracts to adopt the American Heart Association guidelines diet within a 3-month period. Everyone was encouraged to sign a contract to engage in aerobic exercise three times per week; 96 did so. The results indicate that contractors achieved greater beneficial health changes than non-contractors, and that the group which fully met their contract obligations experienced the greatest health benefit of all (either a lowering of cholesterol or a decreased exercising heart rate).

The association between academic engagement and achievement in health sciences students

Science.gov (United States)

2013-01-01

Background Educational institutions play an important role in encouraging student engagement, being necessary to know how engaged are students at university and if this factor is involved in student success point and followed. To explore the association between academic engagement and achievement. Methods Cross-sectional study. The sample consisted of 304 students of Health Sciences. They were asked to fill out an on-line questionnaire. Academic achievements were calculated using three types of measurement. Results Positive correlations were found in all cases. Grade point average was the academic rate most strongly associated with engagement dimensions and this association is different for male and female students. The independent variables could explain between 18.9 and 23.9% of the variance (p < 0.05) in the population of university students being analyzed. Conclusions Engagement has been shown to be one of the many factors, which are positively involved, in the academic achievements of college students. PMID:23446005

The Role of Public Health Nutrition in Achieving the Sustainable Development Goals in the Asia Pacific Region.

Science.gov (United States)

Binns, Colin; Lee, Mi Kyung; Low, Wah Yun; Zerfas, Alfred

2017-10-01

The Sustainable Development Goals (SDGs) replaced the Millennium Development Goals (MDCs) in 2015, which included several goals and targets primarily related to nutrition: to eradicate extreme poverty and hunger and to reduce child mortality and improve maternal health. In the Asia-Pacific Academic Consortium for Public Health (APACPH) member countries as a group, infant and child mortality were reduced by more than 65% between 1990 and 2015, achieving the MDG target of two-thirds reduction, although these goals were not achieved by several smaller countries. The SDGs are broader in focus than the MDGs, but include several goals that relate directly to nutrition: 2 (zero hunger-food), 3 (good health and well-being-healthy life), and 12 (responsible consumption and production-sustainability). Other SDGs that are closely related to nutrition are 4 and 5 (quality education and equality in gender-education and health for girls and mothers, which is very important for infant health) and 13 (climate action). Goal 3 is "good health and well-being," which includes targets for child mortality, maternal mortality, and reducing chronic disease. The Global Burden of Disease Project has confirmed that the majority of risk for these targets can be attributed to nutrition-related targets. Dietary Guidelines were developed to address public health nutrition risk in the Asia Pacific region at the 48th APACPH 2016 conference and they are relevant to the achievement of the SDGs. Iron deficiency increases the risk of maternal death from haemorrhage, a cause of 300000 deaths world-wide each year. Improving diets and iron supplementation are important public health interventions in the APACPH region. Chronic disease and obesity rates in the APACPH region are now a major challenge and healthy life course nutrition is a major public health priority in answering this challenge. This article discusses the role of public health nutrition in achieving the SDGs. It also examines the role of

Optimization of the sample dilution for minimization of the matrix effects and achieving maximal sensitivity in XRFA

International Nuclear Information System (INIS)

Dimov, L.; Benova, M.

1989-01-01

The method of neutral medium dilution can lead to practically full leveling of the matrix but the high degree of dilution at which this effect is achieved will inevitably result in loss of sensitivity. In the XRFA of heavy elements in a light matrix the dependence of the fluorescence intensity upon concentration is characterized by gradually decreasing steepness reacting saturation (as in analysis of Pb in a Pb-concentrate). The dilution by neutral medium can shift the concentration range to a zone of greater steepness but this results in an increase of sensitivity towards the concentration in the initial (undiluted) material only to a certain degree of dilution. This work presents an optimization of the degree of dilution by neutral medium which achieves a sufficient leveling of the matrix when using different materials and also maximal sensitivity towards higher concentrations. Furthermore an original solution is found to the problem of selecting a neutral medium enabling to achieve good homogenization with various materials and particularly - with marble flour. (author)

Optimizing the Office Visit for Adolescents with Special Health Care Needs.

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Nathawad, Rita; Hanks, Christopher

2017-08-01

Youth with special health care needs (YSHCN) experience health care disparities and often need additional support to receive optimal medical care, particularly in adolescence as they prepare to transition to adult care. Many medical practices struggle to address their needs. Here, we discuss approaches to improve medical care in office-based settings for YSHCN. Office visits can be optimized by training staff in developmentally appropriate care and ensuring that the physical office space facilitates care. Participating in previsit preparation, including managing patient registries of YSHCN, engaging in regular team huddles, and incorporating previsit planning, can improve preparation and ensure that important needs are not overlooked. Additionally, approaches to improve patient and medical provider comfort with office visits with YSHCN, including approaches to measuring vital signs, examining patients, and communicating with patients with various disabilities, are reviewed. Finally, we discuss methods of supporting adolescents with special health care needs in developing self-management skills that will allow them to be better prepared to enter adult health care settings when appropriate. Although YSHCN can present challenges to medical teams, their care can be improved by developing office-based changes and processes to support improved care for these patients. This may help overcome the health care disparities they experience and increase comfort for all members of the medical team. Copyright © 2017. Published by Elsevier Inc.

Optimism and spontaneous self-affirmation are associated with lower likelihood of cognitive impairment and greater positive affect among cancer survivors

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Taber, Jennifer M.; Klein, William M. P.; Ferrer, Rebecca A.; Kent, Erin E.; Harris, Peter R.

2016-01-01

Background Optimism and self-affirmation promote adaptive coping, goal achievement, and better health. Purpose To examine the associations of optimism and spontaneous self-affirmation (SSA) with physical, mental, and cognitive health and information seeking among cancer survivors. Methods Cancer survivors (n=326) completed the Health Information National Trends Survey 2013, a national survey of U.S. adults. Participants reported optimism, SSA, cognitive and physical impairment, affect, health status, and information seeking. Results Participants higher in optimism reported better health on nearly all indices examined, even when controlling for SSA. Participants higher in SSA reported lower likelihood of cognitive impairment, greater happiness and hopefulness, and greater likelihood of cancer information seeking. SSA remained significantly associated with greater hopefulness and cancer information seeking when controlling for optimism. Conclusions Optimism and SSA may be associated with beneficial health-related outcomes among cancer survivors. Given the demonstrated malleability of self-affirmation, these findings represent important avenues for future research. PMID:26497697

Optimism and Spontaneous Self-affirmation are Associated with Lower Likelihood of Cognitive Impairment and Greater Positive Affect among Cancer Survivors.

Science.gov (United States)

Taber, Jennifer M; Klein, William M P; Ferrer, Rebecca A; Kent, Erin E; Harris, Peter R

2016-04-01

Optimism and self-affirmation promote adaptive coping, goal achievement, and better health. The aim of this study is to examine the associations of optimism and spontaneous self-affirmation (SSA) with physical, mental, and cognitive health and information seeking among cancer survivors. Cancer survivors (n = 326) completed the Health Information National Trends Survey 2013, a national survey of US adults. Participants reported optimism, SSA, cognitive and physical impairment, affect, health status, and information seeking. Participants higher in optimism reported better health on nearly all indices examined, even when controlling for SSA. Participants higher in SSA reported lower likelihood of cognitive impairment, greater happiness and hopefulness, and greater likelihood of cancer information seeking. SSA remained significantly associated with greater hopefulness and cancer information seeking when controlling for optimism. Optimism and SSA may be associated with beneficial health-related outcomes among cancer survivors. Given the demonstrated malleability of self-affirmation, these findings represent important avenues for future research.

Unequally distributed psychological assets: are there social disparities in optimism, life satisfaction, and positive affect?

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Boehm, Julia K; Chen, Ying; Williams, David R; Ryff, Carol; Kubzansky, Laura D

2015-01-01

Socioeconomic status is associated with health disparities, but underlying psychosocial mechanisms have not been fully identified. Dispositional optimism may be a psychosocial process linking socioeconomic status with health. We hypothesized that lower optimism would be associated with greater social disadvantage and poorer social mobility. We also investigated whether life satisfaction and positive affect showed similar patterns. Participants from the Midlife in the United States study self-reported their optimism, satisfaction, positive affect, and socioeconomic status (gender, race/ethnicity, education, occupational class and prestige, income). Social disparities in optimism were evident. Optimistic individuals tended to be white and highly educated, had an educated parent, belonged to higher occupational classes with more prestige, and had higher incomes. Findings were generally similar for satisfaction, but not positive affect. Greater optimism and satisfaction were also associated with educational achievement across generations. Optimism and life satisfaction are consistently linked with socioeconomic advantage and may be one conduit by which social disparities influence health.

Financing of health systems to achieve the health Millennium Development Goals in low-income countries.

Science.gov (United States)

Fryatt, Robert; Mills, Anne; Nordstrom, Anders

2010-01-30

Concern that underfunded and weak health systems are impeding the achievement of the health Millennium Development Goals in low-income countries led to the creation of a High Level Taskforce on Innovative International Financing for Health Systems in September, 2008. This report summarises the key challenges faced by the Taskforce and its Working Groups. Working Group 1 examined the constraints to scaling up and costs. Challenges included: difficulty in generalisation because of scarce and context-specific health-systems knowledge; no consensus for optimum service-delivery approaches, leading to wide cost differences; no consensus for health benefits; difficulty in quantification of likely efficiency gains; and challenges in quantification of the financing gap owing to uncertainties about financial commitments for health. Working Group 2 reviewed the different innovative mechanisms for raising and channelling funds. Challenges included: variable definitions of innovative finance; small evidence base for many innovative finance mechanisms; insufficient experience in harmonisation of global health initiatives; and inadequate experience in use of international investments to improve maternal, newborn, and child health. The various mechanisms reviewed and finally recommended all had different characteristics, some focusing on specific problems and some on raising resources generally. Contentious issues included the potential role of the private sector, the rights-based approach to health, and the move to results-based aid. The challenges and disagreements that arose during the work of the Taskforce draw attention to the many issues facing decision makers in low-income countries. International donors and recipient governments should work together to improve the evidence base for strengthening health systems, increase long-term commitments, and improve accountability through transparent and inclusive national approaches. Copyright 2010 Elsevier Ltd. All rights reserved.

The economics of optimal health and productivity in the commercial dairy.

Science.gov (United States)

Galligan, D T

1999-08-01

Dairy production practices are changing; in order to remain viable, producers must optimise the health and productivity of dairy herds in economic terms. Health care is important in economic terms because disease can substantially reduce the productivity of individual animals. Preventive disease control programmes can thus result in economic gains for the dairy producer. The author describes new approaches to preventing postpartum diseases and dealing with fertility problems which can result from these diseases. Other aspects of dairy production are also changing, employing new technologies where these are judged to be profitable. Innovations include: the use of bovine somatotropin; systematic breeding/culling programmes; new mathematical modelling techniques to determine optimum feed composition and to define optimal growth levels for accelerated heifer-rearing programmes; the use of computers to collect, store and analyse data on animal production and health; and semen selection programmes. Increasing awareness of bio-security is also vital, not least because of the large investment present in dairy herds. Whatever practices are employed, they must offer economic returns to producers that compete with alternative uses of capital. Optimal levels of disease control must be determined for a particular production situation, taking into account not only the economic health of the producer, but also the well-being of the animals.

NASA Human Health and Performance Information Architecture Panel

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Johnson-Throop, Kathy; Kadwa, Binafer; VanBaalen, Mary

2014-01-01

The Human Health and Performance (HH&P) Directorate at NASA's Johnson Space Center has a mission to enable optimization of human health and performance throughout all phases of spaceflight. All HH&P functions are ultimately aimed at achieving this mission. Our activities enable mission success, optimizing human health and productivity in space before, during, and after the actual spaceflight experience of our crews, and include support for ground-based functions. Many of our spaceflight innovations also provide solutions for terrestrial challenges, thereby enhancing life on Earth.

Impatience versus achievement strivings in the Type A pattern: Differential effects on students' health and academic achievement

Science.gov (United States)

Spence, Janet T.; Helmreich, Robert L.; Pred, Robert S.

1987-01-01

Psychometric analyses of college students' responses to the Jenkins Activity Survey, a self-report measure of the Type A behavior pattern, revealed the presence of two relatively independent factors. Based on these analyses, two scales, labeled Achievement Strivings (AS) and Impatience and Irritability (II), were developed. In two samples of male and female college students, scores on AS but not on II were found to be significantly correlated with grade point average. Responses to a health survey, on the other hand, indicated that frequency of physical complaints was significantly correlated with II but not with AS. These results suggest that there are two relatively independent factors in the Type A pattern that have differential effects on performance and health. Future research on the personality factors related to coronary heart disease and other disorders might more profitably focus on the syndrome reflected in the II scale than on the Type A pattern.

Influence of Health Education and Healthy Lifestyle on Students' Academic Achievement in Biology in Nigeria

Science.gov (United States)

Babatunde, Ezekiel Olusegun

2017-01-01

The positive effects of health education and healthy lifestyle on adolescent academic achievement cannot be over emphasized as learning experiences to help students accurately assess the level of risk-taking behaviour among their peers, emphasis on the value of good health that reinforces health-enhancing attitudes and beliefs are paramount.…

Analytical Diagnostics of Non-Optimal Use of Pesticides and Health Hazards for Vegetable Pickers

International Nuclear Information System (INIS)

Zafar, M.; Mehmood, T.; Baig, I. A.; Saboor, A.; Sadiq, S.; Mahmood, K.

2016-01-01

Economically pesticides are meant to control pests in the fields. Up to certain optimal use of a typical pesticide, it enhances the yield of crops and vegetables. But, eventually amplified use of pesticides results in contamination of environment (water, soil, and air) and increase the health cost of vegetable pickers. The purpose of this study is to estimate the excessive use of pesticides and economic cost of health hazards for the vegetable pickers in district Vehari. Data from 90 respondents were collected and analyzed. The most common health problems identified during the survey were headache, eye irritation, skin infection, cough and shortness of breath. Health cost consists of costs related to precautionary measure, medication, traveling, the opportunity cost of attended persons and productivity loss. The mean health cost of vegetable pickers in the study area was about Rs. 385 per picker per year. Health cost model was used to measure the health cost of vegetable pickers. The regression results showed that pesticides were being applied non-optimally in the study area i.e., number of pesticide applications for vegetables (7-31) were substantially higher than the recommended dose. Health cost function was significantly different from zero as indicated by F-stat (32.18) and it is also supported by R/sup 2/ that about 70 percent variation in health cost is explained by medication accompanied by productivity loss (Rs. 223), precautionary measure (Rs. 134), attended person cost (Rs. 14) and traveling expenditures (Rs. 16). Hence, strict legislation is required to overcome the availability of hazardous pesticides and to keep the vegetable pickers aware of the optimal use of pesticides through appropriate extension services. (author)

Optimal Network QoS over the Internet of Vehicles for E-Health Applications

Directory of Open Access Journals (Sweden)

Di Lin

2016-01-01

Full Text Available Wireless technologies are pervasive to support ubiquitous healthcare applications. However, a critical issue of using wireless communications under a healthcare scenario is the electromagnetic interference (EMI caused by RF transmission, and a high level of EMI may lead to a critical malfunction of medical sensors. In consideration of EMI on medical sensors, we study the optimization of quality of service (QoS within the whole Internet of vehicles for E-health and propose a novel model to optimize the QoS by allocating the transmit power of each user. Our results show that the optimal power control policy depends on the objective of optimization problems: a greedy policy is optimal to maximize the summation of QoS of each user, whereas a fair policy is optimal to maximize the product of QoS of each user. Algorithms are taken to derive the optimal policies, and numerical results of optimizing QoS are presented for both objectives and QoS constraints.

Energy Management Strategy in Consideration of Battery Health for PHEV via Stochastic Control and Particle Swarm Optimization Algorithm

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Yuying Wang

2017-11-01

Full Text Available This paper presents an energy management strategy for plug-in hybrid electric vehicles (PHEVs that not only tries to minimize the energy consumption, but also considers the battery health. First, a battery model that can be applied to energy management optimization is given. In this model, battery health damage can be estimated in the different states of charge (SOC and temperature of the battery pack. Then, because of the inevitability that limiting the battery health degradation will increase energy consumption, a Pareto energy management optimization problem is formed. This multi-objective optimal control problem is solved numerically by using stochastic dynamic programming (SDP and particle swarm optimization (PSO for satisfying the vehicle power demand and considering the tradeoff between energy consumption and battery health at the same time. The optimization solution is obtained offline by utilizing real historical traffic data and formed as mappings on the system operating states so as to implement online in the actual driving conditions. Finally, the simulation results carried out on the GT-SUITE-based PHEV test platform are illustrated to demonstrate that the proposed multi-objective optimal control strategy would effectively yield benefits.

Optimism and hope as predictors of subjective health in post-myocardial infarction patients: A comparison of the role of coping strategies.

Science.gov (United States)

Wlodarczyk, Dorota

2017-03-01

This study explored the effects intervening in the linkages of optimism and hope with subjective health in the short term after myocardial infarction. A two-wave study design was used. The sample consisted of 222 myocardial infarction survivors. When adopting a cross-sectional design, optimism and hope predicted subjective health at Time 1 and Time 2. After controlling for baseline subjective health, they were no longer significant predictors of subjective health at Time 2. Parallel indirect effects of seeking social support and problem solving were significant for both optimism and hope. After controlling for the shared variance between optimism and hope, these effects remained significant only for optimism.

Maternal health: There is cause for optimism | Burton | South African ...

African Journals Online (AJOL)

Maternal health: There is cause for optimism. R Burton. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.7196/SAMJ.7237 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for ...

Mental health nurses' perceptions of good work in an acute setting.

Science.gov (United States)

Cleary, Michelle; Horsfall, Jan; O'Hara-Aarons, Maureen; Jackson, Debra; Hunt, Glenn E

2012-10-01

Frequently, research and conference papers explore difficult or problematic areas of practice that can inadvertently render daily nursing accomplishments invisible and create the perception of a discipline in crisis. In this qualitative study, we explore the views of registered nurses about achievements in the workplace and good nursing work in an acute inpatient mental health setting in Sydney, Australia. Mental health nurses were asked a series of questions about their experiences and understanding of what constitutes good nursing work as well as their sense of optimism about their work. A total of 40 structured face-to-face interviews were completed. Among the responses to questions about achievements and good nursing practice, five broad themes were identified: i) teamwork; (ii) interpersonal interactions with patients; (iii) providing practical and holistic support to patients; (iv) patients' mental health improvements; and (v) optimism-pessimism continuum. Findings contribute to a discussion of good nursing work in acute mental health settings, as well as self-perceptions of optimism and hopefulness, which are important contributors to positive, supportive health-care settings and patient recovery. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

The neglected role of adolescent emotional well-being in national educational achievement: bridging the gap between education and mental health policies.

Science.gov (United States)

Sznitman, Sharon R; Reisel, Liza; Romer, Daniel

2011-02-01

Although child poverty is recognized as a critical determinant of poor educational achievement in the United States, policy discussions on raising academic achievement rarely include the importance of the effects of poverty on the mental health of adolescents. This article examines the role of adolescent emotional well-being (indicators of depression) as a mediator of the effects of poverty on differences in educational achievement at the national and U.S. state levels. Differences in standardized adolescent academic achievement across 23 developed countries and 39 U.S. states were analyzed using path analytic techniques to test the hypothesis that indicators of adolescent emotional well-being mediate relations between child poverty rates and academic achievement. Child poverty rates were related to both adolescent emotional well-being and educational achievement across both U.S. states and developed countries. Path analyses showed that the status of a country's or state's adolescent emotional well-being is a strong predictor of its educational achievement and that emotional well-being mediates the relationship between poverty and educational achievement. Policies designed to ameliorate the adverse effects of poverty on mental health are critical as they are likely to improve both average educational achievement and student emotional well-being. Attention to improving mental health care not only has the potential to reduce societal and individual costs directly related to health but also to reduce the indirect costs of poor educational achievement. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Tracking the Market Performance of Companies That Integrate a Culture of Health and Safety: An Assessment of Corporate Health Achievement Award Applicants.

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Fabius, Raymond; Loeppke, Ronald R; Hohn, Todd; Fabius, Dan; Eisenberg, Barry; Konicki, Doris L; Larson, Paul

2016-01-01

The aim of this study was to assess the hypothesis that stock market performance of companies achieving high scores on either health or safety in the Corporate Health Achievement Award (CHAA) process will be superior to average index performance. The stock market performance of portfolios of CHAA winners was examined under six different scenarios using simulation and past market performance in tests of association framed to inform the investor community. CHAA portfolios out-performed the S&P average on all tests. This study adds to the growing evidence that a healthy and safe workforce correlates with a company's performance and its ability to provide positive returns to shareholders. It advances the idea that a proven set of health and safety metrics based on the CHAA evaluation process merits inclusion with existing measures for market valuation.

Reversible Masking Using Low-Molecular-Weight Neutral Lipids to Achieve Optimal-Targeted Delivery

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Nancy Smyth Templeton

2012-01-01

Full Text Available Intravenous injection of therapeutics is required to effectively treat or cure metastatic cancer, certain cardiovascular diseases, and other acquired or inherited diseases. Using this route of delivery allows potential uptake in all disease targets that are accessed by the bloodstream. However, normal tissues and organs also have the potential for uptake of therapeutic agents. Therefore, investigators have used targeted delivery to attempt delivery solely to the target cells; however, use of ligands on the surface of delivery vehicles to target specific cell surface receptors is not sufficient to avoid nonspecific uptake. PEGylation has been used for decades to try to avoid nonspecific uptake but suffers from many problems known as “The PEGylation Dilemma.” We have solved this dilemma by replacing PEGylation with reversible masking using low-molecular-weight neutral lipids in order to achieve optimal-targeted delivery solely to target cells. Our paper will focus on this topic.

Colombian public policies contributing to the achievement of Millennium Development Goals in the health sector, 2006

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Lina M. Grisales

2008-02-01

Full Text Available During the General Assembly of the United Nations, in September 2000,189 countries (including Colombia committed to eight objectives leading to a more human and fairer world. Such objectives are called the Millennium Development Goals (mdg and to achieve them it is crucial to incorporate them in the action agendas of each country. The purpose of this monograph is to recognize current public policies in Colombia and Antioquia leading the achievement of the Millennium Development Goals, specifically those related to the reduction of mortality among children less than 5 years of age, improvement of maternal health and fighting against hiv/aids, malaria and dengue.In Colombia, Conpes 91 of 2005 is the only guideline given by the Government establishing goals and strategies to achieve the Millennium Development Goals in 2015. Nevertheless, other policies, programs and projects before and even after the Millennium Statement (but without explicit purpose contribute to achieving such goals. Revision of those policies is an effort for the research project “Degree of contribution of public policies to the achievement of the Millennium Development Goals related to the health sector, Antioquia, 2006”, which will evaluate the impact these guidelines have had in the achievement of the development goals in that particular sector.

Minimizing the health and climate impacts of emissions from heavy-duty public transportation bus fleets through operational optimization.

Science.gov (United States)

Gouge, Brian; Dowlatabadi, Hadi; Ries, Francis J

2013-04-16

In contrast to capital control strategies (i.e., investments in new technology), the potential of operational control strategies (e.g., vehicle scheduling optimization) to reduce the health and climate impacts of the emissions from public transportation bus fleets has not been widely considered. This case study demonstrates that heterogeneity in the emission levels of different bus technologies and the exposure potential of bus routes can be exploited though optimization (e.g., how vehicles are assigned to routes) to minimize these impacts as well as operating costs. The magnitude of the benefits of the optimization depend on the specific transit system and region. Health impacts were found to be particularly sensitive to different vehicle assignments and ranged from worst to best case assignment by more than a factor of 2, suggesting there is significant potential to reduce health impacts. Trade-offs between climate, health, and cost objectives were also found. Transit agencies that do not consider these objectives in an integrated framework and, for example, optimize for costs and/or climate impacts alone, risk inadvertently increasing health impacts by as much as 49%. Cost-benefit analysis was used to evaluate trade-offs between objectives, but large uncertainties make identifying an optimal solution challenging.

SOCIAL-COMPARISON OF HEALTH RISKS - LOCUS OF CONTROL, THE PERSON-POSITIVITY BIAS, AND UNREALISTIC OPTIMISM

NARCIS (Netherlands)

HOORENS, [No Value; BUUNK, BP

1993-01-01

People typically attribute lower health risks to themselves than to others, a phenomenon referred to as unrealistic optimism. The present study tested the person positivity bias as a previously unexamined explanation of the phenomenon and analyzed the relationship between unrealistic optimism and

Teachers' Autonomy Support, Autonomy Suppression and Conditional Negative Regard as Predictors of Optimal Learning Experience among High-Achieving Bedouin Students

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Kaplan, Haya

2018-01-01

The study is based on self-determination theory and focuses on the motivation of high-achieving Bedouin students who belong to a hierarchical-collectivist society. The study focuses on the question: What are the relations between teachers' autonomy support and control and an optimal learning experience among students? The study is unique in its…

Housing Affordability And Children's Cognitive Achievement.

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Newman, Sandra; Holupka, C Scott

2016-11-01

Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant. Project HOPE—The People-to-People Health Foundation, Inc.

Older women in an aging world: achieving health across the life course.

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Bonita, R; Howe, A L

1996-01-01

This article, based on a report (Women, aging and health: achieving health across the life span) prepared for the WHO Global Commission on Women's Health under the guidance of WHO's Aging and Health Programme, presents demographic data that clearly demonstrate the need for recognition of the health of aging women as a global issue of major public health concern. The authors show that, while female life expectancy at birth is significantly different in developed and developing countries (because of high infant and maternal mortality in the latter), these differences tend to decrease for women in developing countries who reach middle age. The authors review the various facets of the "gender transition" brought about by demographic and epidemiological transitions, drawing attention to contrasts between the situation in developing countries in Asia and Latin America and that in Eastern Europe, for example. The role of older women as care-givers is discussed, as is the likelihood of a future increase in the proportion of older women living alone in the developing world (a factor which renders them particularly vulnerable in many socioeconomic and health respects). Suggestions are made on methodologies for monitoring health trends in aging women, and on the role of WHO in this respect. A basic goal for global strategies relating to the health of older women is formulated: reduction of the inequities in life expectancy between developed and developing countries.

The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals

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Izutsu Takashi

2011-01-01

Full Text Available Abstract Mental health problems in women during pregnancy and after childbirth and their adverse consequences for child health and development have received sustained detailed attention in high-income countries. In contrast, evidence has only been generated more recently in resource-constrained settings. In June 2007 the United Nations Population Fund, the World Health Organization, the Key Centre for Women's Health in Society, a WHO Collaborating Centre for Women's Health and the Research and Training Centre for Community Development in Vietnam convened the first international expert meeting on maternal mental health and child health and development in resource-constrained settings. It aimed to appraise the evidence about the nature, prevalence and risks for common perinatal mental disorders in women; the consequences of these for child health and development and ameliorative strategies in these contexts. The substantial disparity in rates of perinatal mental disorders between women living in high- and low-income settings, suggests social rather than biological determinants. Risks in resource-constrained contexts include: poverty; crowded living situations; limited reproductive autonomy; unintended pregnancy; lack of empathy from the intimate partner; rigid gender stereotypes about responsibility for household work and infant care; family violence; poor physical health and discrimination. Development is adversely affected if infants lack day-to-day interactions with a caregiver who can interpret their cues, and respond effectively. Women with compromised mental health are less able to provide sensitive, responsive infant care. In resource-constrained settings infants whose mothers are depressed are less likely to thrive and to receive optimal care than those whose mothers are well. The meeting outcome is the Hanoi Expert Statement (Additional file 1. It argues that the Millennium Development Goals to improve maternal health, reduce child

A public health achievement under adversity: the eradication of poliomyelitis from Peru, 1991.

Science.gov (United States)

Sobti, Deepak; Cueto, Marcos; He, Yuan

2014-12-01

The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America's story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public-private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru's Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements.

Accurate Open-Shell Noncovalent Interaction Energies from the Orbital-Optimized Møller-Plesset Perturbation Theory: Achieving CCSD Quality at the MP2 Level by Orbital Optimization.

Science.gov (United States)

Soydaş, Emine; Bozkaya, Uğur

2013-11-12

The accurate description of noncovalent interactions is one of the most challenging problems in modern computational chemistry, especially those for open-shell systems. In this study, an investigation of open-shell noncovalent interactions with the orbital-optimized MP2 and MP3 (OMP2 and OMP3) is presented. For the considered test set of 23 complexes, mean absolute errors in noncovalent interaction energies (with respect to CCSD(T) at complete basis set limits) are 0.68 (MP2), 0.37 (OMP2), 0.59 (MP3), 0.23 (OMP3), and 0.38 (CCSD) kcal mol(-1) . Hence, with a greatly reduced computational cost, one may achieve CCSD quality at the MP2 level by orbital optimization [scaling formally as O(N(6)) for CCSD compared to O(N(5)) for OMP2, where N is the number of basis functions]. Further, one may obtain a considerably better performance than CCSD using the OMP3 method, which has also a lower cost than CCSD.

Sustainable food systems for optimal planetary health.

Science.gov (United States)

Canavan, Chelsey R; Noor, Ramadhani A; Golden, Christopher D; Juma, Calestous; Fawzi, Wafaie

2017-06-01

Sustainable food systems are an important component of a planetary health strategy to reduce the threat of infectious disease, minimize environmental footprint and promote nutrition. Human population trends and dietary transition have led to growing demand for food and increasing production and consumption of meat, amid declining availability of arable land and water. The intensification of livestock production has serious environmental and infectious disease impacts. Land clearing for agriculture alters ecosystems, increases human-wildlife interactions and leads to disease proliferation. Context-specific interventions should be evaluated towards optimizing nutrition resilience, minimizing environmental footprint and reducing animal and human disease risk. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Learning optimal embedded cascades.

Science.gov (United States)

Saberian, Mohammad Javad; Vasconcelos, Nuno

2012-10-01

The problem of automatic and optimal design of embedded object detector cascades is considered. Two main challenges are identified: optimization of the cascade configuration and optimization of individual cascade stages, so as to achieve the best tradeoff between classification accuracy and speed, under a detection rate constraint. Two novel boosting algorithms are proposed to address these problems. The first, RCBoost, formulates boosting as a constrained optimization problem which is solved with a barrier penalty method. The constraint is the target detection rate, which is met at all iterations of the boosting process. This enables the design of embedded cascades of known configuration without extensive cross validation or heuristics. The second, ECBoost, searches over cascade configurations to achieve the optimal tradeoff between classification risk and speed. The two algorithms are combined into an overall boosting procedure, RCECBoost, which optimizes both the cascade configuration and its stages under a detection rate constraint, in a fully automated manner. Extensive experiments in face, car, pedestrian, and panda detection show that the resulting detectors achieve an accuracy versus speed tradeoff superior to those of previous methods.

A probabilistic approach for optimal sensor allocation in structural health monitoring

International Nuclear Information System (INIS)

Azarbayejani, M; Reda Taha, M M; El-Osery, A I; Choi, K K

2008-01-01

Recent advances in sensor technology promote using large sensor networks to efficiently and economically monitor, identify and quantify damage in structures. In structural health monitoring (SHM) systems, the effectiveness and reliability of the sensor network are crucial to determine the optimal number and locations of sensors in SHM systems. Here, we suggest a probabilistic approach for identifying the optimal number and locations of sensors for SHM. We demonstrate a methodology to establish the probability distribution function that identifies the optimal sensor locations such that damage detection is enhanced. The approach is based on using the weights of a neural network trained from simulations using a priori knowledge about damage locations and damage severities to generate a normalized probability distribution function for optimal sensor allocation. We also demonstrate that the optimal sensor network can be related to the highest probability of detection (POD). The redundancy of the proposed sensor network is examined using a 'leave one sensor out' analysis. A prestressed concrete bridge is selected as a case study to demonstrate the effectiveness of the proposed method. The results show that the proposed approach can provide a robust design for sensor networks that are more efficient than a uniform distribution of sensors on a structure

Health physics experiences in achieving ALARA exposures to plant personnel at NAPS

International Nuclear Information System (INIS)

Ramakrishna, V.; Lal Chand

2000-01-01

Unit 1 of NAPS achieved first criticality on 12.3.1989 and Unit 2 achieved on 24.10.1991. Till the end of Feb-2000 these units have completed 1890 and 1811 full power days respectively. The performance of NAPS was expected to be better than the earlier Indian reactors in respect of safe production as well as cumulative radiation exposures. This is because of the major design improvements like: fully double containment system, elimination of 41 Ar by introducing light water in calandria vault, reduction of core based fuel failure rate, separation of high radiation equipment to no occupancy areas during normal operation, a separate purification building for the purification of both moderator and PHT systems, a better layout of equipment and plant areas, elimination of unnecessary equipment in various systems besides ensuring the reliability of equipment for safe operation, selection of materials with low corrosion and activation characteristics etc. In this paper, the operational health physics experiences at NAPS to achieve ALARA exposures to plant personnel are described briefly. (author)

Achieving Optimal Privacy in Trust-Aware Social Recommender Systems

Science.gov (United States)

Dokoohaki, Nima; Kaleli, Cihan; Polat, Huseyin; Matskin, Mihhail

Collaborative filtering (CF) recommenders are subject to numerous shortcomings such as centralized processing, vulnerability to shilling attacks, and most important of all privacy. To overcome these obstacles, researchers proposed for utilization of interpersonal trust between users, to alleviate many of these crucial shortcomings. Till now, attention has been mainly paid to strong points about trust-aware recommenders such as alleviating profile sparsity or calculation cost efficiency, while least attention has been paid on investigating the notion of privacy surrounding the disclosure of individual ratings and most importantly protection of trust computation across social networks forming the backbone of these systems. To contribute to addressing problem of privacy in trust-aware recommenders, within this paper, first we introduce a framework for enabling privacy-preserving trust-aware recommendation generation. While trust mechanism aims at elevating recommender's accuracy, to preserve privacy, accuracy of the system needs to be decreased. Since within this context, privacy and accuracy are conflicting goals we show that a Pareto set can be found as an optimal setting for both privacy-preserving and trust-enabling mechanisms. We show that this Pareto set, when used as the configuration for measuring the accuracy of base collaborative filtering engine, yields an optimized tradeoff between conflicting goals of privacy and accuracy. We prove this concept along with applicability of our framework by experimenting with accuracy and privacy factors, and we show through experiment how such optimal set can be inferred.

