U.S. Environmental Protection Agency — Surface water monitoring data from national aquatic surveys (lakes, streams, rivers). This dataset is associated with the following publication: Stoddard , J., J....
Collaborative Governance Models for Managing Aquatic Resources and Fisheries in the Peruvian ... The idea is to consolidate this knowledge in a model for the participatory ... Linking research to urban planning at the ICLEI World Congress 2018 ... In partnership with UNESCO's Organization for Women in Science for the ...
Increasing numbers of stakeholders are recognizing the need for changes in the way aquatic ecosystems are governed. ... for Resource Management and Environmental Studies (CERMES), University of the West Indies, on the application of new thinking (resilience, Complex Adaptive Systems theory) to coastal practices.
Neuenfeldt, Stefan; Köster, Fritz
DTU Aqua conducts research, provides advice,educates at university level and contributes toinnovation in sustainable exploitation andmanagement of aquatic resources. The vision of DTUAqua is to enable ecologically and economicallysustainable exploitation of aquatic resourcesapplying an integrated...... management. Marineecosystems aims at understanding the mechanisms that govern the interaction between individuals,species and populations in an ecosystem enabling us to determine the stability and flexibility of theecosystem.Marine living resources looks at the sustainable utilization of fish and shellfish...... stocks.Ecosystem effects expands from the ecosystem approach to fisheries management to an integratedapproach where other human activities are taken into consideration. Fisheries management developsmethods, models and tools for predicting and evaluating the effects of management measures andregulations...
Archer, Will; Braun, David R; Harris, Jack W K; McCoy, Jack T; Richmond, Brian G
Evidence for the acquisition of nutritionally dense food resources by early Pleistocene hominins has implications for both hominin biology and behavior. Aquatic fauna may have comprised a source of highly nutritious resources to hominins in the Turkana Basin at ∼1.95 Ma. Here we employ multiple datasets to examine the issue of aquatic resource use in the early Pleistocene. This study focuses on four components of aquatic faunal assemblages (1) taxonomic diversity, (2) skeletal element proportion, (3) bone fragmentation and (4) bone surface modification. These components are used to identify associations between early Pleistocene aquatic remains and hominin behavior at the site of FwJj20 in the Koobi Fora Fm. (Kenya). We focus on two dominant aquatic species: catfish and turtles. Further we suggest that data on aquatic resource availability as well as ethnographic examples of aquatic resource use complement our observations on the archaeological remains from FwJj20. Aquatic food items provided hominins with a valuable nutritional alternative to an exclusively terrestrial resource base. We argue that specific advantages afforded by an aquatic alternative to terrestrial resources include (1) a probable reduction in required investment of energy relative to economic return in the form of nutritionally dense food items, (2) a decrease in the technological costs of resource acquisition, and (3) a reduced level of inter-specific competition associated with carcass access and an associated reduction of predation risk relative to terrestrial sources of food. The combined evidence from FwJj20 suggests that aquatic resources may have played a substantial role in early Pleistocene diets and these resources may have been overlooked in previous interpretations of hominin behavior. Copyright © 2014 Elsevier Ltd. All rights reserved.
The National Aquatic Resource Surveys (NARS) data are being used and applied above and beyond the regional and national assessments. This page includes a list of recent journal articles that reference NARS data.
Federal Laboratory Consortium — Colorado State University has received funding from the U.S. Environmental Protection Agency (EPA) for its Space-Time Aquatic Resources Modeling and Analysis Program...
Full Text Available AquaticHealth.net is an open-source aquatic biosecurity intelligence application. By combining automated data collection and human analysis, AquaticHealth.net provides fast and accurate disease outbreak detection and forecasts, accompanied with nuanced explanations. The system has been online and open to the public since 1 January 2010, it has over 200 registered expert users around the world, and it typically publishes about seven daily reports and two weekly disease alerts. We document the major trends in aquatic animal health that the system has detected over these two years, and conclude with some forecasts for the future.
This report gives an overview of completed research activities on the value ascribed by users, local communities and stakeholders to functions, goods and services (including non‐use values) derived from the aquatic resources in the study areas. The perceived impact of factors such as environmental...... degradation, changing demand for goods and services and modified highland aquatic resources management practices on these values has also been assessed. To help structure this analysis stakeholder Delphi studies have been undertaken in each country involving representatives from all stakeholder groups...
... identify key choices in a state-of-the-art publication. They will also undertake field research in collaboration with the Centre for Resource Management and Environmental Studies (CERMES), University of the West Indies, on the application of new thinking (resilience, Complex Adaptive Systems theory) to coastal practices.
Purcell, Maureen K.; Harris, M. Camille
Healthy aquatic ecosystems are home to a diversity of plants, invertebrates, fish and wildlife. Aquatic animal populations face unprecedented threats to their health and survival from climate change, water shortages, habitat alteration, invasive species and environmental contaminants. These environmental stressors can directly impact the prevalence and severity of disease in aquatic populations. For example, periodic fish kills in the upper Chesapeake Bay Watershed are associated with many different opportunistic pathogens that proliferate in stressed fish populations. An estimated 80 percent of endangered juvenile Puget Sound steelhead trout die within two weeks of entering the marine environment, and a role for disease in these losses is being investigated. The introduction of viral hemorrhagic septicemia virus (VHSV) into the Great Lakes—a fishery worth an estimated 7 billion dollars annually—resulted in widespread fish die-offs and virus detections in 28 different fish species. Millions of dying sea stars along the west coast of North America have led to investigations into sea star wasting disease. U.S. Geological Survey (USGS) scientists are assisting managers with these issues through ecological investigations of aquatic animal diseases, field surveillance, and research to promote the development of mitigation strategies.
Seafood is the primary source of animal protein for more than one billion people. Many economies and communities, in particular those in developing nations and coastal regions, depend on fisheries. Whereas the dire effects of overfishing on open-access ocean fisheries are already recognized, impacts of catches on freshwater systems are still underestimated. IIASA’s fisheries research elucidates how to secure and expand aquatic food resources, emphasizing three topical challenges. First, impro...
Gu, Yang-Guang; Huang, Hong-Hui; Lin, Qin
Heavy metal concentrations in edible organisms from the core area of Daya Bay's Fishery Resource Reserve, South China Sea, were determined. Samples of 14 crustacean, fish, and shellfish species were collected and analyzed. The As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn concentrations were 0.18-1.16, 0.002-0.919, 0.40-2.85, 0.07-4.10, 0.004-0.055, 0.14-1.19, 0.014-0.070, and 4.57-15.94μg/g wet weight, respectively. The As concentrations were higher than the Chinese maximum permissible levels in all of the fish and shellfish species and two crustacean species, indicating that consumption of these wild species by humans may pose health risks. However, calculations of the health risks posed to humans indicated that no significant adverse health effects would be associated with consuming these species. Copyright © 2016 Elsevier B.V. All rights reserved.
Vigon, B. W.; Arthur, M. F.; Taft, L. G.; Wagner, C. K.; Lipinsky, E. S.; Litchfield, J. H.; McCandlish, C. D.; Clark, R.
This research project has been designed to facilitate the eventual selection of biomass production systems using aquatic species (microalgal and emergent aquatic plant species (MEAP) which effectively exploit the potentially available resources of the Southwest.
McNamara, M; Ernst, I; Adlard, R D
Diseases of aquatic animals have had, and continue to have, a significant impact on aquatic animal health. In Australia, where fisheries and aquaculture are important industries, aquatic species have been subject to serious disease outbreaks, including pilchard herpesvirus, the cause of one of the largest wild fish kills ever recorded. At the same time, there is a consensus that Australia's parasite fauna are largely unknown, and that aquatic animal health information is difficult to access. Managing aquatic animal diseases is challenging because they may be entirely new, their hosts may be new to aquaculture, and specialist expertise and basic diagnostic tools may be lacking or absent. The Neptune project was created in response to these challenges, and it aims to increase awareness of aquatic animal diseases, improve disease management, and promote communication between aquatic animal health professionals in Australia. The project consists of an online database, a digital microscopy platform containing a whole-slide image library, a community space, and online communications technology. The database contains aquatic animal health information from published papers, government reports, and other sources, while the library contains slides of key diseases both endemic and exotic to Australia. These assets make Neptune a powerful resource for researchers, students, and biosecurity officials.
ERDC/TN ANSRP-06-3 September 2006 Freshwater Aquatic Nuisance Species Impacts and Management Costs and Benefits at Federal Water Resources...Cole, R. A. (2006). “ Freshwater aquatic nuisance species impacts and management costs and benefits at Federal Water resources projects,” ANSRP...Projects1 by Richard A. Cole THE ISSUE: A small fraction of the species that inhabit the nation’s fresh waters become aquatic nuisance species (ANS
Cushing, C.E.; Mueller, R.P.
Biologists from Pacific Northwest National Laboratory (PNNL) were requested by personnel from Fort Irwin to conduct a biological reconnaissance of the Avawatz Mountains northeast of Fort Irwin, an area for proposed expansion of the Fort. Surveys of vegetation, small mammals, birds, reptiles, amphibians, and aquatic resources were conducted during 1995 to characterize the populations and habitats present with emphasis on determining the presence of any species of special concern. This report presents a description of the sites sampled, a list of the organisms found and identified, and a discussion of relative abundance. Taxonomic identifications were done to the lowest level possible commensurate with determining the status of the taxa relative to its possible listing as a threatened, endangered, or candidate species. Consultation with taxonomic experts was undertaken for the Coleoptera ahd Hemiptera. In addition to listing the macroinvertebrates found, the authors also present a discussion related to the possible presence of any threatened or endangered species or species of concern found in Sheep Creek Springs, Tin Cabin Springs, and the Amargosa River.
Issue: Excess nitrogen from fertilizer, septic tanks, animal feedlots, and runoff from pavement can threaten aquatic ecosystem health. Riparian buffers -- the vegetated region adjacent to streams and wetlands -- are thought to be effective at intercepting and controlling excess ...
Pennsylvania State Dept. of Education, Harrisburg.
Based on findings of Project HAPPIER surveys and intended as a resource for health care providers and educators who serve the migrant community, this guide describes over 375 instructional materials in the areas of dental health, disease control, fitness, health promotion, human growth and development, hypertension, maternal and child care, mental…
Nguyen, Thi Dieu Phuong; Lund, Søren; Banta, Gary Thomas
The present report on stakeholder evaluation of highland aquatic resources provides an overview of completed research activities undertaken within the HighARCS project on the value ascribed by users, local communities and stakeholders to functions, goods and services (including non-use values......) derived from the aquatic resources in the Northern and Central of Vietnam. The perceived impact of factors such as environmental degradation, changing demand for goods and services and modified highland aquatic resources management practices on these values has also been assessed....
Hoorman, James J.
Soil health and cover crops are topics of interest to farmers, gardeners, and students. Three soil health and cover crop demonstrations provide educational resources. Demonstrations one outlines two educational cover crop seed displays, including the advantages and disadvantages. Demonstration two shows how to construct and grow a cover crop root…
U.S. Environmental Protection Agency — The National Aquatic Resource Survey (NARS) findings for nutrients in streams and lakes highlight that nutrient pollution is widespread across the United States and...
The National Aquatic Resource Surveys (NARS) use probability-survey designs to assess the condition of the nation’s waters. In probability surveys (also known as sample-surveys or statistical surveys), sampling sites are selected randomly.
U.S. Environmental Protection Agency — The National Aquatic Resource Survey (NARS) findings for nutrients in streams and lakes highlight that nutrient pollution is widespread across the United States and...
Consequently, temperatures rise and oxygen levels fall. Primary producers in these stretches shift from periphyton to phytoplankton (suspended algae ...trees and have rocky substrates. Primary production in these cold- water and coolwater reaches is generally limited to periphyton (attached algae ...Adams County. Biotic components investigated included phytoplankton , zooplankton, aquatic macrophytes, benthic macroinvertebrates, fish eggs and
Municipal waste water treatment is mainly achieved by biological processes. These processes produce huge volumes of waste sludge (up 1.5 million m3/year in the Netherlands). Further processing of the waste sludge involves transportation, thickening and incineration. A decrease in the amount of waste sludge would be both environmentally and economically attractive. Aquatic worms can be used to reduce the amount of waste sludge. After predation by the worms, the amount of final sludge is lower....
Lund, Søren; Banta, Gary Thomas; Bunting, Stuart W
and Vietnam. The purpose of this paper is to give an account of how the stakeholder Delphi method was adapted and applied to support the participatory integrated action planning for sustainable use of aquatic resources facilitated within the HighARCS project. An account of the steps taken and results recorded......The HighARCS (Highland Aquatic Resources Conservation and Sustainable Development) project was a participatory research effort to map and better understand the patterns of resource use and livelihoods of communities who utilize highland aquatic resources in five sites across China, India...... of the stakeholder Delphi requires the presence of multidisciplinary and facilitating skills and competences within the implementing teams which should be considered before deciding to include a Stakeholder Delphi as a decision-making tool...
Agboola, Julius Ibukun
Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.
Orijemie, Emuobosa Akpo
Full Text Available The Badagry Cultural Area (BCA is one of the significant socio-cultural places in coastal south-western Nigeria. Palynological and archaeological studies at Ahanve, a settlement in the BCA were undertaken recently to improve the understanding of past human exploitation of aquatic resources. Collected data revealed contrasts in the availability and utilisation of aquatic resources between a first occupation phase (9th-17th centuries AD and a second occupation phase (17th century AD to present. The environment during the first phase was characterised by secondary forest and freshwater swamp. During this period, the inhabitants consumed cat-fish (Clariidae and bivalves (Anodonta sp., and engaged in salt production. The salt was produced from brine obtained from the Atlantic Ocean. Aquatic food resources were supplemented with terrestrial animal and plant foods. During the second occupation phase, aquatic resources (cat-fish and bivalves declined and subsequently disappeared; salt production was discontinued while terrestrial foods, particularly plant-based types, increased significantly. These events coincided with the arrival of European travellers. Oral sources suggest that the decline in the exploitation of aquatic resources was in part due to the fear of being taken captive while on fishing expeditions, restrictions by Europeans who controlled the water-ways, and the massive importation of salt which replaced local production.
Collaborative effort with the Office of Water to provide science in support of the development and implementation of new or revised ambient water quality criteria for microbial and chemical contaminants for human health and aquatic life. The research also addresses implementation...
The public health implications of pathogens in polluted aquatic ecosystems: a review. ... Pathogen contamination in water sources and related diseases constitute ... of public water supply and most importantly, increased rate of human mortality. ... illnesses related to respiratory, gastrointestinal and dermatological systems, ...
Oidtmann, B; Johnston, C; Klotins, K; Mylrea, G; Van, P T; Cabot, S; Martin, P Rosado; Ababouch, L; Berthe, F
Trading of aquatic animals and aquatic animal products has become increasingly globalized during the last couple of decades. This commodity trade has increased the risk for the spread of aquatic animal pathogens. The World Organisation for Animal Health (OIE) is recognized as the international standard-setting organization for measures relating to international trade in animals and animal products. In this role, OIE has developed the Aquatic Animal Health Code, which provides health measures to be used by competent authorities of importing and exporting countries to avoid the transfer of agents pathogenic for animals or humans, whilst avoiding unjustified sanitary barriers. An OIE ad hoc group developed criteria for assessing the safety of aquatic animals or aquatic animal products for any purpose from a country, zone or compartment not declared free from a given disease 'X'. The criteria were based on the absence of the pathogenic agent in the traded commodity or inactivation of the pathogenic agent by the commercial processing used to produce the commodity. The group also developed criteria to assess the safety of aquatic animals or aquatic animal products for retail trade for human consumption from potentially infected areas. Such commodities were assessed considering the form and presentation of the product, the expected volume of waste tissues generated by the consumer and the likely presence of viable pathogenic agent in the waste. The ad hoc group applied the criteria to commodities listed in the individual disease chapters of the Aquatic Animal Health Code (2008 edition). Revised lists of commodities for which no additional measures should be required by the importing countries regardless of the status for disease X of the exporting country were developed and adopted by the OIE World Assembly of Delegates in May 2011. The rationale of the criteria and their application will be explained and demonstrated using examples. © 2012 Crown Copyright. Reproduced
Adam, K E; Gunn, G J
Aquaculture is an increasingly important source of animal protein for a growing global population. Disease is a major constraint to production, with resultant socio-economic impacts for individuals, communities and economies which rely on aquaculture. Aquatic animal health is also strongly influenced by human factors, ranging from international trade regulations to the behaviours of individuals working in aquaculture. This article summarises the human factors associated with aquaculture production using international examples for illustration.
Baron, Jill S.; Hall, E.K.; Nolan, B.T.; Finlay, J.C.; Bernhardt, E.S.; Harrison, J.A.; Chan, F.; Boyer, E.W.
Nearly all freshwaters and coastal zones of the US are degraded from inputs of excess reactive nitrogen (Nr), sources of which are runoff, atmospheric N deposition, and imported food and feed. Some major adverse effects include harmful algal blooms, hypoxia of fresh and coastal waters, ocean acidification, long-term harm to human health, and increased emissions of greenhouse gases. Nitrogen fluxes to coastal areas and emissions of nitrous oxide from waters have increased in response to N inputs. Denitrification and sedimentation of organic N to sediments are important processes that divert N from downstream transport. Aquatic ecosystems are particularly important denitrification hotspots. Carbon storage in sediments is enhanced by Nr, but whether carbon is permanently buried is unknown. The effect of climate change on N transport and processing in fresh and coastal waters will be felt most strongly through changes to the hydrologic cycle, whereas N loading is mostly climate-independent. Alterations in precipitation amount and dynamics will alter runoff, thereby influencing both rates of Nr inputs to aquatic ecosystems and groundwater and the water residence times that affect Nr removal within aquatic systems. Both infrastructure and climate change alter the landscape connectivity and hydrologic residence time that are essential to denitrification. While Nr inputs to and removal rates from aquatic systems are influenced by climate and management, reduction of N inputs from their source will be the most effective means to prevent or to minimize environmental and economic impacts of excess Nr to the nation’s water resources.
Edsall, Thomas A.; Brock, R.H.; Bukata, R.P.; Dawson, J.J.; Horvath, F.J.; Busch, W.-Dieter N.; Sly, Peter G.
This section of the Classification and Inventory of Great Lakes Aquatic Habitat report was prepared as a series of individually authored contributions that describe, in various levels of detail, state-of-the-art techniques that can be used alone or in combination to inventory aquatic habitats and resources in the Laurentian Great Lakes system. No attempt was made to review and evaluate techniques that are used routinely in limnological and fisheries surveys and inventories because it was felt that users of this document would be familiar with them.
Fraser, A S
To ascertain quantitative estimates of resources at risk for eastern Canada, linkage must be made between geological terrain sensitivity to acid deposition and water chemistry. An evaluation has been made of watershed areas principally in the Province of Quebec to identify and characterize factors related to LRTAP effects. The watershed areas are geographically located within the bounds of the high sulphate deposition zone of the continental plume. To identify specific test watersheds for detailed analysis, alkalinity frequency distributions were computed. A selection of watersheds has been made that spans the Pre-Cambrian shield region of the Laurentian highlands, the St. Lawrence lowlands and the Gaspe Peninsula. There is evidence that areas in the far eastern areas of Quebec, removed from strong anthropogenic sources may be considered as approaching critical levels of alkalinity. Ionic composition for selected watersheds display similar chemical characteristics. These differences have been assessed in light of the common effects of sulphate deposition. 11 references.
Ana Paula Vidotto-Magnoni
Full Text Available We evaluated the feeding of fish species of the Nova Avanhandava Reservoir, low Tietê River, São Paulo State, Brazil. Fishes were collected in two stretches of the reservoir: Santa Bárbara (14 samples and Bonito (two samples between September 2002 and March 2004, using gill and seining nets. The results of stomach contents analysis were expressed with the frequency of occurrence and gravimetric method, combined in the Alimentary Index (AI. The 20 species studied consumed 52 food items, grouped in 10 food categories: aquatic insects, terrestrial insects, crustaceans, fish, macroinvertebrates, microcrustaceans, algae, vegetal matter, detritus/sediment and scales. The aquatic insects (mainly Chironomidae, Odonata and Ephemeroptera were the most common food resources, consumed by 18 species. The diet composition of the community (species grouped indicated that the dominant food category in the diet of fishes was aquatic insects (AI = 77.6%, followed by crustaceans (AI = 7.1%. Four trophic guilds were identified according a cluster analysis (Pearson distance: insectivorous (10 species, omnivorous (4 species, detritivorous (3 species and piscivorous/carcinophagous (3 species. Despite the highest number of species, the insectivorous guild was responsible for more than 80% in captures in number and biomass (CPUEn and CPUEb. The low values of niche breadth presented by all species, along with the low values of diet overlap between species pairs indicate a high degree of food resources partitioning among species. The aquatic insects, despite being the main food resource of insectivorous fishes, also complemented the diet of other species, which demonstrate the importance of this food resource for the fish community, sustaining a high diversity, abundance and biomass of fishes.
Surface and storm water conditions on the Naval Submarine Base (NSB), Bangor, Washington, are evaluated, and recommendations are made to improve water quality and enhance the ecological integrity of aquatic resources located on the base...
Fitzsimons, R. E.; Laurino, C. N.; Vallejos, R. H.
The use of aquatic plants in artificial lakes as a biomass source for biogas and fertilizer production through anaerobic fermentation is evaluated, and the magnitude of this resource and the potential production of biogas and fertilizer are estimated. The specific case considered is the artificial lake that will be created by the construction of Parana Medio Hydroelectric Project on the middle Parana River in Argentina. The growth of the main aquatic plant, water hyacinth, on the middle Parana River has been measured, and its conversion to methane by anaerobic fermentation is determined. It is estimated that gross methane production may be between 1.0-4.1 x 10 to the 9th cu cm/year. The fermentation residue can be used as a soil conditioner, and it is estimated production of the residue may represent between 54,900-221,400 tons of nitrogen/year, a value which is 2-8 times the present nitrogen fertilizer demand in Argentina.
Gleason, Robert A.; Contributions by Chesley-Preston, Tara L.; Coleman, James L.; Haines, Seth S.; Jenni, Karen E.; Nieman, Timothy L.; Peterman, Zell E.; van der Burg, Max Post; Preston, Todd M.; Smith, Bruce D.; Tangen, Brian A.; Thamke, Joanna N.; Gleason, Robert A.; Tangen, Brian A.
The Williston Basin, which includes parts of Montana, North Dakota, and South Dakota in the United States and the provinces of Manitoba and Saskatchewan in Canada, has been a leading domestic oil and gas producing region for more than one-half a century. Currently, there are renewed efforts to develop oil and gas resources from deep geologic formations, spurred by advances in recovery technologies and economic incentives associated with the price of oil. Domestic oil and gas production has many economic benefits and provides a means for the United States to fulfill a part of domestic energy demands; however, environmental hazards can be associated with this type of energy production in the Williston Basin, particularly to aquatic resources (surface water and shallow groundwater) by extremely saline water, or brine, which is produced with oil and gas. The primary source of concern is the migration of brine from buried reserve pits that were used to store produced water during recovery operations; however, there also are considerable risks of brine release from pipeline failures, poor infrastructure construction, and flow-back water from hydraulic fracturing associated with modern oilfield operations. During 2008, a multidisciplinary (biology, geology, water) team of U.S. Geological Survey researchers was assembled to investigate potential energy production effects in the Williston Basin. Researchers from the U.S. Geological Survey participated in field tours and met with representatives from county, State, tribal, and Federal agencies to identify information needs and focus research objectives. Common questions from agency personnel, especially those from the U.S. Fish and Wildlife Service, were “are the brine plumes (plumes of brine-contaminated groundwater) from abandoned oil wells affecting wetlands on Waterfowl Production Areas and National Wildlife Refuges?” and “are newer wells related to Bakken and Three Forks development different than the older
S. R. Ahn
Full Text Available Watershed health, including the natural environment, hydrology, water quality, and aquatic ecology, is assessed for the Han River basin (34 148 km2 in South Korea by using the Soil and Water Assessment Tool (SWAT. The evaluation procedures follow those of the Healthy Watersheds Assessment by the U.S. Environmental Protection Agency (EPA. Six components of the watershed landscape are examined to evaluate the watershed health (basin natural capacity: stream geomorphology, hydrology, water quality, aquatic habitat condition, and biological condition. In particular, the SWAT is applied to the study basin for the hydrology and water-quality components, including 237 sub-watersheds (within a standard watershed on the Korea Hydrologic Unit Map along with three multipurpose dams, one hydroelectric dam, and three multifunction weirs. The SWAT is calibrated (2005–2009 and validated (2010–2014 by using each dam and weir operation, the flux-tower evapotranspiration, the time-domain reflectometry (TDR soil moisture, and groundwater-level data for the hydrology assessment, and by using sediment, total phosphorus, and total nitrogen data for the water-quality assessment. The water balance, which considers the surface–groundwater interactions and variations in the stream-water quality, is quantified according to the sub-watershed-scale relationship between the watershed hydrologic cycle and stream-water quality. We assess the integrated watershed health according to the U.S. EPA evaluation process based on the vulnerability levels of the natural environment, water resources, water quality, and ecosystem components. The results indicate that the watershed's health declined during the most recent 10-year period of 2005–2014, as indicated by the worse results for the surface process metric and soil water dynamics compared to those of the 1995–2004 period. The integrated watershed health tended to decrease farther downstream within the watershed.