Latin America and the Caribbean: assessment of the advances in public health for the achievement of the Millennium Development Goals.

Science.gov (United States)

Mitra, Amal K; Rodriguez-Fernandez, Gisela

2010-05-01

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC.

Moving beyond the treatment package approach to developing behavioral interventions: addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST).

Science.gov (United States)

Wyrick, David L; Rulison, Kelly L; Fearnow-Kenney, Melodie; Milroy, Jeffrey J; Collins, Linda M

2014-09-01

Given current pressures to increase the public health contributions of behavioral interventions, intervention scientists may wish to consider moving beyond the classical treatment package approach that focuses primarily on achieving statistical significance. They may wish also to focus on goals directly related to optimizing public health impact. The Multiphase Optimization Strategy (MOST) is an innovative methodological framework that draws on engineering principles to achieve more potent behavioral interventions. MOST is increasingly being adopted by intervention scientists seeking a systematic framework to engineer an optimized intervention. As with any innovation, there are challenges that arise with early adoption. This article describes the solutions to several critical questions that we addressed during the first-ever iterative application of MOST. Specifically, we describe how we have applied MOST to optimize an online program (myPlaybook) for the prevention of substance use among college student-athletes. Our application of MOST can serve as a blueprint for other intervention scientists who wish to design optimized behavioral interventions. We believe using MOST is feasible and has the potential to dramatically improve program effectiveness thereby advancing the public health impact of behavioral interventions.

Leveraging health information technology to achieve the "triple aim" of healthcare reform.

Science.gov (United States)

Sheikh, Aziz; Sood, Harpreet S; Bates, David W

2015-07-01

To investigate experiences with leveraging health information technology (HIT) to improve patient care and population health, and reduce healthcare expenditures. In-depth qualitative interviews with federal government employees, health policy, HIT and medico-legal experts, health providers, physicians, purchasers, payers, patient advocates, and vendors from across the United States. The authors undertook 47 interviews. There was a widely shared belief that Health Information Technology for Economic and Clinical Health (HITECH) had catalyzed the creation of a digital infrastructure, which was being used in innovative ways to improve quality of care and curtail costs. There were however major concerns about the poor usability of electronic health records (EHRs), their limited ability to support multi-disciplinary care, and major difficulties with health information exchange, which undermined efforts to deliver integrated patient-centered care. Proposed strategies for enhancing the benefits of HIT included federal stimulation of competition by mandating vendors to open-up their application program interfaces, incenting development of low-cost consumer informatics tools, and promoting Congressional review of the The Health Insurance Portability and Accountability Act (HIPPA) to optimize the balance between data privacy and reuse. Many underscored the need to "kick the legs from underneath the fee-for-service model" and replace it with a data-driven reimbursement system that rewards high quality care. The HITECH Act has stimulated unprecedented, multi-stakeholder interest in HIT. Early experiences indicate that the resulting digital infrastructure is being used to improve quality of care and curtail costs. Reform efforts are however severely limited by problems with usability, limited interoperability and the persistence of the fee-for-service paradigm-addressing these issues therefore needs to be the federal government's main policy target. © The Author 2015

Modelling the implications of reducing smoking prevalence: the public health and economic benefits of achieving a 'tobacco-free' UK.

Science.gov (United States)

Hunt, Daniel; Knuchel-Takano, André; Jaccard, Abbygail; Bhimjiyani, Arti; Retat, Lise; Selvarajah, Chit; Brown, Katrina; Webber, Laura L; Brown, Martin

2018-03-01

Smoking is still the most preventable cause of cancer, and a leading cause of premature mortality and health inequalities in the UK. This study modelled the health and economic impacts of achieving a 'tobacco-free' ambition (TFA) where, by 2035, less than 5% of the population smoke tobacco across all socioeconomic groups. A non-linear multivariate regression model was fitted to cross-sectional smoking data to create projections to 2035. These projections were used to predict the future incidence and costs of 17 smoking-related diseases using a microsimulation approach. The health and economic impacts of achieving a TFA were evaluated against a predicted baseline scenario, where current smoking trends continue. If trends continue, the prevalence of smoking in the UK was projected to be 10% by 2035-well above a TFA. If this ambition were achieved by 2035, it could mean 97 300 +/- 5 300 new cases of smoking-related diseases are avoided by 2035 (tobacco-related cancers: 35 900+/- 4 100; chronic obstructive pulmonary disease: 29 000 +/- 2 700; stroke: 24 900 +/- 2 700; coronary heart disease: 7600 +/- 2 700), including around 12 350 diseases avoided in 2035 alone. The consequence of this health improvement is predicted to avoid £67 +/- 8 million in direct National Health Service and social care costs, and £548 million in non-health costs, in 2035 alone. These findings strengthen the case to set bold targets on long-term declines in smoking prevalence to achieve a tobacco 'endgame'. Results demonstrate the health and economic benefits that meeting a TFA can achieve over just 20 years. Effective ambitions and policy interventions are needed to reduce the disease and economic burden of smoking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Use of Insulin Analogues in Children and Adolescents: Topical Issues and Possibilities for Achieving Optimal Type 1 Diabetes Mellitus Compensation

OpenAIRE

О.A. Budreyko

2013-01-01

The review contains an analysis of the data of numerous scientific studies on the results of use of insulin analogues in comprehensive treatment of type 1 diabetes mellitus in children and adolescents. Problem of mitogenic potential of insulin preparations and ways to prevent its realization in clinical practice is discussed. Advisability of the use of insulin analogues glulisine and glargine in children and adolescents is substantiated for achievement of optimal compensation of carbohydrate ...

The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement.

Science.gov (United States)

Langford, Rebecca; Bonell, Christopher P; Jones, Hayley E; Pouliou, Theodora; Murphy, Simon M; Waters, Elizabeth; Komro, Kelli A; Gibbs, Lisa F; Magnus, Daniel; Campbell, Rona

2014-04-16

The World Health Organization's (WHO's) Health Promoting Schools (HPS) framework is an holistic, settings-based approach to promoting health and educational attainment in school. The effectiveness of this approach has not been previously rigorously reviewed. To assess the effectiveness of the Health Promoting Schools (HPS) framework in improving the health and well-being of students and their academic achievement. We searched the following electronic databases in January 2011 and again in March and April 2013: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, Campbell Library, ASSIA, BiblioMap, CAB Abstracts, IBSS, Social Science Citation Index, Sociological Abstracts, TRoPHI, Global Health Database, SIGLE, Australian Education Index, British Education Index, Education Resources Information Centre, Database of Education Research, Dissertation Express, Index to Theses in Great Britain and Ireland, ClinicalTrials.gov, Current controlled trials, and WHO International Clinical Trials Registry Platform. We also searched relevant websites, handsearched reference lists, and used citation tracking to identify other relevant articles. We included cluster-randomised controlled trials where randomisation took place at the level of school, district or other geographical area. Participants were children and young people aged four to 18 years, attending schools or colleges. In this review, we define HPS interventions as comprising the following three elements: input to the curriculum; changes to the school's ethos or environment or both; and engagement with families or communities, or both. We compared this intervention against schools that implemented either no intervention or continued with their usual practice, or any programme that included just one or two of the above mentioned HPS elements. At least two review authors identified relevant trials, extracted data, and assessed risk of bias in the trials. We grouped different types of

Achieving the health Millennium Development Goals for South Africa: challenges and priorities.

Science.gov (United States)

Chopra, Mickey; Lawn, Joy E; Sanders, David; Barron, Peter; Abdool Karim, Salim S; Bradshaw, Debbie; Jewkes, Rachel; Abdool Karim, Quarraisha; Flisher, Alan J; Mayosi, Bongani M; Tollman, Stephen M; Churchyard, Gavin J; Coovadia, Hoosen

2009-09-19

15 years after liberation from apartheid, South Africans are facing new challenges for which the highest calibre of leadership, vision, and commitment is needed. The effect of the unprecedented HIV/AIDS epidemic has been immense. Substantial increases in mortality and morbidity are threatening to overwhelm the health system and undermine the potential of South Africa to attain the Millennium Development Goals (MDGs). However The Lancet's Series on South Africa has identified several examples of leadership and innovation that point towards a different future scenario. We discuss the type of vision, leadership, and priority actions needed to achieve such a change. We still have time to change the health trajectory of the country, and even meet the MDGs. The South African Government, installed in April, 2009, has the mandate and potential to address the public health emergencies facing the country--will they do so or will another opportunity and many more lives be lost?

Solving Disparities Through Payment And Delivery System Reform: A Program To Achieve Health Equity.

Science.gov (United States)

DeMeester, Rachel H; Xu, Lucy J; Nocon, Robert S; Cook, Scott C; Ducas, Andrea M; Chin, Marshall H

2017-06-01

Payment systems generally do not directly encourage or support the reduction of health disparities. In 2013 the Finding Answers: Solving Disparities through Payment and Delivery System Reform program of the Robert Wood Johnson Foundation sought to understand how alternative payment models might intentionally incorporate a disparities-reduction component to promote health equity. A qualitative analysis of forty proposals to the program revealed that applicants generally did not link payment reform tightly to disparities reduction. Most proposed general pay-for-performance, global payment, or shared savings plans, combined with multicomponent system interventions. None of the applicants proposed making any financial payments contingent on having successfully reduced disparities. Most applicants did not address how they would optimize providers' intrinsic and extrinsic motivation to reduce disparities. A better understanding of how payment and care delivery models might be designed and implemented to reduce health disparities is essential. Project HOPE—The People-to-People Health Foundation, Inc.

Interleaved segment correction achieves higher improvement factors in using genetic algorithm to optimize light focusing through scattering media

Science.gov (United States)

Li, Runze; Peng, Tong; Liang, Yansheng; Yang, Yanlong; Yao, Baoli; Yu, Xianghua; Min, Junwei; Lei, Ming; Yan, Shaohui; Zhang, Chunmin; Ye, Tong

2017-10-01

Focusing and imaging through scattering media has been proved possible with high resolution wavefront shaping. A completely scrambled scattering field can be corrected by applying a correction phase mask on a phase only spatial light modulator (SLM) and thereby the focusing quality can be improved. The correction phase is often found by global searching algorithms, among which Genetic Algorithm (GA) stands out for its parallel optimization process and high performance in noisy environment. However, the convergence of GA slows down gradually with the progression of optimization, causing the improvement factor of optimization to reach a plateau eventually. In this report, we propose an interleaved segment correction (ISC) method that can significantly boost the improvement factor with the same number of iterations comparing with the conventional all segment correction method. In the ISC method, all the phase segments are divided into a number of interleaved groups; GA optimization procedures are performed individually and sequentially among each group of segments. The final correction phase mask is formed by applying correction phases of all interleaved groups together on the SLM. The ISC method has been proved significantly useful in practice because of its ability to achieve better improvement factors when noise is present in the system. We have also demonstrated that the imaging quality is improved as better correction phases are found and applied on the SLM. Additionally, the ISC method lowers the demand of dynamic ranges of detection devices. The proposed method holds potential in applications, such as high-resolution imaging in deep tissue.

SU-D-206-01: Employing a Novel Consensus Optimization Strategy to Achieve Iterative Cone Beam CT Reconstruction On a Multi-GPU Platform

International Nuclear Information System (INIS)

Li, B; Tian, Z; Jiang, S; Jia, X; Zhou, L

2016-01-01

Purpose: While compressed sensing-based cone-beam CT (CBCT) iterative reconstruction techniques have demonstrated tremendous capability of reconstructing high-quality images from undersampled noisy data, its long computation time still hinders wide application in routine clinic. The purpose of this study is to develop a reconstruction framework that employs modern consensus optimization techniques to achieve CBCT reconstruction on a multi-GPU platform for improved computational efficiency. Methods: Total projection data were evenly distributed to multiple GPUs. Each GPU performed reconstruction using its own projection data with a conventional total variation regularization approach to ensure image quality. In addition, the solutions from GPUs were subject to a consistency constraint that they should be identical. We solved the optimization problem with all the constraints considered rigorously using an alternating direction method of multipliers (ADMM) algorithm. The reconstruction framework was implemented using OpenCL on a platform with two Nvidia GTX590 GPU cards, each with two GPUs. We studied the performance of our method and demonstrated its advantages through a simulation case with a NCAT phantom and an experimental case with a Catphan phantom. Result: Compared with the CBCT images reconstructed using conventional FDK method with full projection datasets, our proposed method achieved comparable image quality with about one third projection numbers. The computation time on the multi-GPU platform was ∼55 s and ∼ 35 s in the two cases respectively, achieving a speedup factor of ∼ 3.0 compared with single GPU reconstruction. Conclusion: We have developed a consensus ADMM-based CBCT reconstruction method which enabled performing reconstruction on a multi-GPU platform. The achieved efficiency made this method clinically attractive.

SU-D-206-01: Employing a Novel Consensus Optimization Strategy to Achieve Iterative Cone Beam CT Reconstruction On a Multi-GPU Platform

Energy Technology Data Exchange (ETDEWEB)

Li, B [University of Texas Southwestern Medical Center, Dallas, TX (United States); Southern Medical University, Guangzhou, Guangdong (China); Tian, Z; Jiang, S; Jia, X [University of Texas Southwestern Medical Center, Dallas, TX (United States); Zhou, L [Southern Medical University, Guangzhou, Guangdong (China)

2016-06-15

Purpose: While compressed sensing-based cone-beam CT (CBCT) iterative reconstruction techniques have demonstrated tremendous capability of reconstructing high-quality images from undersampled noisy data, its long computation time still hinders wide application in routine clinic. The purpose of this study is to develop a reconstruction framework that employs modern consensus optimization techniques to achieve CBCT reconstruction on a multi-GPU platform for improved computational efficiency. Methods: Total projection data were evenly distributed to multiple GPUs. Each GPU performed reconstruction using its own projection data with a conventional total variation regularization approach to ensure image quality. In addition, the solutions from GPUs were subject to a consistency constraint that they should be identical. We solved the optimization problem with all the constraints considered rigorously using an alternating direction method of multipliers (ADMM) algorithm. The reconstruction framework was implemented using OpenCL on a platform with two Nvidia GTX590 GPU cards, each with two GPUs. We studied the performance of our method and demonstrated its advantages through a simulation case with a NCAT phantom and an experimental case with a Catphan phantom. Result: Compared with the CBCT images reconstructed using conventional FDK method with full projection datasets, our proposed method achieved comparable image quality with about one third projection numbers. The computation time on the multi-GPU platform was ∼55 s and ∼ 35 s in the two cases respectively, achieving a speedup factor of ∼ 3.0 compared with single GPU reconstruction. Conclusion: We have developed a consensus ADMM-based CBCT reconstruction method which enabled performing reconstruction on a multi-GPU platform. The achieved efficiency made this method clinically attractive.

Time-optimal control with finite bandwidth

Science.gov (United States)

Hirose, M.; Cappellaro, P.

2018-04-01

Time-optimal control theory provides recipes to achieve quantum operations with high fidelity and speed, as required in quantum technologies such as quantum sensing and computation. While technical advances have achieved the ultrastrong driving regime in many physical systems, these capabilities have yet to be fully exploited for the precise control of quantum systems, as other limitations, such as the generation of higher harmonics or the finite response time of the control apparatus, prevent the implementation of theoretical time-optimal control. Here we present a method to achieve time-optimal control of qubit systems that can take advantage of fast driving beyond the rotating wave approximation. We exploit results from time-optimal control theory to design driving protocols that can be implemented with realistic, finite-bandwidth control fields, and we find a relationship between bandwidth limitations and achievable control fidelity.

Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

Directory of Open Access Journals (Sweden)

Amal K. Mitra

2010-05-01

Full Text Available To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs, that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1 eradicating extreme poverty and hunger; (2 achieving universal primary education; (3 promoting gender equality; (4 reducing child mortality; (5 improving maternal health; (6 combating HIV/AIDS, malaria and other diseases; (7 ensuring environmental sustainability; and (8 developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC. The paper also identifies areas of deficits for the achievement of MDGs in LAC.

Association between scores in high school, aptitude and achievement exams and early performance in health science college

Directory of Open Access Journals (Sweden)

Al-Alwan Ibrahim

2009-01-01

Full Text Available This retrospective study was carried out to assess the correlation between admi-ssion criteria to health science colleges, namely, final high school grade and Saudi National Apti-tude and Achievement exams, and early academic performance in these colleges. The study inclu-ded 91 male students studying in the two-year pre-professional program at the King Saud bin Abdulaziz University for Health Sciences (KSAU-HS, Riyadh, Saudi Arabia. Records of these students were used to extract relevant information and their academic performance (based on the grade point average achieved at the end of the first semester of the pre-professional program, which were analytically studied. Pearson correlation coefficient was used to assess the associa-tions between the different scores. SPSS statistical program (version 12.0 was used for data ana-lyses. We found a strong correlation between the academic performance and the Achievement Exam, Aptitude Exam and high school final grade, with Pearson Correlation Coefficients of 0.96, 0.93, 0.87, respectively. The Saudi National Achievement Exam showed the most significant correla-tion. Our results indicate that academic performance showed good correlation with the admission criteria used, namely final high school grade, Saudi National Aptitude and Achievement Exams.

Website Optimization

CERN Document Server

King, Andrew

2008-01-01

Remember when an optimized website was one that merely didn't take all day to appear? Times have changed. Today, website optimization can spell the difference between enterprise success and failure, and it takes a lot more know-how to achieve success. This book is a comprehensive guide to the tips, techniques, secrets, standards, and methods of website optimization. From increasing site traffic to maximizing leads, from revving up responsiveness to increasing navigability, from prospect retention to closing more sales, the world of 21st century website optimization is explored, exemplified a

Measuring the influence of a mental health training module on the therapeutic optimism of advanced nurse practitioner students in the United Kingdom.

Science.gov (United States)

Hemingway, Steve; Rogers, Melanie; Elsom, Stephen

2014-03-01

To evaluate the influence of a mental health training module on the therapeutic optimism of advanced nurse practitioner (ANP) students in primary care (family practice). Three cohorts of ANPs who undertook a Mental Health Problems in Primary Care Module as part of their MSc ANP (primary care) run by the University of Huddersfield completed the Elsom Therapeutic Optimism Scale (ETOS), in a pre- and postformat. The ETOS is a 10-item, self-administered scale, which has been used to evaluate therapeutic optimism previously in mental health professionals. All three cohorts who completed the scale showed an improvement in their therapeutic optimism scores. With stigma having such a detrimental effect for people diagnosed with a mental health problem, ANPs who are more mental health literate facilitated by education and training in turn facilitates them to have the skills and confidence to engage and inspire hope for the person diagnosed with mental health problems. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Imaging Live Cells at the Nanometer-Scale with Single-Molecule Microscopy: Obstacles and Achievements in Experiment Optimization for Microbiology

Science.gov (United States)

Haas, Beth L.; Matson, Jyl S.; DiRita, Victor J.; Biteen, Julie S.

2015-01-01

Single-molecule fluorescence microscopy enables biological investigations inside living cells to achieve millisecond- and nanometer-scale resolution. Although single-molecule-based methods are becoming increasingly accessible to non-experts, optimizing new single-molecule experiments can be challenging, in particular when super-resolution imaging and tracking are applied to live cells. In this review, we summarize common obstacles to live-cell single-molecule microscopy and describe the methods we have developed and applied to overcome these challenges in live bacteria. We examine the choice of fluorophore and labeling scheme, approaches to achieving single-molecule levels of fluorescence, considerations for maintaining cell viability, and strategies for detecting single-molecule signals in the presence of noise and sample drift. We also discuss methods for analyzing single-molecule trajectories and the challenges presented by the finite size of a bacterial cell and the curvature of the bacterial membrane. PMID:25123183

A dual response surface optimization methodology for achieving uniform coating thickness in powder coating process

Directory of Open Access Journals (Sweden)

Boby John

2015-09-01

Full Text Available The powder coating is an economic, technologically superior and environment friendly painting technique compared with other conventional painting methods. However large variation in coating thickness can reduce the attractiveness of powder coated products. The coating thickness variation can also adversely affect the surface appearance and corrosion resistivity of the product. This can eventually lead to customer dissatisfaction and loss of market share. In this paper, the author discusses a dual response surface optimization methodology to minimize the thickness variation around the target value of powder coated industrial enclosures. The industrial enclosures are cabinets used for mounting the electrical and electronic equipment. The proposed methodology consists of establishing the relationship between the coating thickness & the powder coating process parameters and developing models for the mean and variance of coating thickness. Then the powder coating process is optimized by minimizing the standard deviation of coating thickness subject to the constraint that the thickness mean would be very close to the target. The study resulted in achieving a coating thickness mean of 80.0199 microns for industrial enclosures, which is very close to the target value of 80 microns. A comparison of the results of the proposed approach with that of existing methodologies showed that the suggested method is equally good or even better than the existing methodologies. The result of the study is also validated with a new batch of industrial enclosures.

The Contributions of Physical Activity and Fitness to Optimal Health and Wellness

Science.gov (United States)

Ohuruogu, Ben

2016-01-01

The paper examined the role of physical activity and fitness more especially in the area of disease prevention and control by looking at the major ways by which regular physical activity and fitness contributes to optimal health and wellness. The Surgeor General's Report (1996), stressed that physical inactivity is a national problem which…

Optimization of Medication Use at Accountable Care Organizations.

Science.gov (United States)

Wilks, Chrisanne; Krisle, Erik; Westrich, Kimberly; Lunner, Kristina; Muhlestein, David; Dubois, Robert

2017-10-01

Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use. This cross-sectional study consisted of a survey and interviews that gathered information on the perceptions of ACO leadership. The survey contained a medication practices inventory (MPI) composed of 38 capabilities across 6 functional domains related to optimizing medication use. ACOs completed self-assessments that included rating each component of the MPI on a scale of 1 to 10. Fisher's exact tests, 2-proportions tests, t-tests, and logistic regression were used to test for associations between ACO scores on the MPI and performance on financial and quality metrics, and on ACO descriptive characteristics. Of the 847 ACOs that were contacted, 49 provided usable survey data. These ACOs rated their own system's ability to manage the quality and costs of optimizing medication use, providing a 64% and 31% affirmative response, respectively. Three ACOs achieved an overall MPI score of 8 or higher, 45 scored between 4 and 7.9, and 1 scored between 0 and 3.9. Using the 3 score groups, the study did not identify a relationship between MPI scores and achievement on financial or quality benchmarks, ACO provider type, member volume, date of ACO creation, or the presence of a pharmacist in a leadership position. Barriers to optimizing medication use relate to reimbursement for pharmacist integration, lack of health information technology interoperability, lack of data, feasibility issues, and physician buy

On using priced timed automata to achieve optimal scheduling

DEFF Research Database (Denmark)

Rasmussen, Jacob Illum; Larsen, Kim Guldstrand; Subramani, K.

2006-01-01

This contribution reports on the considerable effort made recently towards extending and applying well-established timed automata technology to optimal scheduling and planning problems. The effort of the authors in this direction has to a large extent been carried out as part of the European proj...... of so-called priced timed automata....

Optimized distributed systems achieve significant performance improvement on sorted merging of massive VCF files.

Science.gov (United States)

Sun, Xiaobo; Gao, Jingjing; Jin, Peng; Eng, Celeste; Burchard, Esteban G; Beaty, Terri H; Ruczinski, Ingo; Mathias, Rasika A; Barnes, Kathleen; Wang, Fusheng; Qin, Zhaohui S

2018-06-01

Sorted merging of genomic data is a common data operation necessary in many sequencing-based studies. It involves sorting and merging genomic data from different subjects by their genomic locations. In particular, merging a large number of variant call format (VCF) files is frequently required in large-scale whole-genome sequencing or whole-exome sequencing projects. Traditional single-machine based methods become increasingly inefficient when processing large numbers of files due to the excessive computation time and Input/Output bottleneck. Distributed systems and more recent cloud-based systems offer an attractive solution. However, carefully designed and optimized workflow patterns and execution plans (schemas) are required to take full advantage of the increased computing power while overcoming bottlenecks to achieve high performance. In this study, we custom-design optimized schemas for three Apache big data platforms, Hadoop (MapReduce), HBase, and Spark, to perform sorted merging of a large number of VCF files. These schemas all adopt the divide-and-conquer strategy to split the merging job into sequential phases/stages consisting of subtasks that are conquered in an ordered, parallel, and bottleneck-free way. In two illustrating examples, we test the performance of our schemas on merging multiple VCF files into either a single TPED or a single VCF file, which are benchmarked with the traditional single/parallel multiway-merge methods, message passing interface (MPI)-based high-performance computing (HPC) implementation, and the popular VCFTools. Our experiments suggest all three schemas either deliver a significant improvement in efficiency or render much better strong and weak scalabilities over traditional methods. Our findings provide generalized scalable schemas for performing sorted merging on genetics and genomics data using these Apache distributed systems.

UES: an optimization software package for power and energy

International Nuclear Information System (INIS)

Vohryzek, J.; Havlena, V.; Findejs, J.; Jech, J.

2004-01-01

Unified Energy Solutions components are designed to meet specific requirements of the electric utilities, industrial power units, and district heating (combined heat and power) plants. The optimization objective is to operate the plant with maximum process efficiency and operational profit under the constraints imposed by technology and environmental impacts. Software applications for advanced control real-time optimization may provide a low-cost, high return alternative to expensive boiler retrofits for improving operational profit as well as reducing emissions. Unified Energy Solutions (UES) software package is a portfolio of advanced control and optimization components running on top of the standard process regulatory and control system. The objective of the UES is to operate the plant with maximum achievable profit (maximum efficiency) under the constraints imposed by technology (life-time consumption, asset health) and environmental impacts (CO and NO x emissions). Fast responsiveness to varying economic conditions and integration of real-time optimization and operator decision support (off-line) features are critical for operation in real-time economy. Optimization Features are targeted to combustion process, heat and power load allocation to parallel resources, electric power delivery and ancillary services. Optimization Criteria include increased boiler thermal efficiency, maintaining emission limits, economic load allocation of the heat and generation sources. State-of-the-art advanced control algorithms use model based predictive control principles and provide superior response in transient states. Individual software modules support open control platforms and communication protocols. UES can be implemented on a wide range of distributed control systems. Typical achievable benefits include heat and power production costs savings, increased effective boiler operation range, optimized flue gas emissions, optimized production capacity utilization, optimized

Scale-up of HIV treatment through PEPFAR: a historic public health achievement.

Science.gov (United States)

El-Sadr, Wafaa M; Holmes, Charles B; Mugyenyi, Peter; Thirumurthy, Harsha; Ellerbrock, Tedd; Ferris, Robert; Sanne, Ian; Asiimwe, Anita; Hirnschall, Gottfried; Nkambule, Rejoice N; Stabinski, Lara; Affrunti, Megan; Teasdale, Chloe; Zulu, Isaac; Whiteside, Alan

2012-08-15

Since its inception in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems.

An Efficient Taguchi Approach for the Performance Optimization of Health, Safety, Environment and Ergonomics in Generation Companies.

Science.gov (United States)

Azadeh, Ali; Sheikhalishahi, Mohammad

2015-06-01

A unique framework for performance optimization of generation companies (GENCOs) based on health, safety, environment, and ergonomics (HSEE) indicators is presented. To rank this sector of industry, the combination of data envelopment analysis (DEA), principal component analysis (PCA), and Taguchi are used for all branches of GENCOs. These methods are applied in an integrated manner to measure the performance of GENCO. The preferred model between DEA, PCA, and Taguchi is selected based on sensitivity analysis and maximum correlation between rankings. To achieve the stated objectives, noise is introduced into input data. The results show that Taguchi outperforms other methods. Moreover, a comprehensive experiment is carried out to identify the most influential factor for ranking GENCOs. The approach developed in this study could be used for continuous assessment and improvement of GENCO's performance in supplying energy with respect to HSEE factors. The results of such studies would help managers to have better understanding of weak and strong points in terms of HSEE factors.

Vaccination ecosystem health check: achieving impact today and sustainability for tomorrow.

Science.gov (United States)

Saadatian-Elahi, Mitra; Bloom, David; Plotkin, Stanley; Picot, Valentina; Louis, Jacques; Watson, Michael

2017-01-01

Vaccination is a complex ecosystem with several components that interact with one another and with the environment. Today's vaccine ecosystem is defined by the pursuit of polio eradication, the drive to get as many of the new vaccines to as many people as possible and the research and development against immunologically challenging diseases. Despite these successes, vaccine ecosystem is facing keys issues with regard to supply/distribution and cost/profitability asymmetry that risk slowing its global growth. The conference "Vaccination ecosystem health check: achieving impact today and sustainability for tomorrow" held in Annecy-France (January 19-21, 2015) took stock of the health of today's vaccination ecosystem and its ability to reliably and sustainably supply high-quality vaccines while investing in tomorrow's needed innovation. Small and decreasing numbers of suppliers/manufacturing facilities; paucity of research-driven companies; regulatory pressures; market uncertainties; political prioritization; anti-vaccine movements/complacency; and technological and programmatic issues were acknowledged as the major challenges that could weaken today's vaccination ecosystem. The expert panel discussed also drivers and barriers to a sustainable vaccination ecosystem; the metrics of a vaccination ecosystem; and what should be added, removed, increased, or reduced to maintain the health of the vaccination ecosystem.

Optimization of thermal insulation to achieve energy savings in low energy house (refurbishment)

International Nuclear Information System (INIS)

Bojić, Milorad; Miletić, Marko; Bojić, Ljubiša

2014-01-01

Highlights: • For buildings that require heating, a thickness of their thermal insulation is optimized. • The objective was to improve energy efficiency of the building. • The optimization is performed by using EnergyPlus and Hooke–Jeeves method. • The embodied energy of thermal insulation and the entire life cycle of the house are taken into account. - Abstract: Due to the current environmental situation, saving energy and reducing CO 2 emission have become the leading drive in modern research. For buildings that require heating, one of the solutions is to optimize a thickness of their thermal insulation and thus improve energy efficiency and reduce energy needs. In this paper, for a small residential house in Serbia, an optimization in the thickness of its thermal insulation layer is investigated by using EnergyPlus software and Hooke–Jeeves direct search method. The embodied energy of thermal insulation is taken into account. The optimization is done for the entire life cycle of thermal insulation. The results show the optimal thickness of thermal insulation that yields the minimum primary energy consumption

Global commitments and China's endeavors to promote health and achieve sustainable development goals.

Science.gov (United States)

Tan, Xiaodong; Wu, Qian; Shao, Haiyan

2018-04-12

With its immense population and as the largest developing country in the world, China has made remarkable achievements in health promotion at a relatively low cost. However, China is still faced with challenges such as changes of disease spectrum, the coming era of an aging society, and the risk of environmental pollution. On October 25, 2016, China formally passed the blueprint of "Healthy China 2030," working towards the national goal of reaching a health standard on par with developed countries by 2030, which was also a response to realize the 2030 United Nations Sustainable Development Goals. "Healthy China 2030" is comprised of 29 chapters that cover five health areas. China is sparing no effort to transfer from being merely the most populous country, to becoming a leading nation in health education. In "Healthy China 2030," collaborated construction and resource sharing were clearly stated as the core strategy. A shift in concentration towards coordinated development of health-based economy from a previous pursuit of rapid economic growth was also underlined. There are also several major issues, such as severely aging population, the burden of chronic diseases, the insufficiency of health expenditure, and the great demand on health protection, waiting to be dealt with during the implementation process of "Healthy China 2030". "Healthy China 2030" is a momentous move to enhance public health, which is also a response to the global commitments. We also need to rethink our approach to reach the living standards and maintain a better environment.

Optimization of health protection of the public following a major nuclear accident: Interaction between radiation protection and social and psychological factors

International Nuclear Information System (INIS)

Allen, P.T.; Archangelskaya, G.V.; Ramsaev, P.V.

1996-01-01

National and international guidance on the optimization of countermeasures to reduce doses in the post-release phase of an accident rightly emphasizes the importance and relevance of psychological, social, and economic factors to this process (e.g., NRPB 1990; ICRP 1991: CEC 1993; IAEA 1994). However, whilst economic factors are, at least partially, taken into account in developing the advice, explicit guidance is not provided on how psychological and social factors should be included in the optimization. Instead it is suggested that this is a matter for those with the appropriate competence and those with responsibility for making the final decisions. This approach implicitly assumes that the optimization of psychological and social factors, and that the results of the two procedures can then be combined to arrive at an optimum course of action. We recognize that formal optimization only forms one input to the process of making decisions on countermeasures and that it is important that psychological and social factors, as well as any other factors, are not open-quotes double-counted.close quotes i.e., accounted for within international advice and then again at the time of the decision. It is our view that the optimization of radiation protection and economic factors, and certain psychological and social factors, should not be carried out independently. Research conducted by our respective organization indicates a number of areas in which the optimization of radiation protection and economic factors requires an understanding of key psychological and social processes. These areas fall into three groups; the need to ensure that countermeasures are successfully implemented, the need to achieve a net benefit for overall health, and the need to ensure a smooth transition back to normal living. 10 refs

Health Cost Risk and Optimal Retirement Provision : A Simple Rule for Annuity Demand

NARCIS (Netherlands)

Peijnenburg, J.M.J.; Nijman, T.E.; Werker, B.J.M.

2010-01-01

We analyze the effect of health cost risk on optimal annuity demand and consumption/savings decisions. Many retirees are exposed to sizeable out-of-pocket medical expenses, while annuities potentially impair the ability to get liquidity to cover these costs and smooth consumption. We find that if

The quest for universal health coverage: achieving social protection for all in Mexico.

Science.gov (United States)

Knaul, Felicia Marie; González-Pier, Eduardo; Gómez-Dantés, Octavio; García-Junco, David; Arreola-Ornelas, Héctor; Barraza-Lloréns, Mariana; Sandoval, Rosa; Caballero, Francisco; Hernández-Avila, Mauricio; Juan, Mercedes; Kershenobich, David; Nigenda, Gustavo; Ruelas, Enrique; Sepúlveda, Jaime; Tapia, Roberto; Soberón, Guillermo; Chertorivski, Salomón; Frenk, Julio

2012-10-06

Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganisation of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries. Copyright

The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome.

Science.gov (United States)

Millstein, Rachel A; Celano, Christopher M; Beale, Eleanor E; Beach, Scott R; Suarez, Laura; Belcher, Arianna M; Januzzi, James L; Huffman, Jeff C

This study examined the effects of optimism and gratitude on self-reported health behavior adherence, physical functioning and emotional well-being after an acute coronary syndrome (ACS). Among 156 patients, we examined associations between optimism and gratitude measured 2 weeks post-ACS and 6-month outcomes: adherence to medical recommendations, mental and physical health-related quality of life (HRQoL), physical functioning, depressive symptoms and anxiety. Multivariable linear regression models were used, controlling for increasing levels of adjustment. Optimism [β=.11, standard error (S.E.)=.05, P=.038] and gratitude (β=.10, S.E.=.05, P=.027) at 2 weeks were associated with subsequent self-reported adherence to medical recommendations (diet, exercise, medication adherence, stress reduction) at 6 months in fully adjusted models. Two-week optimism and gratitude were associated with improvements in mental HRQoL (optimism: β=.44, S.E.=.13, P=.001; gratitude: β=.33, S.E.=.12, P=.005) and reductions in symptoms of depression (optimism: β=-.11, S.E.=.05, P=.039; gratitude: β=-.10, S.E.=.05, P=.028) and anxiety (optimism: β=-.15, S.E.=.05, P=.004; gratitude: β=-.10, S.E.=.05, P=.034) at 6 months. Optimism and gratitude at 2 weeks post-ACS were associated with higher self-reported adherence and improved emotional well-being 6 months later, independent of negative emotional states. Optimism and gratitude may help recovery from an ACS. Interventions promoting these positive constructs could help improve adherence and well-being. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimization of radiation protection at Bohunice NPP

International Nuclear Information System (INIS)

Dobis, L.; Svitek, J.

2003-01-01

Bohunice Nuclear Power Plant is situated in south - western part of Slovakia about 50 km away from Bratislava. There are four PWR reactors 440 MW e each - two units with reactors WWER - 230 (V1 NPP) and two units with WWER - 213 (V2 NPP). requirements for the optimization process are given in the mentioned Code No.12 of Ministry of Health. Code 12 stipulates the technical and organizational requirements for proving the Rational Achievable Level (RAL) of radiation protection. This level can be proved by means of the comparison of the dose distribution to the costs of protection. An example of two figures of dose constraints is: collective dose 20 man mSv for the specific task; individual exposure 1 mSv per day. The values of the financial equivalents of personal exposure - so called the alpha coefficients - are used for the calculation of the benefit of proposed measures. Impact of legislative changes into Bohunice NPP and optimization process are presented. Apparently the new law and the associate code created a base of transparent and understandable policy of radiation protection and optimization in Slovak Republic. The radiation protection legislative was implemented into the praxis and persons became familiar with it. Defining clear and unambiguous terms facilitated the communication between users and the regulatory body - State Health Institute. Optimization was generally accepted by the workers and managers and began to be a part of safety culture of operation at nuclear power plants. (authors)

Lifecycle-Based Swarm Optimization Method for Numerical Optimization

Directory of Open Access Journals (Sweden)

Hai Shen

2014-01-01

Full Text Available Bioinspired optimization algorithms have been widely used to solve various scientific and engineering problems. Inspired by biological lifecycle, this paper presents a novel optimization algorithm called lifecycle-based swarm optimization (LSO. Biological lifecycle includes four stages: birth, growth, reproduction, and death. With this process, even though individual organism died, the species will not perish. Furthermore, species will have stronger ability of adaptation to the environment and achieve perfect evolution. LSO simulates Biological lifecycle process through six optimization operators: chemotactic, assimilation, transposition, crossover, selection, and mutation. In addition, the spatial distribution of initialization population meets clumped distribution. Experiments were conducted on unconstrained benchmark optimization problems and mechanical design optimization problems. Unconstrained benchmark problems include both unimodal and multimodal cases the demonstration of the optimal performance and stability, and the mechanical design problem was tested for algorithm practicability. The results demonstrate remarkable performance of the LSO algorithm on all chosen benchmark functions when compared to several successful optimization techniques.

QoC-based Optimization of End-to-End M-Health Data Delivery Services

NARCIS (Netherlands)

Widya, I.A.; van Beijnum, Bernhard J.F.; Salden, Alfons

2006-01-01

This paper addresses how Quality of Context (QoC) can be used to optimize end-to-end mobile healthcare (m-health) data delivery services in the presence of alternative delivery paths, which is quite common in a pervasive computing and communication environment. We propose min-max-plus based

Energy-aware hybrid fruitfly optimization for load balancing in cloud environments for EHR applications

Directory of Open Access Journals (Sweden)

M. Lawanyashri

Full Text Available Cloud computing has gained precise attention from the research community and management of IT, due to its scalable and dynamic capabilities. It is evolving as a vibrant technology to modernize and restructure healthcare organization to provide best services to the consumers. The rising demand for healthcare services and applications in cloud computing leads to the imbalance in resource usage and drastically increases the power consumption resulting in high operating cost. To achieve fast execution time and optimum utilization of the virtual machines, we propose a multi-objective hybrid fruitfly optimization technique based on simulated annealing to improve the convergence rate and optimization accuracy. The proposed approach is used to achieve the optimal resource utilization and reduces the energy consumption and cost in cloud computing environment. The result attained in our proposed technique provides an improved solution. The experimental results show that the proposed algorithm efficiently outperforms compared to the existing load balancing algorithms. Keywords: Cloud computing, Electronic Health Records (EHR, Load balancing, Fruitfly Optimization Algorithm (FOA, Simulated Annealing (SA, Energy consumption

The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals.

Science.gov (United States)

Fisher, Jane Rw; de Mello, Meena Cabral; Izutsu, Takashi; Tran, Tuan

2011-01-07

Mental health problems in women during pregnancy and after childbirth and their adverse consequences for child health and development have received sustained detailed attention in high-income countries. In contrast, evidence has only been generated more recently in resource-constrained settings.In June 2007 the United Nations Population Fund, the World Health Organization, the Key Centre for Women's Health in Society, a WHO Collaborating Centre for Women's Health and the Research and Training Centre for Community Development in Vietnam convened the first international expert meeting on maternal mental health and child health and development in resource-constrained settings. It aimed to appraise the evidence about the nature, prevalence and risks for common perinatal mental disorders in women; the consequences of these for child health and development and ameliorative strategies in these contexts.The substantial disparity in rates of perinatal mental disorders between women living in high- and low-income settings, suggests social rather than biological determinants. Risks in resource-constrained contexts include: poverty; crowded living situations; limited reproductive autonomy; unintended pregnancy; lack of empathy from the intimate partner; rigid gender stereotypes about responsibility for household work and infant care; family violence; poor physical health and discrimination. Development is adversely affected if infants lack day-to-day interactions with a caregiver who can interpret their cues, and respond effectively. Women with compromised mental health are less able to provide sensitive, responsive infant care. In resource-constrained settings infants whose mothers are depressed are less likely to thrive and to receive optimal care than those whose mothers are well.The meeting outcome is the Hanoi Expert Statement (Additional file 1). It argues that the Millennium Development Goals to improve maternal health, reduce child mortality, promote gender equality

Equity of the premium of the Ghanaian National Health Insurance Scheme and the implications for achieving universal coverage.

Science.gov (United States)

Amporfu, Eugenia

2013-01-07

The Ghanaian National Health Insurance Scheme (NHIS) was introduced to provide access to adequate health care regardless of ability to pay. By law the NHIS is mandatory but because the informal sector has to make premium payment before they are enrolled, the authorities are unable to enforce mandatory nature of the scheme. The ultimate goal of the Scheme then is to provide all residents with access to adequate health care at affordable cost. In other words, the Scheme intends to achieve universal coverage. An important factor for the achievement of universal coverage is that revenue collection be equitable. The purpose of this study is to examine the vertical and horizontal equity of the premium collection of the Scheme. The Kakwani index method as well as graphical analysis was used to study the vertical equity. Horizontal inequity was measured through the effect of the premium on redistribution of ability to pay of members. The extent to which the premium could cause catastrophic expenditure was also examined. The results showed that revenue collection was both vertically and horizontally inequitable. The horizontal inequity had a greater effect on redistribution of ability to pay than vertical inequity. The computation of catastrophic expenditure showed that a small minority of the poor were likely to incur catastrophic expenditure from paying the premium a situation that could impede the achievement of universal coverage. The study provides recommendations to improve the inequitable system of premium payment to help achieve universal coverage.

Equity of the premium of the Ghanaian national health insurance scheme and the implications for achieving universal coverage

Directory of Open Access Journals (Sweden)

Amporfu Eugenia

2013-01-01

Full Text Available Abstract The Ghanaian National Health Insurance Scheme (NHIS was introduced to provide access to adequate health care regardless of ability to pay. By law the NHIS is mandatory but because the informal sector has to make premium payment before they are enrolled, the authorities are unable to enforce mandatory nature of the scheme. The ultimate goal of the Scheme then is to provide all residents with access to adequate health care at affordable cost. In other words, the Scheme intends to achieve universal coverage. An important factor for the achievement of universal coverage is that revenue collection be equitable. The purpose of this study is to examine the vertical and horizontal equity of the premium collection of the Scheme. The Kakwani index method as well as graphical analysis was used to study the vertical equity. Horizontal inequity was measured through the effect of the premium on redistribution of ability to pay of members. The extent to which the premium could cause catastrophic expenditure was also examined. The results showed that revenue collection was both vertically and horizontally inequitable. The horizontal inequity had a greater effect on redistribution of ability to pay than vertical inequity. The computation of catastrophic expenditure showed that a small minority of the poor were likely to incur catastrophic expenditure from paying the premium a situation that could impede the achievement of universal coverage. The study provides recommendations to improve the inequitable system of premium payment to help achieve universal coverage.

Positive and negative affect in the future teacher: relationships with their academic achievement, mental health and satisfaction with life

Directory of Open Access Journals (Sweden)

Ruth Pinedo González

2017-02-01

Full Text Available Affects are composed of two key dimensions: the positive affect (PA and negative affect (NA. Both dimensions are related to psychological adjustment of the person and life satisfaction. This study is exploratory in nature and aims to make a first correlational analysis between different constructs: emotional disposition, academic achievement, mental health and life satisfaction in a sample of 143 student teachers. We have used the following scales adapted to the culture: The Positive and Negative Affect Schedule (PANAS, the Mental Health Inventory (MHI-5 and the Satisfaction With Life Scale (SWLS. Among the most interesting results it was found that positive affect was associated with academic achievement, mental health and life satisfaction. Positive and negative affects and satisfaction with life were formed as predictors of future teachers’ mental health. Extensive analysis and discussion of the results is included in the document.

42 CFR 3.304 - Principles for achieving compliance.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Principles for achieving compliance. 3.304 Section 3.304 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... Principles for achieving compliance. (a) Cooperation. The Secretary will, to the extent practicable, seek the...

Optimal learning with Bernstein online aggregation

DEFF Research Database (Denmark)

Wintenberger, Olivier

2017-01-01

batch version achieves the fast rate of convergence log (M) / n in deviation. The BOA procedure is the first online algorithm that satisfies this optimal fast rate. The second order refinement is required to achieve the optimality in deviation as the classical exponential weights cannot be optimal, see...... is shown to be sufficiently small to assert the fast rate in the iid setting when the loss is Lipschitz and strongly convex. We also introduce a multiple learning rates version of BOA. This fully adaptive BOA procedure is also optimal, up to a log log (n) factor....

Two Blades-Up Runs Using the JetStream Navitus Atherectomy Device Achieve Optimal Tissue Debulking of Nonocclusive In-Stent Restenosis: Observations From a Porcine Stent/Balloon Injury Model.

Science.gov (United States)

Shammas, Nicolas W; Aasen, Nicole; Bailey, Lynn; Budrewicz, Jay; Farago, Trent; Jarvis, Gary

2015-08-01

To determine the number of runs with blades up (BU) using the JetStream Navitus to achieving optimal debulking in a porcine model of femoropopliteal artery in-stent restenosis (ISR). In this porcine model, 8 limbs were implanted with overlapping nitinol self-expanding stents. ISR was treated initially with 2 blades-down (BD) runs followed by 4 BU runs (BU1 to BU4). Quantitative vascular angiography (QVA) was performed at baseline, after 2 BD runs, and after each BU run. Plaque surface area and percent stenosis within the treated stented segment were measured. Intravascular ultrasound (IVUS) was used to measure minimum lumen area (MLA) and determine IVUS-derived plaque surface area. QVA showed that plaque surface area was significantly reduced between baseline (83.9%±14.8%) and 2 BD (67.7%±17.0%, p=0.005) and BU1 (55.4%±9.0%, p=0.005) runs, and between BU1 and BU2 runs (50.7%±9.7%, patherectomy. JetStream Navitus achieved optimal tissue debulking after 2 BD and 2 BU runs with no further statistical gain in debulking after the BU2 run. Operators treating ISR with JetStream Navitus may be advised to limit their debulking to 2 BD and 2 BU runs to achieve optimal debulking. © The Author(s) 2015.

Identifying factors for optimal development of health-related websites: a delphi study among experts and potential future users.

Science.gov (United States)

Schneider, Francine; van Osch, Liesbeth; de Vries, Hein

2012-02-14

The Internet has become a popular medium for offering tailored and targeted health promotion programs to the general public. However, suboptimal levels of program use in the target population limit the public health impact of these programs. Optimizing program development is considered as one of the main processes to increase usage rates. To distinguish factors potentially related to optimal development of health-related websites by involving both experts and potential users. By considering and incorporating the opinions of experts and potential users in the development process, involvement in the program is expected to increase, consequently resulting in increased appreciation, lower levels of attrition, and higher levels of sustained use. We conducted a systematic three-round Delphi study through the Internet. Both national and international experts (from the fields of health promotion, health psychology, e-communication, and technical Web design) and potential users were invited via email to participate. During this study an extensive list of factors potentially related to optimal development of health-related websites was identified, by focusing on factors related to layout, general and risk information provision, questionnaire use, additional services, and ease of use. Furthermore, we assessed the extent to which experts and potential users agreed on the importance of these factors. Differences as well as similarities among experts and potentials users were deduced. In total, 20 of 62 contacted experts participated in the first round (32% response rate); 60 of 200 contacted experts (30% response rate) and 210 potential users (95% response rate) completed the second-round questionnaire, and 32 of 60 contacted experts completed the third round (53% response rate). Results revealed important factors consented upon by experts and potential users (eg, ease of use, clear structure, and detailed health information provision), as well as differences regarding

Comprehensive approach to improving maternal health and achieving MDG 5: report from the mountains of Lesotho.

Directory of Open Access Journals (Sweden)

Hind Satti

Full Text Available BACKGROUND: Although it is now widely recognized that reductions in maternal mortality and improvements in women's health cannot be achieved through simple, vertical strategies, few programs have provided successful models for how to integrate services into a comprehensive program for maternal health. We report our experience in rural Lesotho, where Partners In Health (PIH in partnership with the Ministry of Health and Social Welfare implemented a program that provides comprehensive care of pregnant women from the community to the clinic level. METHODS: Between May and July 2009, PIH trained 100 women, many of whom were former traditional birth attendants, to serve as clinic-affiliated maternal health workers. They received performance-based incentives for accompanying pregnant women during antenatal care (ANC visits and facility-based delivery. A nurse-midwife provided ANC and delivery care and supervised the maternal health workers. To overcome geographic barriers to delivering at the clinic, women who lived far from the clinic stayed at a maternal lying-in house prior to their expected delivery dates. We analyzed data routinely collected from delivery and ANC registers to compare service utilization before and after implementation of the program. RESULTS: After the establishment of the program, the average number first ANC visits increased from 20 to 31 per month. The clinic recorded 178 deliveries in the first year of the program and 216 in the second year, compared to 46 in the year preceding the program. During the first two years of the program, 49 women with complications were successfully transported to the district hospital, and no maternal deaths occurred among the women served by the program. CONCLUSIONS: Our results demonstrate that it is possible to achieve dramatic improvements in the utilization of maternal health services and facility-based delivery by strengthening human resource capacity, implementing active follow-up in the

Technical assistance from state health departments for communities engaged in policy, systems, and environmental change: the ACHIEVE Program.

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Hefelfinger, Jenny; Patty, Alice; Ussery, Ann; Young, Walter

2013-10-24

This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches' meetings, webinars, and technical assistance conference calls. This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events.

The Relation among School District Health, Total Quality Principles for School Organization and Student Achievement

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Marshall, Jon; Pritchard, Ruie; Gunderson, Betsey

2004-01-01

The purpose of this study was to determine the congruence among W. E. Deming's 14 points for Total Quality Management (TQM), the organizational health of school districts, and student achievement. Based on Kanter's (1983) concept of a Culture of Pride with a Climate of Success, healthy districts were defined as having an organizational culture…

Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh Health Centre experience.

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Wong, J S; Rahimah, N

2004-08-01

Achieving glycaemic goals in diabetics has always been a problem, especially in a developing country with inadequate facilities such as in Sarawak in Malaysia. There are no reported studies on the control of diabetes mellitus in a diabetic clinic in the primary health care setting in Sarawak. This paper describes the profile of 1031 patients treated in Klinik Kesihatan Tanah Puteh Health Centre. The mean age was 59 years, the mean BMI 27 kg/m2. There was a female preponderance and mainly type-2 diabetes. Mean HbA1c was 7.4%. Glycaemic control was optimal in 28% (HbA1c 7.5%). Reasonable glycaemic control can be achieved in the primary health care setting in Sarawak.

Can universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics.

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Vonk, Robert A A; Schut, Frederik T

2018-05-07

For almost a century, the Netherlands was marked by a large market for voluntary private health insurance alongside state-regulated social health insurance. Throughout this period, private health insurers tried to safeguard their position within an expanding welfare state. From an institutional logics perspective, we analyze how private health insurers tried to reconcile the tension between a competitive insurance market pressuring for selective underwriting and actuarially fair premiums (the insurance logic), and an upcoming welfare state pressuring for universal access and socially fair premiums (the welfare state logic). Based on primary sources and the extant historiography, we distinguish six periods in which the balance between both logics changed significantly. We identify various strategies employed by private insurers to reconcile the competing logics. Some of these were temporarily successful, but required measures that were incompatible with the idea of free entrepreneurship and consumer choice. We conclude that universal access can only be achieved in a competitive individual private health insurance market if this market is effectively regulated and mandatory cross-subsidies are effectively enforced. The Dutch case demonstrates that achieving universal access in a competitive private health insurance market is institutionally complex and requires broad political and societal support.

How Positive Is Their Future? Assessing the Role of Optimism and Social Support in Understanding Mental Health Symptomatology among Homeless Adults.

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Fitzpatrick, Kevin M

2017-04-01

Optimism has been noted as a primary protective factor in understanding mental health symptomatology in clinical and non-clinical settings. Any exploration of optimism has been absent in understanding mental health outcomes among homeless people. This study, using intensive interviews with 168 homeless adults in Northwest Arkansas, examines the role that social support and optimism play in lessening the negative impact of homeless circumstances/experiences on mental health symptomatology. Using OLS, findings support a mediating/protective role that social support and optimism play in lowering the negative effects of childhood life experiences on depressive symptoms among homeless persons. Despite the overwhelming conditions of homelessness, persons with higher levels of optimism and social support report lower depression and anxiety symptoms. The findings are discussed paying particular attention to the importance of developing and maintaining the perception of support and resiliency in preserving a positive outlook for the future among homeless persons facing often-debilitating circumstances. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

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Subramanian Savitha

2011-12-01

Full Text Available Abstract Background There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs. But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. Methods A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. Results We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. Conclusions The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current

Do we have the right models for scaling up health services to achieve the Millennium Development Goals?

Science.gov (United States)

Subramanian, Savitha; Naimoli, Joseph; Matsubayashi, Toru; Peters, David H

2011-12-14

There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches. We identified six conceptual models for scaling up in health based on experience with expanding pilot projects and diffusion of innovations. They place importance on paying attention to enhancing organizational, functional, and political capabilities through experimentation and adaptation of strategies in addition to increasing the coverage and range of health services. These scaling up approaches focus on fostering sustainable institutions and the constructive engagement between end users and the provider and financing organizations. The current approaches to scaling up health services to reach the MDGs are overly simplistic and not working adequately. Rather than relying on blueprint planning and raising funds, an approach characteristic of current global health efforts, experience with alternative models suggests that more promising pathways involve "learning by doing" in ways that engage key stakeholders, uses data to address constraints, and incorporates results from pilot projects. Such approaches should be applied to current strategies to achieve the MDGs.

Health 2020 – Achieving Health and Development in Today’s Europe

Directory of Open Access Journals (Sweden)

Zsuzsanna Jakab

2014-09-01

CONCLUSION: This article presents the development process of Health 2020 and its main strategic goals, objectives and content. Further, it describes what is needed to successfully implement Health 2020 in countries and how WHO can provide technical assistance to countries that embark on developing health policy aligned with the Health 2020 policy framework. The development and implementation of Health 2020 is a powerful vehicle for concerted inter-sectoral action across the WHO European Region for improving health and well-being of present and future generations. Successful implementation of Health 2020 needs providing technical assistance by WHO to the countries to embark on developing health policy aligned with the Health 2020 policy framework.

Authentic leadership as a source of optimism, trust in the organisation and work engagement in the public health care sector

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Frederick W. Stander

2015-06-01

Full Text Available Orientation: The orientation of this study is towards authentic leadership (AL and its influence on optimism, trust in the organisation and work engagement of employees in the public health care sector. Research purpose: The objectives of this study were to determine whether the leadership style of AL could predict optimism, trust in the organisation and work engagement amongst a large sample of employees from various functions in public hospitals and clinics in Gauteng and to establish whether optimism and trust in the organisation could mediate the relationship between AL and work engagement. Research approach, design and method: A convenience sample of 633 public health employees from various functions within 27 public hospitals and clinics in the province was used in this research. A cross-sectional research design was implemented. Structural equation modelling was utilised to investigate the Authentic Leadership Inventory (ALI, and the validity and fit of the measurement model, to position AL as a job resource within the nomological net and to test its mediating effects. Main findings: The statistical analysis revealed that AL was a significant predictor of optimism and trust in the organisation and that optimism and trust in the organisation mediated the relationship between AL and work engagement. Practical/managerial implications: The research results suggested that organisations in the public health care sector should encourage their managers to adopt a more authentic leadership style. This will lead to higher levels of optimism, trust in the organisation and eventually work engagement. This will greatly assist employees in the domain of public health care to manage their demanding working environment. Contribution: This study provides evidence that the ALI can be used reliably within the South African context and specifically within the public health care sector. It further substantiates for the implementation of AL as a leadership

Preschool self regulation predicts later mental health and educational achievement in very preterm and typically developing children.

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Woodward, Lianne J; Lu, Zhigang; Morris, Alyssa R; Healey, Dione M

2017-02-01

To examine the extent to which preschool emotional and behavioral regulatory difficulties were associated with an increased risk of later mental health and educational problems. Of particular interest was whether early regulatory abilities contributed to later risk once baseline child behavioral adjustment and cognitive function were taken into account. Data were drawn from a prospective longitudinal study of 223 children born very preterm (VPT; Regulation Checklist, and (3) tester ratings of child behavior during neuropsychological testing. At age 9 years, mental health and educational achievement were assessed using the Development and Well-being Assessment interview and the Woodcock Johnson-III Tests of Achievement. VPT-born children had poorer emotional and behavioral regulation across all measures and time points. They also had higher rates of DSM-IV mental health disorder and educational delay at age 9. Across both study groups, poorer self regulation was associated with an increased risk of ADHD, conduct disorder, anxiety disorders and any disorder net of preschool child behavior problems and social risk. In contrast, only associations between early regulation and later language and any educational delay remained significant after adjustment for preschool cognitive functioning and family social risk. Early assessment of regulation in addition to behavioral screening may improve the early identification of preschool children at mental health risk.

Use of Insulin Analogues in Children and Adolescents: Topical Issues and Possibilities for Achieving Optimal Type 1 Diabetes Mellitus Compensation

Directory of Open Access Journals (Sweden)

О.A. Budreyko

2013-03-01

Full Text Available The review contains an analysis of the data of numerous scientific studies on the results of use of insulin analogues in comprehensive treatment of type 1 diabetes mellitus in children and adolescents. Problem of mitogenic potential of insulin preparations and ways to prevent its realization in clinical practice is discussed. Advisability of the use of insulin analogues glulisine and glargine in children and adolescents is substantiated for achievement of optimal compensation of carbohydrate metabolism due to their high efficiency and adequate level of safety, confirmed by the regulations of international consensuses (ISPAD and IDF.

The association between optimal lifestyle-related health behaviors and employee productivity.

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Katz, Abigail S; Pronk, Nicolaas P; Lowry, Marcia

2014-07-01

To investigate the association between lifestyle-related health behaviors including sleep and the cluster of physical activity, no tobacco use, fruits and vegetables intake, and alcohol consumption termed the "Optimal Lifestyle Metric" (OLM), and employee productivity. Data were obtained from employee health assessments (N = 18,079). Regression techniques were used to study the association between OLM and employee productivity, sleep and employee productivity, and the interaction of both OLM and sleep on employee productivity. Employees who slept less or more than 7 or 8 hours per night experienced significantly more productivity loss. Employees who adhered to all four OLM behaviors simultaneously experienced less productivity loss compared with those who did not. Adequate sleep and adherence to the OLM cluster of behaviors are associated with significantly less productivity loss.

School Values: A Comparison of Academic Motivation, Mental Health Promotion, and School Belonging with Student Achievement

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Allen, Kelly-Ann; Kern, Margaret L.; Vella-Brodrick, Dianne; Waters, Lea

2017-01-01

School vision and mission statements are an explicit indication of a school's priorities. Research has found academic motivation, mental health promotion, and school belonging to be the most frequently cited themes in these statements. The present study sought to examine whether these themes relate to student academic achievement, as indicated by…

Health physics manual of good practices for reducing radiation exposure to levels that are as low as reasonably achievable (ALARA)

International Nuclear Information System (INIS)

Herrington, W.N.; Higby, D.P.; Kathren, R.L.; Merwin, S.E.; Stoetzel, G.A.

1988-06-01

A primary objective of the US Department of Energy (DOE) health physics and radiation protection program has been to limit radiation exposures to those levels that are as low as reasonably achievable (ALARA). As a result, the ALARA concept developed into a program and a set of operational principles to ensure that the objective was consistently met. Implementation of these principles required that a guide be produced. The original ALARA guide was issued by DOE in 1980 to promote improved understanding of ALARA concepts within the DOE community and to assist those responsible for operational ALARA activities in attaining their goals. Since 1980, additional guidance has been published by national and international organizations to provide further definition and clarification to ALARA concepts. As basic ALARA experience increased, the value and role of the original guide prompted the DOE Office of Nuclear Safety (ONS) to support a current revision. The revised manual of good practices includes six sections: 1.0 Introduction, 2.0 Administration, 3.0 Optimization, 4.0 Setting and Evaluating ALARA Goals, 5.0 Radiological Design, and 6.0 Conduct of Operations. The manual is directed primarily to contractor and DOE staff who are responsible for conduct and overview of radiation protection and ALARA programs at DOE facilities. The intent is to provide sufficient guidance such that the manual, if followed, will ensure that radiation exposures are maintained as low as reasonably achievable and will establish the basis for a formally structured and auditable program. 118 refs., 16 figs., 3 tabs

High Performance with Prescriptive Optimization and Debugging

DEFF Research Database (Denmark)

Jensen, Nicklas Bo

parallelization and automatic vectorization is attractive as it transparently optimizes programs. The thesis contributes an improved dependence analysis for explicitly parallel programs. These improvements lead to more loops being vectorized, on average we achieve a speedup of 1.46 over the existing dependence...... analysis and vectorizer in GCC. Automatic optimizations often fail for theoretical and practical reasons. When they fail we argue that a hybrid approach can be effective. Using compiler feedback, we propose to use the programmer’s intuition and insight to achieve high performance. Compiler feedback...... enlightens the programmer why a given optimization was not applied, and suggest how to change the source code to make it more amenable to optimizations. We show how this can yield significant speedups and achieve 2.4 faster execution on a real industrial use case. To aid in parallel debugging we propose...

Optimism is universal: exploring the presence and benefits of optimism in a representative sample of the world.

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Gallagher, Matthew W; Lopez, Shane J; Pressman, Sarah D

2013-10-01

Current theories of optimism suggest that the tendency to maintain positive expectations for the future is an adaptive psychological resource associated with improved well-being and physical health, but the majority of previous optimism research has been conducted in industrialized nations. The present study examined (a) whether optimism is universal, (b) what demographic factors predict optimism, and (c) whether optimism is consistently associated with improved subjective well-being and perceived health worldwide. The present study used representative samples of 142 countries that together represent 95% of the world's population. The total sample of 150,048 individuals had a mean age of 38.28 (SD = 16.85) and approximately equal sex distribution (51.2% female). The relationships between optimism, subjective well-being, and perceived health were examined using hierarchical linear modeling. Results indicated that most individuals and most countries worldwide are optimistic and that higher levels of optimism are associated with improved subjective well-being and perceived health worldwide. The present study provides compelling evidence that optimism is a universal phenomenon and that the associations between optimism and improved psychological functioning are not limited to industrialized nations. © 2012 Wiley Periodicals, Inc.

Student Health and Academic Achievement

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... are consistently linked to poor grades and test scores and lower educational attainment. 1-3 In turn, ... education by early adulthood. Perspectives on Sexual and Reproductive Health 2008;40(3):152–161. Srabstein J, ...

Mental health care system optimization from a health-economics perspective: where to sow and where to reap?

Science.gov (United States)

Lokkerbol, Joran; Weehuizen, Rifka; Mavranezouli, Ifigeneia; Mihalopoulos, Cathrine; Smit, Filip

2014-06-01

Health care expenditure (as % of GDP) has been rising in all OECD countries over the last decades. Now, in the context of the economic downturn, there is an even more pressing need to better guarantee the sustainability of health care systems. This requires that policy makers are informed about optimal allocation of budgets. We take the Dutch mental health system in the primary care setting as an example of new ways to approach optimal allocation. To demonstrate how health economic modelling can help in identifying opportunities to improve the Dutch mental health care system for patients presenting at their GP with symptoms of anxiety, stress, symptoms of depression, alcohol abuse/dependence, anxiety disorder or depressive disorder such that changes in the health care system have the biggest leverage in terms of improved cost-effectiveness. Investigating such scenarios may serve as a starting point for setting an agenda for innovative and sustainable health care policies. A health economic simulation model was used to synthesize clinical and economic evidence. The model was populated with data from GPs' national register on the diagnosis, treatment, referral and prescription of their patients in the year 2009. A series of `what-if' analyses was conducted to see what parameters (uptake, adherence, effectiveness and the costs of the interventions) are associated with the most substantial impact on the cost-effectiveness of the health care system overall. In terms of improving the overall cost-effectiveness of the primary mental health care system, substantial benefits could be derived from increasing uptake of psycho-education by GPs for patients presenting with stress and when low cost interventions are made available that help to increase the patients' compliance with pharmaceutical interventions, particularly in patients presenting with symptoms of anxiety. In terms of intervention costs, decreasing the costs of antidepressants is expected to yield the biggest

Combining agreement and frequency rating scales to optimize psychometrics in measuring behavioral health functioning.

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Marfeo, Elizabeth E; Ni, Pengsheng; Chan, Leighton; Rasch, Elizabeth K; Jette, Alan M

2014-07-01

The goal of this article was to investigate optimal functioning of using frequency vs. agreement rating scales in two subdomains of the newly developed Work Disability Functional Assessment Battery: the Mood & Emotions and Behavioral Control scales. A psychometric study comparing rating scale performance embedded in a cross-sectional survey used for developing a new instrument to measure behavioral health functioning among adults applying for disability benefits in the United States was performed. Within the sample of 1,017 respondents, the range of response category endorsement was similar for both frequency and agreement item types for both scales. There were fewer missing values in the frequency items than the agreement items. Both frequency and agreement items showed acceptable reliability. The frequency items demonstrated optimal effectiveness around the mean ± 1-2 standard deviation score range; the agreement items performed better at the extreme score ranges. Findings suggest an optimal response format requires a mix of both agreement-based and frequency-based items. Frequency items perform better in the normal range of responses, capturing specific behaviors, reactions, or situations that may elicit a specific response. Agreement items do better for those whose scores are more extreme and capture subjective content related to general attitudes, behaviors, or feelings of work-related behavioral health functioning. Copyright © 2014 Elsevier Inc. All rights reserved.