Hering, Daniel; Carvalho, Laurence; Argillier, Christine; Beklioglu, Meryem; Borja, Angel; Cardoso, Ana Cristina; Duel, Harm; Ferreira, Teresa; Globevnik, Lidija; Hanganu, Jenica; Hellsten, Seppo; Jeppesen, Erik; Kodeš, Vit; Solheim, Anne Lyche; Nõges, Tiina; Ormerod, Steve; Panagopoulos, Yiannis; Schmutz, Stefan; Venohr, Markus; Birk, Sebastian
Water resources globally are affected by a complex mixture of stressors resulting from a range of drivers, including urban and agricultural land use, hydropower generation and climate change. Understanding how stressors interfere and impact upon ecological status and ecosystem services is essential for developing effective River Basin Management Plans and shaping future environmental policy. This paper details the nature of these problems for Europe's water resources and the need to find solutions at a range of spatial scales. In terms of the latter, we describe the aims and approaches of the EU-funded project MARS (Managing Aquatic ecosystems and water Resources under multiple Stress) and the conceptual and analytical framework that it is adopting to provide this knowledge, understanding and tools needed to address multiple stressors. MARS is operating at three scales: At the water body scale, the mechanistic understanding of stressor interactions and their impact upon water resources, ecological status and ecosystem services will be examined through multi-factorial experiments and the analysis of long time-series. At the river basin scale, modelling and empirical approaches will be adopted to characterise relationships between multiple stressors and ecological responses, functions, services and water resources. The effects of future land use and mitigation scenarios in 16 European river basins will be assessed. At the European scale, large-scale spatial analysis will be carried out to identify the relationships amongst stress intensity, ecological status and service provision, with a special focus on large transboundary rivers, lakes and fish. The project will support managers and policy makers in the practical implementation of the Water Framework Directive (WFD), of related legislation and of the Blueprint to Safeguard Europe's Water Resources by advising the 3rd River Basin Management Planning cycle, the revision of the WFD and by developing new tools for
Bunting, Stuart W.; Luo, S.; Cai, K.
The need for enhanced environmental planning and management for highland aquatic resources is described and rationale for integrated action planning presented. Past action planning initiatives for biodiversity conservation and wetland management are reviewed. A reflective account is given...... of integrated action planning from five sites in China, India and Vietnam. Eight planning phases are described encompassing: stakeholder assessment and partner selection; rapport building and agreement on collaboration; integrated biodiversity, ecosystem services, livelihoods and policy assessment; problem...... analysis and target setting; strategic planning; planning and organisation of activities; coordinated implementation and monitoring; evaluation and revised target-setting. The scope and targeting of actions was evaluated using the DPSIR framework and compatibility with biodiversity conservation and socio...
Kahn, S; Mylrea, G; Yaacov, K Bar
Animal health is fundamental to efficient animal production and, therefore, to food security and human health. This holds true for both terrestrial and aquatic animals. Although partnership between producers and governmental services is vital for effective animal health programmes, many key activities are directly carried out by governmental services. Noting the need to improve the governance of such services in many developing countries, the World Organisation for Animal Health (OIE), using the OIE Tool for the Evaluation of Performance of Veterinary Services, conducts assessments of Veterinary Services and Aquatic Animal Health Services (AAHS) to help strengthen governance and support more effective delivery of animal health programmes. While good governance and the tools to improve governance in the aquatic animal sector are largely based on the same principles as those that apply in the terrestrial animal sector, there are some specific challenges in the aquatic sector that have a bearing on the governance of services in this area. For example, the aquaculture industry has experienced rapid growth and the use of novel species is increasing; there are important gaps in scientific knowledge on diseases of aquatic animals; there is a need for more information on sustainable production; the level of participation of the veterinary profession in aquatic animal health is low; and there is a lack of standardisation in the training of aquatic animal health professionals. Aquaculture development can be a means of alleviating poverty and hunger in developing countries. However, animal diseases, adverse environmental impacts and food safety risks threaten to limit this development. Strengthening AAHS governance and, in consequence, aquatic animal health programmes, is the best way to ensure a dynamic and sustainable aquaculture sector in future. This paper discusses the specific challenges to AAHS governance and some OIE initiatives to help Member Countries to address
The Division of Training and Medical Applications is the component of the Bureau of Radiological Health which has the responsibility for providing training assistance to the Nation's radiological health agencies. Recognizing that these agencies are establishing their own user and personnel training programs, the Division offers through the Training Resources Center a variety of educational materials which may be utilized for specific training purposes. This bulletin contains a list of educational materials, including publications, booklets, slides and transparencies, movies, video tapes, training guides, and training seminars for the education of x-ray technicians in radiation protection
Full Text Available Takuya Honda1, Hiroharu Kamioka21Research Fellow of the Japanese Society for the Promotion of Science, 2Laboratory of Physical and Health Education, Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, JapanBackground: The purpose of this study was to report on the health benefits and curative effects of aquatic exercise.Methods: We adopted the results of high-grade study designs (ie, randomized controlled trials and nonrandomized controlled trials, for which there were many studies on aquatic exercise. Aquatic exercise, in this study, means walking in all directions, stretching, and various exercises and conditioning performed with the feet grounded on the floor of a swimming pool. We excluded swimming. We decided to treat aquatic exercise, underwater exercise, hydrotherapy, and pool exercise as all having the same meaning.Results: Aquatic exercise had significant effects on pain relief and related outcome measurements for locomotor diseases.Conclusion: Patients may become more active, and improve their quality of life, as a result of aquatic exercise.Keywords: aquatic exercise, health enhancement, evidence
Farag, Aïda M.; Harper, David D.
Salts are frequently a major constituent of waste waters produced during oil and gas production. These produced waters or brines must be treated and/or disposed and provide a daily challenge for operators and resource managers. Some elements of salts are regulated with water quality criteria established for the protection of aquatic wildlife, e.g. chloride (Cl−), which has an acute standard of 860 mg/L and a chronic standard of 230 mg/L. However, data for establishing such standards has only recently been studied for other components of produced water, such as bicarbonate (HCO3−), which has acute median lethal concentrations (LC50s) ranging from 699 to > 8000 mg/L and effects on chronic toxicity from 430 to 657 mg/L. While Cl− is an ion of considerable importance in multiple geographical regions, knowledge about the effects of hardness (calcium and magnesium) on its toxicity and about mechanisms of toxicity is not well understood. A multiple-approach design that combines studies of both individuals and populations, conducted both in the laboratory and the field, was used to study toxic effects of bicarbonate (as NaHCO3). This approach allowed interpretations about mechanisms related to growth effects at the individual level that could affect populations in the wild. However, additional mechanistic data for HCO3−, related to the interactions of calcium (Ca2 +) precipitation at the microenvironment of the gill would dramatically increase the scientific knowledge base about how NaHCO3 might affect aquatic life. Studies of the effects of mixtures of multiple salts present in produced waters and more chronic effect studies would give a better picture of the overall potential toxicity of these ions. Organic constituents in hydraulic fracturing fluids, flowback waters, etc. are a concern because of their carcinogenic properties and this paper is not meant to minimize the importance of maintaining vigilance with respect to potential organic contamination.
Background: Community health promotion efforts involve communicating resource information to priority populations. Which communication strategies are most effective is largely unknown for specific populations. Objective: A random-dialed telephone survey was conducted to assess health resource comm...
Spitsbergen, Jan M.; Blazer, Vicki S.; Bowser, Paul R.; Cheng, Keith C.; Cooper, Keith R.; Cooper, Timothy K.; Frasca, Salvatore; Groman, David B.; Harper, Claudia M.; (Mac) Law, Jerry M.; Marty, Gary D.; Smolowitz, Roxanna M.; Leger, Judy St.; Wolf, Douglas C.; Wolf, Jeffrey C.
Utilization of finfish and aquatic invertebrates in biomedical research and as environmental sentinels has grown dramatically in recent decades. Likewise the aquaculture of finfish and invertebrates has expanded rapidly worldwide as populations of some aquatic food species and threatened or endangered aquatic species have plummeted due to overharvesting or habitat degradation. This increasing intensive culture and use of aquatic species has heightened the importance of maintaining a sophisticated understanding of pathology of various organ systems of these diverse species. Yet, except for selected species long cultivated in aquaculture, pathology databases and the workforce of highly trained pathologists lag behind those available for most laboratory animals and domestic mammalian and avian species. Several factors must change to maximize the use, understanding, and protection of important aquatic species: 1) improvements in databases of abnormalities across species; 2) standardization of diagnostic criteria for proliferative and nonproliferative lesions; and 3) more uniform and rigorous training in aquatic morphologic pathology. PMID:18948226
Gordon, Janice M.; Chkhenkeli, Nina; Govoni, David L.; Lightsom, Frances L.; Ostroff, Andrea C.; Schweitzer, Peter N.; Thongsavanh, Phethala; Varanka, Dalia E.; Zednik, Stephan
Use cases, information modeling, and linked data techniques are Semantic Web technologies used to develop a prototype system that integrates scientific observations from four independent USGS and cooperator data systems. The techniques were tested with a use case goal of creating a data set for use in exploring potential relationships among freshwater fish populations and environmental factors. The resulting prototype extracts data from the BioData Retrieval System, the Multistate Aquatic Resource Information System, the National Geochemical Survey, and the National Hydrography Dataset. A prototype user interface allows a scientist to select observations from these data systems and combine them into a single data set in RDF format that includes explicitly defined relationships and data definitions. The project was funded by the USGS Community for Data Integration and undertaken by the Community for Data Integration Semantic Web Working Group in order to demonstrate use of Semantic Web technologies by scientists. This allows scientists to simultaneously explore data that are available in multiple, disparate systems beyond those they traditionally have used.
Anthropogenic forced warming of the Earth due to the greenhouse effect could have profound impacts on the world's living aquatic resources. An extensive review is provided of literature concerning such impacts, including physical changes in the ocean and coastal zone, biological changes in coastal wetlands and estuaries, effects of temperature rises and changes in ice cover on marine species, physical and biological impacts on inland waters, and impacts on fisheries. The principal effects would be caused by the increases in temperature and sea-level rise, but changes in precipitation would also be important. Suitable habitats would generally shift poleward and inland. Species would likely shift in abundances and distribution, thus affecting fisheries. It is likely that global warming will produce collapses of some fisheries and expansions of others. The likelihood of collapse may be aggravated by inadequate management due to insufficient authority, unwillingness to act, or lack of knowledge. Options available for reducing the impact of these changes are discussed, along with research needed to help prepare for climate change. 111 refs
Brittingham, Margaret C; Maloney, Kelly O; Farag, Aïda M; Harper, David D; Bowen, Zachary H
Technological advances in hydraulic fracturing and horizontal drilling have led to the exploration and exploitation of shale oil and gas both nationally and internationally. Extensive development of shale resources has occurred within the United States over the past decade, yet full build out is not expected to occur for years. Moreover, countries across the globe have large shale resources and are beginning to explore extraction of these resources. Extraction of shale resources is a multistep process that includes site identification, well pad and infrastructure development, well drilling, high-volume hydraulic fracturing and production; each with its own propensity to affect associated ecosystems. Some potential effects, for example from well pad, road and pipeline development, will likely be similar to other anthropogenic activities like conventional gas drilling, land clearing, exurban and agricultural development and surface mining (e.g., habitat fragmentation and sedimentation). Therefore, we can use the large body of literature available on the ecological effects of these activities to estimate potential effects from shale development on nearby ecosystems. However, other effects, such as accidental release of wastewaters, are novel to the shale gas extraction process making it harder to predict potential outcomes. Here, we review current knowledge of the effects of high-volume hydraulic fracturing coupled with horizontal drilling on terrestrial and aquatic ecosystems in the contiguous United States, an area that includes 20 shale plays many of which have experienced extensive development over the past decade. We conclude that species and habitats most at risk are ones where there is an extensive overlap between a species range or habitat type and one of the shale plays (leading to high vulnerability) coupled with intrinsic characteristics such as limited range, small population size, specialized habitat requirements, and high sensitivity to disturbance
McKee, Martin; Dubois, Carl-Ardy; Nolte, Ellen
... systems in the field of personnel. The authors also identify which strategies are most likely to lead to the optimal management of health professionals in the future. Human Resources for Health in Europe is key reading for health policymakers and postgraduates taking courses in health services management, health policy and health economics. It is also ...
Barton, Carrie L; Johnson, Eric W; Tanguay, Robert L
The number of researchers and institutions moving to the utilization of zebrafish for biomedical research continues to increase because of the recognized advantages of this model. Numerous factors should be considered before building a new or retooling an existing facility. Design decisions will directly impact the management and maintenance costs. We and others have advocated for more rigorous approaches to zebrafish health management to support and protect an increasingly diverse portfolio of important research. The Sinnhuber Aquatic Research Laboratory (SARL) is located ∼3 miles from the main Oregon State University campus in Corvallis, Oregon. This facility supports several research programs that depend heavily on the use of adult, larval, and embryonic zebrafish. The new zebrafish facility of the SARL began operation in 2007 with a commitment to build and manage an efficient facility that diligently protects human and fish health. An important goal was to ensure that the facility was free of Pseudoloma neurophilia (Microsporidia), which is very common in zebrafish research facilities. We recognize that there are certain limitations in space, resources, and financial support that are institution dependent, but in this article, we describe the steps taken to build and manage an efficient specific pathogen-free facility.
Stolbov A. G.
Full Text Available The state of fisheries has been researched based on a systematic approach and comprehensive analysis of statistical data, the following issues have been characterized: the catch of aquatic biological resources (ABR, consumption of fish products, problems in the development of the fishing industry (fleet aging, lack of innovative technologies, the proliferation of IUU fishing4 , the high level of retail prices for fish, low degree of processing export products, overshoot "improper objects" of fishing, the gap in aquaculture development, low economic efficiency. To improve the quality of fishery management it has been proposed to form the organizational and economic mechanism of ABR rational use, which should include effective tools for the implementation of management decisions. Instead of the so-called "historical" principle it has been suggested to use the investment principle of quota allocation and rental payments. The basis for management of fishing industry should be scientifically based on the bioeconomic concept of ABR rational use, the essence of which is to preserve the ABR and at the same time to obtain the maximum output of finished products with high added value. To form the organizational and economic mechanism it is necessary to develop a programme of innovative development of the fisheries sector, a calendar programme of upgrading of fishing fleet, wellreasoned differential rates of rent payments for the ABR use, scenarios and graphic organization of work of fishing vessels in specific fishing areas, to form regional financial and industrial clusters, to expand the authority of the Fisheries Agency, to improve corporate social responsibility of the fishing business communities. Modernization of management system for ABR rational use can significantly reduce environmental pollution, ensure the effective delivery of catch to shore, their high-quality processing and the needs of the population in fish products.
Eddlemon, G.K.; Webb, J.W.; Hunsaker, D.B. Jr.; Miller, R.L.
To help reduce US dependence on imported petroleum, Congress passed the Energy Security Act of 1980 (public Law 96-294). This legislation authorized the US Department of Energy (DOE) to promote expansion of the fuel alcohol industry through, among other measures, its Alcohol Fuels Loan Guarantee Program. Under this program, selected proposals for the conversion of plant biomass into fuel-grade ethanol would be granted loan guarantees. of 57 applications submitted for loan guarantees to build and operate ethanol fuel projects under this program, 11 were considered by DOE to have the greatest potential for satisfying DOE's requirements and goals. In accordance with the National Environmental Policy Act (NEPA), DOE evaluated the potential impacts of proceeding with the Loan Guarantee Program in a programmatic environmental assessment (DOE 1981) that resulted in a finding of no significant impact (FANCY) (47 Federal Register 34, p. 7483). The following year, DOE conducted site-specific environmental assessments (EAs) for 10 of the proposed projects. These F-As predicted no significant environmental impacts from these projects. Eventually, three ethanol fuel projects received loan guarantees and were actually built: the Tennol Energy Company (Tennol; DOE 1982a) facility near Jasper in southeastern Tennessee; the Agrifuels Refining Corporation (Agrifuels; DOE 1985) facility near New Liberia in southern Louisiana; and the New Energy Company of Indiana (NECI; DOE 1982b) facility in South Bend, Indiana. As part of a larger retrospective examination of a wide range of environmental effects of ethanol fuel plants, we compared the actual effects of the three completed plants on aquatic and terrestrial resources with the effects predicted in the NEPA EAs several years earlier. A secondary purpose was to determine: Why were there differences, if any, between actual effects and predictions? How can assessments be improved and impacts reduced?
Andrew J. Loftus; Curtis H. Flather
The Forest and Rangeland Renewable Resources Planning Act (RPA) of 1974 requires periodic assessments of the status and trends in the Nation's renewable natural resources including fish and other aquatic species and their habitats. Data from a number of sources are used to document trends in habitat quality, populations, resource use, and patterns of imperilment...
Sedeno-Diaz, J. E.; Lopez-Lopez, E.; Jimenez-Trujillo, P.; Tejeda-Vera, R.; Espainal Carrion, T.
The pollution of water bodies reduces their quality and is stressful to their biota. In a river, water usually is of the high-est quality in its headwaters reaches, becoming dirtier along its length as it passes through different land uses. Therefore, the aquatic environment should be assessed using physicochemical and biological features in order to provide a full spectrum of aquatic ecosystem health. Water Quality Indexes can be used to aggregate data on water quality parameters and to translate this information into a single value. The use of bio markers as indicators of toxicity delineates the effects of xenobiotics before the appearance of diseases in aquatic organism. The use of a battery bio markers may be useful to evaluate the various response to mixtures of pollutants. (Author)
Charles A. Osunla
Full Text Available Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens.
Osunla, Charles A; Okoh, Anthony I
Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens.
Osunla, Charles A.
Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens. PMID:28991153
Goldman, J.C.; Ryther, J.H.; Waaland, R.; Wilson, E.H.
Background information is documented on the mass cultivation of aquatic plants and systems design that is available from the literature and through consultation with active research scientists and engineers. The biology of microalgae, macroalgae, and aquatic angiosperms is discussed in terms of morphology, life history, mode of existence, and ecological significance, as they relate to cultivation. The requirements for growth of these plants, which are outlined in the test, suggest that productivity rates are dependent primarily on the availability of light and nutrients. It is concluded that the systems should be run with an excess of nutrients and with light as the limiting factor. A historical review of the mass cultivation of aquatic plants describes the techniques used in commercial large-scale operations throughout the world and recent small-scale research efforts. This review presents information on the biomass yields that have been attained to date in various geographical locations with different plant species and culture conditions, emphasizing the contrast between high yields in small-scale operations and lower yields in large-scale operations.
Swee Joo Teh; Hinton, D.E.
Environmental regulators are increasingly looking for better, more cost-effective ways to protect biological resources from harmful consequences of pollution, and to restore the formerly contaminated watersheds. Where financial restraints are a reality, prioritization of efforts becomes necessary. Detection of harmful contaminant effects by direct analysis of fishes residing in streams and coastal waters of varying quality can yield information necessary to prioritize future efforts and to verify whether remediation has been achieved. Responses of tissues, body fluids, and cells signal exposure and these B iomarkers , on the other hand, reflect the bioavailability of contaminants, provide a rapid and inexpensive means for toxicity assessment, may serve as fingerprints of specific classes of chemicals, and serve as an early warning of population and community stress. Furthermore, biomarkers can identify early stages of disease and serve as a powerful integrator between contaminant exposure and biologic responses to xenobiotics found in the environment. This report will focus on the application of biomarkers as an indicator of xenobiotic exposure and deleterious effect and to evaluate progress of remediation efforts. Various levels of biomarker approaches, from biochemical to morphologic, which have been shown to be powerful tools for assessing environmental contamination and health, will be presented and their application for field validation will be discussed. When integrated with chemical analysis, biomarker approaches provide unique information on infaunal organisms and on the health of their ecosystems. (Author)
Angell, C; Hemingway, A; Hartwell, H
To identify public health open educational resources (OER) available online, map the identified OER to The Public Health Skills and Career Framework (PHSCF), and triangulate these findings with public health practitioners. Systematic online search for public health OER. An online search was undertaken using a pre-defined set of search terms and inclusion/exclusion criteria. Public health OER were then mapped against the UK PHSCF. The findings of the search were discussed with public health specialists to determine whether or not they used these resources. A number of public health OER were identified, located on 42 websites from around the world. Mapping against the UK PHSCF demonstrated a lack of coverage in some areas of public health education. It was noted that many of the OER websites identified were not those generally used in practice, and those sites preferred by public health specialists were not identified by the online search. Public health OER are available from a number of providers, frequently universities and government organizations. However, these reflect a relatively small pool of original OER providers. Tagging of websites does not always identify their public health content. In addition, users of public health OER may not use search engines to identify resources but locate them using other means. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Swasti, an International Health Resource Centre was established in 2002 in India. The objective was to enhance the health and well-being of communities, particularly the marginalized. Swasti’s main focus lies in the areas of primary health, sexual and reproductive health including HIV, communicable and non-communicable diseases, water, sanitation and hygiene and gender based violence. The organization, during the last decade has grown in leaps and bounds reaching out to the most affected comm...
Munzer, J.E.; Sauer, K.G.
The training collection maintained by the Division of Training and Medical Applications includes videocassettes, movies, and printed material. Titles are limited to radiological health subjects only and include a variety of topics ranging from basic fundamentals to historical perspectives to current state-of-the-art
Full Text Available Abstract Organisms in polluted environments are typically exposed to a complex mixture of chemical contaminants. The great concern about the health of aquatic ecosystems has led to the increased use of biomarkers over the past years. The aim of this work was to review the papers published from 2000 to 2015, which used biomarkers to assess the health of aquatic ecosystems in Brazil. A research resulted in 99 eligible papers. More than 80% of studies were conducted in the states of São Paulo and Rio Grande do Sul. Approximately 63% of studies used fish as bioindicator, whereas the micronucleus test and biochemical analyses were the most used biomarkers. A multibiomarker approach was used by 60.6% of studies, while 39.4% used one single biomarker. Furthermore, 68% were field studies and more than 75% of these used control animals sampled at reference sites. A relationship between the biomarker responses and pollution was reported by 87% of studies; however, 43.4% of studies analyzed only one sampling period, limiting comparisons and comprehension about possible seasonal variations. This review evidenced some weak points in studies using biomarkers in Brazil, especially related to the lack of studies in two important biomes (the Pantanal and the Amazon Rainforest and experimental designs (small sample size, sampling in one single period, use of one single biomarker. Thus, future studies should consider mainly the use of multiple biomarkers, greater sample size, seasonal sampling and water physicochemical parameters to better diagnose the health of aquatic ecosystems.
Cole, Richard A
...) when they significantly degrade services provided by water resources. Government agencies, utilities, and other water resource managers incur substantial costs controlling ANS and repairing damage to restore service performance to desired levels...
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
El Anshasy, Amany A; Katsaiti, Marina-Selini
The purpose of this paper is to empirically examine whether economic dependence on various natural resources is associated with lower investment in health, after controlling for countries' geographical and historical fixed effects, corruption, autocratic regimes, income levels, and initial health status. Employing panel data for 118 countries for the period 1990-2008, we find no compelling evidence in support of a negative effect of resources on healthcare spending and outcomes. On the contrary, higher dependence on agricultural exports is associated with higher healthcare spending, higher life expectancy, and lower diabetes rates. Similarly, healthcare spending increases with higher mineral intensity. Finally, more hydrocarbon resource rents are associated with less diabetes and obesity rates. There is however evidence that public health provision relative to the size of the economy declines with greater hydrocarbon resource-intensity; the magnitude of this effect is less severe in non-democratic countries. Copyright © 2014 Elsevier Ltd. All rights reserved.
Bradford, Michael J.
Biodiversity offset programs attempt to minimize unavoidable environmental impacts of anthropogenic activities by requiring offsetting measures in sufficient quantity to counterbalance losses due to the activity. Multipliers, or offsetting ratios, have been used to increase the amount of offsets to account for uncertainty but those ratios have generally been derived from theoretical or ad-hoc considerations. I analyzed uncertainty in the offsetting process in the context of offsetting for impacts to freshwater fisheries productivity. For aquatic habitats I demonstrate that an empirical risk-based approach for evaluating prediction uncertainty is feasible, and if data are available appropriate adjustments to offset requirements can be estimated. For two data-rich examples I estimate multipliers in the range of 1.5:1 - 2.5:1 are sufficient to account for the uncertainty in the prediction of gains and losses. For aquatic habitats adjustments for time delays in the delivery of offset benefits can also be calculated and are likely smaller than those for prediction uncertainty. However, the success of a biodiversity offsetting program will also depend on the management of the other components of risk not addressed by these adjustments.
Bradford, Michael J
Biodiversity offset programs attempt to minimize unavoidable environmental impacts of anthropogenic activities by requiring offsetting measures in sufficient quantity to counterbalance losses due to the activity. Multipliers, or offsetting ratios, have been used to increase the amount of offsets to account for uncertainty but those ratios have generally been derived from theoretical or ad-hoc considerations. I analyzed uncertainty in the offsetting process in the context of offsetting for impacts to freshwater fisheries productivity. For aquatic habitats I demonstrate that an empirical risk-based approach for evaluating prediction uncertainty is feasible, and if data are available appropriate adjustments to offset requirements can be estimated. For two data-rich examples I estimate multipliers in the range of 1.5:1 - 2.5:1 are sufficient to account for the uncertainty in the prediction of gains and losses. For aquatic habitats adjustments for time delays in the delivery of offset benefits can also be calculated and are likely smaller than those for prediction uncertainty. However, the success of a biodiversity offsetting program will also depend on the management of the other components of risk not addressed by these adjustments.
Minnesota Department of Natural Resources — Aquatic vegetation represented as polygon features, coded with vegetation type (emergent, submergent, etc.) and field survey date. Polygons were digitized from...
Newman, Scott H.; Chmura, Aleksei; Converse, Kathy; Kilpatrick, A. Marm; Patel, Nikkita; Lammers, Emily; Daszak, Peter
We analyzed data from pathologic investigations in the United States, collected by the USGS National Wildlife Health Center between 1971 and 2005, into aquatic bird mortality events. A total of 3619 mortality events was documented for aquatic birds, involving at least 633 708 dead birds from 158 species belonging to 23 families. Environmental causes accounted for the largest proportion of mortality events (1737 or 48%) and dead birds (437 258 or 69%); these numbers increased between 1971 and 2000, with biotoxin mortalities due to botulinum intoxication (Types C and E) being the leading cause of death. Infectious diseases were the second leading cause of mortality events (20%) and dead birds (20%), with both viral diseases, including duck plague (Herpes virus), paramyxovirus of cormorants (Paramyxovirus PMV1) and West Nile virus (Flavivirus), and bacterial diseases, including avian cholera (Pasteurella multocida), chlamydiosis (Chalmydia psittici), and salmonellosis (Salmonella sp.), contributing. Pelagic, coastal marine birds and species that use marine and freshwater habitats were impacted most frequently by environmental causes of death, with biotoxin exposure, primarily botulinum toxin, resulting in mortalities of both coastal and freshwater species. Pelagic birds were impacted most severely by emaciation and starvation, which may reflect increased anthropogenic pressure on the marine habitat from over-fishing, pollution, and other factors. Our study provides important information on broad trends in aquatic bird mortality and highlights how long-term wildlife disease studies can be used to identify anthropogenic threats to wildlife conservation and ecosystem health. In particular, mortality data for the past 30 yr suggest that biotoxins, viral, and bacterial diseases could have impacted >5 million aquatic birds.
Liu, Liyue; Pan, Luyuan; Li, Kuoyu; Zhang, Yun; Zhu, Zuoyan; Sun, Yonghua
In China, the use of zebrafish as an experimental animal in the past 15 years has widely expanded. The China Zebrafish Resource Center (CZRC), which was established in 2012, is becoming one of the major resource centers in the global zebrafish community. Large-scale use and regular exchange of zebrafish resources have put forward higher requirements on zebrafish health issues in China. This article reports the current aquatic infrastructure design, animal husbandry, and health-monitoring programs in the CZRC. Meanwhile, through a survey of 20 Chinese zebrafish laboratories, we also describe the current health status of major zebrafish facilities in China. We conclude that it is of great importance to establish a widely accepted health standard and health-monitoring strategy in the Chinese zebrafish research community.
Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.
Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851
Clow, David W.; Nanus, Leora; Huggett, Brian
An abundance of exposed bedrock, sparse soil and vegetation, and fast hydrologic flushing rates make aquatic ecosystems in Yosemite National Park susceptible to nutrient enrichment and episodic acidification due to atmospheric deposition of nitrogen (N) and sulfur (S). In this study, multiple linear regression (MLR) models were created to estimate fall‐season nitrate and acid neutralizing capacity (ANC) in surface water in Yosemite wilderness. Input data included estimated winter N deposition, fall‐season surface‐water chemistry measurements at 52 sites, and basin characteristics derived from geographic information system layers of topography, geology, and vegetation. The MLR models accounted for 84% and 70% of the variance in surface‐water nitrate and ANC, respectively. Explanatory variables (and the sign of their coefficients) for nitrate included elevation (positive) and the abundance of neoglacial and talus deposits (positive), unvegetated terrain (positive), alluvium (negative), and riparian (negative) areas in the basins. Explanatory variables for ANC included basin area (positive) and the abundance of metamorphic rocks (positive), unvegetated terrain (negative), water (negative), and winter N deposition (negative) in the basins. The MLR equations were applied to 1407 stream reaches delineated in the National Hydrography Data Set for Yosemite, and maps of predicted surface‐water nitrate and ANC concentrations were created. Predicted surface‐water nitrate concentrations were highest in small, high‐elevation cirques, and concentrations declined downstream. Predicted ANC concentrations showed the opposite pattern, except in high‐elevation areas underlain by metamorphic rocks along the Sierran Crest, which had relatively high predicted ANC (>200 μeq L−1). Maps were created to show where basin characteristics predispose aquatic resources to nutrient enrichment and acidification effects from N and S deposition. The maps can be used to help guide
Clow, D. W.; Nanus, L.; Huggett, B. W.
An abundance of exposed bedrock, sparse soil and vegetation, and fast hydrologic flushing rates make aquatic ecosystems in Yosemite National Park susceptible to nutrient enrichment and episodic acidification due to atmospheric deposition of nitrogen (N) and sulfur (S). In this study, multiple-linear regression (MLR) models were created to estimate fall-season nitrate and acid neutralizing capacity (ANC) in surface water in Yosemite wilderness. Input data included estimated winter N deposition, fall-season surface-water chemistry measurements at 52 sites, and basin characteristics derived from geographic information system layers of topography, geology, and vegetation. The MLR models accounted for 84% and 70% of the variance in surface-water nitrate and ANC, respectively. Explanatory variables (and the sign of their coefficients) for nitrate included elevation (positive) and the abundance of neoglacial and talus deposits (positive), unvegetated terrain (positive), alluvium (negative), and riparian (negative) areas in the basins. Explanatory variables for ANC included basin area (positive) and the abundance of metamorphic rocks (positive), unvegetated terrain (negative), water (negative), and winter N deposition (negative) in the basins. The MLR equations were applied to 1407 stream reaches delineated in the National Hydrography Dataset for Yosemite, and maps of predicted surface-water nitrate and ANC concentrations were created. Predicted surface-water nitrate concentrations were highest in small, high-elevation cirques, and concentrations declined downstream. Predicted ANC concentrations showed the opposite pattern, except in high-elevation areas underlain by metamorphic rocks along the Sierran Crest, which had relatively high predicted ANC (>200 µeq L-1). Maps were created to show where basin characteristics predispose aquatic resources to nutrient enrichment and acidification effects from N and S deposition. The maps can be used to help guide development of
DeMarco, Kristin; Hillmann, Eva R.; Brasher, Michael G.; LaPeyre, Megan K.
Submerged aquatic vegetation (SAV) beds are shallow coastal habitats that are increasingly exposed to the effects of sea-level rise (SLR). In the northern Gulf of Mexico (nGoM), an area especially vulnerable to SLR, the abundance and distribution of SAV food resources (seeds, rhizomes, and tissue) can influence the carrying capacity of coastal marshes to support wintering waterfowl. Despite the known importance of SAV little is known about their distribution across coastal landscapes and salinity zones or how they may be impacted by SLR. We estimated SAV cover and seed biomass in coastal marshes from Texas to Alabama from 1 June – 15 September 2013 to assess variation in SAV and seed resource distribution and abundance across the salinity gradient. Percent cover of SAV was similar among salinity zones (10%–20%) although patterns of distribution differed. Specifically, SAV occurred less frequently in saline zones, but when present the percent coverage was greater than in fresh, intermediate and brackish. Mean seed biomass varied greatly and did not differ significantly among salinity zones. However, when considering only seed species identified as waterfowl foods, the mean seed biomass was lower in saline zones (1.2 g m–2). Alteration of nGoM marshes due to SLR will likely shift the distribution and abundance of SAV resources, and these shifts may affect carrying capacity of coastal marshes for waterfowl and other associated species.
Hancock, Melyssa; Hoa, Michael; Malekzadeh, Sonya
Advances in modern communications and information technology have helped to improve access to, and quality of, health care and education. These enhancements include a variety of World Wide Web-based and mobile learning platforms, such as eLearning, mLearning, and open education resources. This article highlights the innovative approaches that have fostered improved collaboration and coordination of global health efforts in otolaryngology. Copyright © 2018 Elsevier Inc. All rights reserved.
Jun 14, 2007 ... ... of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. 4. ... six year Emergency Human Resource Programme aimed ... therefore to elucidate the extent of major surgical work ... back for review seven days after discharge. ... and 24 hour maternal condition, post-operative fever, wound.
Østerdal, Lars Peter
This paper examines principles of health care resource allocation based on axioms for individual preferences and distributive justice. We establish axioms for representing individual preferences by quality-adjusted life years (QALYs), as well as axioms for existence of a social welfare function...
Dieleman, Marjolein; Hilhorst, Thea
Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH), HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic
Rosenbaum, Ralph K.; Hauschild, Michael Zwicky; Bachmann, Till M.
, called USEtox, to serve as a repository for recommended practice. USEtox is a parsimonious and transparent tool that currently provides human-health characterisation factors (CFs) for some 1000 chemicals and aquatic ecotoxicity CFs for more than 2000 substances. The accuracy of these factors relative...... and distribution of a user-friendly version of USEtox; 8) industry/stakeholder workshops on comparative assessment of chemicals and training courses in USEtox. The promising scientific results now need to be transferred into daily LCA practice, which is the main goal of these activities, aiming at a broad...
Jaime R. Goode; Charles H. Luce; John M. Buffington
The delivery and transport of sediment through mountain rivers affects aquatic habitat and water resource infrastructure. While climate change is widely expected to produce significant changes in hydrology and stream temperature, the effects of climate change on sediment yield have received less attention. In the northern Rocky Mountains, we expect climate change to...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice; correction. SUMMARY: HRSA published a document in the Federal...
Over recent years the growth in aquaculture, accompanied by the emergence of new and transboundary diseases, has stimulated epidemiological studies of aquatic animal diseases. Great potential exists for both observational and theoretical approaches to investigate the processes driving emergence but, to date, compared to terrestrial systems, relatively few studies exist in aquatic animals. Research using risk methods has assessed routes of introduction of aquatic animal pathogens to facilitate safe trade (e.g. import risk analyses) and support biosecurity. Epidemiological studies of risk factors for disease in aquaculture (most notably Atlantic salmon farming) have effectively supported control measures. Methods developed for terrestrial livestock diseases (e.g. risk-based surveillance) could improve the capacity of aquatic animal surveillance systems to detect disease incursions and emergence. The study of disease in wild populations presents many challenges and the judicious use of theoretical models offers some solutions. Models, parameterised from observational studies of host pathogen interactions, have been used to extrapolate estimates of impacts on the individual to the population level. These have proved effective in estimating the likely impact of parasite infections on wild salmonid populations in Switzerland and Canada (where the importance of farmed salmon as a reservoir of infection was investigated). A lack of data is often the key constraint in the application of new approaches to surveillance and modelling. The need for epidemiological approaches to protect aquatic animal health will inevitably increase in the face of the combined challenges of climate change, increasing anthropogenic pressures, limited water sources and the growth in aquaculture. Table of contents 1 Introduction 4 2 The development of aquatic epidemiology 7 3 Transboundary and emerging diseases 9 3.1 Import risk analysis (IRA) 10 3.2 Aquaculture and disease emergence 11 3.3 Climate
Howe, K S
Economics is too important to be left to the experts. This paper is therefore mainly for animal health policy-makers who are not economists but want a better appreciation of how economics can contribute to resource allocation decisions. First, the methodology of economic analysis is outlined with the objective of dispelling criticisms of its simplifying assumption of rationality. Then, unusual in economics but more familiar to biological and veterinary scientists, the technical aspects of transforming resources into products are discussed. Economics' unique contribution is to establish criteria enabling society to obtain maximum value from the production and distribution of goods and services (products) from scarce resources. Animal disease reduces the efficiency of this process. Value is intangible, but people reveal how much they value (i.e. feel a want or need for) products by what they actually consume, in quality and quantity. Animal products, and so implicitly animals themselves, are an example. The strength of people's preferences is reflected both in the prices they pay for market goods and services, and by their political votes where markets do not exist. Importantly, there is a difference between financial value (what the consumer pays for a good or service) and economic value (the maximum amount of money they would be prepared to pay for it). Allocating resources for animal health creates both costs and benefits, financial and economic. Moreover, costs and benefits are both private and social because of externalities, a major consideration in infectious diseases. Where production decisions with animal health implications are made exclusively for private benefit, government has a role in providing incentives for animal sectors to act in ways that result in socially efficient outcomes.
Black, Robert W.; Czuba, Christiana R.; Magirl, Christopher S.; McCarthy, Sarah; Berge, Hans; Comanor, Kyle
Watershed restoration is the focus of many resource managers and can include a multitude of restoration actions each with specific restoration objectives. For the White River flowing through the cities of Pacific and Sumner, Washington, a levee setback has been proposed to reconnect the river with its historical floodplain to help reduce flood risks, as well as provide increased habitat for federally listed species of salmonids. The study presented here documents the use of a modeling framework that integrates two-dimensional hydraulic modeling with process-based bioenergetics modeling for predicting how changes in flow from reconnecting the river with its floodplain affects invertebrate drift density and the net rate of energy intake of juvenile salmonids. Modeling results were calculated for flows of 25.9 and 49.3 cubic meters per second during the spring, summer, and fall. Predicted hypothetical future mean velocities and depths were significantly lower and more variable when compared to current conditions. The abundance of low energetic cost and positive growth locations for salmonids were predicted to increase significantly in the study reach following floodplain reconnection, particularly during the summer. This modeling framework presents a viable approach for evaluating the potential fisheries benefits of reconnecting a river to its historical floodplain that integrates our understanding of hydraulic, geomorphology, and organismal biology.
Matzo, Marianne; Troup, Sandi; Hijjazi, Kamal; Ferrell, Betty
This article shares the findings of an evaluation of a patient teaching resource for sexual health entitled Everything Nobody Tells You About Cancer Treatment and Your Sex Life: From A to Z, which was accomplished through systematic conceptualization, construction, and evaluation with women diagnosed with breast or gynecologic cancer. This resource, which has evolved from patient-focused research and has been tested in the clinical setting, can be used in patient education and support. Oncology professionals are committed to addressing quality-of-life concerns for patients across the trajectory of illness. Sexuality is a key concern for patients and impacts relationships and overall quality of life. Through careful assessment, patient education, and support, clinicians can ensure that sexuality is respected as an essential part of patient-centered care.
Apte, Shree Kumar
Terrestrial sources of uranium are getting depleted fast and may be exhausted in the next few decades. This has triggered a search for alternate or secondary resources for this precious metal. Nearly 4.5 billion tons of uranium on our planet resides in seawater, albeit at very low concentrations of 3 ppb. Recovering uranium from such low concentrations is a major challenge. Two marine cyanobacteria, the unicellular Synechococcus elongatus and the filamentous Anabaena torulosa, were found to be capable of rapidly sequestering uranyl carbonate (the predominant uranyl species at the sea-water pH of 7.8) from aqueous solutions, including simulated sea-water. While Synechococcus strain adsorbed the metal as carbonato complexes on cell surface ligands, A. torulosa trapped it in novel surface-associated polyphosphate bodies. The uranium binding potential of cyanobacterial biomass was comparable to, if not better than, the currently in use polyamidoxime resin. The bound uranium could be desorbed easily and the biomass reused a few times. The method has eminently higher application potential in uranium-contaminated terrestrial waters, where the metal concentration is several times higher. Low concentrations (<1 to few mM) of uranium are also found in acidic/alkaline nuclear waste and arise from metal extraction or during reprocessing of fuel. Removal of uranium from such solutions is very desirable for safer disposal of such waste. Biological agents to be employed in such situations also need to be tolerant to and stable in high radiation environments, unless dead cells can be used. To address such bioremediation, the extremely radio-resistant microbe Deinococcus radiodurans was genetically engineered to express either a non-specific acid phosphatase PhoN or a highly active novel alkaline phosphatase PhoK. Apart from the need for high expression of desired protein, such engineering is also fraught with problems of stability, localization and activity of the expressed
Hollnagel, Hanne; Malterud, Kirsti
autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis......autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis...
Bubenheim, David; Potter, Christopher; Zhang, Minghua; Madsen, John
The California Sacramento-San Joaquin River Delta is the hub for California's water supply and supports important ecosystem services, agriculture, and communities in Northern to Southern California. Expansion of invasive aquatic plants in the Delta coupled with impacts of changing climate and long-term drought is detrimental to the San Francisco Bay/California Delta complex. NASA Ames Research Center and the USDA-ARS partnered with the State of California to develop science-based, adaptive-management strategies for invasive aquatic plant in the Sacramento-San Joaquin Delta. Specific mapping tools developed utilizing satellite and airborne platforms provide regular assessments of population dynamics on a landscape scale and support both strategic planning and operational decision making for resource managers. San Joaquin and Sacramento River watersheds water quality input to the Delta is modeled using the Soil-Water Assessment Tool (SWAT) and a modified SWAT tool has been customized to account for unique landscape and management of agricultural water supply and drainage within the Delta. Environmental response models for growth of invasive aquatic weeds are being parameterized and coupled with spatial distribution/biomass density mapping and water quality to study ecosystem response to climate and aquatic plant management practices. On the water validation and operational utilization of these tools by management agencies and how they are improving decision making, management effectiveness and efficiency will be discussed. The project combines science, operations, and economics related to integrated management scenarios for aquatic weeds to help land and water resource managers make science-informed decisions regarding management and outcomes.
Bubenheim, D.; Potter, C. S.; Zhang, M.; Madsen, J.
The California Sacramento-San Joaquin River Delta is the hub for California's water supply and supports important ecosystem services, agriculture, and communities in Northern and Southern California. Expansion of invasive aquatic plants in the Delta coupled with impacts of changing climate and long-term drought is detrimental to the San Francisco Bay/California Delta complex. NASA Ames Research Center and the USDA-ARS partnered with the State of California to develop science-based, adaptive-management strategies for invasive aquatic plant management in the California Sacramento-San Joaquin Delta. Specific mapping tools developed utilizing satellite and airborne platforms provide regular assessments of population dynamics on a landscape scale and support both strategic planning and operational decision making for resource managers. San Joaquin and Sacramento River watersheds water quality input to the Delta is modeled using the Soil-Water Assessment Tool (SWAT) and a modified SWAT tool has been customized to account for unique landscape and management of agricultural water supply and drainage within the Delta. Environmental response models for growth of invasive aquatic weeds are being parameterized and coupled with spatial distribution/biomass density mapping and water quality to study ecosystem response to climate and aquatic plant management practices. On the water validation and operational utilization of these tools by management agencies and how they improve decision making, management effectiveness and efficiency will be discussed. The project combines science, operations, and economics related to integrated management scenarios for aquatic weeds to help land and water resource managers make science-informed decisions regarding management and outcomes.
Danny C. Lee; James R. Sedell; Bruce E. Rieman; Russell F. Thurow; Jack E. Williams
Continuing human activities threaten the highly prized aquatic resources of the interior Columbia basin. Precipitous declines in native species, particularly Pacific salmon, and a large influx of introduced species have radically altered the composition and distribution of native fishes. Fortunately, areas of relatively high aquatic integrity remain, much of it on...
Taufik Budhi Pramono
Full Text Available This research aimed to know internally conflict on the use of aquatic resources at around Donan River, Segara Anakan region Cilacap. Using on fisheries resources was not free against potential conflict among the user or with its interest’s one related to that resources. The lack on capability of identified conflict would be a limiting factor for the implementation on the fisheries resources management program. The research was hold in the region of Segara Anakan, Donan River from August until October 2005. The data collection techniques applied in this survey included questionnaire; observation; in-depth interview with leaders of fisherman organizations; and focus group discussion. Quantitative data was analyzed by descriptive statistics. The research showed that fisherman’s community along Donan River line were not out of inside potentially conflict among inter micro-micro, intra micro-micro and intra micro-macro. This potential conflict were appeared because of presence on the different perception belong to its authority access against Donan River and their open system on the fisheries resources management.Keywords : Conflict, Donan River, Aquatic Resources, Fisherman Community
Federal Laboratory Consortium — Columbia River and groundwater well water sources are delivered to the Aquatic Research Laboratory (ARL), where these resources are used to conduct research on fish...
Wu, Suqing; He, Shengbing; Zhou, Weili; Gu, Jianya; Huang, Jungchen; Gao, Lei; Zhang, Xu
Decomposition of aquatic macrophytes usually generates significant influence on aquatic environment. Study on the aquatic macrophytes decomposition may help reusing the aquatic macrophytes litters, as well as controlling the water pollution caused by the decomposition process. This study verified that the decomposition processes of three different kinds of aquatic macrophytes (water hyacinth, hydrilla and cattail) could exert significant influences on water quality of the receiving water, including the change extent of pH, dissolved oxygen (DO), the contents of carbon, nitrogen and phosphorus, etc. The influence of decomposition on water quality and the concentrations of the released chemical materials both followed the order of water hyacinth > hydrilla > cattail. Greater influence was obtained with higher dosage of plant litter addition. The influence also varied with sediment addition. Moreover, nitrogen released from the decomposition of water hyacinth and hydrilla were mainly NH 3 -N and organic nitrogen while those from cattail litter included organic nitrogen and NO 3 - -N. After the decomposition, the average carbon to nitrogen ratio (C/N) in the receiving water was about 2.6 (water hyacinth), 5.3 (hydrilla) and 20.3 (cattail). Therefore, cattail litter might be a potential plant carbon source for denitrification in ecological system of a constructed wetland. Copyright © 2017 Elsevier Ltd. All rights reserved.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency..., Public Law 104-13), the Health Resources and Services Administration (HRSA) publishes periodic summaries... Administration (HRSA) plans to conduct a survey of the National Practitioner Data Bank and the Healthcare...
Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.
into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...... of the concept as a health resource for elders lacks clarity. Before 1989, research focused principally on medical self-care at the expense of health care, and self-care was seen more as supplementary to professional health care rather than as a health-promoting approach in health care. METHOD...
Dieleman, Marjolein; Hilhorst, Thea
Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH), HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic series has aimed to expand the evidence base on the role of governance in addressing the HRH crisis. The six articles comprising the series present a range of experiences. The articles report on governance in relation to developing a joint vision, building adherence and strengthening accountability, and on governance with respect to planning, implementation, and monitoring. Other governance issues warrant attention as well, such as corruption and transparency in decision-making in HRH policies and strategies. Acknowledging and dealing with governance should be part and parcel of HRH planning and implementation. To date, few experiences have been shared on improving governance for HRH policy making and implementation, and many questions remain unanswered. There is an urgent need to document experiences and for mutual learning.
Full Text Available Abstract Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH, HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic series has aimed to expand the evidence base on the role of governance in addressing the HRH crisis. The six articles comprising the series present a range of experiences. The articles report on governance in relation to developing a joint vision, building adherence and strengthening accountability, and on governance with respect to planning, implementation, and monitoring. Other governance issues warrant attention as well, such as corruption and transparency in decision-making in HRH policies and strategies. Acknowledging and dealing with governance should be part and parcel of HRH planning and implementation. To date, few experiences have been shared on improving governance for HRH policy making and implementation, and many questions remain unanswered. There is an urgent need to document experiences and for mutual learning.
Birdsong, Timothy W.; Bean, Megan; Grabowski, Timothy B.; Hardy, Thomas B.; Heard, Thomas; Holdstock, Derrick; Kollaus, Kristy; Magnelia, Stephan J.; Tolman, Kristina
Low-cost unmanned aerial systems (UAS) have recently gained increasing attention in natural resources management due to their versatility and demonstrated utility in collection of high-resolution, temporally-specific geospatial data. This study applied low-cost UAS to support the geospatial data needs of aquatic resources management projects in four Texas rivers. Specifically, a UAS was used to (1) map invasive salt cedar (multiple species in the genus Tamarix) that have degraded instream habitat conditions in the Pease River, (2) map instream meso-habitats and structural habitat features (e.g., boulders, woody debris) in the South Llano River as a baseline prior to watershed-scale habitat improvements, (3) map enduring pools in the Blanco River during drought conditions to guide smallmouth bass removal efforts, and (4) quantify river use by anglers in the Guadalupe River. These four case studies represent an initial step toward assessing the full range of UAS applications in aquatic resources management, including their ability to offer potential cost savings, time efficiencies, and higher quality data over traditional survey methods.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National... Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600 Fishers Lane, Room... and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers Lane, Rockville, Maryland...
Resources available for school based mental health services in Enugu urban and head teachers' knowledge of childhood mental health problems. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) ...
Familiarize students affiliated with the Student National Medical Association with the National Library of Medicine's online resources that address medical conditions, health disparities, and public health preparedness needs.
Lee, Kathy E.; Schoenfuss, Heiko L.; Barber, Larry B.; Writer, Jeff H.; Blazer, Vicki; Keisling, Richard L.; Ferrey, Mark L.
The U.S. Geological Survey, in cooperation with St. Cloud State University, Minnesota Department of Health, Minnesota Pollution Control Agency, Minnesota Department of Natural Resources, Metropolitan Council Environmental Services, and the University of Minnesota, has conducted field monitoring studies and laboratory research to determine the presence of endocrine active chemicals and the incidence of endocrine disruption in Minnesota streams and lakes during 1994–2008. Endocrine active chemicals are chemicals that interfere with the natural regulation of endocrine systems, and may mimic or block the function of natural hormones in fish or other organisms. This interference commonly is referred to as endocrine disruption. Indicators of endocrine disruption in fish include vitellogenin (female egg yolk protein normally expressed in female fish) in male fish, oocytes present in male fish testes, reduced reproductive success, and changes in reproductive behavior.
The National Library of Medicine (NLM) is sponsoring this course to increase awareness of the availability and value of NLM’s online environmental health and toxicology information resources that provide invaluable tools to address these issues—for professionals and consumers alike. Participants will receive hands-on practice with selected NLM resources, and demonstrations of other valuable resources will be provided.
Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all le...