Optimal Machining Parameters for Achieving the Desired Surface Roughness in Turning of Steel

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LB Abhang

2012-06-01

Full Text Available Due to the widespread use of highly automated machine tools in the metal cutting industry, manufacturing requires highly reliable models and methods for the prediction of output performance in the machining process. The prediction of optimal manufacturing conditions for good surface finish and dimensional accuracy plays a very important role in process planning. In the steel turning process the tool geometry and cutting conditions determine the time and cost of production which ultimately affect the quality of the final product. In the present work, experimental investigations have been conducted to determine the effect of the tool geometry (effective tool nose radius and metal cutting conditions (cutting speed, feed rate and depth of cut on surface finish during the turning of EN-31 steel. First and second order mathematical models are developed in terms of machining parameters by using the response surface methodology on the basis of the experimental results. The surface roughness prediction model has been optimized to obtain the surface roughness values by using LINGO solver programs. LINGO is a mathematical modeling language which is used in linear and nonlinear optimization to formulate large problems concisely, solve them, and analyze the solution in engineering sciences, operation research etc. The LINGO solver program is global optimization software. It gives minimum values of surface roughness and their respective optimal conditions.

Association of dispositional optimism with Life’s Simple 7’s Cardiovascular Health Index: results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (SCAS)

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Hernandez, Rosalba; González, Hector M; Tarraf, Wassim; Moskowitz, Judith T; Carnethon, Mercedes R; Gallo, Linda C; Penedo, Frank J; Isasi, Carmen R; Ruiz, John Manuel; Arguelles, William; Buelna, Christina; Davis, Sonia; Gonzalez, Franklyn; McCurley, Jessica L; Wu, Donghong; Daviglus, Martha L

2018-01-01

Objectives Mounting evidence links positive psychological functioning to restorative health processes and favourable medical outcomes. However, very little is known about the relationship between optimism, an indicator of psychological functioning and the American Heart Association (AHA)-defined concept of cardiovascular health (CVH), particularly in Hispanics/Latinos of diverse backgrounds. To address limitations of existing literature, this study investigated the association between dispositional optimism and CVH in a heterogeneous sample of Hispanics/Latinos residing in the USA. Design Cross-sectional study. Participants and setting Data were analysed from 4919 adults ages 18–75 of the Hispanic Community Health Study/Study of Latinos parent study and the Sociocultural Ancillary Study. Main outcome measures Optimism was assessed using the 6-item Life Orientation Test-Revised (range from 6 to 30). AHA classification standards were used to derive an additive CVH score with operationalisation of indicators as Ideal, Intermediate and Poor. The overall CVH score included indicators of diet, body mass index, physical activity, cholesterol, blood pressure, fasting glucose and smoking status. Multivariate linear and logistic regressions were used to examine associations of optimism with CVH (Life’s Simple 7), after adjusting for sociodemographic factors and depressive symptoms. Results Each increase in the optimism total score was associated with a greater CVH score (β=0.03 per unit increase, 95% CI 0.01 to 0.05). When modelling tertiles of optimism, participants with moderate (β=0.24 to 95% CI 0.06 to 0.42) and high (β=0.12, 95% CI 0.01 to 0.24) levels of optimism displayed greater CVH scores when compared with their least optimistic peers. Conclusion This study offers preliminary evidence for an association between optimism and CVH in a large heterogeneous group of Hispanic/Latino adults. Our study adds scientific knowledge of psychological assets that may

Obligations of low income countries in ensuring equity in global health financing.

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Barugahare, John; Lie, Reidar K

2015-09-08

Despite common recognition of joint responsibility for global health by all countries particularly to ensure justice in global health, current discussions of countries' obligations for global health largely ignore obligations of developing countries. This is especially the case with regards to obligations relating to health financing. Bearing in mind that it is not possible to achieve justice in global health without achieving equity in health financing at both domestic and global levels, our aim is to show how fulfilling the obligation we propose will make it easy to achieve equity in health financing at both domestic and international levels. Achieving equity in global health financing is a crucial step towards achieving justice in global health. Our general view is that current discussions on global health equity largely ignore obligations of Low Income Country (LIC) governments and we recommend that these obligations should be mainstreamed in current discussions. While we recognise that various obligations need to be fulfilled in order to ultimately achieve justice in global health, for lack of space we prioritise obligations for health financing. Basing on the evidence that in most LICs health is not given priority in annual budget allocations, we propose that LIC governments should bear an obligation to allocate a certain minimum percent of their annual domestic budget resources to health, while they await external resources to supplement domestic ones. We recommend and demonstrate a mechanism for coordinating this obligation so that if the resulting obligations are fulfilled by both LIC and HIC governments it will be easy to achieve equity in global health financing. Although achieving justice in global health will depend on fulfillment of different categories of obligations, ensuring inter- and intra-country equity in health financing is pivotal. This can be achieved by requiring all LIC governments to allocate a certain optimal per cent of their domestic

Implementing optimal thinning strategies

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Kurt H. Riitters; J. Douglas Brodie

1984-01-01

Optimal thinning regimes for achieving several management objectives were derived from two stand-growth simulators by dynamic programming. Residual mean tree volumes were then plotted against stand density management diagrams. The results supported the use of density management diagrams for comparing, checking, and implementing the results of optimization analyses....

The Utrecht Health Project: Optimization of routine healthcare data for research

International Nuclear Information System (INIS)

Grobbee, Diederick E.; Hoes, Arno W.; Verheij, Theo J. M.; Schrijvers, Augustinus J. P.; Ameijden, Erik J. C. van; Numans, Mattijs E.

2005-01-01

Background. Research on the impact of changes in healthcare policy, developments in community and public health and determinants of health and disease during lifetime may effectively make use of routine healthcare data. These data, however, need to meet minimal criteria for quality and completeness. Research opportunities are further improved when routine data are supplemented with a standardized 'baseline' assessment of the full population. This formed the basis for a new study initiated in a newly developed large residential area in Leidsche Rijn, part of the city of Utrecht, the Netherlands.Methods. All new inhabitants are invited by their general practitioner to participate in the Utrecht Health Project (UHP). Informed consent is obtained and an individual health profile (IHP) is made by dedicated research nurses. The IHP is the starting point for the UHP research database as well as for the primary care electronic medical records. Follow-up data are collected through continuous linkage with the computerized medical files recorded by the general practitioners. UHP staff in each practice takes care of quality management of registration as well as data handling.Results. Currently, over 60 of invited new residents in the area have given informed consent with participation steadily increasing. Discussion. The Utrecht Health Project combines key elements of traditional epidemiologic cohort studies with the current power of routine electronic medical record keeping in primary care. The research approach optimizes routine health care data for use in scientific research

The Ontology of Knowledge Based Optimization

OpenAIRE

Nasution, Mahyuddin K. M.

2012-01-01

Optimization has been becoming a central of studies in mathematic and has many areas with different applications. However, many themes of optimization came from different area have not ties closing to origin concepts. This paper is to address some variants of optimization problems using ontology in order to building basic of knowledge about optimization, and then using it to enhance strategy to achieve knowledge based optimization.

An optimized clarithromycin-free 14-day triple therapy for Helicobacter pylori eradication achieves high cure rates in Uruguay.

Science.gov (United States)

Dacoll, Cristina; Sánchez-Delgado, Jordi; Balter, Henia; Pazos, Ximena; Di Pace, María; Sandoya, Gabriela; Cohen, Henry; Calvet, Xavier

Strong acid inhibition increases cure rates with triple therapy and 14-day are more effective than 7-day treatments. The combination of amoxicillin plus metronidazole at full doses has been shown to overcome metronidazole resistance and to achieve good eradication rates even in patients harboring resistant strains. No previous studies have been reported in Latin-America with this optimized triple-therapy scheme. The aim of the present study was to assess the eradication rate and tolerance of a new first-line treatment regimen associating strong acid inhibition, amoxicillin and metronidazole. Patients from the Clínica de Gastroenterología of the Hospital de Clínicas (Montevideo, Uruguay) were included. Hp status was mainly assessed by at least one of the following: histologyor urea breath test (UBT). A 14-day treatment was prescribed comprising esomeprazole 40mg twice a day plus amoxicillin 1g and metronidazole 500mg, both three times a day. H. pylori cure was assessed by UBT. Forty-one patients were enrolled. Mean age was 53.3±13 years and 17.1% of patients were male. Main indications for treatment were: functional dyspepsia (27.5%), gastritis (45%), gastric or duodenal erosions (20%), gastric ulcer (5%) and intestinal metaplasia (2.5%). H. pylori eradication was achieved in 33 of the 37 patients who returned for follow-up. Eradication rates were 80.5% (95% CI: 68.4-92.6) by intention-to-treat (ITT) analysis and 89.2% (95% CI; 79.2-99.2) per protocol (PP). No major side effects were reported; 26 patients (65.8%) complained of mild side effects (nausea, diarrhea and headache). Cure rates of this triple therapy including esomeprazole, amoxicillin and metronidazole were 81% per ITT and the treatment was well tolerated. These optimal results with a simple clarithromycin-free triple therapy are better than described for standard triple therapy but there is still room for improvement to reach the desired target of 90% per ITT. Copyright © 2017 Elsevier España, S

Early childhood trajectories of separation anxiety: Bearing on mental health, academic achievement, and physical health from mid-childhood to preadolescence.

Science.gov (United States)

Battaglia, Marco; Garon-Carrier, Gabrielle; Côté, Sylvana M; Dionne, Ginette; Touchette, Evelyne; Vitaro, Frank; Tremblay, Richard E; Boivin, Michel

2017-10-01

Separation anxiety disorder is the most prevalent childhood anxiety condition, but no study assessed children for separation anxiety at preschool age and followed them longitudinally and directly until mid-childhood/early adolescence. Multi-informant (children, teachers, family), multipoint (at age 8, 10, 12, 13) assessments of 1,290 children of the Quebec Longitudinal Study of Child Development, who had been categorized between age 1.5 and 6 into four specific separation anxiety trajectories (1, low-persistent; 2, low-increasing; 3, high-decreasing, and the less common: 4, high-increasing) by growth mixture modeling. Participants in the high-increasing trajectory were compared to participants in the other three trajectories for: (a) child's internalizing and externalizing problem behavior; (b) physical health; (c) academic achievement; (d) maternal anxiety. Multivariate analyses of variance/covariance at separate time points showed the high-increasing trajectory mostly associated with: (a) higher internalizing, but not externalizing, behavior; (b) worse academic achievement (most consistently by comparisons to the normative low-persistent trajectory; (c) higher rates of maternal panic/agoraphobic anxiety; (d) worse physical health (most consistently by comparisons to the low-persistent trajectory). The high-increasing trajectory had twofold to threefold higher incidences of physical illnesses than the normative low-persistent group; this was specific for headaches at age 12 years, chronic asthma at age 10 and 13, and having received asthma-related medication during the past 12 months. High-increasing separation anxiety in preschool maintains longitudinal relationships to independent health and academic outcomes, at least until preadolescence. This knowledge can inform the deployment of clinical resources at the earlier signs of the more impairing manifestations. © 2017 Wiley Periodicals, Inc.

Predicting Early Adolescents' Academic Achievement, Social Competence, and Physical Health from Parenting, Ego Resilience, and Engagement Coping

Science.gov (United States)

Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn; O'Brien, T. Caitlin

2011-01-01

This study examined ego resilience and engagement coping as mediators of the relationships between supportive and controlling parenting practices and early adolescents' academic achievement, social competence, and physical health. Participants were 240 predominantly Mexican American early adolescents, their parents, and their teachers. There were…

Optimization of metal-clad waveguide sensors

DEFF Research Database (Denmark)

Skivesen, N.; Horvath, R.; Pedersen, H.C.

2005-01-01

The present paper deals with the optimization of metal-clad waveguides for sensor applications to achieve high sensitivity for adlayer and refractive index measurements. By using the Fresnel reflection coefficients both the angular shift and the width of the resonances in the sensorgrams are taken...... into account. Our optimization shows that it is possible for metal-clad waveguides to achieve a sensitivity improvement of 600% compared to surface-plasmon-resonance sensors....

Portfolio optimization with mean-variance model

Science.gov (United States)

Hoe, Lam Weng; Siew, Lam Weng

2016-06-01

Investors wish to achieve the target rate of return at the minimum level of risk in their investment. Portfolio optimization is an investment strategy that can be used to minimize the portfolio risk and can achieve the target rate of return. The mean-variance model has been proposed in portfolio optimization. The mean-variance model is an optimization model that aims to minimize the portfolio risk which is the portfolio variance. The objective of this study is to construct the optimal portfolio using the mean-variance model. The data of this study consists of weekly returns of 20 component stocks of FTSE Bursa Malaysia Kuala Lumpur Composite Index (FBMKLCI). The results of this study show that the portfolio composition of the stocks is different. Moreover, investors can get the return at minimum level of risk with the constructed optimal mean-variance portfolio.

Differential evolution-based multi-objective optimization for the definition of a health indicator for fault diagnostics and prognostics

Science.gov (United States)

Baraldi, P.; Bonfanti, G.; Zio, E.

2018-03-01

The identification of the current degradation state of an industrial component and the prediction of its future evolution is a fundamental step for the development of condition-based and predictive maintenance approaches. The objective of the present work is to propose a general method for extracting a health indicator to measure the amount of component degradation from a set of signals measured during operation. The proposed method is based on the combined use of feature extraction techniques, such as Empirical Mode Decomposition and Auto-Associative Kernel Regression, and a multi-objective Binary Differential Evolution (BDE) algorithm for selecting the subset of features optimal for the definition of the health indicator. The objectives of the optimization are desired characteristics of the health indicator, such as monotonicity, trendability and prognosability. A case study is considered, concerning the prediction of the remaining useful life of turbofan engines. The obtained results confirm that the method is capable of extracting health indicators suitable for accurate prognostics.

Living donor liver transplantation for hepatocellular carcinoma achieves better outcomes.

Science.gov (United States)

Lin, Chih-Che; Chen, Chao-Long

2016-10-01

Liver transplantation (LT) for hepatocellular carcinoma (HCC) at Kaohsiung Chang Gung Memorial Hospital mainly relies on live donor LT (LDLT). Owing to taking the risk of LD, we are obligated to adopt strict selection criteria for HCC patients and optimize the pre-transplant conditions to ensure a high disease-free survival similar to those without HCC, even better than deceased donor LT (DDLT). Better outcomes are attributed to excellent surgical results and optimal patient selection. The hospital mortality of primary and salvage LDLT are lower than 2% in our center. Although Taiwan Health Insurance Policy extended the Milan to University of California, San Francisco (UCSF) criteria in 2006, selection criteria will not be consolidated to take into account only by the morphologic size/number of tumors but also by their biology. The criteria are divided into modifiable image morphology, alpha fetoprotein (AFP), and positron emission tomography (PET) scan with standard uptake value (SUV) and unmodifiable unfavorable pathology such as HCC combined with cholangiocarcinoma (CC), sarcomatoid type, and poor differentiation. Downstaging therapy is necessary for HCC patients beyond criteria to fit all modifiable standards. The upper limit of downstaging treatment seems to be extended by more effective drug eluting transarterial chemoembolization in cases without absolute contraindications. In contrast, the pitfall of unmodifiable tumor pathology should be excluded by the findings of pretransplant core biopsy/resection if possible. More recently, achieving complete tumor necrosis in explanted liver could almost predict no recurrence after transplant. Necrotizing therapy is advised if possible before transplant even the tumor status within criteria to minimize the possibility of tumor recurrence. LDLT with low surgical mortality in experienced centers provides the opportunities of optimizing the pre-transplant tumor conditions and timing of transplant to achieve better

Achieving public and global health competencies: A teaching case study of Botswana's cervical cancer screening program.

Science.gov (United States)

Okatch, Harriet; Sowicz, Timothy Joseph; Teng, Helen; Ramogola-Masire, Doreen; Buttenheim, Alison M

2018-02-09

To design and implement a case study on the cervical cancer screening program in Botswana to teach public and global health competencies to undergraduate nursing students. The case study was developed following a review of the literature on the epidemiology and health policies of cervical cancer in Botswana, and an interview with an obstetrician/gynecologist engaged in both clinical practice and research in Botswana. The case study has been implemented over seven semesters to students enrolled in the Nursing in the Community course at the University of Pennsylvania. Approximately 75-100 students are enrolled each semester. Student's perceptions of epidemiologic skills gained and group functioning. Students responded to an open-ended question about lessons learned and offered suggestions to improve the learning experience. Faculty assessment of student deliverables demonstrated that students achieved the learning objectives and mastered necessary competencies. More than 70% (n = 69) of the students indicated that they acquired relevant skills at greater than a satisfactory level. Generally, students had great experiences working in groups measured across five dimensions: engagement/contribution, creativity/resilience, on task/works independently, social interaction/communication, and preparedness. However, isolated cases of poor group functioning were reported for engagement/contribution, and creativity/resilience. The case study, which has been revised with respect to length, content and group processes, has been valuable in educating undergraduate nursing students in a more engaging way that mimics real life public health nursing scenarios. Students achieved both public and global health competencies through participation in the case study. © 2018 Wiley Periodicals, Inc.

Integrating big data and actionable health coaching to optimize wellness.

Science.gov (United States)

Hood, Leroy; Lovejoy, Jennifer C; Price, Nathan D

2015-01-09

The Hundred Person Wellness Project (HPWP) is a 10-month pilot study of 100 'well' individuals where integrated data from whole-genome sequencing, gut microbiome, clinical laboratory tests and quantified self measures from each individual are used to provide actionable results for health coaching with the goal of optimizing wellness and minimizing disease. In a commentary in BMC Medicine, Diamandis argues that HPWP and similar projects will likely result in 'unnecessary and potential harmful over-testing'. We argue that this new approach will ultimately lead to lower costs, better healthcare, innovation and economic growth. The central points of the HPWP are: 1) it is focused on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities; and 2) by extending this study to 100,000 well people, we will establish multiparameter, quantifiable wellness metrics and identify markers for wellness to early disease transitions for most common diseases, which will ultimately allow earlier disease intervention, eventually transitioning the individual early on from a disease back to a wellness trajectory.

Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

Directory of Open Access Journals (Sweden)

Ahmad Jabir Rahyussalim

2016-01-01

Full Text Available Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity.

Bayesian Optimization for Neuroimaging Pre-processing in Brain Age Classification and Prediction

Directory of Open Access Journals (Sweden)

Jenessa Lancaster

2018-02-01

Full Text Available Neuroimaging-based age prediction using machine learning is proposed as a biomarker of brain aging, relating to cognitive performance, health outcomes and progression of neurodegenerative disease. However, even leading age-prediction algorithms contain measurement error, motivating efforts to improve experimental pipelines. T1-weighted MRI is commonly used for age prediction, and the pre-processing of these scans involves normalization to a common template and resampling to a common voxel size, followed by spatial smoothing. Resampling parameters are often selected arbitrarily. Here, we sought to improve brain-age prediction accuracy by optimizing resampling parameters using Bayesian optimization. Using data on N = 2003 healthy individuals (aged 16–90 years we trained support vector machines to (i distinguish between young (<22 years and old (>50 years brains (classification and (ii predict chronological age (regression. We also evaluated generalisability of the age-regression model to an independent dataset (CamCAN, N = 648, aged 18–88 years. Bayesian optimization was used to identify optimal voxel size and smoothing kernel size for each task. This procedure adaptively samples the parameter space to evaluate accuracy across a range of possible parameters, using independent sub-samples to iteratively assess different parameter combinations to arrive at optimal values. When distinguishing between young and old brains a classification accuracy of 88.1% was achieved, (optimal voxel size = 11.5 mm3, smoothing kernel = 2.3 mm. For predicting chronological age, a mean absolute error (MAE of 5.08 years was achieved, (optimal voxel size = 3.73 mm3, smoothing kernel = 3.68 mm. This was compared to performance using default values of 1.5 mm3 and 4mm respectively, resulting in MAE = 5.48 years, though this 7.3% improvement was not statistically significant. When assessing generalisability, best performance was achieved when applying the entire Bayesian

Hitting the Optimal Vaccination Percentage and the Risks of Error: Why to Miss Right.

Science.gov (United States)

Harvey, Michael J; Prosser, Lisa A; Messonnier, Mark L; Hutton, David W

2016-01-01

To determine the optimal level of vaccination coverage defined as the level that minimizes total costs and explore how economic results change with marginal changes to this level of coverage. A susceptible-infected-recovered-vaccinated model designed to represent theoretical infectious diseases was created to simulate disease spread. Parameter inputs were defined to include ranges that could represent a variety of possible vaccine-preventable conditions. Costs included vaccine costs and disease costs. Health benefits were quantified as monetized quality adjusted life years lost from disease. Primary outcomes were the number of infected people and the total costs of vaccination. Optimization methods were used to determine population vaccination coverage that achieved a minimum cost given disease and vaccine characteristics. Sensitivity analyses explored the effects of changes in reproductive rates, costs and vaccine efficacies on primary outcomes. Further analysis examined the additional cost incurred if the optimal coverage levels were not achieved. Results indicate that the relationship between vaccine and disease cost is the main driver of the optimal vaccination level. Under a wide range of assumptions, vaccination beyond the optimal level is less expensive compared to vaccination below the optimal level. This observation did not hold when the cost of the vaccine cost becomes approximately equal to the cost of disease. These results suggest that vaccination below the optimal level of coverage is more costly than vaccinating beyond the optimal level. This work helps provide information for assessing the impact of changes in vaccination coverage at a societal level.

Supply-Chain Optimization Template

Science.gov (United States)

Quiett, William F.; Sealing, Scott L.

2009-01-01

The Supply-Chain Optimization Template (SCOT) is an instructional guide for identifying, evaluating, and optimizing (including re-engineering) aerospace- oriented supply chains. The SCOT was derived from the Supply Chain Council s Supply-Chain Operations Reference (SCC SCOR) Model, which is more generic and more oriented toward achieving a competitive advantage in business.

Correlates of Achieving the Guidelines of Four Forms of Physical Activity, and the Relationship between Guidelines Achievement and Academic Performance: Undergraduate Students in Finland.

Science.gov (United States)

El Ansari, Walid; Suominen, Sakari; Draper, Steve

2017-06-01

We surveyed and compared, by gender, the levels and correlates of achieving the international guidelines of four forms of physical activity (PA): moderate PA (MPA), vigorous PA (VPA), moderate or vigorous PA (MVPA), and muscle strengthening PA (MSPA). The study assessed the associations between achieving the guidelines of the four PA forms and a range of socio-demographic, health and academic performance variables. Data was collected across the seven faculties of the University of Turku (2013-2014 from a representative sample of 1,189 undergraduates). An English language online self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. We employed cut-offs for the guidelines in accordance with the American Heart Association. Chi-square statistic tested the differences in PA, socio-demographic variables and academic performance between males and females. Binary logistic regression examined the factors associated with achieving the four PA guidelines and linear regression examined the association between the frequency of PA and academic performance. Achievement of PA guidelines was relatively low across the sample. Female students were less likely to achieve the VPA or MSPA guidelines, but were more health conscious and in generally exhibited better academic performace than males. High health awareness and excellent/very good self-rated health were the strongest predictors of achieving all forms of PA. Parents' education level was positively related to likelihood of achieving the VPA, MVPA and MSPA guidelines. Achieving the MPA guidelines (but not VPA or MSPA) was positively associated with subjective perceptions of better academic performance. Achievement of PA guidelines was generally low for this sample of Finnish students, and was associated with positive health status and high health awareness. Universities need a holistic approach to improve awareness of health and promote PA in students' lifestyles. Copyright© by the

Achieving a “Grand Convergence” in Global Health by 2035: Rwanda Shows the Way; Comment on “Improving the World’s Health Through the Post-2015 Development Agenda: Perspectives From Rwanda”

Directory of Open Access Journals (Sweden)

Gavin Yamey

2015-11-01

Full Text Available Global Health 2035, the report of The Lancet Commission on Investing in Health, laid out a bold, highly ambitious framework for making rapid progress in improving global public health outcomes. It showed that with the right health investments, the international community could achieve a “grand convergence” in global health—a reduction in avertable infectious, maternal, and child deaths down to universally low levels—within a generation. Rwanda’s success in rapidly reducing such deaths over the last 20 years shows that convergence is feasible. Binagwaho and Scott have argued that 5 lessons from this success are the importance of equity, quality health services, evidence-informed policy, intersectoral collaboration, and effective collaboration between countries and multilateral agencies. This article re-examines these lessons through the lens of the Global Health 2035 report to analyze how the experience in Rwanda might be generalized for other countries to making progress towards achieving a grand convergence.

Schistosomiasis elimination strategies and potential role of a vaccine in achieving global health goals.

Science.gov (United States)

Mo, Annie X; Agosti, Jan M; Walson, Judd L; Hall, B Fenton; Gordon, Lance

2014-01-01

In March 2013, the National Institute of Allergy and Infectious Diseases and the Bill and Melinda Gates Foundation co-sponsored a meeting entitled "Schistosomiasis Elimination Strategy and Potential Role of a Vaccine in Achieving Global Health Goals" to discuss the potential role of schistosomiasis vaccines and other tools in the context of schistosomiasis control and elimination strategies. It was concluded that although schistosomiasis elimination in some focal areas may be achievable through current mass drug administration programs, global control and elimination will face several significant scientific and operational challenges, and will require an integrated approach with other, additional interventions. These challenges include vector (snail) control; environmental modification; water, sanitation, and hygiene; and other future innovative tools such as vaccines. Defining a clear product development plan that reflects a vaccine strategy as complementary to the existing control programs to combat different forms of schistosomiasis will be important to develop a vaccine effectively.

Organizational health and the achievement level of students in science at the secondary-level schools in Sri Lanka

Science.gov (United States)

Pakkeer-Jaufar, Pakkeer Cadermohideen

This study sought to identify those organizational health factors that might have overriding influence on the achievement level of students in science in Sri Lankan secondary schools. This study involved 752 students, 33 science teachers, and 10 principals from two different districts, Ampara and Colombo, in Sri Lanka. Ten Tamil medium, secondary level, public schools were selected to participate in this study. Data were collected using four types of instruments: a questionnaire for pupils; interview schedules for science teachers and principals; checklists for classroom/school facilities, science laboratory facilities, and science practicals; and a science achievement test. The analysis focused on the collective perceptions of students, science teachers, and principals. Regression and path analyses were used as major analysis techniques, and the qualitative data provided by science teachers and principals were considered for a crosschecking of the quantitative inferences. The researcher found teacher affiliation, academic emphasis, and instructional leadership of the principal, in descending order, were the overriding influential factors on the achievement level of students in science in Sri Lankan secondary schools. At the same time a similar descending order was found in their mean values and qualities. The researcher concluded that increasing the quality of the organizational health factors in Sri Lankan secondary schools would result in improved better achievement in science. The findings further indicate that instructional leadership of the principal had both direct and indirect effects on students' achievement in science when academic emphasis and teacher affiliation were taken into account. In addition, the resource support of the principal did not make any difference in students' science achievement and the findings stress the availability of the resources for individual students instead of assuming the general facilities of the school are available to all

Seeking consensus on universal health coverage indicators in the sustainable development goals.

Science.gov (United States)

Reddock, Jennifer

2017-01-01

There is optimism that the inclusion of universal health coverage in the Sustainable Development Goals advances its prominence in global and national health policy. However, formulating indicators for Target 3.8 through the Inter-Agency Expert Group on Sustainable Development Indicators has been challenging. Achieving consensus on the conceptual and methodological aspects of universal health coverage is likely to take some time in multi-stakeholder fora compared with national efforts to select indicators.

Elitism set based particle swarm optimization and its application

Directory of Open Access Journals (Sweden)

Yanxia Sun

2017-01-01

Full Text Available Topology plays an important role for Particle Swarm Optimization (PSO to achieve good optimization performance. It is difficult to find one topology structure for the particles to achieve better optimization performance than the others since the optimization performance not only depends on the searching abilities of the particles, also depends on the type of the optimization problems. Three elitist set based PSO algorithm without using explicit topology structure is proposed in this paper. An elitist set, which is based on the individual best experience, is used to communicate among the particles. Moreover, to avoid the premature of the particles, different statistical methods have been used in these three proposed methods. The performance of the proposed PSOs is compared with the results of the standard PSO 2011 and several PSO with different topologies, and the simulation results and comparisons demonstrate that the proposed PSO with adaptive probabilistic preference can achieve good optimization performance.

A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons.

Science.gov (United States)

Ajeani, Judith; Mangwi Ayiasi, Richard; Tetui, Moses; Ekirapa-Kiracho, Elizabeth; Namazzi, Gertrude; Muhumuza Kananura, Ronald; Namusoke Kiwanuka, Suzanne; Beyeza-Kashesya, Jolly

2017-08-01

There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model. The cascade model started with initial training of health workers from three districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for further training and mentorship by central mentors. These local mentors then went on to conduct mentorship visits supported by the external mentors. The mentorship process concentrated on partograph use, newborn resuscitation, prevention and management of Post-Partum Haemorrhage (PPH), including active management of third stage of labour, preeclampsia management and management of the sick newborn. Data for this paper was obtained from key informant interviews with district-level managers and local mentors. Mentorship improved several aspects of health-care delivery, ranging from improved competencies and responsiveness to emergencies and health-worker professionalism. In addition, due to better district leadership for Maternal and Newborn Health (MNH), there were improved supplies/medicine availability, team work and innovative local problem-solving approaches. Health workers were ultimately empowered to perform better. The study demonstrated that it is possible to improve the competencies of frontline health workers through performance enhancement for MNH services using locally built capacity in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade mentoring process needed strong external mentorship support at the start to ensure improved

The Implementation of Right-Fulfillment to the Health Care in Achieving the Millennium Development Goal (MDG’S

Directory of Open Access Journals (Sweden)

Muhammad Zuhri

2016-04-01

Full Text Available The vision of Aceh Government in 2012-2017 is Aceh are dignified, prosperous, just, and independent based on the legislation of Aceh government as a form of Memorandum of Understanding. One of the visions of Aceh government 2012-2017 is the improved welfare of Acehnese people through quality health services through increasing life expectancy, infant mortality, decreasing the prevalence of malnutrition as well as the effectiveness of the treatment of infectious diseases to the achievement of the MDG’s. Model policies adopted by the Aceh government is monitoring and track record of cases, tv monitor, routine and case sms, a special program policy model, and the model of budget balancing. Model policies adopted by the district/city government is making a supporting program, All Village Midwives Must Live in the Village, deliveries assistance is performed by professional health workers, adjustment to the ability of APBK. Support new regulation of Regent Regulation (Perbub on Malaria Elimination and No Smoking Area. MDG’s target is not entirely in accordance with the indicator being built, because it requires adjustments in accordance with the ability of both district or city areas. Regulatory support is not adequate to support the achievement of the MDG’s in the field of health.

Strain sensors optimal placement for vibration-based structural health monitoring. The effect of damage on the initially optimal configuration

Science.gov (United States)

Loutas, T. H.; Bourikas, A.

2017-12-01

We revisit the optimal sensor placement of engineering structures problem with an emphasis on in-plane dynamic strain measurements and to the direction of modal identification as well as vibration-based damage detection for structural health monitoring purposes. The approach utilized is based on the maximization of a norm of the Fisher Information Matrix built with numerically obtained mode shapes of the structure and at the same time prohibit the sensorization of neighbor degrees of freedom as well as those carrying similar information, in order to obtain a satisfactory coverage. A new convergence criterion of the Fisher Information Matrix (FIM) norm is proposed in order to deal with the issue of choosing an appropriate sensor redundancy threshold, a concept recently introduced but not further investigated concerning its choice. The sensor configurations obtained via a forward sequential placement algorithm are sub-optimal in terms of FIM norm values but the selected sensors are not allowed to be placed in neighbor degrees of freedom providing thus a better coverage of the structure and a subsequent better identification of the experimental mode shapes. The issue of how service induced damage affects the initially nominated as optimal sensor configuration is also investigated and reported. The numerical model of a composite sandwich panel serves as a representative aerospace structure upon which our investigations are based.

On achievable rates of interference and cognitive channels with a relay

KAUST Repository

Zorgui, Marwen; Rezki, Zouheir; Alouini, Mohamed-Slim

2015-01-01

We consider a two-user interference channel assisted by a relay. Treating interference as noise at the receivers, and adopting an amplify and forward (AF) strategy at the relay, we derive achievable rates of both users, for given powers. Next, we solve the optimal power allocation problem maximizing the weighted sum rate of both users with and without relay power optimization. In particular, we propose a simple iterative line search algorithm solving the joint optimization problem over the three transmit powers and show that optimizing the relay power enhances the performance of the system. Then, considering the first user as a primary user, we determine the maximum instantaneous rate that the secondary user can achieve subject to an outage constraint with respect to the primary user and a peak power constraint. We show that, likewise the first part, jointly optimizing the secondary user and the relay transmit powers enhances the secondary user performance.

On achievable rates of interference and cognitive channels with a relay

KAUST Repository

Zorgui, Marwen

2015-08-30

We consider a two-user interference channel assisted by a relay. Treating interference as noise at the receivers, and adopting an amplify and forward (AF) strategy at the relay, we derive achievable rates of both users, for given powers. Next, we solve the optimal power allocation problem maximizing the weighted sum rate of both users with and without relay power optimization. In particular, we propose a simple iterative line search algorithm solving the joint optimization problem over the three transmit powers and show that optimizing the relay power enhances the performance of the system. Then, considering the first user as a primary user, we determine the maximum instantaneous rate that the secondary user can achieve subject to an outage constraint with respect to the primary user and a peak power constraint. We show that, likewise the first part, jointly optimizing the secondary user and the relay transmit powers enhances the secondary user performance.

Optimization of PZT ceramic IDT sensors for health monitoring of structures.

Science.gov (United States)

Takpara, Rafatou; Duquennoy, Marc; Ouaftouh, Mohammadi; Courtois, Christian; Jenot, Frédéric; Rguiti, Mohamed

2017-08-01

Surface acoustic waves (SAW) are particularly suited to effectively monitoring and characterizing structural surfaces (condition of the surface, coating, thin layer, micro-cracks…) as their energy is localized on the surface, within approximately one wavelength. Conventionally, in non-destructive testing, wedge sensors are used to the generation guided waves but they are especially suited to flat surfaces and sized for a given type material (angle of refraction). Additionally, these sensors are quite expensive so it is quite difficult to leave the sensors permanently on the structure for its health monitoring. Therefore we are considering in this study, another type of ultrasonic sensors, able to generate SAW. These sensors are interdigital sensors or IDT sensors for InterDigital Transducer. This paper focuses on optimization of IDT sensors for non-destructive structural testing by using PZT ceramics. The challenge was to optimize the dimensional parameters of the IDT sensors in order to efficiently generate surface waves. Acoustic tests then confirmed these parameters. Copyright © 2017 Elsevier B.V. All rights reserved.

Optimism, Cynical Hostility, Falls, and Fractures: The Women's Health Initiative Observational Study (WHI-OS).

Science.gov (United States)

Cauley, Jane A; Smagula, Stephen F; Hovey, Kathleen M; Wactawski-Wende, Jean; Andrews, Christopher A; Crandall, Carolyn J; LeBoff, Meryl S; Li, Wenjun; Coday, Mace; Sattari, Maryam; Tindle, Hilary A

2017-02-01

Traits of optimism and cynical hostility are features of personality that could influence the risk of falls and fractures by influencing risk-taking behaviors, health behaviors, or inflammation. To test the hypothesis that personality influences falls and fracture risk, we studied 87,342 women enrolled in WHI-OS. Optimism was assessed by the Life Orientation Test-Revised and cynical hostility, the cynicism subscale of the Cook-Medley questionnaire. Higher scores indicate greater optimism and hostility. Optimism and hostility were correlated at r = -0. 31, p optimism and hostility with tests for trends; Q1 formed the referent group. The average follow-up for fractures was 11.4 years and for falls was 7.6 years. In multivariable (MV)-adjusted models, women with the highest optimism scores (Q4) were 11% less likely to report ≥2 falls in the past year (odds ratio [OR] = 0.89; 95% confidence intervals [CI] 0.85-0.90). Women in Q4 for hostility had a 12% higher risk of ≥2 falls (OR = 1.12; 95% CI 1.07-1.17). Higher optimism scores were also associated with a 10% lower risk of fractures, but this association was attenuated in MV models. Women with the greatest hostility (Q4) had a modest increased risk of any fracture (MV-adjusted hazard ratio = 1. 05; 95% CI 1.01-1.09), but there was no association with specific fracture sites. In conclusion, optimism was independently associated with a decreased risk of ≥2 falls, and hostility with an increased risk of ≥2 falls, independent of traditional risk factors. The magnitude of the association was similar to aging 5 years. Whether interventions aimed at attitudes could reduce fall risks remains to be determined. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

An Optimization of (Q,r Inventory Policy Based on Health Care Apparel Products with Compound Poisson Demands

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An Pan

2014-01-01

Full Text Available Addressing the problems of a health care center which produces tailor-made clothes for specific people, the paper proposes a single product continuous review model and establishes an optimal policy for the center based on (Q,r control policy to minimize expected average cost on an order cycle. A generic mathematical model to compute cost on real-time inventory level is developed to generate optimal order quantity under stochastic stock variation. The customer demands are described as compound Poisson process. Comparisons on cost between optimization method and experience-based decision on Q are made through numerical studies conducted for the inventory system of the center.

Perceived Enablers and Barriers to Optimal Health among Music Students: A Qualitative Study in the Music Conservatoire Setting.

Science.gov (United States)

Perkins, Rosie; Reid, Helen; Araújo, Liliana S; Clark, Terry; Williamon, Aaron

2017-01-01

Student health and wellbeing within higher education has been documented as poor in relation to the general population. This is a particular problem among students at music conservatoires, who are studying within a unique educational context that is known to generate both physical and psychological challenges. This article examines how conservatoire students experience health and wellbeing within their institutional context, using a framework from health promotion to focus attention on perceived enablers and barriers to optimal health in relation to three levels: lifestyle, support services, and conservatoire environment. In order to respond to the individuality of students' experiences, a qualitative approach was taken based on semi-structured interviews with 20 current or recent conservatoire students in the United Kingdom. Thematic analysis revealed a complex set of enablers and barriers: (i) lifestyle enablers included value placed on the importance of optimal health and wellbeing for musicians and daily practices to enable this; lifestyle barriers included struggling to maintain healthy lifestyles within the context of musical practice and learning; (ii) support enablers included accessible support sources within and beyond the conservatoire; support barriers included a perceived lack of availability or awareness of appropriate support; (iii) environmental enablers included positive and enjoyable experiences of performance as well as strong relationships and communities; environmental barriers included experiences of comparison and competition, pressure and stress, challenges with negative performance feedback, psychological distress, and perceived overwork. The findings reveal a need for health promotion to focus not only on individuals but also on the daily practices and routines of conservatoires. Additionally, they suggest that continued work is required to embed health and wellbeing support as an integral component of conservatoire education, raising

Perceived Enablers and Barriers to Optimal Health among Music Students: A Qualitative Study in the Music Conservatoire Setting

Directory of Open Access Journals (Sweden)

Rosie Perkins

2017-06-01

Full Text Available Student health and wellbeing within higher education has been documented as poor in relation to the general population. This is a particular problem among students at music conservatoires, who are studying within a unique educational context that is known to generate both physical and psychological challenges. This article examines how conservatoire students experience health and wellbeing within their institutional context, using a framework from health promotion to focus attention on perceived enablers and barriers to optimal health in relation to three levels: lifestyle, support services, and conservatoire environment. In order to respond to the individuality of students’ experiences, a qualitative approach was taken based on semi-structured interviews with 20 current or recent conservatoire students in the United Kingdom. Thematic analysis revealed a complex set of enablers and barriers: (i lifestyle enablers included value placed on the importance of optimal health and wellbeing for musicians and daily practices to enable this; lifestyle barriers included struggling to maintain healthy lifestyles within the context of musical practice and learning; (ii support enablers included accessible support sources within and beyond the conservatoire; support barriers included a perceived lack of availability or awareness of appropriate support; (iii environmental enablers included positive and enjoyable experiences of performance as well as strong relationships and communities; environmental barriers included experiences of comparison and competition, pressure and stress, challenges with negative performance feedback, psychological distress, and perceived overwork. The findings reveal a need for health promotion to focus not only on individuals but also on the daily practices and routines of conservatoires. Additionally, they suggest that continued work is required to embed health and wellbeing support as an integral component of conservatoire

Healthier students are better learners: high-quality, strategically planned, and effectively coordinated school health programs must be a fundamental mission of schools to help close the achievement gap.

Science.gov (United States)

Basch, Charles E

2011-10-01

To discuss implications for educational policy and practice relevant to closing the achievement gap based on the literature review and synthesis presented in 7 articles of the October 2011 special issue of the Journal of School Health. Implications for closing the achievement gap are drawn from analyses of current literature. During the past several decades, school reform efforts to close the achievement gap have focused on various strategies, yielding very limited progress. Educationally relevant health disparities influence students' motivation and ability to learn, but reducing these disparities has been largely overlooked as an element of an overall strategy for closing the achievement gap. If these health problems are not addressed, the educational benefits of other school reform efforts will be jeopardized. Healthier students are better learners. School health programs and services that are evidence based, strategically planned to influence academic achievement, and effectively coordinated warrant validation as a cohesive school improvement initiative for closing the achievement gap. National, state, and local responsibilities for supporting school health are outlined, including shared strategies; leadership from the U.S. Department of Education; policy development; guidance, technical assistance, and professional development; accountability and data and software systems; and a research agenda. To date, the U.S. Department of Education has not provided leadership for integrating evidence-based, strategically planned, and effectively coordinated school health programs and services into the fundamental mission of schools. Now is an opportune time for change. © 2011, American School Health Association.

Challenges in Achieving Collaboration in Clinical Practice: The Case of Norwegian Health Care

Directory of Open Access Journals (Sweden)

Sissel Steihaug

2016-07-01

Full Text Available Introduction: This article summarizes and synthesizes the findings of four separate but inter-linked empirical projects which explored challenges of collaboration in the Norwegian health system from the perspectives of providers and patients. The results of the four projects are summarised in eight articles. Methods: The eight articles constituted our empirical material. Meta-ethnography was used as a method to integrate, translate, and synthesize the themes and concepts contained in the articles in order to understand how challenges related to collaboration impact on clinical work. Results: Providers’ collaboration across all contexts was hampered by organizational and individual factors, including, differences in professional power, knowledge bases, and professional culture. The lack of appropriate collaboration between providers impeded clinical work. Mental health service users experienced fragmented services leading to insecurity and frustration. The lack of collaboration resulted in inadequate rehabilitation services and lengthened the institutional stay for older patients. Conclusion: Focusing on the different perspectives and the inequality in power between patients and healthcare providers and between different providers might contribute to a better environment for achieving appropriate collaboration. Organizational systems need to be redesigned to better nurture collaborative relationships and information sharing and support integrated working between providers, health care professionals and patients.

Assisting Pupils in Mathematics Achievement (The Common Core Standards)

Science.gov (United States)

Ediger, Marlow

2011-01-01

Mathematics teachers must expect reasonably high standards of achievement from pupils. Too frequently, pupils attain at a substandard level and more optimal achievement is necessary. Thus, pupils should have self esteem needs met in the school and classroom setting. Thus, learners feel that mathematics is worthwhile and effort must be put forth to…

Workshop on Computational Optimization

CERN Document Server

2015-01-01

Our everyday life is unthinkable without optimization. We try to minimize our effort and to maximize the achieved profit. Many real world and industrial problems arising in engineering, economics, medicine and other domains can be formulated as optimization tasks. This volume is a comprehensive collection of extended contributions from the Workshop on Computational Optimization 2013. It presents recent advances in computational optimization. The volume includes important real life problems like parameter settings for controlling processes in bioreactor, resource constrained project scheduling, problems arising in transport services, error correcting codes, optimal system performance and energy consumption and so on. It shows how to develop algorithms for them based on new metaheuristic methods like evolutionary computation, ant colony optimization, constrain programming and others.

From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health Outcomes

Science.gov (United States)

O’Flynn, Janine

2016-01-01

Many public policy programs fail to translate ambitious headlines to on-the-ground action. The reasons for this are many and varied, but for public administration and management scholars a large part of the gap between ambition and achievement is the challenge associated with the operation of the machinery of government itself, and how it relates to the other parties that it relies on to fulfill these outcomes. In their article, Carey and Friel set out key reasons why public health scholars should seek to better understand important ideas in public administration. In commenting on their contribution, I draw out two critical questions that are raised by this discussion: (i) what are boundaries and what forms do they take? and (ii) why work across boundaries? Expanding on these key questions extends the points made by Carey and Friel on the importance of understanding public administration and will better place public health scholars and practitioners to realise health outcomes. PMID:27694672

Correlates of willingness to engage in residential gardening: implications for health optimization in ibadan, Nigeria.

Science.gov (United States)

Motunrayo Ibrahim, Fausat

2013-01-01

Gardening is a worthwhile adventure which engenders health op-timization. Yet, a dearth of evidences that highlights motivations to engage in gardening exists. This study examined willingness to engage in gardening and its correlates, including some socio-psychological, health related and socio-demographic variables. In this cross-sectional survey, 508 copies of a structured questionnaire were randomly self administered among a group of civil servants of Oyo State, Nigeria. Multi-item measures were used to assess variables. Step wise multiple regression analysis was used to identify predictors of willingness to engage in gar-dening Results: Simple percentile analysis shows that 71.1% of respondents do not own a garden. Results of step wise multiple regression analysis indicate that descriptive norm of gardening is a good predictor, social support for gardening is better while gardening self efficacy is the best predictor of willingness to engage in gardening (Pgardening response efficacy, education and age are not predictors of this willingness (P> 0.05). Results of t-test and ANOVA respectively shows that gender is not associated with this willingness (P> 0.05), but marital status is (Pgardening. The nexus between gardening and health optimization appears to be highly obscured in this population.

Optimizing Implementation of Hepatitis C Birth-Cohort Screening and Treatment Strategies

Directory of Open Access Journals (Sweden)

Yuankun Li MS

2017-01-01

Full Text Available Background: Chronic hepatitis C (HCV is a significant public health problem affecting more than three million Americans. The US health care systems are ramping up costly HCV screening and treatment efforts with limited budget. We determine the optimal implementation of HCV birth-cohort screening and treatment strategies under budget constraints and health care payer’s perspective. Methods: Markov model and scenario-based simulation optimization. The target population is birth cohort born between 1945 and 1975. The interventions are allocating annual budget to screen a proportion of the target population and treat a proportion of the identified chronic HCV-positive patients over 10 years. Outcomes measure is to maximize lifetime discounted quality-adjusted life-years. Results: Allocate a percentage of the annual budget to screening, then treat patients with the remaining budget and prioritize the sickest patients. When the budget is $1 billion/year, the best strategy is to allocate the entire budget to treatment. When the budget is $5 billion/year, it is optimal to allocate 60% of the budget to screening in the first 2 years and 0% thereafter for age cohort 40 to 49; and allocate 20% of the budget to screening starting in year 3 for age cohorts 50 to 59 and 60 to 69. Health benefits are sensitive to budget in the first 2 years. Results are not sensitive to distribution of fibrosis stages by awareness of HCV. Conclusion: When budget is limited, all efforts should be focused on early treatment. With higher budget, better population health outcomes are achieved by reserving some budget for HCV screening while implementing a priority-based treatment strategy. This work has broad applicability to diverse health care systems and helps determine how much effort should be devoted to screening versus treatment under resource limitations.

Early Empowerment Strategies Boost Self-Efficacy to Improve Cardiovascular Health Behaviors

OpenAIRE

Kashani, Mariam; Eliasson, Arn H; Walizer, Elaine M; Fuller, Clarie E; Engler, Renata J; Villines, Todd C; Vernalis, Marina N

2016-01-01

Background: Self-efficacy, defined as confidence in the ability to carry out behavior to achieve a desired goal, is considered to be a prerequisite for behavior change. Self-efficacy correlates with cardiovascular health although optimal timing to incorporate self-efficacy strategies is not well established. We sought to study the effect of an empowerment approach implemented in the introductory phase of a multicomponent lifestyle intervention on cardiovascular health outcomes. Design: Prospe...

Achieving Consistent Near-Optimal Pattern Recognition Accuracy Using Particle Swarm Optimization to Pre-Train Artificial Neural Networks

Science.gov (United States)

Nikelshpur, Dmitry O.

2014-01-01

Similar to mammalian brains, Artificial Neural Networks (ANN) are universal approximators, capable of yielding near-optimal solutions to a wide assortment of problems. ANNs are used in many fields including medicine, internet security, engineering, retail, robotics, warfare, intelligence control, and finance. "ANNs have a tendency to get…

The Expanded Invasive Weed Optimization Metaheuristic for Solving Continuous and Discrete Optimization Problems

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Henryk Josiński

2014-01-01

Full Text Available This paper introduces an expanded version of the Invasive Weed Optimization algorithm (exIWO distinguished by the hybrid strategy of the search space exploration proposed by the authors. The algorithm is evaluated by solving three well-known optimization problems: minimization of numerical functions, feature selection, and the Mona Lisa TSP Challenge as one of the instances of the traveling salesman problem. The achieved results are compared with analogous outcomes produced by other optimization methods reported in the literature.

Spatio-temporal optimization of agricultural practices to achieve a sustainable development at basin level; framework of a case study in Colombia

Science.gov (United States)

Uribe, Natalia; corzo, Gerald; Solomatine, Dimitri

2016-04-01

The flood events present during the last years in different basins of the Colombian territory have raised questions on the sensitivity of the regions and if this regions have common features. From previous studies it seems important features in the sensitivity of the flood process were: land cover change, precipitation anomalies and these related to impacts of agriculture management and water management deficiencies, among others. A significant government investment in the outreach activities for adopting and promoting the Colombia National Action Plan on Climate Change (NAPCC) is being carried out in different sectors and regions, having as a priority the agriculture sector. However, more information is still needed in the local environment in order to assess were the regions have this sensitivity. Also the continuous change in one region with seasonal agricultural practices have been pointed out as a critical information for optimal sustainable development. This combined spatio-temporal dynamics of crops cycle in relation to climate change (or variations) has an important impact on flooding events at basin areas. This research will develop on the assessment and optimization of the aggregated impact of flood events due to determinate the spatio-temporal dynamic of changes in agricultural management practices. A number of common best agricultural practices have been identified to explore their effect in a spatial hydrological model that will evaluate overall changes. The optimization process consists on the evaluation of best performance in the agricultural production, without having to change crops activities or move to other regions. To achieve this objectives a deep analysis of different models combined with current and future climate scenarios have been planned. An algorithm have been formulated to cover the parametric updates such that the optimal temporal identification will be evaluated in different region on the case study area. Different hydroinformatics

Affectionless control by the same-sex parents increases dysfunctional attitudes about achievement.

Science.gov (United States)

Otani, Koichi; Suzuki, Akihito; Matsumoto, Yoshihiko; Sadahiro, Ryoichi; Enokido, Masanori

2014-08-01

The affectionless control parenting has been associated with depression in recipients. The aim of this study was to examine the effect of this parenting style on dysfunctional attitudes predisposing to depression. The subjects were 666 Japanese volunteers. Perceived parental rearing was evaluated by the Parental Bonding Instrument, which has the care and protection subscales. Parental rearing was classified into four types, i.e., optimal parenting (high care/low protection), affectionate constraint (high care/high protection), neglectful parenting (low care/low protection), and affectionless control (low care/high protection). Dysfunctional attitudes were evaluated by the 24-item Dysfunctional Attitude Scale, which has the achievement, dependency and self-control subscales. Males with paternal affectionless control had higher achievement scores than those with paternal optimal parenting (P=.016). Similarly, females with maternal affectionless control had higher achievement scores than those with maternal optimal parenting (P=.016). The present study suggests that affectionless control by the same-sex parents increases dysfunctional attitudes about achievement. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

PORTFOLIO OPTIMIZATION ON CROATIAN CAPITAL MARKET

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Sinisa Bogdan

2013-12-01

Full Text Available Purpose of this paper was to research portfolio optimization problem on Croatian capital market using Markowitz theory. Research systematically investigated the selection of securities, and defined the importance of using fundamental analysis when selecting the best combination of securities. Since fundamental analysis involves a large number of indicators, this paper selected key indicators that enable a complete and quick securities review on the market. This paper clarifies diversification effect and influence of the correlation coefficient on diversification. Two basic types of assets (stocks and cash funds have been chosen to build the optimal portfolio. Cash funds were selected because they represent a form of risk-free investment, while stocks were chosen because of the high level of return which they achieve. At the end of paper, optimal portfolio was calculated with an excellent yield of 1.82% and deviation of 5.77% on a monthly basis which corresponds to the minimum deviation of the selected stocks. Calculated optimal portfolio achieves better expected value than investing in stock index CROBEX, which for the same period achieves the expected result of -0.02%.

A Class-Specific Optimizing Compiler

Directory of Open Access Journals (Sweden)

Michael D. Sharp

1993-01-01

Full Text Available Class-specific optimizations are compiler optimizations specified by the class implementor to the compiler. They allow the compiler to take advantage of the semantics of the particular class so as to produce better code. Optimizations of interest include the strength reduction of class:: array address calculations, elimination of large temporaries, and the placement of asynchronous send/recv calls so as to achieve computation/communication overlap. We will outline our progress towards the implementation of a C++ compiler capable of incorporating class-specific optimizations.

The role of self-efficacy, self-esteem and optimism for using routine health check-ups in a population-based sample. A longitudinal perspective.

Science.gov (United States)

Hajek, André; Hans-Helmut-König

2017-12-01

While several cross-sectional studies have shown that self-efficacy, self-esteem and optimism are associated with the use of routine health check-ups, little is known about this relationship based on longitudinal studies. Consequently, the purpose of this study was to examine whether these factors are associated with routine health check-ups longitudinally. Data were retrieved from a population-based longitudinal study of individuals (≥40years of age) residing in private households in Germany (two waves: 2008 and 2011). Widely established scales were used to quantify self-efficacy, self-esteem, and optimism. Respondents reported whether they used a health check-up in the last two years. Conditional fixed-effects logistic regressions were used (n=1504), adjusting for socio-demographic, lifestyle and health-related variables. After adjusting for various potential confounders, regression analysis revealed that the use of routine health check-ups increased with self-efficacy [OR: 1.71 (95%-CI: 1.14-2.55)], self-esteem [OR: 1.78 (1.16-2.73)], and optimism [OR: 1.37 (1.01-1.86)]. Furthermore, the use of routine health check-ups increased with changes from employment to retirement [OR: 2.60 (1.34-5.03)], whereas it was not associated with changes in age, marital status, smoking status, the number of physical illnesses, self-rated health and body-mass index. The current study stresses the importance of an association between screening behavior and self-efficacy, self-esteem and optimism longitudinally. Interventions aiming at modifying these psychological factors might help to increase the use of routine health check-ups. Copyright © 2017 Elsevier Inc. All rights reserved.

Academic Optimism and Collective Responsibility: An Organizational Model of the Dynamics of Student Achievement

Science.gov (United States)

Wu, Jason H.

2013-01-01

This study was designed to examine the construct of academic optimism and its relationship with collective responsibility in a sample of Taiwan elementary schools. The construct of academic optimism was tested using confirmatory factor analysis, and the whole structural model was tested with a structural equation modeling analysis. The data were…

Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study.

Science.gov (United States)

Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2018-05-01

There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced

[Health system sustainability from a network perspective: a proposal to optimize healthy habits and social support].

Science.gov (United States)

Marqués Sánchez, Pilar; Fernández Peña, Rosario; Cabrera León, Andrés; Muñoz Doyague, María F; Llopis Cañameras, Jaime; Arias Ramos, Natalia

2013-01-01

The search of new health management formulas focused to give wide services is one of the priorities of our present health policies. Those formulas examine the optimization of the links between the main actors involved in public health, ie, users, professionals, local socio-political and corporate agents. This paper is aimed to introduce the Social Network Analysis as a method for analyzing, measuring and interpreting those connections. The knowledge of people's relationships (what is called social networks) in the field of public health is becoming increasingly important at an international level. In fact, countries such as UK, Netherlands, Italy, Australia and U.S. are looking formulas to apply this knowledge to their health departments. With this work we show the utility of the ARS on topics related to sustainability of the health system, particularly those related with health habits and social support, topics included in the 2020 health strategies that underline the importance of the collaborative aspects in networks.

Computed tomography-based lung nodule volumetry - do optimized reconstructions of routine protocols achieve similar accuracy, reproducibility and interobserver variability to that of special volumetry protocols?

International Nuclear Information System (INIS)

Bolte, H.; Riedel, C.; Knoess, N.; Hoffmann, B.; Heller, M.; Biederer, J.; Freitag, S.

2007-01-01

Purpose: The aim of this in vitro and ex vivo CT study was to investigate whether the use of a routine thorax protocol (RTP) with optimized reconstruction parameters can provide comparable accuracy, reproducibility and interobserver variability of volumetric analyses to that of a special volumetry protocol (SVP). Materials and Methods: To assess accuracy, 3 polyurethane (PU) spheres (35 HU; diameters: 4, 6 and 10 mm) were examined with a recommended SVP using a multislice CT (collimation 16 x 0.75 mm, pitch 1.25, 20 mAs, slice thickness 1 mm, increment 0.7 mm, medium kernel) and an optimized RTP (collimation 16 x 1.5 mm, pitch 1.25, 100 mAs, reconstructed slice thickness 2 mm, increment 0.4 mm, sharp kernel). For the assessment of intrascan and interscan reproducibility and interobserver variability, 20 artificial small pulmonary nodules were placed in a dedicated ex vivo chest phantom and examined with identical scan protocols. The artificial lesions consisted of a fat-wax-Lipiodol registered mixture. Phantoms and ex vivo lesions were examined afterwards using commercial volumetry software. To describe accuracy the relative deviations from the true volumes of the PU phantoms were calculated. For intrascan and interscan reproducibility and interobserver variability, the 95 % normal range (95 % NR) of relative deviations between two measurements was calculated. Results: For the SVP the achieved relative deviations for the 4, 6 and 10 mm PU phantoms were - 14.3 %, - 12.7 % and - 6.8 % and were 4.5 %, - 0.6 % and - 2.6 %, respectively, for the optimized RTP. SVP showed a 95 % NR of 0 - 1.5 % for intrascan and a 95 % NR of - 10.8 - 2.9 % for interscan reproducibility. The 95 % NR for interobserver variability was - 4.3 - 3.3 %. The optimized RTP achieved a 95 % NR of - 3.1 - 4.3 % for intrascan reproducibility and a 95 % NR of - 7.0 - 3.5 % for interscan reproducibility. The 95 % NR for interobserver variability was - 0.4 - 6.8 %. (orig.)

Fuzzy Adaptive Particle Swarm Optimization for Power Loss Minimisation in Distribution Systems Using Optimal Load Response

DEFF Research Database (Denmark)

Hu, Weihao; Chen, Zhe; Bak-Jensen, Birgitte

2014-01-01

Consumers may decide to modify the profile of their demand from high price periods to low price periods in order to reduce their electricity costs. This optimal load response to electricity prices for demand side management generates different load profiles and provides an opportunity to achieve...... power loss minimization in distribution systems. In this paper, a new method to achieve power loss minimization in distribution systems by using a price signal to guide the demand side management is proposed. A fuzzy adaptive particle swarm optimization (FAPSO) is used as a tool for the power loss...

Physical Activity and Academic Achievement

Centers for Disease Control (CDC) Podcasts

2014-12-09

This podcast highlights the evidence that supports the link between physical activity and improved academic achievement. It also identifies a few actions to support a comprehensive school physical activity program to improve academic achievement.  Created: 12/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/9/2014.

Healthy Eating and Academic Achievement

Centers for Disease Control (CDC) Podcasts

2014-12-09

This podcast highlights the evidence that supports the link between healthy eating and improved academic achievement. It also identifies a few actions to support a healthy school nutrition environment to improve academic achievement.  Created: 12/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/9/2014.

Health, Health Care, and Systems Science: Emerging Paradigm.

Science.gov (United States)

Janecka, Ivo

2017-02-15

Health is a continuum of an optimized state of a biologic system, an outcome of positive relationships with the self and others. A healthy system follows the principles of systems science derived from observations of nature, highlighting the character of relationships as the key determinant. Relationships evolve from our decisions, which are consequential to the function of our own biologic system on all levels, including the genome, where epigenetics impact our morphology. In healthy systems, decisions emanate from the reciprocal collaboration of hippocampal memory and the executive prefrontal cortex. We can decide to change relationships through choices. What is selected, however, only represents the cognitive interpretation of our limited sensory perception; it strongly reflects inherent biases toward either optimizing state, making a biologic system healthy, or not. Health or its absence is then the outcome; there is no inconsequential choice. Public health effort should not focus on punitive steps (e.g. taxation of unhealthy products or behaviors) in order to achieve a higher level of public's health. It should teach people the process of making healthy decisions; otherwise, people will just migrate/shift from one unhealthy product/behavior to another, and well-intended punitive steps will not make much difference. Physical activity, accompanied by nutrition and stress management, have the greatest impact on fashioning health and simultaneously are the most cost-effective measures. Moderate-to-vigorous exercise not only improves aerobic fitness but also positively influences cognition, including memory and senses. Collective, rational societal decisions can then be anticipated. Health care is a business system principally governed by self-maximizing decisions of its components; uneven and contradictory outcomes are the consequences within such a non-optimized system. Health is not health care. We are biologic systems subject to the laws of biology in spite of

Perceived Academic Control: Mediating the Effects of Optimism and Social Support on College Students' Psychological Health

Science.gov (United States)

Ruthig, Joelle C.; Haynes, Tara L.; Stupnisky, Robert H.; Perry, Raymond P.

2009-01-01

The first year of college presents numerous challenges experienced as overwhelming by some freshmen who may become overly stressed and depressed. This longitudinal study examined perceived academic control (PAC) as a mediator of optimism and social support's buffering effects on freshman students' psychological health. Multiple regressions…

Revisiting Primary Care's Critical Role in Achieving Health Equity: Pisacano Scholars' Reflections from Starfield Summit II.

Science.gov (United States)

Park, Brian; Coutinho, Anastasia J; Doohan, Noemi; Jimenez, Jonathan; Martin, Sara; Romano, Max; Wohler, Diana; DeVoe, Jennifer

2018-01-01

The second Starfield Summit was held in Portland, Oregon, in April 2017. The Summit addressed the role of primary care in advancing health equity by focusing on 4 key domains: social determinants of health in primary care, vulnerable populations, economics and policy, and social accountability. Invited participants represented an interdisciplinary group of primary care clinicians, researchers, educators, policymakers, community leaders, and trainees. The Pisacano Leadership Foundation was one of the Summit sponsors and held its annual leadership symposium in conjunction with the Summit, enabling several Pisacano Scholars to attend the Summit. After the Summit, a small group of current and former Pisacano Scholars formed a writing group to highlight key themes and implications for action discussed at the Summit. The Summit resonated as a call to action for primary care to move beyond identifying existing health inequities and toward the development of interventions that advance health equity, through education, research, and enhanced community partnerships. In doing so, the Summit aimed to build on the foundational work of Dr. Starfield, challenging us to explore the significant role of primary care in truly achieving health equity. © Copyright 2018 by the American Board of Family Medicine.

Optimization of the production process using virtual model of a workspace

Science.gov (United States)

Monica, Z.

2015-11-01

Optimization of the production process is an element of the design cycle consisting of: problem definition, modelling, simulation, optimization and implementation. Without the use of simulation techniques, the only thing which could be achieved is larger or smaller improvement of the process, not the optimization (i.e., the best result it is possible to get for the conditions under which the process works). Optimization is generally management actions that are ultimately bring savings in time, resources, and raw materials and improve the performance of a specific process. It does not matter whether it is a service or manufacturing process. Optimizing the savings generated by improving and increasing the efficiency of the processes. Optimization consists primarily of organizational activities that require very little investment, or rely solely on the changing organization of work. Modern companies operating in a market economy shows a significant increase in interest in modern methods of production management and services. This trend is due to the high competitiveness among companies that want to achieve success are forced to continually modify the ways to manage and flexible response to changing demand. Modern methods of production management, not only imply a stable position of the company in the sector, but also influence the improvement of health and safety within the company and contribute to the implementation of more efficient rules for standardization work in the company. This is why in the paper is presented the application of such developed environment like Siemens NX to create the virtual model of a production system and to simulate as well as optimize its work. The analyzed system is the robotized workcell consisting of: machine tools, industrial robots, conveyors, auxiliary equipment and buffers. In the program could be defined the control program realizing the main task in the virtual workcell. It is possible, using this tool, to optimize both the

Bolt Thread Stress Optimization

DEFF Research Database (Denmark)

Pedersen, Niels Leergaard

2012-01-01

of threads and therefore indirectly the bolt fatigue life. The root shape is circular, and from shape optimization for minimum stress concentration it is well known that the circular shape is seldom optimal. An axisymmetric Finite Element (FE) formulation is used to analyze the bolted connection, and a study...... is performed to establish the need for contact modeling with regard to finding the correct stress concentration factor. Optimization is performed with a simple parameterization with two design variables. Stress reduction of up to 9% is found in the optimization process, and some similarities are found...... in the optimized designs leading to the proposal of a new standard. The reductions in the stress are achieved by rather simple changes made to the cutting tool....

A Policy Review on The Distribution of Health Operational Aid Funds in Achieving Maternal and Child Health Program (MDGs 4, 5 in Three Districts/Cities of East Java Province

Directory of Open Access Journals (Sweden)

Niniek Lely Pratiwi

2015-06-01

Full Text Available Background: Health Policy Regulation Number 494/Menkes/SK/IV/2010 on the distribution of BOK funds to local government is one of the government’s responsibility for the development of public health in improving health promotion and prevention efforts in order to accelerate the achievement of MDGs in Health. The purpose of the study is to provide policy recommendations regarding to BOK in achieving the goals of maternal and child health programs. Methods: Secondary data review of the district health profile in 2009-2011 and analysis on the primary data collected from focus group discussion (FGD with invited technical implementor from district health office and health centers as well as some of the staffs of the local government that handle BOK. Results: The decline in maternal and infant mortality rates are still slow and cases of malnutrition increased from the three profile data review Sampang, Gresik and Sidoarjo. Local governments pay little commitment in developing priority strategies of maternal and child health programs in the form of a local action and innovation plan. BOK preventive promotive activities are lacking of monitoring and accountability controls, especially in health centers located far from the district center. Financial accountability is less precise to the programs and targetes, having seen the data of maternal and child health outcomes KN1-KN4 coverage which rose in 2010, but then fell back in 2011. Conclusion: Evaluation and monitoring are needed on the utilization of BOK funds, supervising the activities by the district/city health office, as well as by local community leaders. Prioritise monitoring the health centers in the area with high MMR and IMR. Suggestion: Needed routine and periodic mentoring and coaching in the form of technical assistance related to the utilization of BOK.

Effects of Parental Stress, Optimism, and Health-Promoting Behaviors on the Quality of Life of Primiparous and Multiparous Mothers.

Science.gov (United States)

Loh, Jennifer; Harms, Craig; Harman, Bronwyn

Parental stress, optimism, and health-promoting behaviors (HPBs) are important predictors of the quality of life (QoL) of mothers. However, it is unclear how strongly these predictors affect the QoL of mothers. It is also unclear if the impact of these predictors on QoL differs between primiparous and multiparous mothers. In this study, we defined primiparous as "bearing young for the first time" and multiparous as "having experienced one or more previous childbirths." The first objective of this study was to examine the relative effect of parental stress, optimism, and HPBs on the QoL of mothers. The second objective was to investigate if the effect of these predictors differed between primiparous and multiparous mothers. One hundred ninety-four Australian mothers (n = 87, 44.8% primiparous mothers) participated in an online survey that included the Parental Stress Scale, the Health-Promoting Lifestyle Profile II, the Revised Life Orientation Test, and the Quality of Life Enjoyment and Satisfaction Questionnaire. All predictors (parental stress, optimism, and HPBs) significantly affected the QoL of mothers; higher levels of optimism, greater use of HPBs, and lower parental stress were associated with higher levels of QoL for all mothers. Parity did not affect the relationships. This study sheds light on the nature and unique effect of parental stress, optimism, and HPBs on the QoL of mothers.