Alvaro, Celeste; Lyons, Renée F; Warner, Grace; Hobfoll, Stevan E; Martens, Patricia J; Labonté, Ronald; Brown, Richard E
Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use?In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. COR theory contributes to understanding the role of resources in research use, resistance to
Hobfoll Stevan E
Full Text Available Abstract Background Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use? In this paper, we consider conservation of resources (COR theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. Methods A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. Results The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. Conclusions COR theory contributes to
Espinosa, Verónica; de la Torre, Daniel; Acuña, Cecilia; Cadena, Cristina
Describe strategies implemented by Ecuador's Ministry of Public Health (MPH) to strengthen human resources for health leadership and respond to the new model of care, as a part of the reform process in the period 2012-2015. A documentary review was carried out of primary and secondary sources on development of human resources for health before and after the reform. In the study period, Ecuador developed a new institutional and regulatory framework for developing human resources for health to respond to the requirements of a model of care based on primary health care. The MPH consolidated its steering role by forging strategic partnerships, implementing human resources planning methods, and making an unprecedented investment in health worker training, hiring, and wage increases. These elements constitute the initial core for development of human resources for health policy and a health-services study program consistent with the reform's objectives. Within the framework of the reform carried out from 2012 to 2015, intersectoral work by the MPH has led to considerable achievements in development of human resources for health. Notable achievements include strengthening of the steering role, development and implementation of standards and regulatory instruments, creation of new professional profiles, and hiring of professionals to implement the comprehensive health care model, which helped to solve problems carried over from the years prior to the reform.
Hollman, P.C.H.; Bouwmeester, H.; Peters, R.J.B.
Pollution of the environment with plastics is a growing problem, and is expected to persist for hundreds to thousands of years. As a result microplastics, plastic particles with size smaller than 5 mm, are ubiquitously present in the aquatic food chain. The present literature review shows that the
Full Text Available Health and medical care has always been an important issue. Recently, there has been a rapid increase in consumer health awareness. Therefore, Consumer Health Information has been vastlyemphasized, which results in the development of associated websites. According to an investigation in Taiwan, there are 1,820 different health and medical related websites in 2002. However, due to the lack of regulations, some of these websites’ information contents may be faulty and may confuse users or potentially be harmful. The purpose of this article is to advise consumers how to differentiate between correct and incorrect information in the Health Information websites. The present study analyzes the strengths and weaknesses of some Taiwan’s consumer health websites by comparing their structures, contents and other information with those provided by "the Top Ten Most Useful Health Information Websites" of the USA. [Article content in Chinese
Brooks, J. R.; Compton, J.; Herlihy, A.; Sobota, D. J.; Stoddard, J.; Weber, M.
Nitrogen (N) removal in watersheds is an important regulating ecosystem service that can help reduce N pollution in the nation's waterways. However, processes that remove N such as denitrification are generally determined at point locations. Measures that integrate N processing within watersheds and over time would be particularly useful for assessing the degree of this vital service. Because most N removal processes isotopically enrich the N remaining, δ15N from basal food-chain organisms in aquatic ecosystems can provide information on watershed N processing. As part of EPA's National Aquatic Resource Surveys (NARS), we measured δ15N of Chironomidae in lakes, rivers and streams because these larval aquatic insects were found in abundance in almost every lake and stream in the U.S. Using information on nitrogen loading to the watershed, and total N concentrations within the water, we assessed when elevated chironomid δ15N would indicate N removal rather than possible enriched sources of N. Chironomid δ15N values ranged from -4 to +20 ‰, and were higher in rivers and streams than in lakes (median = 7.6 ‰ vs. 4.8 ‰, respectively), indicating that N was processed to a greater degree in lotic chironomids than in lentic ones. For both, δ15N increased with watershed-level agricultural land cover and N loading, and decreased as precipitation increased. In rivers and streams with high synthetic N loading, we found lower N concentrations in streams with higher chironomid δ15N values, suggesting greater N removal. At low levels of synthetic N loading, the pattern reversed, and streams with enriched chironomid δ15N had higher N concentrations, suggesting enriched sources such as manure or sewage. Our results indicate that chironomid δ15N values can provide valuable information about watershed-level N inputs and processing for national water quality monitoring efforts.
Full Text Available ... the text smaller. U.S. Department of Health and Human Services HOME | CONTACT US | ... HealthSense Title/Keywords: Go Diabetes HealthSense provides easy access to resources to help you live well and meet your ...
Jiménez, Paul; Bregenzer, Anita; Kallus, K Wolfgang; Fruhwirth, Bianca; Wagner-Hartl, Verena
Leaders engaging in health-promoting leadership can influence their employees' health directly by showing health awareness or indirectly by changing working conditions. With health-promoting leadership, leaders are able to support a healthy working environment by providing resource-oriented working conditions for their employees to support their health. Changing working conditions in a health-supportive way can prevent possible negative consequences from critical working conditions (e.g., burnout risk). The present study examined the relationship between health-promoting leadership and the employees' resources, stress and burnout. To analyze our proposed model, structural equation modelling was conducted in two samples. The resulting model from the first sample of 228 Austrian workers was cross-validated and could be verified with the second sample (N = 263 Austrian workers). The results supported a model in which health-promoting leadership has a strong direct effect on the employees' resources and an indirect effect on stress and burnout, which was mediated by resources. The results indicate that health-promoting leadership describes the leaders' capability and dedication creating the right working conditions for their employees by increasing the employees' resources at the workplace. This in turn minimizes the risk of experiencing burnout.
Full Text Available Leaders engaging in health-promoting leadership can influence their employees’ health directly by showing health awareness or indirectly by changing working conditions. With health-promoting leadership, leaders are able to support a healthy working environment by providing resource-oriented working conditions for their employees to support their health. Changing working conditions in a health-supportive way can prevent possible negative consequences from critical working conditions (e.g., burnout risk. The present study examined the relationship between health-promoting leadership and the employees’ resources, stress and burnout. To analyze our proposed model, structural equation modelling was conducted in two samples. The resulting model from the first sample of 228 Austrian workers was cross-validated and could be verified with the second sample (N = 263 Austrian workers. The results supported a model in which health-promoting leadership has a strong direct effect on the employees’ resources and an indirect effect on stress and burnout, which was mediated by resources. The results indicate that health-promoting leadership describes the leaders’ capability and dedication creating the right working conditions for their employees by increasing the employees’ resources at the workplace. This in turn minimizes the risk of experiencing burnout.
Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.
into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical...... practice, policy-making and research into health care of frail or robust elders.......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...
Full Text Available ... Diabetes HealthSense provides easy access to resources to help you live well and meet your goals—whether ... be overwhelming, but you can reach out for help. People living with diabetes share their stories about ...
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and scaling up health professionals' education and training, calling for sustainable and ... SA faces similar human resource challenges to other African countries. ... It also supports teacher ... as opposed to the traditional didactic-only lectures.
Rana, Gurpreet K
The Taubman Health Sciences Library (THL) collaborates with health sciences schools to provide information skills instruction for students preparing for international experiences. THL enhances students' global health learning through predeparture instruction for students who are involved in global health research, clinical internships, and international collaborations. This includes teaching international literature searching skills, providing country-specific data sources, building awareness of relevant mobile resources, and encouraging investigation of international news. Information skills empower creation of stronger global partnerships. Use of information resources has enhanced international research and training experiences, built lifelong learning foundations, and contributed to the university's global engagement. THL continues to assess predeparture instruction.
Blewett, Lynn A; Call, Kathleen Thiede; Turner, Joanna; Hest, Robert
Rich federal data resources provide essential data inputs for monitoring the health and health care of the US population and are essential for conducting health services policy research. The six household surveys we document in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP). New federal activities are linking federal surveys with administrative data to reduce duplication and response burden. In the private sector, vendors are aggregating data from medical records and claims to enhance our understanding of treatment, quality, and outcomes of medical care. Federal agencies must continue to innovate to meet the continuous challenges of scarce resources, pressures for more granular data, and new multimode data collection methodologies.
Sun, Jian; Luo, Hongye
China is faced with a daunting challenge to equality and efficiency in health resources allocation and health services utilization in the context of rapid economic growth. This study sought to evaluate the equality and efficiency of health resources allocation and health services utilization in China. Demographic, economic, and geographic area data was sourced from China Statistical Yearbook 2012-2016. Data related to health resources and health services was obtained from China Health Statistics Yearbook 2012-2016. Furthermore, we evaluated the equality of health resources allocation based on Gini coefficient. Concentration index was used to measure the equality in utilization of health services. Data envelopment analysis (DEA) was employed to assess the efficiency of health resources allocation. From 2011 to 2015, the Gini coefficients for health resources by population ranged between 0.0644 and 0.1879, while the Gini coefficients for the resources by geographic area ranged from 0.6136 to 0.6568. Meanwhile, the concentration index values for health services utilization ranged from -0.0392 to 0.2110. Moreover, in 2015, 10 provinces (32.26%) were relatively efficient in terms of health resources allocation, while 7 provinces (22.58%) and 14 provinces (45.16%) were weakly efficient and inefficient, respectively. There exist distinct regional disparities in the distribution of health resources in China, which are mainly reflected in the geographic distribution of health resources. Furthermore, the people living in the eastern developed areas are more likely to use outpatient care, while the people living in western underdeveloped areas are more likely to use inpatient care. Moreover, the efficiency of health resources allocation in 21 provinces (67.74%) of China was low and needs to be improved. Thus, the government should pay more attention to the equality based on geographic area, guide patients to choose medical treatment rationally, and optimize the resource
Dyess, Susan MacLeod
It is important to use all holistic resource opportunities in communities, such as integrative healing centers, and mind-body-spirit approaches to health. These holistic approaches may be realized through nontraditional avenues, such as faith-based resources. This article reports on an exploratory study that describes faith-based resources supporting holistic health in a southeastern region of the United States. A working definition for "faith-based health resources" was "ecumenical and interfaith community-based, open-access health resources that include in mission for service a reference to faith." Excluded from the definition were institutional services from hospitals, focused social services from area agencies, and federally funded services.
Full Text Available Abstract The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated
Kalita, Anuska; Zaidi, Sarover; Prasad, Vandana; Raman, V R
The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated though often isolated health
Jones, Peter; Sopina, Liza Elizaveta; Ashton, Toni
Background The Shorter Stays in Emergency Departments health target was introduced in New Zealand in 2009. District Health Boards (DHBs) are expected to meet the target with no additional funding or incentives. The costs of implementing such targets have not previously been studied. Method A survey.......03), whereas expenditure in the hospital was not (r = 0.08, P = 0.75). Conclusion The fact that estimated expenditure on the target was over $50 million without additional funding suggests that DHBs were able to make savings through improved efficiencies and/or that funds were reallocated from other services...
Full Text Available The Ertebølle culture is a late Mesolithic hunter-gatherer-fisher culture in southern Scandinavia, northern Germany and Poland. Archaeological finds as well as scientific analyses of humans and their artefacts indicate the great importance of aquatic resources, both marine and freshwater, to Ertebølle subsistence. In northern Germany, modern freshwater fish samples can have very high apparent radiocarbon ages (up to 3000 years. If such dramatic 'freshwater reservoir effects' also existed during the late Mesolithic, they could lead to artificially old radiocarbon dates for the bones of Ertebølle humans and domestic dogs, and for carbonised food crusts on cooking pots. Conversely, if we can demonstrate radiocarbon age 'offsets' in such samples, we can often attribute them to the exploitation of freshwater food resources. This article discusses methods of identifying freshwater resources in prehistoric pottery, including radiocarbon reservoir effects. We consider the results of radiocarbon, stable isotope and elemental analyses of food crusts on prehistoric pottery from four sites in the Alster and Trave valleys: Kayhude, Schlamersdorf, Bebensee and Seedorf.
Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab
A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.
Kinman, G; Clements, A J; Hart, J
Research findings indicate that working as a prison officer can be highly stressful, but the aspects of work that predict their mental health status are largely unknown. To examine, using elements of the demands-resources model, the extent to which work pressure and several potential resources (i.e. control, support from managers and co-workers, role clarity, effective working relationships and positive change management) predict mental health in a sample of UK prison officers. The Health and Safety Executive Management Standards Indicator Tool was used to measure job demands and resources. Mental health was assessed by the General Health Questionnaire-28. The effects of demands and resources on mental health were examined via linear regression analysis with GHQ score as the outcome. The study sample comprised 1267 prison officers (86% male). Seventy-four per cent met 'caseness' criteria for mental health problems. Job demands, poor interpersonal relationships, role ambiguity and, to a lesser extent, low job control and poor management of change were key predictors of mental health status. The findings of this study can help occupational health practitioners and psychologists develop structured interventions to improve well-being among prison officers. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: email@example.com
Chad M. Dacus
Full Text Available Soil productivity effects nutritive quality of food plants, growth of humans and animals, and reproductive health of domestic animals. Game-range surveys sometimes poorly explained variations in wildlife populations, but classification of survey data by major soil types improved effectiveness. Our study evaluates possible health effects of lower condition and reproductive rates for wild populations of Odocoileus virginianus Zimmerman (white-tailed deer in some physiographic regions of Mississippi. We analyzed condition and reproductive data for 2400 female deer from the Mississippi Department of Wildlife, Fisheries, and Parks herd health evaluations from 1991–1998. We evaluated age, body mass (Mass, kidney mass, kidney fat mass, number of corpora lutea (CL and fetuses, as well as fetal ages. Region affected kidney fat index (KFI, which is a body condition index, and numbers of fetuses of adults (P ≤ 0.001. Region affected numbers of CL of adults (P ≤ 0.002. Mass and conception date (CD were affected (P ≤ 0.001 by region which interacted significantly with age for Mass (P ≤ 0.001 and CD (P < 0.04. Soil region appears to be a major factor influencing physical characteristics of female deer.
Madsen, T. V.; Sand-Jensen, K.
Aquatic fl owering plants form a relatively young plant group on an evolutionary timescale. The group has developed over the past 80 million years from terrestrial fl owering plants that re-colonised the aquatic environment after 60-100 million years on land. The exchange of species between terre...... terrestrial and aquatic environments continues today and is very intensive along stream banks. In this chapter we describe the physical and chemical barriers to the exchange of plants between land and water.......Aquatic fl owering plants form a relatively young plant group on an evolutionary timescale. The group has developed over the past 80 million years from terrestrial fl owering plants that re-colonised the aquatic environment after 60-100 million years on land. The exchange of species between...
Overview. The current crisis in human resources for health in. Africa has reached a serious level in many countries. A complex set of reasons has contributed to this problem, some exogenous, such as the severe economic measures introduced by structural adjustment, which often result in cutbacks in the number of health ...
Full Text Available ... or school health professional K-8th grade Community health worker Community organization Age Select one: Child Teen and young adult Adult Older adult (65+) Type of Resource Select one: Printable documents Online ... The National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892-2560, Telephone: 301.496.3583
The aquatic environment makes up the major part of our environment and resources, therefore its safety is directly related to the safety our health. In this study, three tilapia species (Oreochromis niloticus, Oreochromis aureus and Tilapia zilli) and Clarias gariepinus were employed to estimate water pollution using ...
Méndez, Claudio A
Omission of human resources from health policy development has been identified as a barrier in the health sector reform's adoption phase. Since 2002, Chile's health care system has been undergoing a transformation based on the principles of health as a human right, equity, solidarity, efficiency, and social participation. While the reform has set forth the redefinition of the medical professions, continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. However, there is still time to undo the shortcomings, in large part because the reform's implementation phase only recently has begun. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies.
Full Text Available Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all levels in the healthcare delivery system. The article aimed at understanding the current status of human resources for health and initiatives adopted to deal with existing shortage and to highlight factors leading to further shortage and to bring to notice the use of talent management strategy as a retention tool. Review Methodology The review used descriptive research design using secondary sources from journals-articles using key words. The study also used exclusion and inclusion criteria to select the articles. The study was done using extensive review of literature on health sector, health workforce, its availability and scarcity due to attrition/emigration in India. The critical review helped in setting objective for the study. Findings The review of articles provided insight into the current status of health workforce in India. The earlier studies emphasized that gap between demand and supply of human resource for health is mainly due to increasing population and burden of diseases. Studies have now identified other factors leading to further shortage as attrition/emigration of skilled health workforce. Most of the initiatives are mainly directed towards increasing supply of human resources for health to deal with the scarcity and less emphasis to control attrition. Few studies highlighted the use of talent management strategy to deal with the challenges of attrition and emigration that helps in retention and controlling further shortage. Recommendations
Mark S. Wipfli; Robert L. Deal; Paul E. Hennon; Adelaide C. Johnson; Toni L. de Santo; Thomas A. Hanley; Mark E. Schultz; Mason D. Bryant; Richard T. Edwards; Ewa H. Orlikowska; Takashi Gomi
Red alder (Alnus rubra Bong.) appears to influence the productivity of young-growth conifer forests and affect the major resources (timber, wildlife, and fisheries) of forested ecosystems in southeast Alaska. We propose an integrated approach to understanding how alder influences trophic links and processes in young-growth ecosystems. The presence...
Salami, Bukola; Dada, Foluke O; Adelakun, Folake E
The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.
Maloney, Stephen; Chamberlain, Michael; Morrison, Shane; Kotsanas, George; Keating, Jennifer L; Ilic, Dragan
Web-based digital repositories allow educational resources to be accessed efficiently and conveniently from diverse geographic locations, hold a variety of resource formats, enable interactive learning, and facilitate targeted access for the user. Unlike some other learning management systems (LMS), resources can be retrieved through search engines and meta-tagged labels, and content can be streamed, which is particularly useful for multimedia resources. The aim of this study was to examine usage and user experiences of an online learning repository (Physeek) in a population of physiotherapy students. The secondary aim of this project was to examine how students prefer to access resources and which resources they find most helpful. The following data were examined using an audit of the repository server: (1) number of online resources accessed per day in 2010, (2) number of each type of resource accessed, (3) number of resources accessed during business hours (9 am to 5 pm) and outside business hours (years 1-4), (4) session length of each log-on (years 1-4), and (5) video quality (bit rate) of each video accessed. An online questionnaire and 3 focus groups assessed student feedback and self-reported experiences of Physeek. Students preferred the support provided by Physeek to other sources of educational material primarily because of its efficiency. Peak usage commonly occurred at times of increased academic need (ie, examination times). Students perceived online repositories as a potential tool to support lifelong learning and health care delivery. The results of this study indicate that today's health professional students welcome the benefits of online learning resources because of their convenience and usability. This represents a transition away from traditional learning styles and toward technological learning support and may indicate a growing link between social immersions in Internet-based connections and learning styles. The true potential for Web
Okorafor, Okore A; Thomas, Stephen
The introduction of fiscal federalism or decentralization of functions to lower levels of government is a reform not done primarily with health sector concerns. A major concern for the health sector is that devolution of expenditure responsibilities to sub-national levels of government can adversely affect the equitable distribution of financial resources across local jurisdictions. Since the adoption of fiscal federalism in South Africa, progress towards achieving a more equitable distribution of public sector health resources (financial) has slowed down considerably. This study attempts to identify appropriate resource allocation mechanisms under the current South African fiscal federal system that could be employed to promote equity in primary health care (PHC) allocations across provinces and districts. The study uses data from interviews with government officials involved in the budgeting and resource allocation process for PHC, literature on fiscal federalism and literature on international experience to inform analysis and recommendations. The results from the study identify historical incremental budgeting, weak managerial capacity at lower levels of government, poor accounting of PHC expenditure, and lack of protection for PHC funds as constraints to the realization of a more equitable distribution of PHC allocations. Based on interview data, no one resource allocation mechanism received unanimous support from stakeholders. However, the study highlights the particularly high level of autonomy enjoyed by provincial governments with regards to decision making for allocations to health and PHC services as the major constraint to achieving a more equitable distribution of PHC resources. The national government needs to have more involvement in decision making for resource allocation to PHC services if significant progress towards equity is to be achieved.
Grossman, Sara; Zerilli, Tina
Health care practitioners have increasingly used the Internet to obtain health and medication information. The vast number of Internet Web sites providing such information and concerns with their reliability makes it essential for users to carefully select and evaluate Web sites prior to use. To this end, this article reviews the general principles to consider in this process. Moreover, as cost may limit access to subscription-based health and medication information resources with established reputability, freely accessible online resources that may serve as an invaluable addition to one's reference collection are highlighted. These include government- and organization-sponsored resources (eg, US Food and Drug Administration Web site and the American Society of Health-System Pharmacists' Drug Shortage Resource Center Web site, respectively) as well as commercial Web sites (eg, Medscape, Google Scholar). Familiarity with such online resources can assist health care professionals in their ability to efficiently navigate the Web and may potentially expedite the information gathering and decision-making process, thereby improving patient care.
O'Neil Mary L
Full Text Available Abstract This article is the lead article in the Human Resources for Health journal's first quarterly feature. The series of seven articles has been contributed by Management Sciences for Health (MSH under the theme of leadership and management in public health and will be published article by article over the next few weeks. The journal has invited Dr Manuel M. Dayrit, Director of the WHO Department of Human Resources for Health and former Minister of Health for the Philippines to launch the feature with an opening editorial to be found in the journal's blog. This opening article describes the human resource challenges that managers around the world report and analyses why solutions often fail to be implemented. Despite rising attention to the acute shortage of health care workers, solutions to the human resource (HR crisis are difficult to achieve, especially in the poorest countries. Although we are aware of the issues and have developed HR strategies, the problem is that some old systems of leading and managing human resources for health do not work in today's context. The Leadership Development Program (LDP is grounded on the belief that good leadership and management can be learned and practiced at all levels. The case studies in this issue were chosen to illustrate results from using the LDP at different levels of the health sector. The LDP makes a profound difference in health managers' attitudes towards their work. Rather than feeling defeated by a workplace climate that lacks motivation, hope, and commitment to change, people report that they are mobilized to take action to change the status quo. The lesson is that without this capacity at all levels, global policy and national HR strategies will fail to make a difference.
Kappelman, John; Tewabe, Dereje; Todd, Lawrence; Feseha, Mulugeta; Kay, Marvin; Kocurek, Gary; Nachman, Brett; Tabor, Neil; Yadeta, Meklit
Aquatic food resources are important components of many modern human hunter-gatherer diets and yet evidence attesting to the widespread exploitation of this food type appears rather late in the archaeological record. While there are times when, for example, the capture of fish and shellfish requires sophisticated technology, there are other cases when the exact ecological attributes of an individual species and the particulars of its environment make it possible for these foods to be incorporated into the human diet with little or no tool use and only a minimal time investment. In order to better understand the full set of variables that are considered in these sorts of foraging decisions, it is necessary to detail the attributes of each particular aquatic environment. We discuss here some of the characteristics of the trunk tributaries of the Nile and Blue Rivers in the Horn of Africa. Unlike typical perennial rivers, these 'temporary' rivers flow only during a brief but intense wet season; during the much longer dry season, the rivers are reduced to a series of increasingly disconnected waterholes, and the abundant and diverse fish and mollusk populations are trapped in ever smaller evaporating pools. The local human population today utilizes a number of diverse capture methods that range from simple to complex, and vary according to the size and depth of the waterhole and the time of the year. When we view the particular characteristics of an individual river system, we find that each river is 'unique' in its individual attributes. The Horn of Africa is believed to be along the route that modern humans followed on their migration out of Africa, and it is likely that the riverine-based foraging behaviors of these populations accompanied our species on its movement into the rest of the Old World. Copyright © 2014 Elsevier Ltd. All rights reserved.
Hillmann, Eva R.; DeMarco, Kristin; LaPeyre, Megan K.
Coastal ecosystems are dynamic and productive areas that are vulnerable to effects of global climate change. Despite their potentially limited spatial extent, submerged aquatic vegetation (SAV) beds function in coastal ecosystems as foundation species, and perform important ecological services. However, limited understanding of the factors controlling SAV distribution and abundance across multiple salinity zones (fresh, intermediate, brackish, and saline) in the northern Gulf of Mexico restricts the ability of models to accurately predict resource availability. We sampled 384 potential coastal SAV sites across the northern Gulf of Mexico in 2013 and 2014, and examined community and species-specific SAV distribution and biomass in relation to year, salinity, turbidity, and water depth. After two years of sampling, 14 species of SAV were documented, with three species (coontail [Ceratophyllum demersum], Eurasian watermilfoil [Myriophyllum spicatum], and widgeon grass [Ruppia maritima]) accounting for 54% of above-ground biomass collected. Salinity and water depth were dominant drivers of species assemblages but had little effect on SAV biomass. Predicted changes in salinity and water depths along the northern Gulf of Mexico coast will likely alter SAV production and species assemblages, shifting to more saline and depth-tolerant assemblages, which in turn may affect habitat and food resources for associated faunal species.
Full Text Available Cyanobacteria or blue-green algae are among the pioneer organisms of planet Earth. They developed an efficient photosynthetic capacity and played a significant role in the evolution of the early atmosphere. Essential for the development and evolution of species, they proliferate easily in aquatic environments, primarily due to human activities. Eutrophic environments are conducive to the appearance of cyanobacterial blooms that not only affect water quality, but also produce highly toxic metabolites. Poisoning and serious chronic effects in humans, such as cancer, have been described. On the other hand, many cyanobacterial genera have been studied for their toxins with anticancer potential in human cell lines, generating promising results for future research toward controlling human adenocarcinomas. This review presents the knowledge that has evolved on the topic of toxins produced by cyanobacteria, ranging from their negative impacts to their benefits.
Zanchett, Giliane; Oliveira-Filho, Eduardo C
Cyanobacteria or blue-green algae are among the pioneer organisms of planet Earth. They developed an efficient photosynthetic capacity and played a significant role in the evolution of the early atmosphere. Essential for the development and evolution of species, they proliferate easily in aquatic environments, primarily due to human activities. Eutrophic environments are conducive to the appearance of cyanobacterial blooms that not only affect water quality, but also produce highly toxic metabolites. Poisoning and serious chronic effects in humans, such as cancer, have been described. On the other hand, many cyanobacterial genera have been studied for their toxins with anticancer potential in human cell lines, generating promising results for future research toward controlling human adenocarcinomas. This review presents the knowledge that has evolved on the topic of toxins produced by cyanobacteria, ranging from their negative impacts to their benefits.
Zanchett, Giliane; Oliveira-Filho, Eduardo C.
Cyanobacteria or blue-green algae are among the pioneer organisms of planet Earth. They developed an efficient photosynthetic capacity and played a significant role in the evolution of the early atmosphere. Essential for the development and evolution of species, they proliferate easily in aquatic environments, primarily due to human activities. Eutrophic environments are conducive to the appearance of cyanobacterial blooms that not only affect water quality, but also produce highly toxic metabolites. Poisoning and serious chronic effects in humans, such as cancer, have been described. On the other hand, many cyanobacterial genera have been studied for their toxins with anticancer potential in human cell lines, generating promising results for future research toward controlling human adenocarcinomas. This review presents the knowledge that has evolved on the topic of toxins produced by cyanobacteria, ranging from their negative impacts to their benefits. PMID:24152991
Full Text Available Phytoplankton acts as a primary producer and biological filter of aquatic ecosystem. Jute retting during monsoon is a common anthropological activity in the rural Bengal. Quantitative seasonal bio-monitoring of phytoplankton community composition with relative abundance and its diversity indices was carried out in this study from April 2013 to March 2014 to assess water quality and the impact of jute retting on phytoplankton diversity of a tropical fresh water oxbow lake in Nadia district of India. We recorded a total of 34 genera of 5 distinct classes, Chlorophyceae (15, Bacillariophyceae (13, Cyanophyceae (4, Dinophyceae (1 and Euglenophyceae (1. Members of Chlorophyceae dominated throughout the year. Unlike Cyanophyceae, Bacillariophyceae was found to be significantly increased during monsoon when compared to the rest of the year. Average phytoplankton density was highest in post-monsoon (8760/L followed by monsoon (4680/L and pre-monsoon (3650/L. Owing to the dominance of class Chlorophyceae and Bacillariophyceae we found this lake to be oligotrophic to mesotrophic. Indices values of genera richness, Shannon-Wiener, evenness and Simpson’s diversity reached their lowest 14, 1.61, 0.61 and 0.68 in monsoon and highest 23, 2.42, 0.77 and 0.86 in post monsoon respectively. The lowest diversity values during monsoon clearly suggested that the selected lake has highest anthropogenic pollution due to jute retting which impacted significantly on phytoplankton diversity. Therefore, the lake is not conducive for fish growth especially during monsoon and we opine that there is a need to regulate jute retting process, intensity and its density in the lake during the monsoon to ensure enhanced biodiversity for sustainable management and conservation of aquatic environment of this Oxbow lake.
Cooper, Robert C.; And Others
This laboratory manual presents information and techniques dealing with aquatic microbiology as it relates to environmental health science, sanitary engineering, and environmental microbiology. The contents are divided into three categories: (1) ecological and physiological considerations; (2) public health aspects; and (3)microbiology of water…
Bullich-Marín, Ingrid; Sánchez-Ferrín, Pau; Cabanes-Duran, Concepció; Salvà-Casanovas, Antoni
The network of social and health care has advanced since its inception. Furthermore, news services have been created and some resources have been adapted within the framework of respective health plans. This article presents the current situation of the different social and health resources in Catalonia, as well as the main changes that have occurred in recent years, more specifically in the period of the Health Plan 2011-2015. This period is characterised by an adaptation of the social and health network within the context of chronic care, for which the development of intermediate care resources has become the most relevant aspect. There is also a need to create a single long-term care sector in which the health care quality is guaranteed. Moreover, in this period, integral and cross-care level is promoted in the health system through a greater coordination between all different levels of care. The social and health network, due to its trajectory and expertise, plays a key role in the quality of care for people with social and medical needs. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.
Rice, J.; Joyce, L. A.; Armel, B.; Bevenger, G.; Zubic, R.
Climate change introduces a significant challenge for land managers and decision makers managing the natural resources that provide many benefits from forests. These benefits include water for urban and agricultural uses, wildlife habitat, erosion and climate control, aquifer recharge, stream flows regulation, water temperature regulation, and cultural services such as outdoor recreation and aesthetic enjoyment. The Forest Service has responded to this challenge by developing a national strategy for responding to climate change (the National Roadmap for Responding to Climate Change, July 2010). In concert with this national strategy, the Forest Service's Westwide Climate Initiative has conducted 4 case studies on individual Forests in the western U.S to develop climate adaptation tools. Western National Forests are particularly vulnerable to climate change as they have high-mountain topography, diversity in climate and vegetation, large areas of water limited ecosystems, and increasing urbanization. Information about the vulnerability and capacity of resources to adapt to climate change and extremes is lacking. There is an urgent need to provide customized tools and synthesized local scale information about the impacts to resources from future climate change and extremes, as well as develop science based adaptation options and strategies in National Forest management and planning. The case study on the Shoshone National Forest has aligned its objectives with management needs by developing a climate extreme vulnerability tool that guides adaptation options development. The vulnerability tool determines the likely degree to which native Yellowstone cutthroat trout and water availability are susceptible to, or unable to cope with adverse effects of climate change extremes. We spatially categorize vulnerability for water and native trout resources using exposure, sensitivity, and adaptive capacity indicators that use minimum and maximum climate and GIS data. Results
Mackey, Timothy Ken; Liang, Bryan Albert
Global public health is threatened by an imbalance in health worker migration from resource-poor countries to developed countries. This "brain drain" results in health workforce shortages, health system weakening, and economic loss and waste, threatening the well-being of vulnerable populations and effectiveness of global health interventions. Current structural imbalances in resource allocation and global incentive structures have resulted in 57 countries identified by WHO as having a "critical shortage" of health workers. Yet current efforts to strengthen domestic health systems have fallen short in addressing this issue. Instead, global solutions should focus on sustainable forms of equitable resource sharing. This can be accomplished by adoption of mandatory global resource and staff-sharing programs in conjunction with implementation of state-based health services corps. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Xu, Xinglong; Zhou, Lulin; Antwi, Henry Asante; Chen, Xi
While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China's Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.
Bound, John; Stinebrickner, Todd; Waidmann, Timothy
We specify a dynamic programming model that addresses the interplay among health, financial resources, and the labor market behavior of men late in their working lives. We model health as a latent variable, for which self reported disability status is an indicator, and allow self-reported disability to be endogenous to labor market behavior. We use panel data from the Health and Retirement Study. While we find large impacts of health on behavior, they are substantially smaller than in models that treat self-reports as exogenous. We also simulate the impacts of several potential reforms to the Social Security program. PMID:27158180
Ozawa, Sachiko; Pongpirul, Krit
Mixed methods research has become increasingly popular in health systems. Qualitative approaches are often used to explain quantitative results and help to develop interventions or survey instruments. Mixed methods research is especially important in low- and middle-income country (LMIC) settings, where understanding social, economic and cultural contexts are essential to assess health systems performance. To provide researchers and programme managers with a guide to mixed methods research in health systems, we review the best resources with a focus on LMICs. We selected 10 best resources (eight peer-reviewed articles and two textbooks) based on their importance and frequency of use (number of citations), comprehensiveness of content, usefulness to readers and relevance to health systems research in resource-limited contexts. We start with an overview on mixed methods research and discuss resources that are useful for a better understanding of the design and conduct of mixed methods research. To illustrate its practical applications, we provide examples from various countries (China, Vietnam, Kenya, Tanzania, Zambia and India) across different health topics (tuberculosis, malaria, HIV testing and healthcare costs). We conclude with some toolkits which suggest what to do when mixed methods findings conflict and provide guidelines for evaluating the quality of mixed methods research.
Each of Canada's ten provinces has a publicly administered system of health insurance, funded by provincial and federal taxes, that is accessible to all citizens and covers all medically necessary services provided by physicians and hospitals. Canadians spend an estimated 9.2 percent of their gross national product on health care (about 2.8 percentage points below US spending), of which three quarters is public-sector spending. According to the Organization for Economic Cooperation and Development, Canada's health status is equal to or better than that of the United States, despite lower per capita health spending. About seven percent of the Canadian labour force works in health care, and attempts to introduce coordinated planning of human resources in health care have not as yet proceeded far. The predominant policy issue here is the supply and the role of physicians. It has been argued that entrenching within the system the fee-for-service method of paying physicians has created a disincentive to the delegation of responsibility to health personnel other than doctors. It is also argued that introduction of government-run health insurance provided the opportunity for human resource planning, but that the decision by governments to act only as the payer resulted in ad-hoc planning approaches. However, governments' concern over health care costs has led to a more direct role by them in the planning of the human resources in health. They are re-examining the autonomy and jurisdictional rights of the professions that deliver health care to Canadians.
Avelino, George; Barberia, Lorena G; Biderman, Ciro
This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.
Full Text Available ... exercise and physical activity for at all activity levels, and has tips to help you be active in ways that suit your lifestyle, interests, health, and budget. Eat Healthy A Healthier You This easy-to-use resource guide ...
Cite as: Abimanyi-Ochom J. Practicalities of health survey field work research in a resource limited setting: challenges and ... vided only ART while TASO provided social support in ..... first aid box in case of any minor accident but was limited.
Review of different documents on human resource for health was undertaken. Particular attention was given to documents from Ethiopia. Generally there is shortage in number of different groups of professionals, mal distribution of professionals between regions, urban and rural setting, and governmental and non ...
Full Text Available ... Your Everyday Guide from the National Institute on Aging This guide has many types of exercise and physical activity for at all activity levels, and has tips to help you be active in ways that suit your lifestyle, interests, health, and budget. Eat Healthy A Healthier You This easy-to-use resource ...
Full Text Available ... a program to prevent or delay the onset of the disease. MOVE! This national weight management program is designed to help veterans lose weight, ... professional K-8th grade Community health worker Community organization Age ... (65+) Type of Resource Select one: Printable documents Online programs In- ...
Full Text Available ... Community health worker Community organization Age Select one: Child Teen and young adult Adult Older adult (65+) Type of Resource Select one: Printable documents Online programs In-person programs Videos and podcasts Presentations Mobile Application Website Webinar Language ...
Full Text Available ... E-MAIL UPDATES External Link Disclaimer National Diabetes Education Program HealthSense Home Make a Plan Articles About ... 65+) Type of Resource Select one: Printable documents Online programs In-person programs Videos and podcasts Presentations ...
Lingle, V A
Benchmarking is a quality improvement tool that is increasingly being applied to the health care field and to the libraries within that field. Using mostly resources assessible at no charge through the Internet, a collection of information was compiled on benchmarking and its applications. Sources could be identified in several formats including books, journals and articles, multi-media materials, and organizations.
... by the experiences of managing the WIRHE scholarship programme, which highlighted the challenges faced by students from rural communities who try to gain access to institutions of higher education. This report describes the Wits CRH experience of organising a student-led rural health careers day as a pilot project, ...
Lawrence, Gregory B.; Sullivan, Timothy J.; Burns, Douglas A.; Bailey, Scott W.; Cosby, Bernard J.; Dovciak, Martin; Ewing, Holly A.; McDonnell, Todd C.; Minocha, Rakesh; Riemann, Rachel; Quant, Juliana; Rice, Karen C.; Siemion, Jason; Weathers, Kathleen C.
The Appalachian National Scenic Trail (AT), a unit of the National Park Service (NPS), spans nearly 2,200 miles from Georgia to Maine, encompassing a diverse range of ecosystems. Acidic deposition (acid rain) threatens the AT’s natural resources. Acid rain is a result of sulfur (S) and nitrogen (N) compounds produced from fossil fuel combustion, motor vehicles, and agricultural practices. The AT is particularly vulnerable to S and N because it passes along ridgetops that receive higher levels of acid rain than lower valley terrain, and these ridges are often underlain by bedrock with minimal ability to buffer acidic inputs. Further, there are numerous S and N emission sources across the region. In the environment, acidic deposition can lower the pH of streams and soils which can ultimately affect fish, invertebrates, and vegetation that inhabit these areas. To address this concern, the MegaTransect Deposition Effects Study evaluated the condition and sensitivity of the AT corridor with respect to acidic deposition, and defined air pollution thresholds (critical and target loads) and recovery rates. Findings indicate that additional S emission
Ahn, Roy; Alpert, Elaine J; Purcell, Genevieve; Konstantopoulos, Wendy Macias; McGahan, Anita; Cafferty, Elizabeth; Eckardt, Melody; Conn, Kathryn L; Cappetta, Kate; Burke, Thomas F
Human trafficking is an increasingly well-recognized human rights violation that is estimated to involve more than 2 million victims worldwide each year. The health consequences of this issue bring victims into contact with health systems and healthcare providers, thus providing the potential for identification and intervention. A robust healthcare response, however, requires a healthcare workforce that is aware of the health impact of this issue; educated about how to identify and treat affected individuals in a compassionate, culturally aware, and trauma-informed manner; and trained about how to collaborate efficiently with law enforcement, case management, and advocacy partners. This article describes existing educational offerings about human trafficking designed for a healthcare audience and makes recommendations for further curriculum development. A keyword search and structured analysis of peer-reviewed and gray literature, conducted in 2011 and 2012, yielded 27 items that provide basic guidance to health professionals on human trafficking. The 27 resources differed substantially in format, length, scope, and intended audience. Topic areas covered by these resources included trafficking definitions and scope, health consequences, victim identification, appropriate treatment, referral to services, legal issues, and security. None of the educational resources has been rigorously evaluated. There is a clear need to develop, implement, and evaluate high-quality education and training programs that focus on human trafficking for healthcare providers. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background At the MDG Summit in September 2010, the UN Secretary-General launched the Global Strategy for Women's and Children's Health. Central within the Global Strategy are the ambitions of "more money for health" and "more health for the money". These aim to leverage more resources for health financing whilst simultaneously generating more results from existing resources - core tenets of public expenditure management and governance. This paper considers these ambitions from a human resources for health (HRH perspective. Methods Using data from the UK Department for International Development (DFID we set out to quantify and qualify the British government's contributions on HRH in developing countries and to establish a baseline.. To determine whether activities and financing could be included in the categorisation of 'HRH strengthening' we adopted the Agenda for Global Action on HRH and a WHO approach to the 'working lifespan' of health workers as our guiding frameworks. To establish a baseline we reviewed available data on Official Development Assistance (ODA and country reports, undertook a new survey of HRH programming and sought information from multilateral partners. Results In financial year 2008/9 DFID spent £901 million on direct 'aid to health'. Due to the nature of the Creditor Reporting System (CRS of the Organisation for Economic Co-operation and Development (OECD it is not feasible to directly report on HRH spending. We therefore employed a process of imputed percentages supported by detailed assessment in twelve countries. This followed the model adopted by the G8 to estimate ODA on maternal, newborn and child health. Using the G8's model, and cognisant of its limitations, we concluded that UK 'aid to health' on HRH strengthening is approximately 25%. Conclusions In quantifying DFID's disbursements on HRH we encountered the constraints of the current CRS framework. This limits standardised measurement of ODA on HRH
Campbell, James; Jones, Iain; Whyms, Desmond
At the MDG Summit in September 2010, the UN Secretary-General launched the Global Strategy for Women's and Children's Health. Central within the Global Strategy are the ambitions of "more money for health" and "more health for the money". These aim to leverage more resources for health financing whilst simultaneously generating more results from existing resources - core tenets of public expenditure management and governance. This paper considers these ambitions from a human resources for health (HRH) perspective. Using data from the UK Department for International Development (DFID) we set out to quantify and qualify the British government's contributions on HRH in developing countries and to establish a baseline.. To determine whether activities and financing could be included in the categorisation of 'HRH strengthening' we adopted the Agenda for Global Action on HRH and a WHO approach to the 'working lifespan' of health workers as our guiding frameworks. To establish a baseline we reviewed available data on Official Development Assistance (ODA) and country reports, undertook a new survey of HRH programming and sought information from multilateral partners. In financial year 2008/9 DFID spent £901 million on direct 'aid to health'. Due to the nature of the Creditor Reporting System (CRS) of the Organisation for Economic Co-operation and Development (OECD) it is not feasible to directly report on HRH spending. We therefore employed a process of imputed percentages supported by detailed assessment in twelve countries. This followed the model adopted by the G8 to estimate ODA on maternal, newborn and child health. Using the G8's model, and cognisant of its limitations, we concluded that UK 'aid to health' on HRH strengthening is approximately 25%. In quantifying DFID's disbursements on HRH we encountered the constraints of the current CRS framework. This limits standardised measurement of ODA on HRH. This is a governance issue that will benefit from further
Mahesh, Sathiadev; Crow, Stephen M
The health care sector has seen a major increase in the use of information technology (IT). The increasing permeation of IT into the enterprise has resulted in many non-IT employees acquiring IT-related skills and becoming an essential part of the IT-enabled enterprise. Health care IT employees work in a continually changing environment dealing with new specializations that are often unfamiliar to other personnel. The widespread use of outsourcing and offshoring in IT has introduced a third layer of complexity in the traditional hierarchy and its approach to managing human resources. This article studies 3 major issues in managing these human resources in an IT-enabled health care enterprise and recommends solutions to the problem.
Copley-Merriman, C; Lair, T J
This paper reviews the issues that are critical for the valuation of medical resources in the context of health economic studies. There are several points to consider when undertaking the valuation of medical resources. The perspective of the analysis should be established before determining the valuation process. Future costs should be discounted to present values, and time and effort spent in assigning a monetary value to a medical resource should be proportional to its importance in the analysis. Prices vary considerably based on location of the service and the severity of the illness episode. Because of the wide variability in pricing data, sensitivity analysis is an important component of validation of study results. A variety of data sources have been applied to the valuation of medical resources. Several types of data are reviewed in this paper, including claims data, national survey data, administrative data, and marketing research data. Valuation of medical resources collected in clinical trials is complex because of the lack of standardization of the data sources. A national pricing data source for health economic valuation would greatly facilitate study analysis and make comparisons between results more meaningful.
Rao Krishna D
Full Text Available Abstract Background In many developing countries, such as India, information on human resources in the health sector is incomplete and unreliable. This prevents effective workforce planning and management. This paper aims to address this deficit by producing a more complete picture of India’s health workforce. Methods Both the Census of India and nationally representative household surveys collect data on self-reported occupations. A representative sample drawn from the 2001 census was used to estimate key workforce indicators. Nationally representative household survey data and official estimates were used to compare and supplement census results. Results India faces a substantial overall deficit of health workers; the density of doctors, nurses and midwifes is a quarter of the 2.3/1000 population World Health Organization benchmark. Importantly, a substantial portion of the doctors (37%, particularly in rural areas (63% appears to be unqualified. The workforce is composed of at least as many doctors as nurses making for an inefficient skill-mix. Women comprise only one-third of the workforce. Most workers are located in urban areas and in the private sector. States with poorer health and service use outcomes have a lower health worker density. Conclusions Among the important human resources challenges that India faces is increasing the presence of qualified health workers in underserved areas and a more efficient skill mix. An important first step is to ensure the availability of reliable and comprehensive workforce information through live workforce registers.
Full Text Available The National Wildlife Refuge system is a vital resource for the protection and conservation of biodiversity and biological integrity in the United States. Surveys were conducted to determine the spatial and temporal patterns of fish, macroinvertebrate, and crayfish populations in two watersheds that encompass three refuges in southern Indiana. The Patoka River National Wildlife Refuge had the highest number of aquatic species with 355 macroinvertebrate taxa, six crayfish species, and 82 fish species, while the Big Oaks National Wildlife Refuge had 163 macroinvertebrate taxa, seven crayfish species, and 37 fish species. The Muscatatuck National Wildlife Refuge had the lowest diversity of macroinvertebrates with 96 taxa and six crayfish species, while possessing the second highest fish species richness with 51 species. Habitat quality was highest in the Muscatatuck River drainage with increased amounts of forested habitats compared to the Patoka River drainage. Biological integrity of the three refuges ranked the Patoka NWR as the lowest biological integrity (mean IBI reach scores = 35 IBI points, while Big Oaks had the highest biological integrity (mean IBI reach score = 41 IBI points. The Muscatatuck NWR had a mean IBI reach score of 31 during June, which seasonally increased to a mean of 40 IBI points during summer. Watershed IBI scores and habitat condition were highest in the Big Oaks NWR.
Morris, Charles C.; Robb, Joseph R.; McCoy, William
Abstract The National Wildlife Refuge system is a vital resource for the protection and conservation of biodiversity and biological integrity in the United States. Surveys were conducted to determine the spatial and temporal patterns of fish, macroinvertebrate, and crayfish populations in two watersheds that encompass three refuges in southern Indiana. The Patoka River National Wildlife Refuge had the highest number of aquatic species with 355 macroinvertebrate taxa, six crayfish species, and 82 fish species, while the Big Oaks National Wildlife Refuge had 163 macroinvertebrate taxa, seven crayfish species, and 37 fish species. The Muscatatuck National Wildlife Refuge had the lowest diversity of macroinvertebrates with 96 taxa and six crayfish species, while possessing the second highest fish species richness with 51 species. Habitat quality was highest in the Muscatatuck River drainage with increased amounts of forested habitats compared to the Patoka River drainage. Biological integrity of the three refuges ranked the Patoka NWR as the lowest biological integrity (mean IBI reach scores = 35 IBI points), while Big Oaks had the highest biological integrity (mean IBI reach score = 41 IBI points). The Muscatatuck NWR had a mean IBI reach score of 31 during June, which seasonally increased to a mean of 40 IBI points during summer. Watershed IBI scores and habitat condition were highest in the Big Oaks NWR. PMID:25632261
Full Text Available Portuguese public health policies do not surpass eighty years in terms of concerted decision-making, and it is inappropriate to speak of a national health policy before the second half of the twentieth century. This article describes the pathway of policymaking from 1900 to 2013, concerning Portuguese Welfare State emergence. It systematises the main stages of the Portuguese health policies, and analyses its stronger lines, highlighting the relationship between political stability, resources and the State's intervention, strongly related to the emergence of the Welfare State. It summarises the milestones of health policy decisions and describes each of them since 1910. A larger description of changes occurred after the democratic regime and the origins of the Welfare State, embodied in the creation of the National Health Service are given, emphasising the process of epidemiological transition, the decline of infant mortality rate and the growth of life expectancy average levels.
MENG Wei; ZHANG Nan; ZHANG Yuan; ZHENG Binghui
The health conditions of Liao River were assessed using 25 sampling sites in April 2005, with water quality index, biotic index and physical habitat quality index.Based on the method of cluster analysis (CA) for water quality indices, it reveals that heavily polluted sites of Liao River are located at estuary and mainstream.The aquatic species surveyed were attached algae and benthic invertebrates.The result shows that the diversity and biomass of attached algae and benthic index of biotic integrity (B-IBI) are degrading as the chemical and physical quality of water bodies deteriorating.Physiochemical parameters, BOD5, CODCr, TN, TP, NH3-N, DO, petroleum hydrocarbon and conductivity, were statistically analyzed with principal component analysis and correlation analysis.The statistical results were incorporated into the integrated assessing water quality index, combining fecal coliform count, attached algae diversity, B-IBI and physical habitat quality score, a comprehensive integrated assessing system of river ecological health was established.Based on the systimetic assesment, the assessed sites are categorized into 9 "healthy" and "sub-healthy" sites and 8 "sub-sick" and "sick" sites.
Gage-Bouchard, Elizabeth A
Recent research has focused attention on the role of patients' and clinicians' cultural skills and values in generating inequalities in health care experiences. Yet, examination of how social structural factors shape people's abilities to build, refine, and leverage strategies for navigating the health care system have received less attention. In this paper I place focus on one such social structural factor, social support, and examine how social support operates as a flexible resource that helps people navigate the health care system. Using the case of families navigating pediatric cancer care this study combines in-depth interviews with parents of pediatric cancer patients (N = 80), direct observation of clinical interactions between families and physicians (N = 73), and in-depth interviews with pediatric oncologists (N = 8). Findings show that physicians assess parental visibility in the hospital, medical vigilance, and adherence to their child's treatment and use these judgments to shape clinical decision-making. Parents who had help from their personal networks had more agility in balancing competing demands, and this allowed parents to more effectively meet institutional expectations for appropriate parental involvement in the child's health care. In this way, social support served as a flexible resource for some families that allowed parents to more quickly adapt to the demands of caring for a child with cancer, foster productive interpersonal relationships with health care providers, and play a more active role in their child's health care. Copyright © 2017 Elsevier Ltd. All rights reserved.
Atmospheric emissions from fossil-fuel power plants and other sources continue to cause concern about impacts of these pollutants on human health and the environment. Assessing these impacts requires a regional-scale approach that integrates spatial and temporal patterns of emissions, environmental factors and human populations. Two examples of regional studies are presented, including a comparison of patterns of coal-fired power plants and selected diseases and identification of areas sensitive to acid rain which may transfer acid and toxic metals to aquatic systems and man. Energy, socio-economic, health and environmental data are often collected and summarized for counties in the USA. Counties are well-defined geopolitical units which can be used to integrate data, to aggregate data into larger regional units, and to display data as thematic maps. However, researchers are too frequently faced with the tedious task of assembling and reformatting files from several data-collection agencies prior to conducting regional studies. Systems such as UPGRADE, DIDS, SEEDIS and Geoecology have standardized many files into integrated data bases which utilize counties as the primary spatial unit. These systems are compared and data resources discussed. (author)
Prata, Ndola; Montagu, Dominic; Jefferys, Emma
In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance.