Health behavior and academic achievement among adolescents: the relative contribution of dietary habits, physical activity, body mass index, and self-esteem.

Science.gov (United States)

Kristjánsson, Alfgeir Logi; Sigfúsdóttir, Inga Dóra; Allegrante, John P

2010-02-01

This study tested a structural equation model to estimate the relationship between health behaviors, body mass index (BMI), and self-esteem and the academic achievement of adolescents. The authors analyzed survey data from the 2000 study of Youth in Iceland , a population-based, cross-sectional sample of 6,346 adolescents in Iceland. The model demonstrated good fit with chi-square of 2685 (n = 5,810, df = 180), p Comparative Fit Index value of .94, and a root mean square error of approximation of .049. Lower BMI, physical activity, and good dietary habits were all associated with higher academic achievement; however, health behavior was positively and robustly associated with greater self-esteem. Self-esteem was positively influenced both through physical activity (beta = .16) and the consumption of fruits and vegetables (beta = .14). In contrast, poor dietary habits negatively influenced self-esteem and academic achievement, and self-esteem was negatively influenced by increasing levels of BMI (beta = -.05).

Achieving low latency and energy consumption by 5G TDD mode optimization

DEFF Research Database (Denmark)

Lähetkangas, Eeva; Pajukoski, Kari; Vihriälä, Jaakko

2014-01-01

and discussing on the consequent frame length limits. We then provide a description on how the achieved short TDD latency can further be utilized to enable remarkably low energy consumption. A numerical analysis comparing the battery life time of the suggested 5G TDD air interface and LTE is provided, showing......The target for a new 5G radio access technology is to support multi-Gbps and ms latency connectivity simultaneously at noticeably lower energy consumption and cost compared to the existing 4G technologies, such as LTE-Advanced. Extremely short air interface latency is required to achieve...... these requirements in a TDD-based local area network. In this paper, we discuss how the required short TDD latency can be achieved and further utilized in 5G physical air interface. First, we investigate the enablers and limits of TDD latency by analyzing the performance of OFDM in different channel environments...

An Integrated Simulation, Inference and Optimization Approach for Groundwater Remediation with Two-stage Health-Risk Assessment

Directory of Open Access Journals (Sweden)

Aili Yang

2018-05-01

Full Text Available In this study, an integrated simulation, inference and optimization approach with two-stage health risk assessment (i.e., ISIO-THRA is developed for supporting groundwater remediation for a petroleum-contaminated site in western Canada. Both environmental standards and health risk are considered as the constraints in the ISIO-THRA model. The health risk includes two parts: (1 the health risk during the remediation process and (2 the health risk in the natural attenuation period after remediation. In the ISIO-THRA framework, the relationship between contaminant concentrations and time is expressed through first-order decay models. The results demonstrate that: (1 stricter environmental standards and health risk would require larger pumping rates for the same remediation duration; (2 higher health risk may happen in the period of the remediation process; (3 for the same environmental standard and acceptable health-risk level, the remediation techniques that take the shortest time would be chosen. ISIO-THRA can help to systematically analyze interaction among contaminant transport, remediation duration, and environmental and health concerns, and further provide useful supportive information for decision makers.

Capacity-achieving CPM schemes

OpenAIRE

Perotti, Alberto; Tarable, Alberto; Benedetto, Sergio; Montorsi, Guido

2008-01-01

The pragmatic approach to coded continuous-phase modulation (CPM) is proposed as a capacity-achieving low-complexity alternative to the serially-concatenated CPM (SC-CPM) coding scheme. In this paper, we first perform a selection of the best spectrally-efficient CPM modulations to be embedded into SC-CPM schemes. Then, we consider the pragmatic capacity (a.k.a. BICM capacity) of CPM modulations and optimize it through a careful design of the mapping between input bits and CPM waveforms. The s...

Numerical difficulties associated with using equality constraints to achieve multi-level decomposition in structural optimization

Science.gov (United States)

Thareja, R.; Haftka, R. T.

1986-01-01

There has been recent interest in multidisciplinary multilevel optimization applied to large engineering systems. The usual approach is to divide the system into a hierarchy of subsystems with ever increasing detail in the analysis focus. Equality constraints are usually placed on various design quantities at every successive level to ensure consistency between levels. In many previous applications these equality constraints were eliminated by reducing the number of design variables. In complex systems this may not be possible and these equality constraints may have to be retained in the optimization process. In this paper the impact of such a retention is examined for a simple portal frame problem. It is shown that the equality constraints introduce numerical difficulties, and that the numerical solution becomes very sensitive to optimization parameters for a wide range of optimization algorithms.

Optimism and Cause-Specific Mortality: A Prospective Cohort Study.

Science.gov (United States)

Kim, Eric S; Hagan, Kaitlin A; Grodstein, Francine; DeMeo, Dawn L; De Vivo, Immaculata; Kubzansky, Laura D

2017-01-01

Growing evidence has linked positive psychological attributes like optimism to a lower risk of poor health outcomes, especially cardiovascular disease. It has been demonstrated in randomized trials that optimism can be learned. If associations between optimism and broader health outcomes are established, it may lead to novel interventions that improve public health and longevity. In the present study, we evaluated the association between optimism and cause-specific mortality in women after considering the role of potential confounding (sociodemographic characteristics, depression) and intermediary (health behaviors, health conditions) variables. We used prospective data from the Nurses' Health Study (n = 70,021). Dispositional optimism was measured in 2004; all-cause and cause-specific mortality rates were assessed from 2006 to 2012. Using Cox proportional hazard models, we found that a higher degree of optimism was associated with a lower mortality risk. After adjustment for sociodemographic confounders, compared with women in the lowest quartile of optimism, women in the highest quartile had a hazard ratio of 0.71 (95% confidence interval: 0.66, 0.76) for all-cause mortality. Adding health behaviors, health conditions, and depression attenuated but did not eliminate the associations (hazard ratio = 0.91, 95% confidence interval: 0.85, 0.97). Associations were maintained for various causes of death, including cancer, heart disease, stroke, respiratory disease, and infection. Given that optimism was associated with numerous causes of mortality, it may provide a valuable target for new research on strategies to improve health. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Optimized emission in nanorod arrays through quasi-aperiodic inverse design.

Science.gov (United States)

Anderson, P Duke; Povinelli, Michelle L

2015-06-01

We investigate a new class of quasi-aperiodic nanorod structures for the enhancement of incoherent light emission. We identify one optimized structure using an inverse design algorithm and the finite-difference time-domain method. We carry out emission calculations on both the optimized structure as well as a simple periodic array. The optimized structure achieves nearly perfect light extraction while maintaining a high spontaneous emission rate. Overall, the optimized structure can achieve a 20%-42% increase in external quantum efficiency relative to a simple periodic design, depending on material quality.

Achieving the sustainable development goals: transforming public ...

African Journals Online (AJOL)

Achieving the sustainable development goals: transforming public health ... PROMOTING ACCESS TO AFRICAN RESEARCH ... The conference focused on transforming public health education and practice in the context of South Africa.

Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.

Science.gov (United States)

Hoffman, Sarah R; Vines, Anissa I; Halladay, Jacqueline R; Pfaff, Emily; Schiff, Lauren; Westreich, Daniel; Sundaresan, Aditi; Johnson, La-Shell; Nicholson, Wanda K

2018-06-01

Women with symptomatic uterine fibroids can report a myriad of symptoms, including pain, bleeding, infertility, and psychosocial sequelae. Optimizing fibroid research requires the ability to enroll populations of women with image-confirmed symptomatic uterine fibroids. Our objective was to develop an electronic health record-based algorithm to identify women with symptomatic uterine fibroids for a comparative effectiveness study of medical or surgical treatments on quality-of-life measures. Using an iterative process and text-mining techniques, an effective computable phenotype algorithm, composed of demographics, and clinical and laboratory characteristics, was developed with reasonable performance. Such algorithms provide a feasible, efficient way to identify populations of women with symptomatic uterine fibroids for the conduct of large traditional or pragmatic trials and observational comparative effectiveness studies. Symptomatic uterine fibroids, due to menorrhagia, pelvic pain, bulk symptoms, or infertility, are a source of substantial morbidity for reproductive-age women. Comparing Treatment Options for Uterine Fibroids is a multisite registry study to compare the effectiveness of hormonal or surgical fibroid treatments on women's perceptions of their quality of life. Electronic health record-based algorithms are able to identify large numbers of women with fibroids, but additional work is needed to develop electronic health record algorithms that can identify women with symptomatic fibroids to optimize fibroid research. We sought to develop an efficient electronic health record-based algorithm that can identify women with symptomatic uterine fibroids in a large health care system for recruitment into large-scale observational and interventional research in fibroid management. We developed and assessed the accuracy of 3 algorithms to identify patients with symptomatic fibroids using an iterative approach. The data source was the Carolina Data Warehouse for

Optimal and safe standard doses of midazolam and propofol to achieve patient and doctor satisfaction with dental treatment: A prospective cohort study

Science.gov (United States)

Nonaka, Mutsumi; Nishimura, Akiko; Gotoh, Kinuko; Oka, Shuichirou; Iijima, Takehiko

2017-01-01

Background The incidences of morbidity and mortality caused by pharmacosedation for dental treatment have not yet reached zero. Adverse events are related to inappropriate respiratory management, mostly originating from an overdose of sedatives. Since sedation is utilized for the satisfaction of both the dentist and the patient, the optimal dose should be minimized to prevent adverse events. We attempted to define the optimal doses of midazolam and propofol required to achieve high levels of patient and dentist satisfaction. Methods One thousand dental patients, including those undergoing third molar extractions, were enrolled in this study. A dose of 1 mg of midazolam was administered at 1-minute intervals until adequate sedation was achieved. Propofol was then infused continuously to maintain the sedation level. Both the patients and the dentists were subsequently interviewed and asked to complete a questionnaire. A multivariate logistic regression analysis was used to examine the factors that contributed to patient and dentist satisfaction. Results The peak midazolam dose resulting in the highest percentage of patient satisfaction was 3 mg. Both a lower dose and a higher dose reduced patient satisfaction. Patient satisfaction increased with an increasing dosage of propofol up until 4 mg/kg/hr, reaching a peak of 78.6%. The peak midazolam dose resulting in the highest percentage of dentist satisfaction (78.8%) was 2 mg. Incremental propofol doses reduced dentist satisfaction, in contrast to their effect on patient satisfaction. The strongest independent predictors of patient satisfaction and dentist satisfaction were no intraoperative memory (OR, 5.073; 95% CI, 3.532–7.287; Psedation is relatively light, memory loss and an absence of unintentional patient movements can be expected without adverse events. PMID:28182732

A Novel Hybridization of Applied Mathematical, Operations Research and Risk-based Methods to Achieve an Optimal Solution to a Challenging Subsurface Contamination Problem

Science.gov (United States)

Johnson, K. D.; Pinder, G. F.

2013-12-01

The objective of the project is the creation of a new, computationally based, approach to the collection, evaluation and use of data for the purpose of determining optimal strategies for investment in the solution of remediation of contaminant source areas and similar environmental problems. The research focuses on the use of existing mathematical tools assembled in a unique fashion. The area of application of this new capability is optimal (least-cost) groundwater contamination source identification; we wish to identify the physical environments wherein it may be cost-prohibitive to identify a contaminant source, the optimal strategy to protect the environment from additional insult and formulate strategies for cost-effective environmental restoration. The computational underpinnings of the proposed approach encompass the integration into a unique of several known applied-mathematical tools. The resulting tool integration achieves the following: 1) simulate groundwater flow and contaminant transport under uncertainty, that is when the physical parameters such as hydraulic conductivity are known to be described by a random field; 2) define such a random field from available field data or be able to provide insight into the sampling strategy needed to create such a field; 3) incorporate subjective information, such as the opinions of experts on the importance of factors such as locations of waste landfills; 4) optimize a search strategy for finding a potential source location and to optimally combine field information with model results to provide the best possible representation of the mean contaminant field and its geostatistics. Our approach combines in a symbiotic manner methodologies found in numerical simulation, random field analysis, Kalman filtering, fuzzy set theory and search theory. Testing the algorithm for this stage of the work, we will focus on fabricated field situations wherein we can a priori specify the degree of uncertainty associated with the

Optimization analysis of propulsion motor control efficiency

Directory of Open Access Journals (Sweden)

CAI Qingnan

2017-12-01

Full Text Available [Objectives] This paper aims to strengthen the control effect of propulsion motors and decrease the energy used during actual control procedures.[Methods] Based on the traditional propulsion motor equivalence circuit, we increase the iron loss current component, introduce the definition of power matching ratio, calculate the highest efficiency of a motor at a given speed and discuss the flux corresponding to the power matching ratio with the highest efficiency. In the original motor vector efficiency optimization control module, an efficiency optimization control module is added so as to achieve motor efficiency optimization and energy conservation.[Results] MATLAB/Simulink simulation data shows that the efficiency optimization control method is suitable for most conditions. The operation efficiency of the improved motor model is significantly higher than that of the original motor model, and its dynamic performance is good.[Conclusions] Our motor efficiency optimization control method can be applied in engineering to achieve energy conservation.

THERAPEUTIC DIFFICULTIES IN ACHIEVEMENT OF OPTIMAL ROOT COVERAGE AND AESTHETIC IN CLASS III GINGIVAL RECESSION.

Directory of Open Access Journals (Sweden)

Christina Popova

2013-07-01

Full Text Available The width of the attached gingiva is defined as a distance between the depth of the gingival sulcus or gingival/periodontal pocket to the mucogingival junction. Authors suggest that a minimal amount of attached gingiva is necessary to ensure the gingival health. When the buccal bone plate and gingival tissues are thin and the position of the tooth is too vestibular gingival margin often displaces apically, and gingival recession develops. In the presence of gingival recession and reduced vestibular depth oral hygiene procedures are embarrassed.The definition of class III gingival recession is marginal lack of tissue extended to/or beyond the mucogingival junction with bone and soft tissue loss interdentally or malpositioning of the tooth.Prognosis for class III and IV gingival recession is that only partial coverage can be expected after root coverage procedures - FGG (free gingival graft or connective tissue graft (CTG. Adjunctive surgical techniques would be helpful to achieve better aesthetic outcomes.

The Contribution of Civil Society Organizations in Achieving Health ...

International Development Research Centre (IDRC) Digital Library (Canada)

Global gaps in health care The World Health Organization's Health for All ... Making the invisible visible: gender, data, and evidence for development ... Strengthening Governance in Health Systems for Reproductive Health and Rights in ...

Multi-objective optimization design method of radiation shielding

International Nuclear Information System (INIS)

Yang Shouhai; Wang Weijin; Lu Daogang; Chen Yixue

2012-01-01

Due to the shielding design goals of diversification and uncertain process of many factors, it is necessary to develop an optimization design method of intelligent shielding by which the shielding scheme selection will be achieved automatically and the uncertainties of human impact will be reduced. For economical feasibility to achieve a radiation shielding design for automation, the multi-objective genetic algorithm optimization of screening code which combines the genetic algorithm and discrete-ordinate method was developed to minimize the costs, size, weight, and so on. This work has some practical significance for gaining the optimization design of shielding. (authors)

Optimal Aging and Death

DEFF Research Database (Denmark)

Dalgaard, Carl-Johan Lars; Strulik, Holger

2010-01-01

health investments. At the same time, physiological aspects of the aging process influence optimal savings and health investment. We calibrate the model for the average US male in 2000 and proceed to show that the calibrated model accounts well for the cross-country link between labor productivity......This study introduces physiological aging into a simple model of optimal intertemporal consumption. In this endeavor we draw on the natural science literature on aging. According to the purposed theory, the speed of the aging process and the time of death are endogenously determined by optimal...... and life expectancy in the same year ("the Preston curve"); cross-country income differences can explain differences in life expectancy at age 20 of up to a decade. Moreover, technological change in health care of about 1.1% per year can account for the observed shift in the Preston curve between 1980...

Optimization of conditions to achieve high content of gamma amino butyric acid in germinated black rice, and changes in bioactivities

Directory of Open Access Journals (Sweden)

Chaiyavat CHAIYASUT

Full Text Available Abstract The present study estimated the optimum germination conditions to achieve high content of Gamma-amino butyric acid (GABA and other phytochemicals in Thai black rice cultivar Kum Payao (BR. The Box–Behnken design of response surface methodology was employed to optimize the germination conditions. The changes in the GABA, phytochemical content, impact of salt, and temperature stress variation on phytochemical content, and stability of GABA were studied. The results showed that 12 h of soaking at pH 7, followed by 36 h of germination was the optimum condition to achieve maximum GABA content (0.2029 mg/g of germinated BR (GBR. The temperature (8 and 30 °C, and salt (50-200 mM NaCl content affected the phytochemicals of GBR, especially GABA, and anthocyanins. Obviously, the antioxidant capability, and enzyme (α-amylase and α-glucosidase inhibiting nature of BR was significantly (P < 0.001 increased after germination. The storage of GBR at 4 °C significantly, preserved the GABA content (∼80% for 45 days. Primarily, the current study revealed the changes in phytochemical content, and bioactivity of Thai black rice cr. Kum Payao during germination. More studies should be carried out on pharmacological benefits of GABA-rich GBR.

Cost benefit analysis for optimization of radiation protection

International Nuclear Information System (INIS)

Lindell, B.

1984-01-01

ICRP recommends three basic principles for radiation protection. One is the justification of the source. Any use of radiation should be justified with regard to its benefit. The second is the optimization of radiation protection, i.e. all radiation exposure should be kept as low as resonably achievable. And the third principle is that there should be a limit for the radiation dose that any individual receives. Cost benefit assessment or cost benefit analysis is one tool to achieve the optimization, but the optimization is not identical with cost benefit analysis. Basically, in principle, the cost benefit analysis for the optimization of radiation protection is to find the minimum sum of the cost of protection and some cost of detriment. (Mori, K.)

Achieving Energy Efficiency Through Real-Time Feedback

Energy Technology Data Exchange (ETDEWEB)

Nesse, Ronald J.

2011-09-01

Through the careful implementation of simple behavior change measures, opportunities exist to achieve strategic gains, including greater operational efficiencies, energy cost savings, greater tenant health and ensuing productivity and an improved brand value through sustainability messaging and achievement.

Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary

Directory of Open Access Journals (Sweden)

R. Kishore Kumar

2017-05-01

; (11 checking for optimal weight and sucking/swallowing ability is essential prior to discharge of preterm infants; and (12 appropriate counseling and regular follow-up and monitoring after discharge will help achieve better long-term health outcomes. This consensus summary serves as a useful guide to clinicians in addressing the challenges and providing optimal nutrition to preterm LBW infants.

Incorporating multi-leaf collimator leaf sequencing into iterative IMRT optimization

International Nuclear Information System (INIS)

Siebers, Jeffrey V.; Lauterbach, Marc; Keall, Paul J.; Mohan, Radhe

2002-01-01

Intensity modulated radiation therapy (IMRT) treatment planning typically considers beam optimization and beam delivery as separate tasks. Following optimization, a multi-leaf collimator (MLC) or other beam delivery device is used to generate fluence patterns for patient treatment delivery. Due to limitations and characteristics of the MLC, the deliverable intensity distributions often differ from those produced by the optimizer, leading to differences between the delivered and the optimized doses. Objective function parameters are then adjusted empirically, and the plan is reoptimized to achieve a desired deliverable dose distribution. The resulting plan, though usually acceptable, may not be the best achievable. A method has been developed to incorporate the MLC restrictions into the optimization process. Our in-house IMRT system has been modified to include the calculation of the deliverable intensity into the optimizer. In this process, prior to dose calculation, the MLC leaf sequencer is used to convert intensities to dynamic MLC sequences, from which the deliverable intensities are then determined. All other optimization steps remain the same. To evaluate the effectiveness of deliverable-based optimization, 17 patient cases have been studied. Compared with standard optimization plus conversion to deliverable beams, deliverable-based optimization results show improved isodose coverage and a reduced dose to critical structures. Deliverable-based optimization results are close to the original nondeliverable optimization results, suggesting that IMRT can overcome the MLC limitations by adjusting individual beamlets. The use of deliverable-based optimization may reduce the need for empirical adjustment of objective function parameters and reoptimization of a plan to achieve desired results

THE MARKETING MIX OPTIMIZATION

Directory of Open Access Journals (Sweden)

SABOU FELICIA

2014-02-01

Full Text Available ing mix a particularly important issue is to choose the best combination of its variables, this lead to the achievement objectives, in time. Choosing the right marketing mix is possible only by reporting information to some clear benchmarks, these criteria a related to the objective of the company at the time of analyze. The study shows that the companies must give a great importance to optimize the marketing mix, because of how its combines and integrates company policies relating to the product, price, distribution and promotion, depends the success or the failure on its market. The practice has shown that if an element of the marketing mix is wrong implemented, marketing strategies and programs do not achieve their objectives, and the company can not generate the expected profit. To optimize the marketing mix, companies should consider the following issues: the resources (materials, financial and human, which will be properly allocated to all the elements of the marketing mix, the specific marketing tools and the relationship of interdependence of all the methods and tools used to optimize the marketing mix.

Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

Directory of Open Access Journals (Sweden)

Abiiro Gilbert

2012-10-01

Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

Simulation-based optimization of sustainable national energy systems

International Nuclear Information System (INIS)

Batas Bjelić, Ilija; Rajaković, Nikola

2015-01-01

The goals of the EU2030 energy policy should be achieved cost-effectively by employing the optimal mix of supply and demand side technical measures, including energy efficiency, renewable energy and structural measures. In this paper, the achievement of these goals is modeled by introducing an innovative method of soft-linking of EnergyPLAN with the generic optimization program (GenOpt). This soft-link enables simulation-based optimization, guided with the chosen optimization algorithm, rather than manual adjustments of the decision vectors. In order to obtain EnergyPLAN simulations within the optimization loop of GenOpt, the decision vectors should be chosen and explained in GenOpt for scenarios created in EnergyPLAN. The result of the optimization loop is an optimal national energy master plan (as a case study, energy policy in Serbia was taken), followed with sensitivity analysis of the exogenous assumptions and with focus on the contribution of the smart electricity grid to the achievement of EU2030 goals. It is shown that the increase in the policy-induced total costs of less than 3% is not significant. This general method could be further improved and used worldwide in the optimal planning of sustainable national energy systems. - Highlights: • Innovative method of soft-linking of EnergyPLAN with GenOpt has been introduced. • Optimal national energy master plan has been developed (the case study for Serbia). • Sensitivity analysis on the exogenous world energy and emission price development outlook. • Focus on the contribution of smart energy systems to the EU2030 goals. • Innovative soft-linking methodology could be further improved and used worldwide.

Achieving health equity: from root causes to fair outcomes.

Science.gov (United States)

Marmot, Michael

2007-09-29

Health is a universal human aspiration and a basic human need. The development of society, rich or poor, can be judged by the quality of its population's health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage due to ill-health. Health equity is central to this premise and to the work of the Commission on Social Determinants of Health. Strengthening health equity--globally and within countries--means going beyond contemporary concentration on the immediate causes of disease. More than any other global health endeavour, the Commission focuses on the "causes of the causes"--the fundamental structures of social hierarchy and the socially determined conditions these create in which people grow, live, work, and age. The time for action is now, not just because better health makes economic sense, but because it is right and just. The outcry against inequity has been intensifying for many years from country to country around the world. These cries are forming a global movement. The Commission on Social Determinants of Health places action to ensure fair health at the head and the heart of that movement.

Maternal perinatal mental health and offspring academic achievement at age 16: the mediating role of childhood executive function.

Science.gov (United States)

Pearson, Rebecca M; Bornstein, Marc H; Cordero, Miguel; Scerif, Gaia; Mahedy, Liam; Evans, Jonathan; Abioye, Abu; Stein, Alan

2016-04-01

Elucidating risk pathways for under-achieving at school can inform strategies to reduce the number of adolescents leaving school without passing grades in core subjects. Maternal depression can compromise the quality of parental care and is associated with multiple negative child outcomes. However, only a few small studies have investigated the association between perinatal maternal depression and poor academic achievement in adolescence. The pathways to explain the risks are also unclear. Prospective observational data from 5,801 parents and adolescents taking part in a large UK population cohort (Avon-Longitudinal-Study-of-Parents-and-Children) were used to test associations between maternal and paternal depression and anxiety in the perinatal period, executive function (EF) at age 8, and academic achievement at the end of compulsory school at age 16. Adolescents of postnatally depressed mothers were 1.5 times (1.19, 1.94, p = .001) as likely as adolescents of nondepressed mothers to fail to achieve a 'pass' grade in math; antenatal anxiety was also an independent predictor of poor math. Disruption in different components of EF explained small but significant proportions of these associations: attentional control explained 16% (4%, 27%, p working memory explained 17% (13%, 30%, p = .003) of the association with antenatal anxiety. A similar pattern was seen for language grades, but associations were confounded by maternal education. There was no evidence that paternal factors were independently associated with impaired child EF or adolescent exams. Maternal postnatal depression and antenatal anxiety are risk factors for adolescents underachieving in math. Preventing, identifying, and treating maternal mental health in the perinatal period could, therefore, potentially increase adolescents' academic achievement. Different aspects of EF partially mediated these associations. Further work is needed, but if these pathways are causal, improving EF could reduce

Study on Feasibility of Applying Function Approximation Moment Method to Achieve Reliability-Based Design Optimization

International Nuclear Information System (INIS)

Huh, Jae Sung; Kwak, Byung Man

2011-01-01

Robust optimization or reliability-based design optimization are some of the methodologies that are employed to take into account the uncertainties of a system at the design stage. For applying such methodologies to solve industrial problems, accurate and efficient methods for estimating statistical moments and failure probability are required, and further, the results of sensitivity analysis, which is needed for searching direction during the optimization process, should also be accurate. The aim of this study is to employ the function approximation moment method into the sensitivity analysis formulation, which is expressed as an integral form, to verify the accuracy of the sensitivity results, and to solve a typical problem of reliability-based design optimization. These results are compared with those of other moment methods, and the feasibility of the function approximation moment method is verified. The sensitivity analysis formula with integral form is the efficient formulation for evaluating sensitivity because any additional function calculation is not needed provided the failure probability or statistical moments are calculated

Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

OpenAIRE

Larson, S; Chapman, S; Spetz, J; Brindis, CD

2017-01-01

Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

Optimization of Composite Material System and Lay-up to Achieve Minimum Weight Pressure Vessel

Science.gov (United States)

Mian, Haris Hameed; Wang, Gang; Dar, Uzair Ahmed; Zhang, Weihong

2013-10-01

The use of composite pressure vessels particularly in the aerospace industry is escalating rapidly because of their superiority in directional strength and colossal weight advantage. The present work elucidates the procedure to optimize the lay-up for composite pressure vessel using finite element analysis and calculate the relative weight saving compared with the reference metallic pressure vessel. The determination of proper fiber orientation and laminate thickness is very important to decrease manufacturing difficulties and increase structural efficiency. In the present work different lay-up sequences for laminates including, cross-ply [ 0 m /90 n ] s , angle-ply [ ±θ] ns , [ 90/±θ] ns and [ 0/±θ] ns , are analyzed. The lay-up sequence, orientation and laminate thickness (number of layers) are optimized for three candidate composite materials S-glass/epoxy, Kevlar/epoxy and Carbon/epoxy. Finite element analysis of composite pressure vessel is performed by using commercial finite element code ANSYS and utilizing the capabilities of ANSYS Parametric Design Language and Design Optimization module to automate the process of optimization. For verification, a code is developed in MATLAB based on classical lamination theory; incorporating Tsai-Wu failure criterion for first-ply failure (FPF). The results of the MATLAB code shows its effectiveness in theoretical prediction of first-ply failure strengths of laminated composite pressure vessels and close agreement with the FEA results. The optimization results shows that for all the composite material systems considered, the angle-ply [ ±θ] ns is the optimum lay-up. For given fixed ply thickness the total thickness of laminate is obtained resulting in factor of safety slightly higher than two. Both Carbon/epoxy and Kevlar/Epoxy resulted in approximately same laminate thickness and considerable percentage of weight saving, but S-glass/epoxy resulted in weight increment.

How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

Science.gov (United States)

Pelone, Ferruccio; Kringos, Dionne S; Spreeuwenberg, Peter; De Belvis, Antonio G; Groenewegen, Peter P

2013-09-01

To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. PC systems in 22 European countries in 2009/2010. Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.

An assessment of Makerere University College of Health Sciences: optimizing health research capacity to meet Uganda’s priorities

Directory of Open Access Journals (Sweden)

Groves Sara

2011-03-01

Full Text Available Abstract Background Health research is critical to the institutional mission of the Makerere College of Health Sciences (MakCHS. Optimizing the alignment of health research capacity at MakCHS with the health needs and priorities of Uganda, as outlined in the country’s Health Sector Strategic Plan (HSSP, is a deliberate priority, a responsibility, and a significant opportunity for research. To guide this strategic direction, an assessment of MakCHS’s research grants and publication portfolio was conducted. Methods A survey of all new and ongoing grants, as well as all publications, between January 2005 and December 2009 was conducted. Research, training, and education grants awarded to MakCHS’ constituent faculties and departments, were looked for through financial records at the college or by contact with funding organizations. Published manuscripts registered with PubMed, that included MakCHS faculty authors, were also analyzed. Results A total of 58 active grants were identified, of which 18 had been initiated prior to 2005 and there were an average of about eight new grants per year. Most grants funded basic and applied research, with major focus areas being HIV/AIDS (44%, malaria (19%, maternal and child health (14%, tuberculosis (11%, mental health (3%, and others (8%. MakCHS faculty were identified as Principal Investigators (PIs in only 22 (38% active grants. Grant funding details were only available for one third of the active grants at MakCHS. A total of 837 publications were identified, with an average of 167 publications per year, most of which (66% addressed the country’s priority health areas, and 58% had MakCHS faculty or students as first authors. Conclusions The research grants and publications at MakCHS are generally well-aligned with the Ugandan Health Ministry priorities. Greater efforts to establish centralized and efficient grants management procedures are needed. In addition, greater efforts are needed to expand

Health in All (Foreign) Policy: challenges in achieving coherence.

Science.gov (United States)

Labonté, Ronald

2014-06-01

Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Enhanced recovery pathways optimize health outcomes and resource utilization: A meta-analysis of randomized controlled trials in colorectal surgery

DEFF Research Database (Denmark)

Adamina, Michel; Kehlet, Henrik; Tomlinson, George A

2011-01-01

in costs that threatens the stability of health care systems. Enhanced recovery pathways (ERP) have been proposed as a means to reduce morbidity and improve effectiveness of care. We have reviewed the evidence supporting the implementation of ERP in clinical practice. Methods Medline, Embase...... of health care processes. Thus, while accelerating recovery and safely reducing hospital stay, ERPs optimize utilization of health care resources. ERPs can and should be routinely used in care after colorectal and other major gastrointestinal procedures....

The population-level impacts of a national health insurance program and franchise midwife clinics on achievement of prenatal and delivery care standards in the Philippines.

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Kozhimannil, Katy Backes; Valera, Madeleine R; Adams, Alyce S; Ross-Degnan, Dennis

2009-09-01

Adequate prenatal and delivery care are vital components of successful maternal health care provision. Starting in 1998, two programs were widely expanded in the Philippines: a national health insurance program (PhilHealth); and a donor-funded franchise of midwife clinics (Well Family Midwife Clinics). This paper examines population-level impacts of these interventions on achievement of minimum standards for prenatal and delivery care. Data from two waves of the Demographic and Health Surveys, conducted before (1998) and after (2003) scale-up of the interventions, are employed in a pre/post-study design, using longitudinal multivariate logistic and linear regression models. After controlling for demographic and socioeconomic characteristics, the PhilHealth insurance program scale-up was associated with increased odds of receiving at least four prenatal visits (OR 1.04 [95% CI 1.01-1.06]) and receiving a visit during the first trimester of pregnancy (OR 1.03 [95% CI 1.01-1.06]). Exposure to midwife clinics was not associated with significant changes in achievement of prenatal care standards. While both programs were associated with slight increases in the odds of delivery in a health facility, these increases were not statistically significant. These results suggest that expansion of an insurance program with accreditation standards was associated with increases in achievement of minimal standards for prenatal care among women in the Philippines.

The population-level impacts of a national health insurance program and franchise midwife clinics on achievement of prenatal and delivery care standards in the Philippines

Science.gov (United States)

Kozhimannil, Katy Backes; Valera, Madeleine R.; Adams, Alyce S.; Ross-Degnan, Dennis

2009-01-01

Objectives Adequate prenatal and delivery care are vital components of successful maternal health care provision. Starting in 1998, two programs were widely expanded in the Philippines: a national health insurance program (PhilHealth); and a donor-funded franchise of midwife clinics (Well-Family Midwife Clinics). This paper examines population-level impacts of these interventions on achievement of minimum standards for prenatal and delivery care. Methods Data from two waves of the Demographic and Health Surveys, conducted before (1998) and after (2003) scale up of the interventions, are employed in a pre/post study design, using longitudinal multivariate logistic and linear regression models. Results After controlling for demographic and socioeconomic characteristics, the PhilHealth insurance program scale up was associated with increased odds of receiving at least four prenatal visits (OR 1.04 [95% CI 1.01–1.06]) and receiving a visit during the first trimester of pregnancy (OR 1.03 [95% CI 1.01–1.06]). Exposure to midwife clinics was not associated with significant changes in achievement of prenatal care standards. While both programs were associated with slight increases in the odds of delivery in a health facility, these increases were not statistically significant. Conclusions These results suggest that expansion of an insurance program with accreditation standards was associated with increases in achievement of minimal standards for prenatal care among women in the Philippines. PMID:19327862

How elimination of lymphatic filariasis as a public health problem in the Kingdom of Cambodia was achieved.

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Khieu, Virak; Or, Vandine; Tep, Chhakda; Odermatt, Peter; Tsuyuoka, Reiko; Char, Meng Chuor; Brady, Molly A; Sidwell, Joshua; Yajima, Aya; Huy, Rekol; Ramaiah, Kapa D; Muth, Sinuon

2018-02-20

Endemicity of lymphatic filariasis (LF) in Cambodia was proven in 1956 when microfilariae were detected in mosquitos in the Kratié province. In 2001, an extensive study confirmed the presence of both Brugia malayi and Wuchereria bancrofti microfilariae. In 2003, the Ministry of Health established a national task force to develop policies and strategies for controlling and eliminating neglected tropical diseases (NTDs), with the goal of eliminating LF by 2015. This article summarizes the work accomplished to eliminate LF as a public health problem in Cambodia. The National Program to Eliminate Lymphatic Filariasis made excellent progress in the goal towards elimination due to strong collaboration between ministries, intensive supervision by national staff, and advocacy for mobilization of internal and external resources. Mass drug administration (MDA) with diethylcarbamazine citrate and albendazole was conducted in six implementation units, achieving > 70% epidemiological coverage for five consecutive rounds, from 2005 to 2009. In 2006, in 14 provinces, healthcare workers developed a line list of lymphedema and hydrocele patients, many of whom were > 40 years old and had been affected by LF for many years. The national program also trained healthcare workers and provincial and district staff in morbidity management and disability prevention, and designated health centers to provide care for lymphedema and acute attack. Two reference hospitals were designated to administer hydrocele surgery. Effectiveness of MDA was proven with transmission assessment surveys. These found that less than 1% of school children had antigenemia in 2010, which fell to 0% in both 2013 and 2015. A separate survey in one province in 2015 using Brugia Rapid tests to test for LF antibody found one child positive among 1677 children. The list of chronic LF patients was most recently updated and confirmed in 2011-2012, with 32 lymphoedema patients and 17 hydrocele patients listed. All

A school-based interdisciplinary approach to promote health and academic achievement among children in a deprived neighborhood: study protocol for a mixed-methods evaluation.

Science.gov (United States)

Abrahamse, Mariëlle E; Jonkman, Caroline S; Harting, Janneke

2018-04-10

The large number of children that grow up in poverty is concerning, especially given the negative developmental outcomes that can persist into adulthood. Poverty has been found as a risk factor to negatively affect academic achievement and health outcomes in children. Interdisciplinary interventions can be an effective way to promote health and academic achievement. The present study aims to evaluate a school-based interdisciplinary approach on child health, poverty, and academic achievement using a mixed-method design. Generally taken, outcomes of this study increase the knowledge about effective ways to give disadvantaged children equal chances early in their lives. An observational study with a mixed-methods design including both quantitative and qualitative data collection methods will be used to evaluate the interdisciplinary approach. The overall research project exists of three study parts including a longitudinal study, a cross-sectional study, and a process evaluation. Using a multi-source approach we will assess child health as the primary outcome. Child poverty and child academic achievement will be assessed as secondary outcomes. The process evaluation will observe the program's effects on the school environment and the program's implementation in order to obtain more knowledge on how to disseminate the interdisciplinary approach to other schools and neighborhoods. The implementation of a school-based interdisciplinary approach via primary schools combining the cross-sectoral domains health, poverty, and academic achievement is innovative and a step forward to reach an ethnic minority population. However, the large variety of the interventions and activities within the approach can limit the validity of the study. Including a process evaluation will therefore help to improve the interpretation of our findings. In order to contribute to policy and practice focusing on decreasing the unequal chances of children growing up in deprived neighborhoods, it is

Animal Production and Health Newsletter, No. 63, January 2016

International Nuclear Information System (INIS)

2016-01-01

This past year went particularly fast with many unexpected and emergency food security challenges and it was indeed an asking period for the Animal Production and Health Subprogramme. We have some remarkable achievements but also some gaps, such as improved communication and collaboration, where we need to improve our support to Member States. Both past and future activities are described in detail in this newsletter. The Animal Production and Health Subprogramme will continue to move progressively forward and in pace with developments within the livestock field to optimally serve our Member States

The air quality and health co-benefits of alternative post-2020 pathways for achieving peak carbon targets in Jiangsu, China

Science.gov (United States)

Liu, M.; Bi, J.; Huang, Y.; Kinney, P. L.

2016-12-01

Jiangsu, which has three national low-carbon pilot cities, is set to be a model province in China for achieving peak carbon targets before 2030. However, according to local planning of responding to climate change, carbon emissions are projected to keep going up before 2020 even the strictest measures are implemented. In other words, innovative measures must be in action after 2020. This work aimed at assessing the air quality and health co-benefits of alternative post-2020 measures to help remove barriers of policy implementation through tying it to local incentives for air quality improvement. To achieve the aim, we select 2010 as baseline year and develop Bussiness As Usual (BAU) and Traditional Carbon Reduction (TCR) scenarios before 2020. Under BAU, only existing climate and air pollution control policies are considered; under TCR, potential climate policies in local planning and existing air pollution control policies are considered. After 2020, integrated gasification combined cycle (IGCC) plant with carbon capture and storage (CCS) technology and large-scale substitution of renewable energy seem to be two promising pathways for achieving peak carbon targets. Therefore, two additional scenarios (TCR-IGCC and TCR-SRE) are set after 2020. Based on the projections of future energy balances and industrial productions, we estimate the pollutant emissions and simulate PM2.5 and ozone concentrations by 2017, 2020, 2030 and 2050 using CMAQ. Then using health impact assessment approach, the premature deaths are estimated and monetized. Results show that the carbon peak in Jiangsu will be achieved before 2030 only under TCR-IGCC and TCR-SRE scenarios. Under three policy scenarios, Jiangsu's carbon emission control targets would have substantial effects on primary air pollutant emissions far beyond those we estimate would be needed to meet the PM2.5 concentration targets in 2017. Compared with IGCC with CCS, large-scale substitutions of renewable energy bring

Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

Science.gov (United States)

Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.

2017-01-01

Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…

Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

Science.gov (United States)

Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

2016-09-01

In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning

Optimal correction and design parameter search by modern methods of rigorous global optimization

International Nuclear Information System (INIS)

Makino, K.; Berz, M.

2011-01-01

Frequently the design of schemes for correction of aberrations or the determination of possible operating ranges for beamlines and cells in synchrotrons exhibit multitudes of possibilities for their correction, usually appearing in disconnected regions of parameter space which cannot be directly qualified by analytical means. In such cases, frequently an abundance of optimization runs are carried out, each of which determines a local minimum depending on the specific chosen initial conditions. Practical solutions are then obtained through an often extended interplay of experienced manual adjustment of certain suitable parameters and local searches by varying other parameters. However, in a formal sense this problem can be viewed as a global optimization problem, i.e. the determination of all solutions within a certain range of parameters that lead to a specific optimum. For example, it may be of interest to find all possible settings of multiple quadrupoles that can achieve imaging; or to find ahead of time all possible settings that achieve a particular tune; or to find all possible manners to adjust nonlinear parameters to achieve correction of high order aberrations. These tasks can easily be phrased in terms of such an optimization problem; but while mathematically this formulation is often straightforward, it has been common belief that it is of limited practical value since the resulting optimization problem cannot usually be solved. However, recent significant advances in modern methods of rigorous global optimization make these methods feasible for optics design for the first time. The key ideas of the method lie in an interplay of rigorous local underestimators of the objective functions, and by using the underestimators to rigorously iteratively eliminate regions that lie above already known upper bounds of the minima, in what is commonly known as a branch-and-bound approach. Recent enhancements of the Differential Algebraic methods used in particle

Medical libraries and achieving sustainable development goals in ...

African Journals Online (AJOL)

Medical libraries and achieving sustainable development goals in Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... United Nations 2015 Sustainable Development Goal 3 is designed to achieve good health and well - being for ...

Achieving the optimal performance of the CMS ECAL in Run II

CERN Document Server

Sun, Menglei

2016-01-01

Many physics analyses using the Compact Muon Solenoid (CMS) detector at the LHC require accurate, high resolution electron and photon energy measurements. Particularly important are decays of the Higgs boson resulting in electromagnetic particles in the final state. Di-photon events in CMS are also a very important channel in the search for Higgs boson production in association with other particles or in the search for possible new resonances of higher mass. The requirement for high performance electromagnetic calorimetry therefore remains high during LHC Run II. Following the excellent performance achieved in Run~I at a center of mass energy of 7 and 8 TeV, the CMS electromagnetic calorimeter (ECAL) started operating at the LHC in Spring 2015 with proton-proton collisions at 13 TeV center-of-mass energy. The instantaneous luminosity delivered by the LHC during Run~II is expected to exceed the levels achieved in Run I, using 25 ns bunch spacing. The average number of concurrent proton-proton collisions per bu...

Video game-based exercise, Latino children's physical health, and academic achievement.

Science.gov (United States)

Gao, Zan; Hannan, Peter; Xiang, Ping; Stodden, David F; Valdez, Verónica E

2013-03-01

There is a paucity of research investigating the effects of innovative physical activity programs on physical health and academic performance in the Latino population. To examine the impact of Dance Dance Revolution [DDR]-based exercise on Latino children's physical fitness and academic achievement. A repeated-measures crossover design was used. In Year 1, Grade-4 students were assigned to the intervention group and offered 30 minutes of exercise (DDR, aerobic dance) three times per week. Grade-3 and Grade-5 students made up the comparison group and were offered no structured exercise at school. In Year 2, the Grade-4 students were again assigned to the intervention, whereas Grade-5 and Grade-6 students were in the comparison group. Assessments were conducted with 208 Latino school children. The baseline measures included time to complete a 1-mile run, BMI, and reading and math scores. Data were collected again 9 months later. Overall, data were collected in 2009-2011 and analyzed in 2012. Data yielded significant differences between the intervention and comparison groups in differences in 1-mile run and math scores in Year 1 and Year 2. The results also revealed net differences in the intervention versus comparison group scores on the 1-mile run for Grade 3 (p<0.01). Additionally, children's yearly pre-test and post-test BMI group changes differed (χ(2)((2)) = 6.6, p<0.05) only for the first year of intervention. The DDR-based exercise intervention improved children's cardiorespiratory endurance and math scores over time. Professionals should consider integrating exergaming at schools to achieve the goals of promoting a physically active lifestyle and enhancing academic success among Latino children. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Optimal Control Design for a Solar Greenhouse

NARCIS (Netherlands)

Ooteghem, van R.J.C.

2010-01-01

Abstract: An optimal climate control has been designed for a solar greenhouse to achieve optimal crop production with sustainable instead of fossil energy. The solar greenhouse extends a conventional greenhouse with an improved roof cover, ventilation with heat recovery, a heat pump, a heat

Topology optimization for coated structures

DEFF Research Database (Denmark)

Clausen, Anders; Andreassen, Erik; Sigmund, Ole

2015-01-01

This paper presents new results within the design of three-dimensional (3D) coated structures using topology optimization.The work is an extension of a recently published two-dimensional (2D) method for including coatedstructures into the minimum compliance topology optimization problem. The high...... level of control over key parameters demonstrated for the 2D model can likewise be achieved in 3D. The effectiveness of the approach isdemonstrated with numerical examples, which for the 3D problems have been solved using a parallel topology optimization implementation based on the PETSc toolkit....

Health care financing in Nigeria: Implications for achieving universal ...

African Journals Online (AJOL)

The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms.

Optimization of finances into regional energy

Directory of Open Access Journals (Sweden)

Alexey Yuryevich Domnikov

2014-06-01

Full Text Available The development of modern Russian energy collides with the need for major investments in the modernization and renewal of generation and transmission capacity. In terms of attracting sufficient financial resources and find ways to increase, energy sector profitability and investment attractiveness of particular importance is the problem of investment financing optimizing aimed at minimizing the cost of financing while maintaining financial stability of the power companies and the goals and objectives of Russian energy system long-term development. The article discusses the problem of investment projects financing in power generation from the point of view of the need to achieve optimal investment budget. Presents the author’s approach to the investment financing optimization of power generation company that will achieve the minimum cost of resources involved, taking into account the impact of the funding structure for the power generating company financial sustainability. The developed model is applied to the problem of investment budget optimizing, for example, regional power generating company. The results can improve the efficiency of investment in energy, sustainable and competitive development of regional energy systems.

The Perceptions of Principals and Teachers Regarding Mental Health Providers' Impact on Student Achievement in High Poverty Schools

Science.gov (United States)

Perry, Teresa

2012-01-01

This study examined the perceptions of principals and teachers regarding mental health provider's impact on student achievement and behavior in high poverty schools using descriptive statistics, t-test, and two-way ANOVA. Respondents in this study shared similar views concerning principal and teacher satisfaction and levels of support for the…

Improving scanner wafer alignment performance by target optimization

Science.gov (United States)

Leray, Philippe; Jehoul, Christiane; Socha, Robert; Menchtchikov, Boris; Raghunathan, Sudhar; Kent, Eric; Schoonewelle, Hielke; Tinnemans, Patrick; Tuffy, Paul; Belen, Jun; Wise, Rich

2016-03-01

In the process nodes of 10nm and below, the patterning complexity along with the processing and materials required has resulted in a need to optimize alignment targets in order to achieve the required precision, accuracy and throughput performance. Recent industry publications on the metrology target optimization process have shown a move from the expensive and time consuming empirical methodologies, towards a faster computational approach. ASML's Design for Control (D4C) application, which is currently used to optimize YieldStar diffraction based overlay (DBO) metrology targets, has been extended to support the optimization of scanner wafer alignment targets. This allows the necessary process information and design methodology, used for DBO target designs, to be leveraged for the optimization of alignment targets. In this paper, we show how we applied this computational approach to wafer alignment target design. We verify the correlation between predictions and measurements for the key alignment performance metrics and finally show the potential alignment and overlay performance improvements that an optimized alignment target could achieve.

Radiological optimization

International Nuclear Information System (INIS)

Zeevaert, T.

1998-01-01

Radiological optimization is one of the basic principles in each radiation-protection system and it is a basic requirement in the safety standards for radiation protection in the European Communities. The objectives of the research, performed in this field at the Belgian Nuclear Research Centre SCK-CEN, are: (1) to implement the ALARA principles in activities with radiological consequences; (2) to develop methodologies for optimization techniques in decision-aiding; (3) to optimize radiological assessment models by validation and intercomparison; (4) to improve methods to assess in real time the radiological hazards in the environment in case of an accident; (5) to develop methods and programmes to assist decision-makers during a nuclear emergency; (6) to support the policy of radioactive waste management authorities in the field of radiation protection; (7) to investigate existing software programmes in the domain of multi criteria analysis. The main achievements for 1997 are given

Power Link Optimization for a Neurostimulator in Nasal Cavity

Directory of Open Access Journals (Sweden)

Seunghyun Lee

2017-01-01

Full Text Available This paper examines system optimization for wirelessly powering a small implant embedded in tissue. For a given small receiver in a multilayer tissue model, the transmitter is abstracted as a sheet of tangential current density for which the optimal distribution is analytically found. This proposes a new design methodology for wireless power transfer systems. That is, from the optimal current distribution, the maximum achievable efficiency is derived first. Next, various design parameters are determined to achieve the target efficiency. Based on this design methodology, a centimeter-sized neurostimulator inside the nasal cavity is demonstrated. For this centimeter-sized implant, the optimal distribution resembles that of a coil source and the optimal frequency is around 15 MHz. While the existing solution showed an efficiency of about 0.3 percent, the proposed system could enhance the efficiency fivefold.

Health education and marketing processes: 2 related methods for achieving health behavior change.

Science.gov (United States)

Stellefson, Michael; Eddy, James M

2008-01-01

To make salient the striking similarities between the program planning processes used in both health education and contemporary marketing. Through a discussion of the analogous nature of both processes and a review of the literature, the authors (1) illustrate why marketing principles should be embraced and (2) suggest how marketing strategies can be integrated into health education needs assessments. Core health-marketing concepts are proposed along with 4 recommendations for future marketing activities in health education. To facilitate an advance in health education process and practice, scholars and practitioners should adopt a more consumer-centered, marketing mind-set.

A Simulation Modeling Framework to Optimize Programs Using Financial Incentives to Motivate Health Behavior Change.

Science.gov (United States)

Basu, Sanjay; Kiernan, Michaela

2016-01-01

While increasingly popular among mid- to large-size employers, using financial incentives to induce health behavior change among employees has been controversial, in part due to poor quality and generalizability of studies to date. Thus, fundamental questions have been left unanswered: To generate positive economic returns on investment, what level of incentive should be offered for any given type of incentive program and among which employees? We constructed a novel modeling framework that systematically identifies how to optimize marginal return on investment from programs incentivizing behavior change by integrating commonly collected data on health behaviors and associated costs. We integrated "demand curves" capturing individual differences in response to any given incentive with employee demographic and risk factor data. We also estimated the degree of self-selection that could be tolerated: that is, the maximum percentage of already-healthy employees who could enroll in a wellness program while still maintaining positive absolute return on investment. In a demonstration analysis, the modeling framework was applied to data from 3000 worksite physical activity programs across the nation. For physical activity programs, the incentive levels that would optimize marginal return on investment ($367/employee/year) were higher than average incentive levels currently offered ($143/employee/year). Yet a high degree of self-selection could undermine the economic benefits of the program; if more than 17% of participants came from the top 10% of the physical activity distribution, the cost of the program would be expected to always be greater than its benefits. Our generalizable framework integrates individual differences in behavior and risk to systematically estimate the incentive level that optimizes marginal return on investment. © The Author(s) 2015.

Ethnic identity and mental health in American Indian youth: examining mediation pathways through self-esteem, and future optimism.

Science.gov (United States)

Smokowski, Paul R; Evans, Caroline B R; Cotter, Katie L; Webber, Kristina C

2014-03-01

Mental health functioning in American Indian youth is an understudied topic. Given the increased rates of depression and anxiety in this population, further research is needed. Using multiple group structural equation modeling, the current study illuminates the effect of ethnic identity on anxiety symptoms, depressive symptoms, and externalizing behavior in a group of Lumbee adolescents and a group of Caucasian, African American, and Latino/Hispanic adolescents. This study examined two possible pathways (i.e., future optimism and self-esteem) through which ethnic identity is associated with adolescent mental health. The sample (N = 4,714) is 28.53% American Indian (Lumbee) and 51.38% female. The study findings indicate that self-esteem significantly mediated the relationships between ethnic identity and anxiety symptoms, depressive symptoms, and externalizing behavior for all racial/ethnic groups (i.e., the total sample). Future optimism significantly mediated the relationship between ethnic identity and externalizing behavior for all racial/ethnic groups and was a significant mediator between ethnic identity and depressive symptoms for American Indian youth only. Fostering ethnic identity in all youth serves to enhance mental health functioning, but is especially important for American Indian youth due to the collective nature of their culture.

RF Gun Optimization Study

International Nuclear Information System (INIS)

Alicia Hofler; Pavel Evtushenko

2007-01-01

Injector gun design is an iterative process where the designer optimizes a few nonlinearly interdependent beam parameters to achieve the required beam quality for a particle accelerator. Few tools exist to automate the optimization process and thoroughly explore the parameter space. The challenging beam requirements of new accelerator applications such as light sources and electron cooling devices drive the development of RF and SRF photo injectors. A genetic algorithm (GA) has been successfully used to optimize DC photo injector designs at Cornell University [1] and Jefferson Lab [2]. We propose to apply GA techniques to the design of RF and SRF gun injectors. In this paper, we report on the initial phase of the study where we model and optimize a system that has been benchmarked with beam measurements and simulation

Population health management as a strategy for creation of optimal healing environments in worksite and corporate settings.

Science.gov (United States)

Chapman, Larry S; Pelletier, Kenneth R

2004-01-01

This paper provides an (OHE) overview of a population health management (PHM) approach to the creation of optimal healing environments (OHEs) in worksite and corporate settings. It presents a framework for consideration as the context for potential research projects to examine the health, well-being, and economic effects of a set of newer "virtual" prevention interventions operating in an integrated manner in worksite settings. The main topics discussed are the fundamentals of PHM with basic terminology and core principles, a description of PHM core technology and implications of a PHM approach to creating OHEs.

VMAT optimization with dynamic collimator rotation.

Science.gov (United States)

Lyu, Qihui; O'Connor, Daniel; Ruan, Dan; Yu, Victoria; Nguyen, Dan; Sheng, Ke

2018-04-16

Although collimator rotation is an optimization variable that can be exploited for dosimetric advantages, existing Volumetric Modulated Arc Therapy (VMAT) optimization uses a fixed collimator angle in each arc and only rotates the collimator between arcs. In this study, we develop a novel integrated optimization method for VMAT, accounting for dynamic collimator angles during the arc motion. Direct Aperture Optimization (DAO) for Dynamic Collimator in VMAT (DC-VMAT) was achieved by adding to the existing dose fidelity objective an anisotropic total variation term for regulating the fluence smoothness, a binary variable for forming simple apertures, and a group sparsity term for controlling collimator rotation. The optimal collimator angle for each beam angle was selected using the Dijkstra's algorithm, where the node costs depend on the estimated fluence map at the current iteration and the edge costs account for the mechanical constraints of multi-leaf collimator (MLC). An alternating optimization strategy was implemented to solve the DAO and collimator angle selection (CAS). Feasibility of DC-VMAT using one full-arc with dynamic collimator rotation was tested on a phantom with two small spherical targets, a brain, a lung and a prostate cancer patient. The plan was compared against a static collimator VMAT (SC-VMAT) plan using three full arcs with 60 degrees of collimator angle separation in patient studies. With the same target coverage, DC-VMAT achieved 20.3% reduction of R50 in the phantom study, and reduced the average max and mean OAR dose by 4.49% and 2.53% of the prescription dose in patient studies, as compared with SC-VMAT. The collimator rotation co-ordinated with the gantry rotation in DC-VMAT plans for deliverability. There were 13 beam angles in the single-arc DC-VMAT plan in patient studies that requires slower gantry rotation to accommodate multiple collimator angles. The novel DC-VMAT approach utilizes the dynamic collimator rotation during arc

Optimal control of complex atomic quantum systems.

Science.gov (United States)

van Frank, S; Bonneau, M; Schmiedmayer, J; Hild, S; Gross, C; Cheneau, M; Bloch, I; Pichler, T; Negretti, A; Calarco, T; Montangero, S

2016-10-11

Quantum technologies will ultimately require manipulating many-body quantum systems with high precision. Cold atom experiments represent a stepping stone in that direction: a high degree of control has been achieved on systems of increasing complexity. However, this control is still sub-optimal. In many scenarios, achieving a fast transformation is crucial to fight against decoherence and imperfection effects. Optimal control theory is believed to be the ideal candidate to bridge the gap between early stage proof-of-principle demonstrations and experimental protocols suitable for practical applications. Indeed, it can engineer protocols at the quantum speed limit - the fastest achievable timescale of the transformation. Here, we demonstrate such potential by computing theoretically and verifying experimentally the optimal transformations in two very different interacting systems: the coherent manipulation of motional states of an atomic Bose-Einstein condensate and the crossing of a quantum phase transition in small systems of cold atoms in optical lattices. We also show that such processes are robust with respect to perturbations, including temperature and atom number fluctuations.

Taking It to the Top: A Lesson in Search Engine Optimization

Science.gov (United States)

Frydenberg, Mark; Miko, John S.

2011-01-01

Search engine optimization (SEO), the promoting of a Web site so it achieves optimal position with a search engine's rankings, is an important strategy for organizations and individuals in order to promote their brands online. Techniques for achieving SEO are relevant to students of marketing, computing, media arts, and other disciplines, and many…

Incorporating C60 as Nucleation Sites Optimizing PbI2 Films To Achieve Perovskite Solar Cells Showing Excellent Efficiency and Stability via Vapor-Assisted Deposition Method.

Science.gov (United States)

Chen, Hai-Bin; Ding, Xi-Hong; Pan, Xu; Hayat, Tasawar; Alsaedi, Ahmed; Ding, Yong; Dai, Song-Yuan

2018-01-24

To achieve high-quality perovskite solar cells (PSCs), the morphology and carrier transportation of perovskite films need to be optimized. Herein, C 60 is employed as nucleation sites in PbI 2 precursor solution to optimize the morphology of perovskite films via vapor-assisted deposition process. Accompanying the homogeneous nucleation of PbI 2 , the incorporation of C 60 as heterogeneous nucleation sites can lower the nucleation free energy of PbI 2 , which facilitates the diffusion and reaction between PbI 2 and organic source. Meanwhile, C 60 could enhance carrier transportation and reduce charge recombination in the perovskite layer due to its high electron mobility and conductivity. In addition, the grain sizes of perovskite get larger with C 60 optimizing, which can reduce the grain boundaries and voids in perovskite and prevent the corrosion because of moisture. As a result, we obtain PSCs with a power conversion efficiency (PCE) of 18.33% and excellent stability. The PCEs of unsealed devices drop less than 10% in a dehumidification cabinet after 100 days and remain at 75% of the initial PCE during exposure to ambient air (humidity > 60% RH, temperature > 30 °C) for 30 days.

Using Nuclear Techniques to Assess Breastfeeding Practices for Better Nutrition and Health

International Nuclear Information System (INIS)

Dixit, Aabha

2016-01-01

Appropriate feeding practices in the early months and years of life are important to achieve optimal growth, development and health. Awareness of the important role that breastfeeding plays in preventing malnutrition needs to be increased. The IAEA is supporting Member States in using stable isotope techniques to evaluate activities to improve infant and young child feeding practices.

Action on diabetic macular oedema: achieving optimal patient management in treating visual impairment due to diabetic eye disease.

Science.gov (United States)

Gale, R; Scanlon, P H; Evans, M; Ghanchi, F; Yang, Y; Silvestri, G; Freeman, M; Maisey, A; Napier, J

2017-05-01

This paper identifies best practice recommendations for managing diabetes and sight-threatening diabetic eye disease. The authors provide an update for ophthalmologists and allied healthcare professionals on key aspects of diabetes management, supported by a review of the pertinent literature, and recommend practice principles for optimal patient management in treating visual impairment due to diabetic eye disease. In people with diabetes, early optimal glycaemic control reduces the long-term risk of both microvascular and macrovascular complications. The authors propose more can and should be done to maximise metabolic control, promote appropriate behavioural modifications and encourage timely treatment intensification when indicated to ameliorate diabetes-related complications. All people with diabetes should be screened for sight-threatening diabetic retinopathy promptly and regularly. It is shown that attitudes towards treatment adherence in diabetic macular oedema appear to mirror patients' views and health behaviours towards the management of their own diabetes. Awareness of diabetic macular oedema remains low among people with diabetes, who need access to education early in their disease about how to manage their diabetes to delay progression and possibly avoid eye-related complications. Ophthalmologists and allied healthcare professionals play a vital role in multidisciplinary diabetes management and establishment of dedicated diabetic macular oedema clinics is proposed. A broader understanding of the role of the diabetes specialist nurse may strengthen the case for comprehensive integrated care in ophthalmic practice. The recommendations are based on round table presentations and discussions held in London, UK, September 2016.

Transportation package design using numerical optimization

International Nuclear Information System (INIS)

Harding, D.C.; Witkowski, W.R.

1991-01-01

The purpose of this overview is twofold: first, to outline the theory and basic elements of numerical optimization; and second, to show how numerical optimization can be applied to the transportation packaging industry and used to increase efficiency and safety of radioactive and hazardous material transportation packages. A more extensive review of numerical optimization and its applications to radioactive material transportation package design was performed previously by the authors (Witkowski and Harding 1992). A proof-of-concept Type B package design is also presented as a simplified example of potential improvements achievable using numerical optimization in the design process

Completing advance directives for health care decisions: getting to yes.

Science.gov (United States)

Shewchuk, T R

1998-09-01

The concept of advance directives for health care decision making has been judicially condoned, legislatively promoted, and systematically implemented by health care institutions, yet the execution rate of advance directives remains low. Physicians should discuss with their patients advance care planning generally and end-of-life issues specifically, preferably when patients are in good health and not when they face an acute medical crisis. The physician-hospital relationship poses particular challenges for the optimal implementation of advance directives that must be addressed. Hospital administrators must improve education of patients and physicians on the value of such documents as well as internal mechanisms to ensure better implementation of directives. Health insurance plans may be better able to ensure optimal gathering and implementation of directives. Patients must become more familiar and more comfortable with advance care planning and the reality of death and dying issues. Full acceptance of the value of directives ultimately rests on achieving full participation of all involved--providers, patients, families, and payors--in this most profound process.

Wind Turbine Optimization with WISDEM

Energy Technology Data Exchange (ETDEWEB)

Dykes, Katherine L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Damiani, Rick R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Graf, Peter A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Scott, George N [National Renewable Energy Laboratory (NREL), Golden, CO (United States); King, Ryan N [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Guo, Yi [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Quick, Julian [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sethuraman, Latha [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Veers, Paul S [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Ning, Andrew [Brigham Young University

2018-01-03

This presentation for the Fourth Wind Energy Systems Engineering Workshop explains the NREL wind energy systems engineering initiative-developed analysis platform and research capability to capture important system interactions to achieve a better understanding of how to improve system-level performance and achieve system-level cost reductions. Topics include Wind-Plant Integrated System Design and Engineering Model (WISDEM) and multidisciplinary design analysis and optimization.

High school students with asthma: attitudes about school health, absenteeism, and its impact on academic achievement.

Science.gov (United States)

Krenitsky-Korn, Susan

2011-01-01

Asthma is the most frequent reason for absence from school; it accounts for one-third of all days of missed instruction, placing students at risk for academic failure and social isolation. This study compared high school students with asthma with those without asthma, and examined the relationship of their attitudes toward school health services, absenteeism, academic achievement, and the supposition that school nurse services play an essential part in the academic process. Surveys were completed by all students who participated in the study. Twenty-eight students with asthma reported levels of illness and school nurse support in an additional survey. Data revealed that students with asthma were absent more frequently, scored lower in mathematics, and participated less in school activities than their peers without asthma. Their level of illness did not predict the number of days absent, which was negatively correlated with achievement and positively correlated with students' permissive attitudes toward absenteeism. Findings indicate that school nurse interventions were sources of physical, social, emotional, and academic support.

Worksite health and wellness programs: Canadian achievements & prospects.

Science.gov (United States)

Després, Jean-Pierre; Alméras, Natalie; Gauvin, Lise

2014-01-01

Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area. Copyright © 2014 Elsevier Inc. All rights reserved.

Risk modelling in portfolio optimization

Science.gov (United States)

Lam, W. H.; Jaaman, Saiful Hafizah Hj.; Isa, Zaidi

2013-09-01

Risk management is very important in portfolio optimization. The mean-variance model has been used in portfolio optimization to minimize the investment risk. The objective of the mean-variance model is to minimize the portfolio risk and achieve the target rate of return. Variance is used as risk measure in the mean-variance model. The purpose of this study is to compare the portfolio composition as well as performance between the optimal portfolio of mean-variance model and equally weighted portfolio. Equally weighted portfolio means the proportions that are invested in each asset are equal. The results show that the portfolio composition of the mean-variance optimal portfolio and equally weighted portfolio are different. Besides that, the mean-variance optimal portfolio gives better performance because it gives higher performance ratio than the equally weighted portfolio.

Nutritionally Optimized, Culturally Acceptable, Cost-Minimized Diets for Low Income Ghanaian Families Using Linear Programming.

Science.gov (United States)

Nykänen, Esa-Pekka A; Dunning, Hanna E; Aryeetey, Richmond N O; Robertson, Aileen; Parlesak, Alexandr

2018-04-07

The Ghanaian population suffers from a double burden of malnutrition. Cost of food is considered a barrier to achieving a health-promoting diet. Food prices were collected in major cities and in rural areas in southern Ghana. Linear programming (LP) was used to calculate nutritionally optimized diets (food baskets (FBs)) for a low-income Ghanaian family of four that fulfilled energy and nutrient recommendations in both rural and urban settings. Calculations included implementing cultural acceptability for families living in extreme and moderate poverty (food budget under USD 1.9 and 3.1 per day respectively). Energy-appropriate FBs minimized for cost, following Food Balance Sheets (FBS), lacked key micronutrients such as iodine, vitamin B12 and iron for the mothers. Nutritionally adequate FBs were achieved in all settings when optimizing for a diet cheaper than USD 3.1. However, when delimiting cost to USD 1.9 in rural areas, wild foods had to be included in order to meet nutritional adequacy. Optimization suggested to reduce roots, tubers and fruits and to increase cereals, vegetables and oil-bearing crops compared with FBS. LP is a useful tool to design culturally acceptable diets at minimum cost for low-income Ghanaian families to help advise national authorities how to overcome the double burden of malnutrition.

Multiobjective optimal placement of switches and protective devices in electric power distribution systems using ant colony optimization

Energy Technology Data Exchange (ETDEWEB)

Tippachon, Wiwat; Rerkpreedapong, Dulpichet [Department of Electrical Engineering, Kasetsart University, 50 Phaholyothin Rd., Ladyao, Jatujak, Bangkok 10900 (Thailand)

2009-07-15

This paper presents a multiobjective optimization methodology to optimally place switches and protective devices in electric power distribution networks. Identifying the type and location of them is a combinatorial optimization problem described by a nonlinear and nondifferential function. The multiobjective ant colony optimization (MACO) has been applied to this problem to minimize the total cost while simultaneously minimize two distribution network reliability indices including system average interruption frequency index (SAIFI) and system interruption duration index (SAIDI). Actual distribution feeders are used in the tests, and test results have shown that the algorithm can determine the set of optimal nondominated solutions. It allows the utility to obtain the optimal type and location of devices to achieve the best system reliability with the lowest cost. (author)

Optimizing desalinated sea water blending with other sources to meet magnesium requirements for potable and irrigation waters.