Prata, Ndola; Montagu, Dominic; Jefferys, Emma
In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance. PMID:15868018
Decker, Daniel J; Schuler, Krysten; Forstchen, Ann B; Wild, Margaret A; Siemer, William F
A significant development in wildlife management is the mounting concern of wildlife professionals and the public about wildlife health and diseases. Concurrently, the wildlife profession is reexamining implications of managing wildlife populations as a public trust and the concomitant obligation to ensure the quality (i.e., health) and sustainability of wildlife. It is an opportune time to emphasize the importance of wildlife health, specifically to advocate for comprehensive and consistent integration of wildlife health in wildlife management. We summarize application of public trust ideas in wildlife population management in the US. We argue that wildlife health is essential to fulfilling public trust administration responsibilities with respect to wildlife, due to the central responsibility of trustees for ensuring the well-being of wildlife species (i.e., the core resources of the trust). Because both health of wildlife and risk perceptions regarding threats posed by wildlife disease to humans and domestic animals are issues of growing concern, managing wildlife disease and risk communication vis-à-vis wildlife health is critical to wildlife trust administration. We conclude that wildlife health professionals play a critical role in protecting the wildlife trust and that current conditions provide opportunities for important contributions by wildlife health professionals in wildlife management.
Warren E. Heilman
This publication provides citizens, private and public organizations, scientists, and others with information about the aquatic conditions in or near national forests in the Ozark-Ouachita Highlands: the Mark Twain in Missouri, the Ouachita in Arkansas and Oklahoma, and the Ozark-St. Francis National Forests in Arkansas. This report includes water quality analyses...
This paper suggests new empirical DEA models for the measurement of health indicators and the allocation of health resources. The proposed models were developed by first suggesting a population-based health indicator. By introducing the suggested indicator into DEA models, a new approach that solves the problem of health resource allocation has been developed. The proposed models are applied to an empirical study of Taiwan's health system. Empirical findings show that the suggested indicator can successfully accommodate the differences in health resource demands between populations, providing more reliable performance information than traditional indicators such as physician density. Using our models and a commonly used allocation mechanism, capitation, to allocate medical expenditures, it is found that the proposed model always obtains higher performance than those derived from capitation, and the superiority increases as allocated expenditures rise.
Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline
Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.
Portela, Gustavo Zoio; Fehn, Amanda Cavada; Ungerer, Regina Lucia Sarmento; Poz, Mario Roberto Dal
From the 1990s onwards, national economies became connected and globalized. Changes in the demographic and epidemiological profile of the population highlighted the need for further discussions and strategies on Human Resources for Health (HRH). The health workforce crisis is a worldwide phenomenon. It includes: difficulties in attracting and retaining health professionals to work in rural and remote areas, poor distribution and high turnover of health staff particularly physicians, poor training of health workforces in new sanitation and demographic conditions and the production of scientific evidence to support HRH decision making, policy management, programs and interventions. In this scenario, technical cooperation activities may contribute to the development of the countries involved, strengthening relationships and expanding exchanges as well as contributing to the production, dissemination and use of technical scientific knowledge and evidence and the training of workers and institutional strengthening. This article aims to explore this context highlighting the participation of Brazil in the international cooperation arena on HRH and emphasizing the role of the World Health Organization in confronting this crisis that limits the ability of countries and their health systems to improve the health and lives of their populations.
Preston, Todd M; Chesley-Preston, Tara L; Thamke, Joanna N
Water (brine) co-produced with oil in the Williston Basin is some of the most saline in the nation. The Prairie Pothole Region (PPR), characterized by glacial sediments and numerous wetlands, covers the northern and eastern portion of the Williston Basin. Sheridan County, Montana, lies within the PPR and has a documented history of brine contamination. Surface water and shallow groundwater in the PPR are saline and sulfate dominated while the deeper brines are much more saline and chloride dominated. A Contamination Index (CI), defined as the ratio of chloride concentration to specific conductance in a water sample, was developed by the Montana Bureau of Mines and Geology to delineate the magnitude of brine contamination in Sheridan County. Values >0.035 indicate contamination. Recently, the U.S. Geological Survey completed a county level geographic information system (GIS)-based vulnerability assessment of brine contamination to aquatic resources in the PPR of the Williston Basin based on the age and density of oil wells, number of wetlands, and stream length per county. To validate and better define this assessment, a similar approach was applied in eastern Sheridan County at a greater level of detail (the 2.59 km(2) Public Land Survey System section grid) and included surficial geology. Vulnerability assessment scores were calculated for the 780 modeled sections and these scores were divided into ten equal interval bins representing similar probabilities of contamination. Two surface water and two groundwater samples were collected from the section with the greatest acreage of Federal land in each bin. Nineteen of the forty water samples, and at least one water sample from seven of the ten selected sections, had CI values indicating contamination. Additionally, CI values generally increased with increasing vulnerability assessment score, with a stronger correlation for groundwater samples (R(2)=0.78) than surface water samples (R(2)=0.53). Copyright © 2013
Blazer, V.S.; Iwanowicz, L.R.; Baumann, P.C.
INTRODUCTION The Ashtabula River is located in northeast Ohio, flowing into Lake Erie at Ashtabula, Ohio. Tributaries include Fields Brook, Hubbard Run, Strong Brook, and Ashtabula Creek. The bottom sediments, bank soils and biota of Fields Brook have been severely contaminated by unregulated discharges of hazardous substances. Hazardous substances have migrated downstream from Fields Brook to the Ashtabula River and Harbor, contaminating bottom sediments, fish and wildlife. There are presently more than 1,000,000 cubic yards of contaminated sediment in the Ashtabula River and Harbor, much of which originated from Fields Brook. Contaminants include polychlorinated biphenyls (PCBs), chlorinated benzenes, chlorinated ethenes, hexachlorobutadiene, polyaromatic hydrocarbons (PAHs), other organic chemicals, heavy metals and low level radionuclides. A Preassessment Screen, using existing data, was completed for the Ashtabula River and Harbor on May 18, 2001. Among the findings was that the fish community at Ashtabula contained approximately 45 percent fewer species and 52 percent fewer individuals than the Ohio EPA designated reference area, Conneaut Creek. The Ashtabula River and Conneaut Creek are similar in many respects, with the exception of the presence of contamination at Ashtabula. The difference in the fish communities between the two sites is believed to be at least partially a result of the hazardous substance contamination at Ashtabula. In order to investigate this matter further, the Trustees elected to conduct a study of the status and health of the aquatic biological communities of the Ashtabula River and Conneaut Creek in 2002-2004. The following document contains brief method descriptions (more detail available in attached Appendix A) and a summary of the data used to evaluate the health status of brown bullheads (Ameiurus nebulosus) and largemouth bass (Micropterus salmoides) collected from the above sites.
Full Text Available Appropriately trained Human Resources for Health (HRH are key inputs into One Health. ‘… more than 50% of all infectious diseases of humans originate from animals and that, of the emerging diseases about 75% could be traced back to animal origin’ (Rweyemamu et al. 2006. A comprehensive understanding of the social determinants of health, through an appropriate training model for HRH, is a key input. This study aimed to explore if human and veterinary medical schools were using such a model or providing time for this model in their curricula. Specific objectives were to: determine the time that human and veterinary medical schools’ curricula provide for subjects or courses related to the social determinants of health; analyse the curricula contents to establish how they relate to the social determinants of health; and explore how a bio-medical model may influence the graduates’ understanding and practice of One Health. A review of human and veterinary graduate-level medical schools’ curricula in East Africa was performed in April 2013 and May 2013. The findings were: in the curricula, SDH contents for knowledge enhancement about One Health are minimal and that teaching is Germ Theory model-driven and partisan. Out of the total training time for physicians and veterinarians, less than 10% was provided for the social determinants of health-related courses. In conclusion, the curricula and training times provided are inadequate for graduates to fully understand the social determinants of health and their role in One Health. Furthermore, the Germ Theory model that has been adopted addresses secondary causes and is inappropriate. There is a need for more in-depth model. This article suggests that a vicious cycle of ill-health model must be taught.
Full Text Available Abstract In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM; a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: • the central role of the workforce in the health sector; • the various challenges thrown up by health system reforms; • the need to anticipate the effect on the health workforce (and consequently on service provision arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs. Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH: • to move beyond the traditional approach of personnel administration to a more global concept of HRM; • to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy; • to foster a more proactive attitude among human resources (HR policy-makers and managers; • to promote the full commitment of all professionals and sectors in all phases of the process. The development of explicit human resources
Kim, Dong Yeun; Kim, Oh Sik; Kim, Chang Guk; Park, Cheong Gil; Lee, Gwi Hyeon; Lee, Cheol Hui
This book deals aquatic chemistry, which treats water and environment, chemical kinetics, chemical balance like dynamical characteristic, and thermodynamics, acid-base chemistry such as summary, definition, kinetics, and PH design for mixture of acid-base chemistry, complex chemistry with definition, and kinetics, precipitation and dissolution on summary, kinetics of precipitation and dissolution, and balance design oxidation and resolution with summary, balance of oxidation and resolution.
Full Text Available Pharmaceuticals and Personal Care Products PPCPs are different chemical substances biologically active. They are part of drugs, supplements and cosmetics. An increasing interest in the field of PPCPs is observed recently. High sensitivity analysis methods allowed to detect PPCPs in natural environment in the world . Because of their complex chemical structure these compounds are not completely removed and discharged into the sewage for treatment and as such unchanged or intermediate metabolites may cause pollution of surface and deep water. It is estimated that they may accumulate in living organisms. PPCPs problem becomes a serious challenge for many scientific disciplines. The aim of the study is to present the problem of the occurrence of PPCPs in water environment as a new environmental health hazard. This study presents selected groups of PPCPs as the examples of research in the field of PPCPS and their presence in the environment. Moreover new prospects of removing these substances from water are shown.
National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.
This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,…
Full Text Available Abstract Introduction Following twenty years of economic and social growth, Liberia's fourteen-year civil war destroyed its health system, with most of the health workforce leaving the country. Following the inauguration of the Sirleaf administration in 2006, the Ministry of Health & Social Welfare (MOHSW has focused on rebuilding, with an emphasis on increasing the size and capacity of its human resources for health (HRH. Given resource constraints and the high maternal and neonatal mortality rates, MOHSW concentrated on its largest cadre of health workers: nurses. Case description Based on results from a post-war rapid assessment of health workers, facilities and community access, MOHSW developed the Emergency Human Resources (HR Plan for 2007-2011. MOHSW established a central HR Unit and county-level HR officers and prioritized nursing cadres in order to quickly increase workforce numbers, improve equitable distribution of workers and enhance performance. Strategies included increasing and standardizing salaries to attract workers and prevent outflow to the private sector; mobilizing donor funds to improve management capacity and fund incentive packages in order to retain staff in hard to reach areas; reopening training institutions and providing scholarships to increase the pool of available workers. Discussion and evaluation MOHSW has increased the total number of clinical health workers from 1396 in 1998 to 4653 in 2010, 3394 of which are nurses and midwives. From 2006 to 2010, the number of nurses has more than doubled. Certified midwives and nurse aides also increased by 28% and 31% respectively. In 2010, the percentage of the clinical workforce made up by nurses and nurse aides increased to 73%. While the nursing cadre numbers are strong and demonstrate significant improvement since the creation of the Emergency HR Plan, equitable distribution, retention and performance management continue to be challenges. Conclusion This paper
Garcia, Carolyn M; Lechner, Kate E; Frerich, Ellen A; Lust, Katherine A; Eisenberg, Marla E
Many emerging adults (18-25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students' perceptions of health care providers, specifically in the context of accessing sexual health resources. Students (N = 52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. Open-ended one-to-one interview questions. Inductive qualitative analysis yielded six themes summarizing students' perceptions of provider characteristics, health care resources, the role of their peers, and students' suggestions for strengthening health care services. Importantly, students consider a variety of staff-and their student peers-to be resources for sexual health information and services. Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Postsecondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers' characteristics and interpersonal skills. © 2014 Wiley Periodicals, Inc.
Garcia, Carolyn M.; Lechner, Kate E.; Frerich, Ellen A.; Lust, Katherine A.; Eisenberg, Marla E.
Objective Many emerging adults (18–25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students’ perceptions of health care providers, specifically in the context of accessing sexual health resources. Design and Sample Students (N=52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. Results Inductive qualitative analysis yielded six themes summarizing students’ perceptions of provider characteristics, health care resources, the role of their peers, and students’ suggestions for strengthening health care services. Importantly, students consider a variety of staff—and their student peers—to be resources for sexual health information and services. Conclusions Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Post-secondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers’ characteristics and interpersonal skills. PMID:25159532
In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomized by oil extraction in sub-Saharan Africa. Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined. Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalized and instrumentalized toward economic and corporate interests in resource curse settings. From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms.
Full Text Available Abstract Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan, I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments are further examined. Results Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings. Conclusion From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components and more open perspectives on causal mechanisms.
Spanager, Lene; Østergaard, Doris; Lippert, Anne; Nielsen, Kurt; Dieckmann, Peter
Studies show that human errors contribute to up to 70% of mistakes and mishaps in health care. Crisis resource management, CRM, is a conceptual framework for analysing and training individual and team skills in order to prevent and manage errors. Different CRM training methods, e.g. simulation, are in use and the literature emphasises the need of training the full team or organisation for maximal effect. CRM training has an effect on skill improvement, but few studies have shown an effect on patient outcome. However, these studies show great variability of quality.
Full Text Available Aquatic organisms play a very important role in human nutrition. They also pose a real threat for human health by causing various diseases. Parasites, bacteria and viruses may either directly or indirectly be carried from aquatic organisms to humans. Disease outbreaks are influenced by many factors among which decreased immune response and feeding habits and higyene are most important. More frequent occuence of foodborne diseases has a number of reasons, including international travel and trade, microbial adaptation and changes in the food production system. Parasitic diseases occur most frequently as a result of human role in parasites life cycles. The prevalence is further increased by consuming raw fish and shellfish. The main feature of bacterial infections is facultative pathogenicity of most ethiological agents. In most cases disease occures as a result of decreased immunoreactivity. Several bacteria are, however, hightly pathogenic and capable of causing high morbidity and mortality in human. To date it has not been reported the case of human infection with viruses specific for aquatic organisms. Human infections are caused with human viruses and aquatic organisms play role only as vechicles. The greatest risk in that respect present shellfish. Fish and particularly shellfish are likely to cause food poisoning in humans. In most cases the cause are toxins of phithoplancton origins accumulating in shellfish and fish.
St Clair, Nicole E; Pitt, Michael B; Bakeera-Kitaka, Sabrina; McCall, Natalie; Lukolyo, Heather; Arnold, Linda D; Audcent, Tobey; Batra, Maneesh; Chan, Kevin; Jacquet, Gabrielle A; Schutze, Gordon E; Butteris, Sabrina
Trainees and clinicians from high-income countries are increasingly engaging in global health (GH) efforts, particularly in resource-limited settings. Concomitantly, there is a growing demand for these individuals to be better prepared for the common challenges and controversies inherent in GH work. This is a state-of-the-art review article in which we outline what is known about the current scope of trainee and clinician involvement in GH experiences, highlight specific considerations and issues pertinent to GH engagement, and summarize preparation recommendations that have emerged from the literature. The article is focused primarily on short-term GH experiences, although much of the content is also pertinent to long-term work. Suggestions are made for the health care community to develop and implement widely endorsed preparation standards for trainees, clinicians, and organizations engaging in GH experiences and partnerships. Copyright © 2017 by the American Academy of Pediatrics.
Murray, Katrina N; Varga, Zoltán M; Kent, Michael L
The Zebrafish International Resource Center (ZIRC) is a repository and distribution center for mutant, transgenic, and wild-type zebrafish. In recent years annual imports of new zebrafish lines to ZIRC have increased tremendously. In addition, after 15 years of research, we have identified some of the most virulent pathogens affecting zebrafish that should be avoided in large production facilities, such as ZIRC. Therefore, while importing a high volume of new lines we prioritize safeguarding the health of our in-house fish colony. Here, we describe the biosecurity and health-monitoring program implemented at ZIRC. This strategy was designed to prevent introduction of new zebrafish pathogens, minimize pathogens already present in the facility, and ensure a healthy zebrafish colony for in-house uses and shipment to customers.
Porterfield, Deborah S; Marcial, Laura H; Brown, Stephen; Throop, Cynthia; Pina, Jamie
Quality improvement is a critical mechanism to manage public health agency performance and to strengthen accountability for public funds. The objective of this study was to evaluate a relatively new quality improvement resource, the Public Health Quality Improvement Exchange (PHQIX), a free online communication platform dedicated to making public health quality improvement information accessible to practitioners. We conducted an internet-based survey of registered PHQIX users (n = 536 respondents) in 2013 and key informant interviews with PHQIX frequent users (n = 21) in 2014, in the United States. We assessed use of the PHQIX website, user engagement and satisfaction, communication and knowledge exchange, use of information, and impact on quality improvement capacity and accreditation readiness. Of 462 respondents, 369 (79.9%) browsed quality improvement initiatives, making it the most commonly used site feature, and respondents described PHQIX as a near-unique source for real-world quality improvement examples. Respondents were satisfied with the quality and breadth of topics and relevance to their settings (average satisfaction scores, 3.9-4.1 [where 5 was the most satisfied]). Of 407 respondents, 237 (58.2%) said that they had put into practice information learned on PHQIX, and 209 of 405 (51.6%) said that PHQIX had helped to improve quality improvement capacity. Fewer than half of respondents used the commenting function, the Community Forum, and the Ask an Expert feature. Findings suggest that PHQIX, particularly descriptions of the quality improvement initiatives, is a valued resource for public health practitioners. Users reported sharing information with colleagues and applying what they learned to their own work. These findings may relate to other efforts to disseminate quality improvement knowledge.
Procci, Katelyn; Bowers, Clint; Wong, Christopher; Andrews, Anya
Providing resources and stress management techniques is vital to the improvement of mental health outcomes of deploying warfighters. Despite the large amount of resources available, they are largely ineffective owing in part to lack of familiarity and knowledge of the resources themselves. This may be ameliorated through game-based practice environments. The objective of this study was to develop and evaluate a serious game to teach deploying military personnel about available mental health resources and coping skills, as well as to determine whether the inclusion of minigames improved learning outcomes. Participants played the serious game "Walk in My Shoes" (Novonics Corp., Orlando, FL) to learn about mental health resources and coping skills. Half of the participants applied this knowledge during the game by playing minigames, whereas the other half played minigames featuring irrelevant content. This study was conducted both in-person and online. Participants who practiced the content by playing relevant minigames had positive learning gains, whereas those who played minigames with irrelevant content did not improve from baseline. There were no differences with respect to whether the game was played in the laboratory or in a more naturalistic environment. Web-based serious games can be effective in providing information about resources and skills to deploying warfighters. Including minigames to provide practice in a game-based training environment such as a serious game improves learning outcomes. Such a serious game, regardless of the inclusion of minigames, also increases self-reports of deployment self-efficacy.
Waweru, Catherine; Steenrod, Anna; Wolff, Claudia; Eggington, Simon; Wright, David Jay; Wyrwich, Kathleen W
To estimate health resource utilization (HRU) associated with the management of pacemaker complications in various healthcare systems. Electrophysiologists (EPs) from four geographical regions (Western Europe, Australia, Japan, and North America) were invited to participate. Survey questions focused on HRU in the management of three chronic pacemaker complications (i.e. pacemaker infections requiring extraction, lead fractures/insulation breaches requiring replacement, and upper extremity deep venous thrombosis [DVT]). Panelists completed a maximum of two web-based surveys (iterative rounds). Mean, median values, and interquartile ranges were calculated and used to establish consensus. Overall, 32 and 29 panelists participated in the first and second rounds of the Delphi panel, respectively. Consensus was reached on treatment and HRU associated with a typical pacemaker implantation and complications. HRU was similar across regions, except for Japan, where panelists reported the longest duration of hospital stay in all scenarios. Infections were the most resource-intensive complications and were characterized by intravenous antibiotics days of 9.6?13.5 days and 21.3?29.2 days for pocket and lead infections respectively; laboratory and diagnostic tests, and system extraction and replacement procedures. DVT, on the other hand, was the least resource intensive complication. The results of the panel represent the views of the respondents who participated and may not be generalizable outside of this panel. The surveys were limited in scope and, therefore, did not include questions on management of acute complications (e.g. hematoma, pneumothorax). The Delphi technique provided a reliable and efficient approach to estimating resource utilization associated with chronic pacemaker complications. Estimates from the Delphi panel can be used to generate costs of pacemaker complications in various regions.
Troselj, Mario; Fanton, Davor
The possibilities of creating a health care resources registry and its operating in Croatia as well as the importance of information in health system are described. At the Croatian Institute of Public Health, monitoring of human resources is performed through the national Health Workers Registry. It also covers basic data on all health units, bed capacities of health facilities included. The initiated health care computerization has urged the idea of forming one more database on physical resources, i.e. on registered medical devices and equipment, more complete. Linking these databases on health resources would produce a single Health Care Resources Registry. The concept views Health Care Resources Registry as part of the overall health information system with centralized information on the health system. The planned development of segments of a single health information system is based on the implementation of the accepted international standards and common network services. Network services that are based on verified Internet technologies are used within a safe, reliable and closed health computer network, which makes up the health intranet (WAN--Wide Area Network). The resource registry is a software solution based on the relational database that monitors history, thus permitting the data collected over a longer period to be analyzed. Such a solution assumes the existence of a directory service, which would replace the current independent software for the Health Workers Registry. In the Health Care Resources Registry, the basic data set encompasses data objects and attributes from the directory service. The directory service is compatible with the LDAP protocol (Lightweight Directory Access Protocol), providing services uniformly to the current records on human and physical resources. Through the storage of attributes defined according to the HL7 (Health Level Seven) standard, directory service is accessible to all applications of the health information system
Reveiz, Ludovic; Chapman, Evelina; Flórez, Carlos E Pinzón; Torres, Rubén
Identify priorities for health policy and systems research related to human resources in Latin America and Caribbean countries. An online survey was designed based on a search in PubMed, Cochrane Library, and LILACS that contributed previously prioritized research questions. Respondents, mainly researchers and decision-makers, were identified through various sources. The first round, directed at researchers, aimed at refining and adding research questions and prioritizing questions that researchers regarded as relevant or very relevant. The second round was directed at researchers and decision-makers. A question was considered a priority when 50% (or more) of respondents described it as "relevant" or "very relevant." The first round included 20 questions on human resources and 33/66 researchers responded. Questions suggested by the researchers were added, resulting in 26 questions for the second round, which were sent to 121 researchers and decision-makers. Respondent representation by country was uniform in both rounds. In the second round, 14/26 (54%) questions were described as very relevant. Priority issues related to regulation of the market, integration of education and health care needs, and distribution of human resources. The response rate was 50% in the first round (33/66), and 34% in the second round (41/121). The results of this exercise provide a starting point for mobilization of resources for health policy and systems research. Identification of health systems research priorities is an effective and efficient strategy for reorienting political, financial, management, and social organization efforts for attaining universal health coverage.
Full Text Available Background Human Resource for Health (HRH migration is an emerging concern in the development paradigm due to the critical importance to sustainability of health system in India. Being the largest human resource supplier to the world, it is important to analyze the consequences of the migration of HRH in the delivery of healthcare services to the country’s population. The study evidences limited to examine the size, distribution of the existing human resources or trends or patterns in migration. The consequences of migration have its implications to the healthcare delivery mechanism which needed to be critically analyzed. Review Methodology The methodology adopted in the paper is descriptive design. The critical review used to evaluate the existing evidence and to develop conceptual framework. The process involved the setting of the inclusion and exclusion criteria to select the articles. It included wide range of articles from the world development reports to specific studies oriented on the HRH scenario of the country. The search strategy comprised both form of studies qualitative and quantitative. The study utilizes the official data set published as report form. Main Findings The data on the migration in context of India, not systematically updated in the existing evidences. The availability of data on migration limits to few reports i.e.(World Health Organization WHO’s Joint Learning Initiatives and studies which combines census data of Organization for Economic Cooperation and Development (OECD and results in the number of foreign born health professionals. 1. A major proportion of the research studies reviewed describes the disparity in distribution of HRH between rural-urban and public-private. Few researches focused towards the policy environment of the source and destination country for the migration. 2. There is pool of literature explaining the factors of migration but it margins when to analyze the significant implications to
Pratt, Bridget; Hyder, Adnan A
Global health research partnerships are increasingly taking the form of consortia that conduct programs of research in low and middle-income countries (LMICs). An ethical framework has been developed that describes how the governance of consortia comprised of institutions from high-income countries and LMICs should be structured to promote health equity. It encompasses initial guidance for sharing sovereignty in consortia decision-making and sharing consortia resources. This paper describes a first effort to examine whether and how consortia can uphold that guidance. Case study research was undertaken with the Future Health Systems consortium, performs research to improve health service delivery for the poor in Bangladesh, China, India, and Uganda. Data were thematically analysed and revealed that proposed ethical requirements for sharing sovereignty and sharing resources are largely upheld by Future Health Systems. Facilitating factors included having a decentralised governance model, LMIC partners with good research capacity, and firm budgets. Higher labour costs in the US and UK and the funder's policy of allocating funds to consortia on a reimbursement basis prevented full alignment with guidance on sharing resources. The lessons described in this paper can assist other consortia to more systematically link their governance policy and practice to the promotion of health equity. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ozyapici, Hasan; Tanis, Veyis Naci
Purpose - The purpose of this paper is to explore the differences between a traditional costing system (TCS) and resource consumption accounting (RCA) based on a case study carried out in a hospital. Design/methodology/approach - A descriptive case study was first carried out to identify the current costing system of the case hospital. An exploratory case study was then conducted to reveal how implementing RCA within the case hospital assigns costs differently to gallbladder surgeries than the current costing system (i.e. a TCS). Findings - The study showed that, in contrast to a TCS, RCA considers the unused capacity, which is the difference between the work that can be performed based on current resources and the work that is actually being performed. Therefore, it assigns lower total costs to open and laparoscopic gallbladder surgeries. The study also showed that by separating costs into fixed and variable RCA allows managers to benefit from a pricing strategy based on the difference between the service's selling price and variable costs incurred in providing that service. Research limitations/implications - The limitation of this study is that, because of time constraints, the implementation was performed in the general surgery department only. However, since RCA is an advanced system that has the same application procedures for any department inside in a hospital, managers need only time gaps to implement this system to all parts of the hospital. Practical implications - This study concluded that RCA is better than a TCS for use in health care settings that have high overhead costs because it accurately assigns overhead costs to services by considering unused capacities incurred by a hospital. Consequently, this study provides insight into both measuring and managing unused capacities within the health care sector. This study also concluded that RCA helps health care administrators increase their competitive advantage by allowing them to determine the lowest
Cifuentes de Gramajo, Luisa
The aim of this study was to find out if nejayote produced at household level in Guatemala represents a threat to aquatic ecosystems and, if so, propose sustainable processing, reuse and disposal methods. First, all aspects related to nejayote production were explored. This study presents combined results from literature study on corn consumption and Guatemalan demography, a survey to Guatemalan women of all ethnical groups, nixtamalization replica and solids removal experiments and laborator...
Sutjiningsih, D.; Soeryantono, H.; Anggraheni, E.
Upper Ciliwung watershed in the JABODETABEKPUNJUR area experiencing rapid population growth, which in turn promotes the pace of infrastructure development especially increasing impervious land cover. This will trigger various stressors to the abiotic and biotic elements in the aquatic ecosystem. This study aims to examine whether the relationship between imperviousness in the subwatersheds in Upper Ciliwung and abiotic/biotic elements of its aquatic ecosystems can be used to assess the degree of water-sensitivity of the related regional spatial plan. Two scenarios of impervious cover changes have been assessed, scenario 1 using constant growth of 7.56% per annum, while scenario 2 refers to regional spatial plan of Bogor Regency. Although there are inconsistencies in four (out of 13) subwatersheds, the tests proved that the procedure is succesful to be applied in Upper Ciliwung.
Popejoy, Lori L; Jaddoo, Julie; Sherman, Jan; Howk, Christopher; Nguyen, Raymond; Parker, Jerry C
This initial article describes the development of a health care coordination intervention and documentation system designed using the Agency for Healthcare Research and Quality (AHRQ) Care Coordination Atlas framework for Centers for Medicare & Medicaid-funded innovation project, Leveraging Information Technology to Guide High-Tech, High-Touch Care (LIGHT). The study occurred at an academic medical center that serves 114 counties. Twenty-five registered nurse care managers (NCMs) were hired to work with 137 providers in 10 family community and internal medicine clinics. Patients were allocated into one of the four tiers on the basis of their chronic medical conditions and health care utilization. Using a documentation system on the basis of the AHRQ domains developed for this study, time and touch data were calculated for 8,593 Medicare, Medicaid, or dual-eligible patients. We discovered through the touch and time analysis that the majority of health care coordination activity occurred in the AHRQ domains of communication, assess needs and goals, and facilitate transitions, accounting for 79% of the NCM time and 61% of the touches. As expected, increasing tier levels resulted in increased use of NCM resources. Tier 3 accounted for roughly 16% of the patients and received 159 minutes/member (33% of total minutes), and Tier 4 accounted for 4% of patients and received 316 minutes/member (17% of all minutes). In contrast Tier 2, which did not require routine touches per protocol, had 5,507 patients (64%), and those patients received 5,246 hours of health care coordination, or 57 minutes/member, and took 48% of NCM time. 1. The AHRQ Care Coordination Atlas offered a systematic way to build a documentation system that allowed for the extraction of data that was used to calculate the amount of time and the number of touches that NCMs delivered per member. 2. Using a framework to systematically guide the work of health care coordination helped NCMs to think strategically
national health system, bringing health care as close as possible to .... health facilities whereas the Local government funds the primary health .... neglect of duties/roles by some of them. This in. Table III: .... Health policy and planning 2000 ...
Thermal stress to microorganisms was measured by the production of dissolved organic matter by algal communities and the mineralization of glucose by heterotrophic populations. Mutagenic activity as measured by the Ames/Salmonella/microsome assay indicate that such activity does not occur in Par Pond, although limited mutagenic activity does occur in a nearby canal system due to chlorination of cooling water. Sodium hypochlorite, used as an algicide in the reactor fuel storage basins, caused increased pitting corrosion to reactor fuel targets. Five other compounds selected for testing proved to be superior to sodium hypochlorite. Legionella pneumophila, the pathogen which causes Legionnaire's disease, was found to be a natural part of aquatic ecosystems. It occurs over a wide range of environments and is able to utilize nutrients provided by primary producers. Phytoplankton size classes of less than 3 μm (less than 5% of the total phytoplankton biomass) accounted for 15 to 40% of the total primary productivity in Par Pond, Pond C, and Clark Hill Reservoir. Three major biological data sets were compiled and are available in the SRL computer system for analysis: the SRP deer herd data; 20 years of Par Pond data; and 25 years of biological data on the Savannah River. Results of marine studies indicated that nearly all plutonium in the Savannah River and its estuary resulted from nuclear weapons fallout. The plutonium concentration in the Savannah River is about one fourth the concentration in the Newport River which has no nuclear operations associated with it
Brauchli, Rebecca; Jenny, Gregor J.; Füllemann, Désirée; Bauer, Georg F.
Studies using the Job Demands-Resources (JD-R) model commonly have a heterogeneous focus concerning the variables they investigate?selective job demands and resources as well as burnout and work engagement. The present study applies the rationale of the JD-R model to expand the relevant outcomes of job demands and job resources by linking the JD-R model to the logic of a generic health development framework predicting more broadly positive and negative health. The resulting JD-R health model ...
Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances
In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues. Copyright © 2011
The major objective of this paper is to throw some light on how proper use of family resources could help resolve the problem. All families have certain resources such as money, time, energy, skills of members, and some community resources like schools and traditional society's puberty rites. However, most families do not ...
Shah, Gulzar H; Badana, Adrian N S; Robb, Claire; Livingood, William C
Local health departments (LHDs) are striving to meet public health needs within their jurisdictions, amidst fiscal restraints and complex dynamic environment. Resource sharing across jurisdictions is a critical opportunity for LHDs to continue to enhance effectiveness and increase efficiency. This research examines the extent of cross-jurisdictional resource sharing among LHDs, the programmatic areas and organizational functions for which LHDs share resources, and LHD characteristics associated with resource sharing. Data from the National Association of County & City Health Officials' 2013 National Profile of LHDs were used. Descriptive statistics and multinomial logistic regression were performed for the 5 implementation-oriented outcome variables of interest, with 3 levels of implementation. More than 54% of LHDs shared resources such as funding, staff, or equipment with 1 or more other LHDs on a continuous, recurring basis. Results from the multinomial regression analysis indicate that economies of scale (population size and metropolitan status) had significant positive influences (at P ≤ .05) on resource sharing. Engagement in accreditation, community health assessment, community health improvement planning, quality improvement, and use of the Community Guide were associated with lower levels of engagement in resource sharing. Doctoral degree of the top executive and having 1 or more local boards of health carried a positive influence on resource sharing. Cross-jurisdictional resource sharing is a viable and commonly used process to overcome the challenges of new and emerging public health problems within the constraints of restricted budgets. LHDs, particularly smaller LHDs with limited resources, should consider increased resource sharing to address emerging challenges.
Green, Jamie A; Mor, Maria K; Shields, Anne Marie; Sevick, Mary Ann; Arnold, Robert M; Palevsky, Paul M; Fine, Michael J; Weisbord, Steven D
Although limited health literacy is common in hemodialysis patients, its effects on clinical outcomes are not well understood. Observational study. 260 maintenance hemodialysis patients enrolled in a randomized clinical trial of symptom management strategies from January 2009 through April 2011. Limited health literacy. Dialysis adherence (missed and abbreviated treatments) and health resource utilization (emergency department visits and end-stage renal disease [ESRD]-related hospitalizations). We assessed health literacy using the Rapid Estimate of Adult Literacy in Medicine (REALM) and used negative binomial regression to analyze the independent associations of limited health literacy with dialysis adherence and health resource utilization over 12-24 months. 41 of 260 (16%) patients showed limited health literacy (REALM score, ≤60). There were 1,152 missed treatments, 5,127 abbreviated treatments, 552 emergency department visits, and 463 ESRD-related hospitalizations. Limited health literacy was associated independently with an increased incidence of missed dialysis treatments (missed, 0.6% vs 0.3%; adjusted incidence rate ratio [IRR], 2.14; 95% CI, 1.10-4.17), emergency department visits (annual visits, 1.7 vs 1.0; adjusted IRR, 1.37; 95% CI, 1.01-1.86), and hospitalizations related to ESRD (annual hospitalizations, 0.9 vs 0.5; adjusted IRR, 1.55; 95% CI, 1.03-2.34). Generalizability and potential for residual confounding. Patients receiving maintenance hemodialysis who have limited health literacy are more likely to miss dialysis treatments, use emergency care, and be hospitalized related to their kidney disease. These findings have important clinical practice and cost implications. Copyright © 2013 National Kidney Foundation, Inc. All rights reserved.
Full Text Available Improving the performance of health sector human resources is a goal pursued by all developed or developing countries. However, the lack of human resources planning and lack of clear and transparent human resources policies may lead to a crisis in this area. Human resource planning should be a priority in terms of health policies. In Romania, the lack of a planning concept and the lack of a policy on human resources has led to the actual context, with a human resources crisis of public health organizations. The role that human resources play in the health care system is indisputable. Essential to achieve quality performance in health care is human resources management. To overcome the human resources crisis that public health organizations in Romania is facing , specialists in the field have made several key recommendations: development of a coherent policy formation, development and allocation of human resources in health, increasing the number of medical staff and opportunities of professional career development in the medical field. Health system reform involves changing some aspects of employment, working conditions, degree of decentralization of management, skills, salary system and staff motivation.
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The aim of this study was to assess the equality in the distribution of health material and human resources in Guangxi, and put forward proposal to improve the equality status of the health material and human resources. We used concentration index to evaluate the degree of income-related equality of health material and human resources. The concentration index values of the five resources ranged from -0.0847 to 0.1416 from 2011 to 2015. Health institution was concentrated among the poorer populations, while other four resources were concentrated among the richer populations. Overall, the equality status of health institutions, health care beds, health technical personnel, and certified nurses got better from 2011 to 2015. However, the equality status of practicing physicians has got worse since 2014.
The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations. PMID:29541631
The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations.
Devadasan, K.; Mukundan, M.K.; Antony, P.D.; Viswanathan Nair, P.G.; Perigreen, P.A.; Joseph, Jose
The International Symposium on Nutrients and Bioactive Substances in Aquatic Organisms, was held during 16-17 September 1993 by the Society of Fisheries Technologists (India) to review the progress of research in this area in India and elsewhere. The papers presented indicate that scientific productivity in this field is substantial and that some of the bioactive materials isolated from aquatic organisms have potential application in human health, nutrition and therapy. The symposium focussed attention on toxicants, nutrients and bioactive substances in aquatic organisms in general, and also on pollution of aquatic systems due to thermal effluents. Paper relevant to INIS database is indexed separately. (M.K.V.)
Asante, A D; Zwi, A B
Allocation of financial resources in the health sector is often seen as a formula-driven activity. However, the decision to allocate a certain amount of resources to a particular health jurisdiction or facility may be based on a broader range of factors, sometimes not reflected in the existing resource allocation formula. This study explores the 'other' factors that influence the equity of resource allocation in the health system of Ghana. The extent to which these factors are, or can be, accounted for in the resource allocation process is analysed. An exploratory design focusing on different levels of the health system and diverse stakeholders. Data were gathered through semi-structured qualitative interviews with health authorities at national, regional and district levels, and with donor representatives and local government officials in 2003 and 2004. The availability of human resources for health, local capacity to utilize funds, donor involvement in the health sector, and commitment to promote equity have considerable influence on resource allocation decisions and affect the equity of funding allocations. However, these factors are not accounted for adequately in the resource allocation process. This study highlights the need for a more transparent resource allocation system in Ghana based on needs, and takes into account key issues such as capacity constraints, the inequitable human resource distribution and donor-earmarked funding.
Full Text Available Abstract Background The Brazilian health reform process, following the establishment of the Unified Health System (SUS, has had a strong emphasis on decentralization, with a special focus on financing, management and inter-managerial agreements. Brazil is a federal country and the Ministry of Health (MoH, through the Secretary of Labour Management and Health Education, is responsible for establishing national policy guidelines for health labour management, and also for implementing strategies for the decentralization of management of labour and education in the federal states. This paper assesses whether the process of decentralizing human resources for health (HRH management and organization to the level of the state and municipal health departments has involved investments in technical, political and financial resources at the national level. Methods The research methods used comprise a survey of HRH managers of states and major municipalities (including capitals and focus groups with these HRH managers - all by geographic region. The results were obtained by combining survey and focus group data, and also through triangulation with the results of previous research. Results The results of this evaluation showed the evolution policy, previously restricted to the field of 'personnel administration', now expanded to a conceptual model for health labour management and education-- identifying progress, setbacks, critical issues and challenges for the consolidation of the decentralized model for HRH management. The results showed that 76.3% of the health departments have an HRH unit. It was observed that 63.2% have an HRH information system. However, in most health departments, the HRH unit uses only the payroll and administrative records as data sources. Concerning education in health, 67.6% of the HRH managers mentioned existing cooperation with educational and teaching institutions for training and/or specialization of health workers. Among them
Pierantoni, Celia Regina; Garcia, Ana Claudia P
The Brazilian health reform process, following the establishment of the Unified Health System (SUS), has had a strong emphasis on decentralization, with a special focus on financing, management and inter-managerial agreements. Brazil is a federal country and the Ministry of Health (MoH), through the Secretary of Labour Management and Health Education, is responsible for establishing national policy guidelines for health labour management, and also for implementing strategies for the decentralization of management of labour and education in the federal states. This paper assesses whether the process of decentralizing human resources for health (HRH) management and organization to the level of the state and municipal health departments has involved investments in technical, political and financial resources at the national level. The research methods used comprise a survey of HRH managers of states and major municipalities (including capitals) and focus groups with these HRH managers - all by geographic region. The results were obtained by combining survey and focus group data, and also through triangulation with the results of previous research. The results of this evaluation showed the evolution policy, previously restricted to the field of 'personnel administration', now expanded to a conceptual model for health labour management and education-- identifying progress, setbacks, critical issues and challenges for the consolidation of the decentralized model for HRH management. The results showed that 76.3% of the health departments have an HRH unit. It was observed that 63.2% have an HRH information system. However, in most health departments, the HRH unit uses only the payroll and administrative records as data sources. Concerning education in health, 67.6% of the HRH managers mentioned existing cooperation with educational and teaching institutions for training and/or specialization of health workers. Among them, specialization courses account for 61.4% and short
Conclusion: With regard to aquatics high nutritional value and their important presence in diet one should think of a way to increase it's survivability and maintaining quality. For this, nano technology can help packaging aquatics. Nano can be applied considerably in food health and environment protection.
Baum, Nancy M; DesRoches, Catherine; Campbell, Eric G; Goold, Susan Dorr
The purpose of this study was to gain an empirical understanding of the types of allocation decisions local health officials (LHOs) make and the factors that influence those allocation decisions. We conducted a national survey of LHOs in the United States in 2008 to 2009. The sample was stratified by the size of the population served by the department. We merged our data with data from the 2008 National Association of County and City Health Officials Profile survey. Descriptive statistics were generated using weighted data. Our final sample size was 608 respondents, with an average of 10 years experience. The LHOs reported little shifting of resources among population groups but greater capacity to redirect staffing time. Less than half of LHOs reported using economic analyses or conducting needs assessments when setting priorities. Having sole provider status in a community strongly influenced LHOs' allocation decisions. In addition, the effectiveness of activities, previous budget allocations, and input from boards of health were influential factors in allocation decisions. Public expectations were moderately to very influential, but direct public input had a low impact on allocation decisions. Survey findings provide a clearer understanding of how LHOs fulfill their obligations as stewards of public health resources and ensure effective activities and access to needed services. It may be useful to assess the value of more structured allocation methods (eg, decision frameworks) in the allocation process. Expanding opportunities for public engagement in priority setting may also be valuable for difficult allocation decisions.
Maire, Nicolas; Hegnauer, Michael; Nguyen, Dana; Godelmann, Lucas; Hoffmann, Axel; de Savigny, Don; Tanner, Marcel
The Health Resources Allocation Model (HRAM) is an eLearning tool for health cadres and scientists introducing basic concepts of sub-national, rational district-based health planning and systems thinking under resources constraint. HRAM allows the evaluation of resource allocation strategies in relation to key outcome measures such as coverage, equity of services achieved and number of deaths and disability-adjusted life years (DALYs) prevented. In addition, the model takes into account geographical and demographic characteristics and populations' health seeking behaviour. It can be adapted to different socio-ecological and health system settings.
Full Text Available The Health Resources Allocation Model (HRAM is an eLearning tool for health cadres and scientists introducing basic concepts of sub-national, rational district-based health planning and systems thinking under resources constraint. HRAM allows the evaluation of resource allocation strategies in relation to key outcome measures such as coverage, equity of services achieved and number of deaths and disability-adjusted life years (DALYs prevented. In addition, the model takes into account geographical and demographic characteristics and populations’ health seeking behaviour. It can be adapted to different socio-ecological and health system settings.
Liu, Wen-Xiu; Wang, Yan; He, Wei
Aquatic biota have long been recognized as bioindicators of the contamination caused by hydrophobic organic contaminants (HOCs) in aquatic environments. The primary purpose of the present study is to identify which species of aquatic biota are the most sensitive to organochlorine pesticides (OCPs...
Kiili, Carita; Leu, Donald J.; Marttunen, Miika; Hautala, Jarkko; Leppänen, Paavo H. T.
This study assessed the ability of 426 students (ages 12-13) to critically evaluate two types of online locations on health issues: an academic resource and a commercial resource. The results indicated limited evaluation abilities, especially for the commercial resource, and only a small, partial association with prior stance and offline reading…
Crawshaw, A F; Kirkbride, H
Approximately 13% of the UK population in 2015 was born overseas. Most migrants have come to the UK to work or study although there has been a small increase in the number of asylum applications in the UK in recent years, reflective of the ongoing humanitarian situation across Europe. Migrants in the UK tend to be young and healthy, but some may face unique health needs as a result of their experiences before, during and after migration. For these needs to be appropriately recognised and addressed, evidence-based advice is needed for UK professionals. The Migrant Health Guide is a free online tool for healthcare professionals. It was launched in 2011 and is widely used in the UK and internationally. It has four sections: 1) Migrants and the NHS-information on access and entitlements to the National Health Service (NHS); 2) Assessing patients-includes a checklist for initial healthcare assessments and advice for patients travelling abroad to visit friends and relatives; 3) Countries-country-specific advice on infectious diseases, women's health and nutritional and metabolic concerns; and 4) Health topics-information about communicable and non-communicable diseases and other health issues. The guide has undergone an extensive update in 2017. In particular, the pages on mental health and human trafficking have been expanded. A formal evaluation will obtain feedback on the guide and measure changes in awareness, knowledge, opinions, attitudes and behaviour of end users. Findings will inform future revisions and updates to the guide. Public Health England's Migrant Health Guide is a valuable resource for healthcare professionals. The relaunched guide builds on the previous version in raising awareness of key issues and providing evidence-based advice to improve the health of migrants and refugees internationally and in the UK. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.
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... health care provider. Read more information about health fraud Protecting Yourself (FDA) El Fraude en la Salud ( ... Torre-Díez I, López-Coronado M. Privacy and security in mobile health apps: a review and recommendations. ...
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Ellis, Beverley; Roberts, Jean; Cooper, Helen
This case study report of the establishment of a national repository of multi-media materials describes the creation process, the challenges faced in putting it into operation and the opportunities for the future. The initial resource has been incorporated under standard library and knowledge management practices. A collaborative action research method was used with active experts in the domain to determine the requirements and priorities for further development. The National Health Informatics Collection (NatHIC) is now accessible and the further issues are being addressed by inclusion in future University and NHS strategic plans. Ultimately the Collection will link with other facilities that contribute to the description and maintenance of effective informatics in support of health globally. The issues raised about the National Health Informatics Collection as established in the UK have resonance with the challenges of capturing the overall historic development of an emerging discipline in any country.
Holloway, Kristi; Riley, Geoffrey; Auret, Kirsten
Background Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients. Objective To understand rural clinicians’ attitudes towards the acceptability of online mental health resources as a treatment option in the rural context. Methods In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method. Results Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources. Conclusions Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing
Adisasmito, Wiku; Hunter, Benjamin M; Krumkamp, Ralf; Latief, Kamal; Rudge, James W; Hanvoravongchai, Piya; Coker, Richard J
The failure to contain pandemic influenza A(H1N1) 2009 in Mexico has shifted global attention from containment to mitigation. Limited surveillance and reporting have, however, prevented detailed assessment of mitigation during the pandemic, particularly in low- and middle-income countries. To assess pandemic influenza case management capabilities in a resource-limited setting, the authors used a health system questionnaire and density-dependent, deterministic transmission model for Bali, Indonesia, determining resource gaps. The majority of health resources were focused in and around the provincial capital, Denpasar; however, gaps are found in every district for nursing staff, surgical masks, and N95 masks. A relatively low pathogenicity pandemic influenza virus would see an overall surplus for physicians, antivirals, and antimicrobials; however, a more pathogenic virus would lead to gaps in every resource except antimicrobials. Resources could be allocated more evenly across Bali. These, however, are in short supply universally and therefore redistribution would not fill resource gaps. © 2011 APJPH.
Sood, Anjuli; Uniyal, Perm L; Prasanna, Radha; Ahluwalia, Amrik S
Aquatic macrophytes play an important role in the structural and functional aspects of aquatic ecosystems by altering water movement regimes, providing shelter to fish and aquatic invertebrates, serving as a food source, and altering water quality by regulating oxygen balance, nutrient cycles, and accumulating heavy metals. The ability to hyperaccumulate heavy metals makes them interesting research candidates, especially for the treatment of industrial effluents and sewage waste water. The use of aquatic macrophytes, such as Azolla with hyper accumulating ability is known to be an environmentally friendly option to restore polluted aquatic resources. The present review highlights the phytoaccumulation potential of macrophytes with emphasis on utilization of Azolla as a promising candidate for phytoremediation. The impact of uptake of heavy metals on morphology and metabolic processes of Azolla has also been discussed for a better understanding and utilization of this symbiotic association in the field of phytoremediation.
Pratt, Bridget; Hyder, Adnan A
This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics - namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders' decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. © 2017 John Wiley & Sons Ltd.
Schaufeli, W.B.; Taris, T.W.
The Job Demands-Resources model (JD-R model) became highly popular among researchers. The current version of the model proposes that high job demands lead to strain and health impairment (the health impairment process), and that high resources lead to increased motivation and higher productivity
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Yoder, Jonathan S; Hlavsa, Michele C; Craun, Gunther F; Hill, Vincent; Roberts, Virginia; Yu, Patricia A; Hicks, Lauri A; Alexander, Nicole T; Calderon, Rebecca L; Roy, Sharon L; Beach, Michael J
Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting data related to waterborne-disease outbreaks (WBDOs) associated with drinking water. In 1978, WBDOs associated with recreational water (natural and treated water) were added. This system is the primary source of data regarding the scope and effects of disease associated with recreational water in the United States. In addition, data are collected on individual cases of recreational water-associated illnesses and infections and health events occurring at aquatic facilities but not directly related to water exposure. Data presented summarize WBDOs and case reports associated with recreational water use that occurred during January 2005--December 2006 and previously unreported disease reports and outbreaks during 1978--2004. Public health departments in the states, territories, localities, and the Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) have primary responsibility for detecting, investigating, and voluntarily reporting WBDOs to CDC. Although the surveillance system includes data for WBDOs and cases associated with drinking water, recreational water, and water not intended for drinking, only cases and outbreaks associated with recreational water and health events at aquatic facilities are summarized in this report. During 2005--2006, a total of 78 WBDOs associated with recreational water were reported by 31 states. Illness occurred in 4,412 persons, resulting in 116 hospitalizations and five deaths. The median outbreak size was 13 persons (range: 2--2,307 persons). Of the 78 WBDOs, 48 (61.5%) were outbreaks of gastroenteritis that resulted from infectious agents or
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Full Text Available Abstract Background Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers' responses to the changes in their working environments by taking a 'realistic evaluation' approach. Methods The study findings were generated by triangulating both qualitative and quantitative methods of data collection and analysis among policy technocrats, health managers and groups of health providers. Quantitative surveys were conducted with over 700 individual health workers in both Bangladesh and Uganda and supplemented with qualitative data obtained from focus group discussions and key interviews with professional cadres, health managers and key institutions involved in the design, implementation and evaluation of the reforms of interest. Results The reforms in both countries affected the workforce through various mechanisms. In Bangladesh, the effects of the unification efforts resulted in a power struggle and general mistrust between the two former workforce tracts, family planning and health. However positive effects of the reforms were felt regarding the changes in payment schemes. Ugandan findings show how the workforce responded to a strong and rapidly implemented system of decentralisation where the power of new local authorities was influenced by resource constraints and nepotism in recruitment. On the other hand, closer ties to local authorities provided the opportunity to gain insight into the operational constraints originating from higher levels that health staff were dealing with. Conclusion Findings from the study suggest that a reform planners should use the proposed dynamic responses model to
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The Journal of Aquatic Sciences publishes articles on problems and issues in Aquatic Sciences from all ... The journal accepts for publication manuscripts of very high international standard containing reports of original scientific research.