Science.gov (United States)

Avni, Noa; Eben-Chaime, Moshe; Oron, Gideon

2013-05-01

Sea water desalination provides fresh water that typically lacks minerals essential to human health and to agricultural productivity. Thus the rising proportion of desalinated sea water consumed by both the domestic and agricultural sectors constitutes a public health risk. Research on low-magnesium water irrigation showed that crops developed magnesium deficiency symptoms that could lead to plant death, and tomato yields were reduced by 10-15%. The World Health Organization (WHO) reported on a relationship between sudden cardiac death rates and magnesium intake deficits. An optimization model, developed and tested to provide recommendations for Water Distribution System (WDS) quality control in terms of meeting optimal water quality requirements, was run in computational experiments based on an actual regional WDS. The expected magnesium deficit due to the operation of a large Sea Water Desalination Plant (SWDP) was simulated, and an optimal operation policy, in which remineralization at the SWDP was combined with blending desalinated and natural water to achieve the required quality, was generated. The effects of remineralization costs and WDS physical layout on the optimal policy were examined by sensitivity analysis. As part of the sensitivity blending natural and desalinated water near the treatment plants will be feasible up to 16.2 US cents/m(3), considering all expenses. Additional chemical injection was used to meet quality criteria when blending was not feasible. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Optimism/pessimism and health-related quality of life during pregnancy across three continents: a matched cohort study in China, Ghana, and the United States

Directory of Open Access Journals (Sweden)

Calhoun Cecilia

2009-09-01

Full Text Available Abstract Background Little is known about how optimism/pessimism and health-related quality of life compare across cultures. Methods Three samples of pregnant women in their final trimester were recruited from China, Ghana, and the United States (U.S.. Participants completed a survey that included the Life Orientation Test - Revised (LOT-R, an optimism/pessimism measure, the Short Form 12 (SF-12, a quality of life measure, and questions addressing health and demographic factors. A three-country set was created for analysis by matching women on age, gestational age at enrollment, and number of previous pregnancies. Anovas with post-hoc pairwise comparisons were used to compare results across the cohorts. Multivariate regression analysis was used to create a model to identify those variables most strongly associated with optimism/pessimism. Results LOT-R scores varied significantly across cultures in these samples, with Ghanaian pregnant women being the most optimistic and least pessimistic and Chinese pregnant women being the least optimistic overall and the least pessimistic in subscale analysis. Four key variables predicted approximately 20% of the variance in overall optimism scores: country of origin (p = .006, working for money (p = .05; level of education (p = .002, and ever being treated for emotional issues with medication (p Conclusion This research raises important questions regarding what it is about country of origin that so strongly influences optimism/pessimism among pregnant women. Further research is warranted exploring underlying conceptualization of optimism/pessimism and health related quality of life across countries.

Morocco's policy choices to achieve Universal health coverage ...

African Journals Online (AJOL)

Morocco's health system remains weak in spite of the improvement of other development indicators in the last ten years. Health remains one of the major challenges to lower the social disparities that are the priority for the authorities. Despite the goodwill of all stakeholders, significant reforms implemented respond only ...

Improving educational achievement and anaemia of school children: design of a cluster randomised trial of school-based malaria prevention and enhanced literacy instruction in Kenya

Directory of Open Access Journals (Sweden)

Halliday Katherine E

2010-10-01

Full Text Available Abstract Background Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement. However, there is limited experimental evidence on the benefits of school-based malaria prevention or how health interventions interact with other efforts to improve education quality. This study aims to evaluate the impact of school-based malaria prevention and enhanced literacy instruction on the health and educational achievement of school children in Kenya. Design A factorial, cluster randomised trial is being implemented in 101 government primary schools on the coast of Kenya. The interventions are (i intermittent screening and treatment of malaria in schools by public health workers and (ii training workshops and support for teachers to promote explicit and systematic literacy instruction. Schools are randomised to one of four groups: receiving either (i the malaria intervention alone; (ii the literacy intervention alone; (iii both interventions combined; or (iv control group where neither intervention is implemented. Children from classes 1 and 5 are randomly selected and followed up for 24 months. The primary outcomes are educational achievement and anaemia, the hypothesised mediating variables through which education is affected. Secondary outcomes include malaria parasitaemia, school attendance and school performance. A nested process evaluation, using semi-structured interviews, focus group discussion and a stakeholder analysis will investigate the community acceptability, feasibility and cost-effectiveness of the interventions. Discussion Across Africa, governments are committed to improve health and education of school-aged children, but seek clear policy and technical guidance as to the optimal approach to address malaria and improved literacy. This evaluation will be one of the first to simultaneously evaluate the impact of health and education interventions in the improvement of

Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China

Directory of Open Access Journals (Sweden)

Jing Luo

2017-01-01

Full Text Available A recent advancement in location-allocation modeling formulates a two-step approach to a new problem of minimizing disparity of spatial accessibility. Our field work in a health care planning project in a rural county in China indicated that residents valued distance or travel time from the nearest hospital foremost and then considered quality of care including less waiting time as a secondary desirability. Based on the case study, this paper further clarifies the sequential decision-making approach, termed “two-step optimization for spatial accessibility improvement (2SO4SAI.” The first step is to find the best locations to site new facilities by emphasizing accessibility as proximity to the nearest facilities with several alternative objectives under consideration. The second step adjusts the capacities of facilities for minimal inequality in accessibility, where the measure of accessibility accounts for the match ratio of supply and demand and complex spatial interaction between them. The case study illustrates how the two-step optimization method improves both aspects of spatial accessibility for health care access in rural China.

Maximizing Expected Achievable Rates for Block-Fading Buffer-Aided Relay Channels

KAUST Repository

Shaqfeh, Mohammad

2016-05-25

In this paper, the long-term average achievable rate over block-fading buffer-aided relay channels is maximized using a hybrid scheme that combines three essential transmission strategies, which are decode-and-forward, compress-and-forward, and direct transmission. The proposed hybrid scheme is dynamically adapted based on the channel state information. The integration and optimization of these three strategies provide a more generic and fundamental solution and give better achievable rates than the known schemes in the literature. Despite the large number of optimization variables, the proposed hybrid scheme can be optimized using simple closed-form formulas that are easy to apply in practical relay systems. This includes adjusting the transmission rate and compression when compress-and-forward is the selected strategy based on the channel conditions. Furthermore, in this paper, the hybrid scheme is applied to three different models of the Gaussian block-fading buffer-aided relay channels, depending on whether the relay is half or full duplex and whether the source and the relay have orthogonal or non-orthogonal channel access. Several numerical examples are provided to demonstrate the achievable rate results and compare them to the upper bounds of the ergodic capacity for each one of the three channel models under consideration.

Maximizing Expected Achievable Rates for Block-Fading Buffer-Aided Relay Channels

KAUST Repository

Shaqfeh, Mohammad; Zafar, Ammar; Alnuweiri, Hussein; Alouini, Mohamed-Slim

2016-01-01

In this paper, the long-term average achievable rate over block-fading buffer-aided relay channels is maximized using a hybrid scheme that combines three essential transmission strategies, which are decode-and-forward, compress-and-forward, and direct transmission. The proposed hybrid scheme is dynamically adapted based on the channel state information. The integration and optimization of these three strategies provide a more generic and fundamental solution and give better achievable rates than the known schemes in the literature. Despite the large number of optimization variables, the proposed hybrid scheme can be optimized using simple closed-form formulas that are easy to apply in practical relay systems. This includes adjusting the transmission rate and compression when compress-and-forward is the selected strategy based on the channel conditions. Furthermore, in this paper, the hybrid scheme is applied to three different models of the Gaussian block-fading buffer-aided relay channels, depending on whether the relay is half or full duplex and whether the source and the relay have orthogonal or non-orthogonal channel access. Several numerical examples are provided to demonstrate the achievable rate results and compare them to the upper bounds of the ergodic capacity for each one of the three channel models under consideration.

Achieving Optimal Self-Adaptivity for Dynamic Tuning of Organic Semiconductors through Resonance Engineering.

Science.gov (United States)

Tao, Ye; Xu, Lijia; Zhang, Zhen; Chen, Runfeng; Li, Huanhuan; Xu, Hui; Zheng, Chao; Huang, Wei

2016-08-03

Current static-state explorations of organic semiconductors for optimal material properties and device performance are hindered by limited insights into the dynamically changed molecular states and charge transport and energy transfer processes upon device operation. Here, we propose a simple yet successful strategy, resonance variation-based dynamic adaptation (RVDA), to realize optimized self-adaptive properties in donor-resonance-acceptor molecules by engineering the resonance variation for dynamic tuning of organic semiconductors. Organic light-emitting diodes hosted by these RVDA materials exhibit remarkably high performance, with external quantum efficiencies up to 21.7% and favorable device stability. Our approach, which supports simultaneous realization of dynamically adapted and selectively enhanced properties via resonance engineering, illustrates a feasible design map for the preparation of smart organic semiconductors capable of dynamic structure and property modulations, promoting the studies of organic electronics from static to dynamic.

Cross-country analysis of strategies for achieving progress towards global goals for women's and children's health.

Science.gov (United States)

Ahmed, Syed Masud; Rawal, Lal B; Chowdhury, Sadia A; Murray, John; Arscott-Mills, Sharon; Jack, Susan; Hinton, Rachael; Alam, Prima M; Kuruvilla, Shyama

2016-05-01

To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality. We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme. Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls' education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress. Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals.

Optimal multi-photon phase sensing with a single interference fringe

Science.gov (United States)

Xiang, G. Y.; Hofmann, H. F.; Pryde, G. J.

2013-01-01

Quantum entanglement can help to increase the precision of optical phase measurements beyond the shot noise limit (SNL) to the ultimate Heisenberg limit. However, the N-photon parity measurements required to achieve this optimal sensitivity are extremely difficult to realize with current photon detection technologies, requiring high-fidelity resolution of N + 1 different photon distributions between the output ports. Recent experimental demonstrations of precision beyond the SNL have therefore used only one or two photon-number detection patterns instead of parity measurements. Here we investigate the achievable phase sensitivity of the simple and efficient single interference fringe detection technique. We show that the maximally-entangled “NOON” state does not achieve optimal phase sensitivity when N > 4, rather, we show that the Holland-Burnett state is optimal. We experimentally demonstrate this enhanced sensitivity using a single photon-counted fringe of the six-photon Holland-Burnett state. Specifically, our single-fringe six-photon measurement achieves a phase variance three times below the SNL. PMID:24067490

Achieving excellence in community health centers: implications for health reform.

Science.gov (United States)

Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

2012-02-01

Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

Sootblowing optimization for improved boiler performance

Science.gov (United States)

James, John Robert; McDermott, John; Piche, Stephen; Pickard, Fred; Parikh, Neel J.

2012-12-25

A sootblowing control system that uses predictive models to bridge the gap between sootblower operation and boiler performance goals. The system uses predictive modeling and heuristics (rules) associated with different zones in a boiler to determine an optimal sequence of sootblower operations and achieve boiler performance targets. The system performs the sootblower optimization while observing any operational constraints placed on the sootblowers.

Can health systems be enhanced for optimal health services through disease-specific programs? Results of field studies in Viet Nam and Cambodia.

Science.gov (United States)

Egami, Y; Fujita, N; Akashi, H; Matsumoto, Y; Ohara, H; Takeuchi, M

2012-02-01

Developing better health systems is the key to delivering optimal health services, although more evidence of effective strategies to do so is needed. Field surveys were conducted in Viet Nam and Cambodia to identify best practices in addressing health system bottlenecks to scale up disease control programs. The two countries were compared over time using a framework for analysis developed by the authors. In Viet Nam, a health system was in place for decades at the central to municipal levels, although it was fragile until the 1990s, when the government started taking measures. In Cambodia, the previous health system had been destroyed during previous internal conflict. In the post-conflict period, the health system was rebuilt with support for programs followed by centralization of health services. In different settings, different measures were taken to deal with similar bottlenecks. In Cambodia, vertical programs were dominant, so the government sought to centralize drug management to deal with shortages of essential drugs, while Viet Nam sought to mobilize resources to ensure drug distribution at all levels. This study shows there is no single successful approach to health systems, and a systemic approach needs to be taken because elimination of one bottleneck may reveal another. Efforts to enhance disease-specific programs may not always contribute to overall enhancement of the health system, and the best possible approach may not be the same in different countries. Further study is needed to explore common issues and principles for effective strategies to enhance health systems in different contexts.

A triaxial accelerometer monkey algorithm for optimal sensor placement in structural health monitoring

Science.gov (United States)

Jia, Jingqing; Feng, Shuo; Liu, Wei

2015-06-01

Optimal sensor placement (OSP) technique is a vital part of the field of structural health monitoring (SHM). Triaxial accelerometers have been widely used in the SHM of large-scale structures in recent years. Triaxial accelerometers must be placed in such a way that all of the important dynamic information is obtained. At the same time, the sensor configuration must be optimal, so that the test resources are conserved. The recommended practice is to select proper degrees of freedom (DOF) based upon several criteria and the triaxial accelerometers are placed at the nodes corresponding to these DOFs. This results in non-optimal placement of many accelerometers. A ‘triaxial accelerometer monkey algorithm’ (TAMA) is presented in this paper to solve OSP problems of triaxial accelerometers. The EFI3 measurement theory is modified and involved in the objective function to make it more adaptable in the OSP technique of triaxial accelerometers. A method of calculating the threshold value based on probability theory is proposed to improve the healthy rate of monkeys in a troop generation process. Meanwhile, the processes of harmony ladder climb and scanning watch jump are proposed and given in detail. Finally, Xinghai NO.1 Bridge in Dalian is implemented to demonstrate the effectiveness of TAMA. The final results obtained by TAMA are compared with those of the original monkey algorithm and EFI3 measurement, which show that TAMA can improve computational efficiency and get a better sensor configuration.

Optimizing network connectivity for mobile health technologies in sub-Saharan Africa.

Science.gov (United States)

Siedner, Mark J; Lankowski, Alexander; Musinga, Derrick; Jackson, Jonathon; Muzoora, Conrad; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R; Haberer, Jessica E

2012-01-01

-limited settings should consider this upgrade to optimize mHealth applications.

Always looking on the bright side of life? Exploring optimism and health in three UK post-industrial urban settings.

Science.gov (United States)

Walsh, David; McCartney, Gerry; McCullough, Sarah; van der Pol, Marjon; Buchanan, Duncan; Jones, Russell

2015-09-01

Many theories have been proposed to explain the high levels of 'excess' mortality (i.e. higher mortality over and above that explained by differences in socio-economic circumstances) shown in Scotland-and, especially, in its largest city, Glasgow-compared with elsewhere in the UK. One such proposal relates to differences in optimism, given previously reported evidence of the health benefits of an optimistic outlook. A representative survey of Glasgow, Liverpool and Manchester was undertaken in 2011. Optimism was measured by the Life Orientation Test (Revised) (LOT-R), and compared between the cities by means of multiple linear regression models, adjusting for any differences in sample characteristics. Unadjusted analyses showed LOT-R scores to be similar in Glasgow and Liverpool (mean score (SD): 14.7 (4.0) for both), but lower in Manchester (13.9 (3.8)). This was consistent in analyses by age, gender and social class. Multiple regression confirmed the city results: compared with Glasgow, optimism was either similar (Liverpool: adjusted difference in mean score: -0.16 (95% CI -0.45 to 0.13)) or lower (Manchester: -0.85 (-1.14 to -0.56)). The reasons for high levels of Scottish 'excess' mortality remain unclear. However, differences in psychological outlook such as optimism appear to be an unlikely explanation. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the GAZEL cohort.

Science.gov (United States)

Ferrie, Jane E; Kivimäki, Mika; Westerlund, Hugo; Head, Jenny; Melchior, Maria; Singh-Manoux, Archana; Zins, Marie; Goldberg, Marcel; Alexanderson, Kristina; Vahtera, Jussi

2011-10-01

Although sickness absence is a strong predictor of health, whether this association varies by occupational position has rarely been examined. The aim of this study was to investigate overall and diagnosis-specific sickness absence as a predictor of future long-term sub-optimal health by occupational position. This was a prospective occupational cohort study of 15 320 employees (73% men) aged 37-51. Sickness absences (1990-1992), included in 13 diagnostic categories, were examined by occupational position in relation to self-rated health measured annually during 1993-2006. 60% of employees in higher occupational positions and 22% in lower positions had no sickness absence. Conversely, 9.5% of employees in higher positions and 40% in lower positions had over 30 sick-leave days. Repeated-measures logistic regression analyses adjusted for age, sex and chronic disease showed employees with over 30 days absence, compared to those with no absence, had approximately double the risk of sub-optimal health over the 14-year follow-up in all occupational positions. 1-30 days sick-leave was associated with greater odds of sub-optimal health in the high (OR 1.48; 95% CI 1.27 to 1.72) and intermediate (1.29; 1.15 to 1.45) but not lower occupational positions (1.06; 0.82 to 1.38). Differences by occupational position in the association between sickness absence in 13 specific diagnostic categories and sub-optimal health over the ensuing 14 years were limited to stronger associations observed with cancer and mental disorders in the higher occupational positions. The association between sickness absence of more than 30 days over 3 years and future long-term self-rated health appears to differ little by occupational position.

Cooperative Bacterial Foraging Optimization

Directory of Open Access Journals (Sweden)

Hanning Chen

2009-01-01

Full Text Available Bacterial Foraging Optimization (BFO is a novel optimization algorithm based on the social foraging behavior of E. coli bacteria. This paper presents a variation on the original BFO algorithm, namely, the Cooperative Bacterial Foraging Optimization (CBFO, which significantly improve the original BFO in solving complex optimization problems. This significant improvement is achieved by applying two cooperative approaches to the original BFO, namely, the serial heterogeneous cooperation on the implicit space decomposition level and the serial heterogeneous cooperation on the hybrid space decomposition level. The experiments compare the performance of two CBFO variants with the original BFO, the standard PSO and a real-coded GA on four widely used benchmark functions. The new method shows a marked improvement in performance over the original BFO and appears to be comparable with the PSO and GA.

Engineering applications of heuristic multilevel optimization methods

Science.gov (United States)

Barthelemy, Jean-Francois M.

1989-01-01

Some engineering applications of heuristic multilevel optimization methods are presented and the discussion focuses on the dependency matrix that indicates the relationship between problem functions and variables. Coordination of the subproblem optimizations is shown to be typically achieved through the use of exact or approximate sensitivity analysis. Areas for further development are identified.

Medium optimization for endochitinase production by recombinant ...

African Journals Online (AJOL)

The optimal concentrations of three factors were investigated by the response surface methodology using Box- Behnken design. The optimal medium components obtained for achieving the maximum activity of the endochitinase were as follows: Yeast extract 24.36 g/l, tryptone 20 g/l, YNB 5.0 g/l, potassium phosphate 100 ...

A Two-Stage Robust Optimization for Centralized-Optimal Dispatch of Photovoltaic Inverters in Active Distribution Networks

DEFF Research Database (Denmark)

Ding, Tao; Li, Cheng; Yang, Yongheng

2017-01-01

Optimally dispatching Photovoltaic (PV) inverters is an efficient way to avoid overvoltage in active distribution networks, which may occur in the case of PV generation surplus load demand. Typically, the dispatching optimization objective is to identify critical PV inverters that have the most...... nature of solar PV energy may affect the selection of the critical PV inverters and also the final optimal objective value. In order to address this issue, a two-stage robust optimization model is proposed in this paper to achieve a robust optimal solution to the PV inverter dispatch, which can hedge...... against any possible realization within the uncertain PV outputs. In addition, the conic relaxation-based branch flow formulation and second-order cone programming based column-and-constraint generation algorithm are employed to deal with the proposed robust optimization model. Case studies on a 33-bus...

Penicillin allergy: optimizing diagnostic protocols, public health implications, and future research needs.

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Macy, Eric

2015-08-01

Unverified penicillin allergy is being increasingly recognized as a public health concern. The ideal protocol for verifying true clinically significant IgE-mediated penicillin allergy needs to use only commercially available materials, be well tolerated and easy to perform in both the inpatient and outpatient settings, and minimize false-positive determinations. This review concentrates on articles published in 2013 and 2014 that present new data relating to the diagnosis and management of penicillin allergy. Penicillin allergy can be safely evaluated at this time, in patients with an appropriate clinical history of penicillin allergy, using only penicilloyl-poly-lysine and native penicillin G as skin test reagents, if an oral challenge with amoxicillin 250 mg, followed by 1 h of observation, is given to all skin test negative individuals. Millions of individuals falsely labeled with penicillin allergy need to be evaluated to safely allow them to use penicillin-class antibiotics and avoid morbidity associated with penicillin avoidance. Further research is needed to determine optimal protocol(s). There will still be a 1-2% rate of adverse reactions reported with all future therapeutic penicillin-class antibiotic use, even with optimal methods used to determine acute penicillin tolerance. Only a small minority of these new reactions will be IgE-mediated.

Multi-fidelity optimization of horizontal axis wind turbines

DEFF Research Database (Denmark)

McWilliam, Michael; Zahle, Frederik; Pavese, Christian

2017-01-01

This paper is concerned with the numerical design optimization of wind turbines. Many examples of wind turbine design optimization in literature rely on simplified analysis in some form. This may lead to sub-optimal design, because the optimizer does not see the full fidelity of the problem....... Finally, AMMF was used in full aero-elastic wind turbine rotor design optimization problem based on the DTU 10 MW reference wind turbine design. Mixed results were achieved for the final study and further work is needed to find the best configuration for AMMF....

Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease.

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Vale, Margarite J; Jelinek, Michael V; Best, James D; Dart, Anthony M; Grigg, Leeanne E; Hare, David L; Ho, Betty P; Newman, Robert W; McNeil, John J

Disease management programs in which drugs are prescribed by dietitians or nurses have been shown to improve the coronary risk factor profile in patients with coronary heart disease. However, those disease management programs in which drugs are not prescribed by allied health professionals have not improved coronary risk factor status. The objective of the Coaching patients On Achieving Cardiovascular Health (COACH) study was to determine whether dietitians or nurses who did not prescribe medications could coach patients with coronary heart disease to work with their physicians to achieve the target levels for their total cholesterol (TC) and other risk factors. Multicenter randomized controlled trial in which 792 patients from 6 university teaching hospitals underwent a stratified randomization by cardiac diagnosis within each hospital: 398 were assigned to usual care plus The COACH Program and 394 to usual care alone. Patients in The COACH Program group received regular personal coaching via telephone and mailings to achieve the target levels for their particular coronary risk factors. There was one coach per hospital. The primary outcome was the change in TC (DeltaTC) from baseline (in hospital) to 6 months after randomization. Secondary outcomes included measurement of a wide range of physical, nutritional, and psychological factors. The analysis was performed by intention to treat. The COACH Program achieved a significantly greater DeltaTC than usual care alone: the mean DeltaTC was 21 mg/dL (0.54 mmol/L) (95% confidence interval [CI], 16-25 mg/dL [0.42-0.65 mmol/L]) in The COACH Program vs 7 mg/dL (0.18 mmol/L) (95% CI, 3-11 mg/dL [0.07-0.29 mmol/L]) in the usual care group (PCOACH Program group than in the usual care group. Coaching produced substantial improvements in most of the other coronary risk factors and in patient quality of life. Coaching, delivered as The COACH Program, is a highly effective strategy in reducing TC and many other coronary risk

Optimal design of planar slider-crank mechanism using teaching-learning-based optimization algorithm

International Nuclear Information System (INIS)

Chaudhary, Kailash; Chaudhary, Himanshu

2015-01-01

In this paper, a two stage optimization technique is presented for optimum design of planar slider-crank mechanism. The slider crank mechanism needs to be dynamically balanced to reduce vibrations and noise in the engine and to improve the vehicle performance. For dynamic balancing, minimization of the shaking force and the shaking moment is achieved by finding optimum mass distribution of crank and connecting rod using the equipemental system of point-masses in the first stage of the optimization. In the second stage, their shapes are synthesized systematically by closed parametric curve, i.e., cubic B-spline curve corresponding to the optimum inertial parameters found in the first stage. The multi-objective optimization problem to minimize both the shaking force and the shaking moment is solved using Teaching-learning-based optimization algorithm (TLBO) and its computational performance is compared with Genetic algorithm (GA).

Optimal design of planar slider-crank mechanism using teaching-learning-based optimization algorithm

Energy Technology Data Exchange (ETDEWEB)

Chaudhary, Kailash; Chaudhary, Himanshu [Malaviya National Institute of Technology, Jaipur (Malaysia)

2015-11-15

In this paper, a two stage optimization technique is presented for optimum design of planar slider-crank mechanism. The slider crank mechanism needs to be dynamically balanced to reduce vibrations and noise in the engine and to improve the vehicle performance. For dynamic balancing, minimization of the shaking force and the shaking moment is achieved by finding optimum mass distribution of crank and connecting rod using the equipemental system of point-masses in the first stage of the optimization. In the second stage, their shapes are synthesized systematically by closed parametric curve, i.e., cubic B-spline curve corresponding to the optimum inertial parameters found in the first stage. The multi-objective optimization problem to minimize both the shaking force and the shaking moment is solved using Teaching-learning-based optimization algorithm (TLBO) and its computational performance is compared with Genetic algorithm (GA).

Cost-Effectiveness Thresholds in Global Health: Taking a Multisectoral Perspective.

Science.gov (United States)

Remme, Michelle; Martinez-Alvarez, Melisa; Vassall, Anna

2017-04-01

Good health is a function of a range of biological, environmental, behavioral, and social factors. The consumption of quality health care services is therefore only a part of how good health is produced. Although few would argue with this, the economic framework used to allocate resources to optimize population health is applied in a way that constrains the analyst and the decision maker to health care services. This approach risks missing two critical issues: 1) multiple sectors contribute to health gain and 2) the goods and services produced by the health sector can have multiple benefits besides health. We illustrate how present cost-effectiveness thresholds could result in health losses, particularly when considering health-producing interventions in other sectors or public health interventions with multisectoral outcomes. We then propose a potentially more optimal second best approach, the so-called cofinancing approach, in which the health payer could redistribute part of its budget to other sectors, where specific nonhealth interventions achieved a health gain more efficiently than the health sector's marginal productivity (opportunity cost). Likewise, other sectors would determine how much to contribute toward such an intervention, given the current marginal productivity of their budgets. Further research is certainly required to test and validate different measurement approaches and to assess the efficiency gains from cofinancing after deducting the transaction costs that would come with such cross-sectoral coordination. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Why 'Optimal' Payment for Healthcare Providers Can Never be Optimal Under Community Rating.

Science.gov (United States)

Zweifel, Peter; Frech, H E

2016-02-01

This article extends the existing literature on optimal provider payment by accounting for consumer heterogeneity in preferences for health insurance and healthcare. This heterogeneity breaks down the separation of the relationship between providers and the health insurer and the relationship between consumers and the insurer. Both experimental and market evidence for a high degree of heterogeneity are presented. Given heterogeneity, a uniform policy fails to effectively control moral hazard, while incentives for risk selection created by community rating cannot be neutralized through risk adjustment. Consumer heterogeneity spills over into relationships with providers, such that a uniform contract with providers also cannot be optimal. The decisive condition for ensuring optimality of provider payment is to replace community rating (which violates the principle of marginal cost pricing) with risk rating of contributions combined with subsidization targeted at high risks with low incomes.

Multiphase Nano-Composite Coatings for Achieving Energy Optimization

Energy Technology Data Exchange (ETDEWEB)

Nainaparampil, Jose

2012-03-26

UES Inc. and ANL teamed in this work to develop novel coating systems for the protection of surfaces from thermal degradation mainly in two applications; Machining and Die casting. These coatings were specifically designed for the purpose by incorporating required material phases and the overall architecture, which led to reduce the energy usage and increase efficiency of the operations. Following the UES/ANL's feasibility work, the coatings were developed utilizing High power impulse magnetron sputtering (HiPMS) and Large area filtered arc deposition (LAFAD) techniques. Toughness, hardness and oxidation resistance: contrasting qualities have been mixed in the right proportion to attain the suitable material characteristic for the cause. Hafnium diboride (HfB2) based materials provided such a system and its properties were tamed to attain the right combination of toughness and hardness by working on the microstructure and architecture of coatings. An effective interfacing material (graded concentrations of topcoat) was also achieved in this work to provide the required adhesion between the substrate and the coating. Combination of an appropriate bond coat and a functional top coat provided the present thermal degradation resistant coating for cutting tools and die-casting applications. Laboratory level performance tests and industrial level application tests by partner companies (Beta Site Testing) were used for the development of these coatings.

Evolution of post-deployment indicators of oral health on the Family Health Strategy

Science.gov (United States)

Palacio, Danielle da Costa; Vazquez, Fabiana de Lima; Ramos, Danielle Viana Ribeiro; Peres, Stela Verzinhasse; Pereira, Antonio Carlos; Guerra, Luciane Miranda; Cortellazzi, Karine Laura; Bulgareli, Jaqueline Vilela

2014-01-01

Objective To evaluate the evolution of indicators after the implementation of 21 Oral Healthcare Teams in the Family Health Strategy. Methods We used data from outpatient services of Oral Healthcare Teams to evaluate efficiency, access, percentage of absences and emergencies of oral healthcare professionals who worked in the partnership between the Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein and the Secretaria Municipal de Saúde de São Paulo, during the period 2009-2011. Results Percentages of emergencies, income, and access showed a significant difference during the period analyzed, but no difference for percentage of absences was found. When monthly analysis was made, it is noteworthy that at the beginning of service implementation a fluctuation occurred, which may indicate that the work was consolidated over the months, becoming capable of receiving new professionals and increasing the population served. Comparison of the indicators in that period with the goals agreed upon between the Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein and the Secretaria Municipal de Saúde de São Paulo made it possible to notice that the Oral Health Teams had a good performance. Conclusion The results showed that the goals were achieved reflecting the increasing number of professionals, the maturing of work processes in the Oral Health Teams, and optimization of the manpower available to perform the activities. Understanding these results will be important to guide the actions of Oral Health Teams for the following years and to assess the achievement of goals. PMID:25295445

Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

Science.gov (United States)

2012-01-01

Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN

Directory of Open Access Journals (Sweden)

Burgess Philip

2012-05-01

Full Text Available Abstract Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services.

An Innovative School Health Education Model Designed for Student Achievement.

Science.gov (United States)

Rohwer, John; Wandberg, Bob

New threats to the health of American children, often psychosocial in nature due to societal changes, must be addressed. The Minnesota School Health Education Model is based on the integration of four primary components: (1) school health education goals aimed at health promotion, disease prevention, and long-term positive health effects on…

NASA Human Health and Performance Strategy

Science.gov (United States)

Davis, Jeffrey R.

2012-01-01

In May 2007, what was then the Space Life Sciences Directorate, issued the 2007 Space Life Sciences Strategy for Human Space Exploration. In January 2012, leadership and key directorate personnel were once again brought together to assess the current and expected future environment against its 2007 Strategy and the Agency and Johnson Space Center goals and strategies. The result was a refined vision and mission, and revised goals, objectives, and strategies. One of the first changes implemented was to rename the directorate from Space Life Sciences to Human Health and Performance to better reflect our vision and mission. The most significant change in the directorate from 2007 to the present is the integration of the Human Research Program and Crew Health and Safety activities. Subsequently, the Human Health and Performance Directorate underwent a reorganization to achieve enhanced integration of research and development with operations to better support human spaceflight and International Space Station utilization. These changes also enable a more effective and efficient approach to human system risk mitigation. Since 2007, we have also made significant advances in external collaboration and implementation of new business models within the directorate and the Agency, and through two newly established virtual centers, the NASA Human Health and Performance Center and the Center of Excellence for Collaborative Innovation. Our 2012 Strategy builds upon these successes to address the Agency's increased emphasis on societal relevance and being a leader in research and development and innovative business and communications practices. The 2012 Human Health and Performance Vision is to lead the world in human health and performance innovations for life in space and on Earth. Our mission is to enable optimization of human health and performance throughout all phases of spaceflight. All HH&P functions are ultimately aimed at achieving this mission. Our activities enable

Maternity Care in Russia: Issues, Achievements, and Potential.

Science.gov (United States)

Shuvalova, Marina P; Yarotskaya, Ekaterina L; Pismenskaya, Tatiana V; Dolgushina, Nataliya V; Baibarina, Elena N; Sukhikh, Gennady T

2015-10-01

In this review, we provide basic facts about maternity care services within the health care system in Russia. We give a short overview of such key aspects as the demographic situation, reproductive behaviour, regulatory framework for providing health care for women and children, maternal and perinatal mortality, and the availability of medical personnel. In 2012, Russia began registration of births in accordance with the WHO recommendations (births with weight ≥ 500 g at ≥ 22 weeks' gestation). Introduction of this new registration system increased the completeness and quality of the collected information and expanded possibilities for future international comparative assessments. A three-level system of specialized medical care has been introduced in Russia for women and newborns during pregnancy, childbirth, and the postpartum period. In 2014, the system included 1942 state (public) maternity hospitals providing 20 obstetric beds per 10 000 women aged 15 to 49 years. More than 100 perinatal centres (level III) are currently functioning in the country, with 32 new perinatal centres planned to open by 2016. The total number of obstetrician-gynaecologists in Russia is approximately 44 000, providing a ratio of 5.7 specialists per 10 000 women. The total number of midwives is 62 000, providing a ratio of 8.1 midwives per 10 000 women. In recent years we have succeeded in optimizing the maternity care system by increasing its accessibility and quality. This was achieved through qualitative and quantitative progress in the training of neonatologists, the development of intensive care technologies and neonatal critical care, capacity building of medical-genetic services and counselling, prenatal diagnosis, and the standardization of health care with data collection.