Finger, William, Comp.; Tipton, Margaret, Comp.
As a sequel to YouthLens No. 1, New Resources Available on Youth Reproductive Health and HIV Prevention (July 2002), this YouthLens summarizes major reports and resources that have appeared since July 2002. The resources are organized by overview reports, reproductive health resources, and HIV/AIDS resources. [YouthLens is an activity of YouthNet,…
Full Text Available Abstract Background Implementing initiatives to achieve the targets of MDG 5 requires sufficient financial resources that are mobilized and utilized in an equitable, efficient and sustainable manner. Informed decision making to this end requires the availability of reliable health financing information. This is accomplished by means of Reproductive Health (RH sub-account, which captures and organizes expenditure on RH services in two-dimensional tables from financing sources to end users. The specific objectives of this study are: (i to quantify total expenditure on reproductive health services; and (ii to examine the flow of RH funds from sources to end users. Methods The RH sub-account was part of the general National Health Accounts exercise covering the Financial Years 2007/08 and 2008/09. Primary data were collected from employers, medical aid schemes, donors and government ministries using questionnaire. Secondary data were obtained from various documents of the Namibian Government and the health financing database of the World Health Organization. Data were analyzed using a data screen designed in Microsoft Excel. Results RH expenditure per woman of reproductive age was US$ 148 and US$ 126 in the 2007/08 and 2008/09 financial years respectively. This is by far higher than what is observed in most African countries. RH expenditure constituted more than 10-12% of the total expenditure on health. Out-of-pocket payment for RH was minimal (less than 4% of the RH spending in both years. Government is the key source of RH spending. Moreover, the public sector is the main financing agent with programmatic control of RH funds and also the main provider of services. Most of the RH expenditure is spent on services of curative care (both in- and out-patient. The proportion allocated for preventive and public health services was not more than 5% in the two financial years. Conclusion Namibia's expenditure on reproductive health is remarkable by the
Mbeeli, Thomas; Samahiya, Muine; Ravishankar, Nirmala; Zere, Eyob; Kirigia, Joses M
Implementing initiatives to achieve the targets of MDG 5 requires sufficient financial resources that are mobilized and utilized in an equitable, efficient and sustainable manner. Informed decision making to this end requires the availability of reliable health financing information. This is accomplished by means of Reproductive Health (RH) sub-account, which captures and organizes expenditure on RH services in two-dimensional tables from financing sources to end users. The specific objectives of this study are: (i) to quantify total expenditure on reproductive health services; and (ii) to examine the flow of RH funds from sources to end users. The RH sub-account was part of the general National Health Accounts exercise covering the Financial Years 2007/08 and 2008/09. Primary data were collected from employers, medical aid schemes, donors and government ministries using questionnaire. Secondary data were obtained from various documents of the Namibian Government and the health financing database of the World Health Organization. Data were analyzed using a data screen designed in Microsoft Excel. RH expenditure per woman of reproductive age was US$ 148 and US$ 126 in the 2007/08 and 2008/09 financial years respectively. This is by far higher than what is observed in most African countries. RH expenditure constituted more than 10-12% of the total expenditure on health. Out-of-pocket payment for RH was minimal (less than 4% of the RH spending in both years). Government is the key source of RH spending. Moreover, the public sector is the main financing agent with programmatic control of RH funds and also the main provider of services. Most of the RH expenditure is spent on services of curative care (both in- and out-patient). The proportion allocated for preventive and public health services was not more than 5% in the two financial years. Namibia's expenditure on reproductive health is remarkable by the standards of Africa and other middle-income countries. However
Weaver, Robert R; Lemonde, Manon; Payman, Naghmeh; Goodman, William M
While the "social determinants of health" view compels us to explore how social structures shape health outcomes, it often ignores the role individual agency plays. In contrast, approaches that focus on individual choice and personal responsibility for health often overlook the influence of social structures. Amartya Sen's "capabilities" framework and its derivative the "health capabilities" (HC) approach attempts to accommodate both points of view, acknowledging that individuals function under social conditions over which they have little control, while also acting as agents in their own health and well-being. This paper explores how economic, social, and cultural resources shape the health capability of people with diabetes, focusing specifically on dietary practices. Health capability and agency are central to dietary practices, while also being shaped by immediate and broader social conditions that can generate habits and a lifestyle that constrain dietary behaviors. From January 2011 to December 2012, we interviewed 45 people with diabetes from a primary care clinic in Ontario (Canada) to examine how their economic, social, and cultural resources combine to influence dietary practices relative to their condition. We classified respondents into low, medium, and high resource groups based on economic circumstances, and compared how economic resources, social relationships, health-related knowledge and values combine to enhance or weaken health capability and dietary management. Economic, social, and cultural resources conspired to undermine dietary management among most in the low resource group, whereas social influences significantly influenced diet among many in the medium group. High resource respondents appeared most motivated to maintain a healthy diet, and also had the social and cultural resources to enable them to do so. Understanding the influence of all three types of resources is critical for constructing ways to enhance health capability, chronic
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University of Nairobi, Kenya & Director, Africa Mental Health Foundation. (AMHF) ... The ratios decline further when psychiatrists available for clinical work in public facilities are ..... health problems at the level they are trained to handle medical.
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Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw
The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support
Full Text Available The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources.We employed resource mapping within the Programme for Improving Mental Health Care (PRIME, to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered.The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs represented all the biomedical health services in the district. In addition the Health Development Army (HDA are community volunteers who support health promotion and prevention activities.The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be
Yarbrough, Amy K; Powers, Thomas L
The distribution of management structures in health care has been shifting from independent ownership to interorganizational relationships with other firms. A shortage of resources has been cited as one cause for such collaboration among health care entities. The resource- based view of the firm suggests that organizations differentiate between strategic alliances and acquisition strategies based on a firm's internal resources and the types of resources a potential partner organization possesses. This paper provides a review of the literature using the resource-based theory of the firm to understand what conditions foster different types of health care partnerships. A model of partnership alliances using the resource-based view is presented, strategic linkages are presented, managerial implications are outlined, and directions for future research are given.
Giepmans. P.; Dussault, G.; Batenburg, R.; Frich, J.; Olivers, R.; Sermeus, W.
With health care services significantly changing, the challenge is to initiate innovative, situational and integrated workforce forecasting and planning. Many health systems require a shift in mindset to move to the planning of skill mixes for health care professionals. This implies great challenges
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van Ameijden Erik JC
Full Text Available Abstract Background Variability in health behaviours is an important cause of socioeconomic health disparities. Socioeconomic differences in health behaviours are poorly understood. Previous studies have examined whether (single stressors or psychosocial resources mediate the relationship between socioeconomic position and health or mortality. This study examined: 1 whether the presence of stressors and the absence of resources can be represented by a single underlying factor, and co-occur among those with lower education, 2 whether stressors and resources mediated the relation between education and health behaviours, and 3 addressed the question whether an aggregate measure of stressors and resources has an added effect over the use of individual measures. Methods Questionnaire data on sociodemographic variables, stressors, resources, and health behaviours were collected cross-sectionally among inhabitants (n = 3050 of a medium-sized Dutch city (Utrecht. Descriptive statistics and bootstrap analyses for multiple-mediator effects were used to examine the role of stressors and resources in mediating educational associations with health behaviours. Results Higher levels of stressors and lower levels of resources could be represented by a single underlying factor, and co-occurred among those with lower educational levels. Stressors and resources partially mediated the relationship between education and four health- behaviours (exercise, breakfast frequency, vegetable consumption and smoking. Financial stress and poor perceived health status were mediating stressors, and social support a strong mediating resource. An aggregate measure of the stressors and resources showed similar associations with health behaviours compared to the summed individual measures. Conclusions Lower educated groups are simultaneously affected by the presence of various stressors and absence of multiple resources, which partially explain socioeconomic differences in health
Herrera-Silveira, Jorge A; Morales-Ojeda, Sara M
The coastal environment of the Yucatan Peninsula (SE, Mexico) includes a wide variety of ecosystems ranging from mangroves to coral reefs, resulting in a heterogeneous landscape. Specifically, the marine system is characterized by environmental differences which respond to regional and local forcing functions such as marine currents and groundwater discharges (GD). Such functional characteristics were used here to define four subregions across the Yucatan coast and diagnose the health status of this coastal marine ecosystem. To achieve this goal, we conducted an analysis and integration of water quality variables, an eutrophic assessment, evaluated changes in submerged aquatic vegetation (SAV), and analyzed the community structure and distribution of harmful phytoplankton. The first step was to determine the reference values for each subregion based on data previously collected from 2002 to 2006 along the coast of Yucatan, 200m offshore. The trophic index (TRIX) and Canadian index for aquatic life (CCMEWQI) were used to diagnose each subregion and then the ASSETS approach was conducted for Dzilam and Progreso, sampling localities on each end of the health status continuum (those with the best and worst conditions). Overall, results indicated that the marine coastal ecosystem of Yucatan is in good condition; however, differences were observed between subregions that can be attributed to local forcing functions and human impacts. Specifically, the central region (zone HZII, Progreso-Telchac) showed symptoms of initial eutrophication due to nutrient inputs from human activities. The eastern region (zone HZ III, Dzilam-Las Bocas) showed a meso-eutrophic condition linked to natural groundwater discharges, while the other two subregions western (zone HZI Celestun-Palmar) and caribbean (zone HZ IV Ria Lagartos-El Cuyo) exhibited symptoms of oligo-mesotrophic condition. These findings may be considered baseline information for coastal ecosystem monitoring programs in
Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy
Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing
Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be
Downey, Angela M; Sharp, David J
There is extensive evidence that worksite health promotion (WHP) programmes reduce healthcare costs and improve employee productivity. In many countries, a large proportion of healthcare costs are borne by the state. While the full benefits of WHP are still created, they are shared between employers and the state, even though the employer bears the full (after-tax) cost. Employers therefore have a lower incentive to implement WHP activity. We know little about the beliefs of managers with decision responsibility for the approval and implementation of WHP programmes in this context. This article reports the results of a study of the attitudes of Canadian senior general managers (GMs) and human resource managers (HRMs) in the auto parts industry in Ontario, Canada towards the consequences of increasing discretionary spending on WHP, using Structural Equation Modelling and the Theory of Planned Behaviour. We identified factors that explain managers' intentions to increase discretionary spending on wellness programmes. While both senior GMs and HRMs are motivated primarily by their beliefs that WHP reduces indirect costs of health failure, GMs were also motivated by their moral responsibility towards employees (but surprisingly HRMs were not). Importantly, HRMs, who usually have responsibility for WHP, felt constrained by a lack of power to commit resources. Most importantly, we found no social expectation that organizations should provide WHP programmes. This has important implications in an environment where the adoption of WHP is very limited and cost containment within the healthcare system is paramount.
Vianna, Cid Manso de Mello; Caetano, Rosângela; Ortega, José Antonio; Façanha, Luiz Otávio de Figueiredo; Mosegui, Gabriela Bittencourt Gonzalez; Siqueira, Marien; Costa, Tiago Barros
To map and measure the flows of financial resources for health research and development in Brazil for the years 2000-2002. After adapting the methodology developed for the Center for Economic Policy Research, data were collected on the sources and uses of resources for health research and development. The annual average value of resources apportioned to health research and development was approximately 573 million US dollars. The public sector as a whole invested 417.3 million US dollars and the health department 51.1 million US dollars. Expressed in percentages, the public sector invested 4.15% of the health department's budget although the Ministry of Health assigned only 0.3% of its budget to health research in the country. The universities and the research institutes are the main users of the resources allocated to health research and development, receiving 91.6% of the total public spending, while the private sector receives a small share of around 0.69% of the total. The private sector invested 135.6 million US dollars per year, and the international organizations 20.1 million US dollars per year. Besides measuring the financial resources made available for health research and development, the results allowed the filling of gaps in national information; the identification of the flows of applied financial resources; and the testing and adaptation of the proposed methodology, generating information suitable for international comparisons.
Brauchli, Rebecca; Jenny, Gregor J; Füllemann, Désirée; Bauer, Georg F
Studies using the Job Demands-Resources (JD-R) model commonly have a heterogeneous focus concerning the variables they investigate-selective job demands and resources as well as burnout and work engagement. The present study applies the rationale of the JD-R model to expand the relevant outcomes of job demands and job resources by linking the JD-R model to the logic of a generic health development framework predicting more broadly positive and negative health. The resulting JD-R health model was operationalized and tested with a generalizable set of job characteristics and positive and negative health outcomes among a heterogeneous sample of 2,159 employees. Applying a theory-driven and a data-driven approach, measures which were generally relevant for all employees were selected. Results from structural equation modeling indicated that the model fitted the data. Multiple group analyses indicated invariance across six organizations, gender, job positions, and three times of measurement. Initial evidence was found for the validity of an expanded JD-R health model. Thereby this study contributes to the current research on job characteristics and health by combining the core idea of the JD-R model with the broader concepts of salutogenic and pathogenic health development processes as well as both positive and negative health outcomes.
Full Text Available Studies using the Job Demands-Resources (JD-R model commonly have a heterogeneous focus concerning the variables they investigate—selective job demands and resources as well as burnout and work engagement. The present study applies the rationale of the JD-R model to expand the relevant outcomes of job demands and job resources by linking the JD-R model to the logic of a generic health development framework predicting more broadly positive and negative health. The resulting JD-R health model was operationalized and tested with a generalizable set of job characteristics and positive and negative health outcomes among a heterogeneous sample of 2,159 employees. Applying a theory-driven and a data-driven approach, measures which were generally relevant for all employees were selected. Results from structural equation modeling indicated that the model fitted the data. Multiple group analyses indicated invariance across six organizations, gender, job positions, and three times of measurement. Initial evidence was found for the validity of an expanded JD-R health model. Thereby this study contributes to the current research on job characteristics and health by combining the core idea of the JD-R model with the broader concepts of salutogenic and pathogenic health development processes as well as both positive and negative health outcomes.
Robert J. W. Brewin
Full Text Available Accurate observations of the Earth system are required to understand how our planet is changing and to help manage its resources. The aquatic environment—including lakes, rivers, wetlands, estuaries, coastal and open oceans—is a fundamental component of the Earth system controlling key physical, biological, and chemical processes that allow life to flourish. Yet, this environment is critically undersampled in both time and space. New and cost-effective sampling solutions are urgently needed. Here, we highlight the potential to improve aquatic sampling by tapping into recreation. We draw attention to the vast number of participants that engage in aquatic recreational activities and argue, based on current technological developments and recent research, that the time is right to employ recreational citizens to improve large-scale aquatic sampling efforts. We discuss the challenges that need to be addressed for this strategy to be successful (e.g., sensor integration, data quality, and citizen motivation, the steps needed to realize its potential, and additional societal benefits that arise when engaging citizens in scientific sampling.
Driessen, Julia; Settle, Dykki; Potenziani, David; Tulenko, Kate; Kabocho, Twaha; Wadembere, Ismail
To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation. This case study describes Uganda's Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment. This multisite case study documented a range of perceived benefits of Uganda's HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health. Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in
Full Text Available ... tips on managing your diabetes and preventing kidney disease. Player Controls Use these controls to control the play ... a look at some of the resources below to help you get on the right track. Cope with Stress and Emotions AADE7 Self-Care Behaviors Handouts - Healthy ...
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Full Text Available ... the resources below to help you get on the right track. Cope with Stress and Emotions AADE7 Self-Care Behaviors Handouts - Healthy Coping These handouts provide ... This booklet addresses the special challenges for very large people who are ...
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Freidl, W; Stronegger, W J; Rásky, E; Neuhold, C
Three levels of health indicators (1) self-reported ill-health, (2) internal health resources, and (3) external health resources were analysed in relation to a four-category house-hold income distribution in order to describe possible social gradients. The particular aim of this study was to obtain information on the association of income data with self-reported ill-health. This cross-sectional study was based on a health survey. The sample represents around 10% of the rural population of some communities in Styria, randomly selected from the population registry. Interview data was collected from 3781 participants aged 15 years and older, 1559 males and 2222 females. The results show that individuals from lower house-hold income classes are disadvantaged with regard to indicators of ill-health, internal and external health resources. Overall, the link between low income and poor health is highly consistent within our data. Considering our results we conclude that internal and external health resources are as unequally distributed over income levels as health outcome indicators.
Pritchard, Daryl; Petrilla, Allison; Hallinan, Shawn; Taylor, Donald H; Schabert, Vernon F; Dubois, Robert W
U.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near future. Previous studies have estimated that 5% of patients account for half of all health care costs, while the top 1% of spenders account for over 27% of costs. The distribution of health care expenditures by type of service and the prevalence of particular health conditions for these patients is not clear, and is likely to differ from the overall population. To examine health care spending patterns and what contributes to costs for the top 5% of managed health care users based on total expenditures. This retrospective observational study employed a large administrative claims database analysis of health care claims of managed care enrollees across the full age and care spectrum. Direct health care expenditures were compared during calendar year 2011 by place of service (outpatient, inpatient, and pharmacy), payer type (commercially insured, Medicare Advantage, and Medicaid managed care), and therapy area between the full population and high resource patients (HRP). The mean total expenditure per HRP during calendar year 2011 was $43,104 versus $3,955 per patient for the full population. Treatment of back disorders and osteoarthritis contributed the largest share of expenditures in both HRP and the full study population, while chronic renal failure, heart disease, and some oncology treatments accounted for disproportionately higher expenditures in HRP. The share of overall expenditures attributed to inpatient services was significantly higher for HRP (40.0%) compared with the full population (24.6%), while the share of expenditures attributed to pharmacy (HRP = 18.1%, full = 21.4%) and outpatient services (HRP = 41.9%, full = 54.1%) was reduced. This pattern was observed across payer type. While the use of physician
Kasparian, Nadine A; Lieu, Nathan; Winlaw, David S; Cole, Andrew; Kirk, Edwin; Sholler, Gary F
Introduction This study aimed to (a) examine eHealth literacy, beliefs, and behaviours in parents of children with complex CHD, and (b) identify parents' preferences for the content, format, features, and functions of eHealth resources for CHD. Materials and methods Families (n=198) of children born between 2008 and 2011 and diagnosed with CHD requiring surgery were mailed a survey assessing a range of variables including eHealth literacy, beliefs, and behaviours as well as preferences for the format, functions, features, and content of eHealth resources for CHD. A total of 132 parents (83 mothers, 49 fathers) completed the survey (response rate: 50%). Mothers (96%) were more likely to access eHealth resources than fathers (83%, χ2=6.74, p=0.009). Despite high eHealth resource use, eHealth literacy was relatively low, with results demonstrating considerable and widespread gaps in awareness of, access to, and communication about eHealth resources. Over 50% of parents reported that decisions regarding their child's healthcare were influenced, to some extent, by web-based resources. Barriers to doctor-patient communication about eHealth included limited consultation time and concern about doctors' disapproval. Participants demonstrated a strong desire for "eHealth prescriptions" from their child's healthcare team, and perceived a wide range of eHealth topics as highly important, including treatment-related complications as well as physical, cognitive, and emotional development in children with CHD. Discussion Results suggest a need for stronger, more proactive partnerships between clinicians, researchers, educators, technologists, and patients and families to bring about meaningful innovations in the development and implementation of eHealth interventions in paediatric cardiology.
Competing risks and the development of adaptive management plans for water resources: Field reconnaissance investigation of risks to fishes and other aquatic biota exposed to endocrine disrupting chemicals (edcs) in lake mead, Nevada USA
Linder, G.; Little, E.E.
The analysis and characterization of competing risks for water resources rely on a wide spectrum of tools to evaluate hazards and risks associated with their management. For example, waters of the lower Colorado River stored in reservoirs such as Lake Mead present a wide range of competing risks related to water quantity and water quality. These risks are often interdependent and complicated by competing uses of source waters for sustaining biological resources and for supporting a range of agricultural, municipal, recreational, and industrial uses. USGS is currently conducting a series of interdisciplinary case-studies on water quality of Lake Mead and its source waters. In this case-study we examine selected constituents potentially entering the Lake Mead system, particularly endocrine disrupting chemicals (EDCs). Worldwide, a number of environmental EDCs have been identified that affect reproduction, development, and adaptive behaviors in a wide range of organisms. Many EDCs are minimally affected by current treatment technologies and occur in treated sewage effluents. Several EDCs have been detected in Lake Mead, and several substances have been identified that are of concern because of potential impacts to the aquatic biota, including the sport fishery of Lake Mead and endangered razorback suckers (Xyrauchen texanus) that occur in the Colorado River system. For example, altered biomarkers relevant to reproduction and thyroid function in fishes have been observed and may be predictive of impaired metabolism and development. Few studies, however, have addressed whether such EDC-induced responses observed in the field have an ecologically significant effect on the reproductive success of fishes. To identify potential linkages between EDCs and species of management concern, the risk analysis and characterization in this reconnaissance study focused on effects (and attendant uncertainties) that might be expressed by exposed populations. In addition, risk reduction
Ettinger, Kate Michi; Pharaoh, Hamilton; Buckman, Reymound Yaw; Conradie, Hoffie; Karlen, Walter
In low- and middle-income countries (LMIC), community health care workers (CHCW) are the primary point of care for millions of people. Mobile phone health applications (mHealth app) are the preferred technology platform to deliver clinical support to CHCW. In LMIC, limited regulatory oversight exists to guide quality and safety for medical devices, including mHealth. During the development of a mHealth app to assist CHCW with patient assessment and clinical diagnosis in rural South Africa, we applied human-centred design (HCD) and a bioethics consultation. The HCD approach enabled us to develop a mHealth app that responded to the needs and capacities of CHCW. The bioethics consultation prompted early consideration of safety concerns, social implications of our mHealth app and our technology's impact on the CHCW-patient relationship. In this study, we found that combining a HCD approach with bioethics consultation improved the design quality and reduced safety concerns for our mHealth app.
The Southern African Regional Network on Equity in Health (EQUINET) is a network of professionals, researchers, civil society members and policymakers who have come together to work toward health equity and social justice in the Southern African Development Community (SADC). Earlier phases were funded under ...
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Martins-Coelho, G.; Batenburg, R.
CONTEXT: Manpower is critical for health care systems. It is, however, one of the least strategically planned resources, resulting in mismatches on the health care labour market. There are several approaches available for health manpower planning. Yet little is known about which (if any) is applied
Post, G.B.; Baratta, M.; Wolfson, S.; McGeorge, L. [New Jersey Department of Environmental Protection, Trenton (United States)
The New Jersey Department of Environmental Protection`s responsibilities related to health-based risk assessment are described, including its research projects and its development of health based compound specific standards and guidance levels. The resources used by the agency to support health risk assessment work are outlined.
Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K
Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. A cross-sectional analysis of the baseline data of a prospective cohort study on adherence to first antenatal care visit guidelines was carried out in 11 facilities in the Greater Accra Region of Ghana. Provider adherence was studied in relation to health facility resource availability such as antenatal workload for clinical staffs, routine antenatal drugs, laboratory testing, protocols, ambulance and equipment. Eleven facilities comprising 6 hospitals (54.5 %), 4 polyclinics (36.4 %) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1 % (95 % CI: 41.8-54.2 %), varying significantly amongst the types of facilities, with highest rate in the polyclinics. Average antenatal workload per month per clinical staff member was higher in polyclinics compared to the hospitals. All facility laboratories were able to conduct routine antenatal tests. Most routine antenatal drugs were available in all facilities except magnesium sulphate and sulphadoxine-pyrimethamine which were lacking in some. Antenatal service protocols and equipment were also available in all facilities. Although antenatal workload varies across different facility types in the Greater Accra region, other health facility resources that support implementation of first antenatal care guidelines are equally available in all the facilities. These factors therefore do not adequately account for the low and varying proportions of complete adherence to guidelines across facility types. Providers should be continually engaged for a better understanding of the barriers to their adherence to these guidelines.
Bidonde, Julia; Busch, Angela J; Webber, Sandra C; Schachter, Candice L; Danyliw, Adrienne; Overend, Tom J; Richards, Rachel S; Rader, Tamara
Exercise training is commonly recommended for individuals with fibromyalgia. This review examined the effects of supervised group aquatic training programs (led by an instructor). We defined aquatic training as exercising in a pool while standing at waist, chest, or shoulder depth. This review is part of the update of the 'Exercise for treating fibromyalgia syndrome' review first published in 2002, and previously updated in 2007. The objective of this systematic review was to evaluate the benefits and harms of aquatic exercise training in adults with fibromyalgia. We searched The Cochrane Library 2013, Issue 2 (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, NHS Economic Evaluation Database), MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, WHO international Clinical Trials Registry Platform, and AMED, as well as other sources (i.e., reference lists from key journals, identified articles, meta-analyses, and reviews of all types of treatment for fibromyalgia) from inception to October 2013. Using Cochrane methods, we screened citations, abstracts, and full-text articles. Subsequently, we identified aquatic exercise training studies. Selection criteria were: a) full-text publication of a randomized controlled trial (RCT) in adults diagnosed with fibromyalgia based on published criteria, and b) between-group data for an aquatic intervention and a control or other intervention. We excluded studies if exercise in water was less than 50% of the full intervention. We independently assessed risk of bias and extracted data (24 outcomes), of which we designated seven as major outcomes: multidimensional function, self reported physical function, pain, stiffness, muscle strength, submaximal cardiorespiratory function, withdrawal rates and adverse effects. We resolved discordance through discussion. We evaluated interventions using mean differences
Murray, Katrina N.; Varga, Zolt?n M.; Kent, Michael L.
The Zebrafish International Resource Center (ZIRC) is a repository and distribution center for mutant, transgenic, and wild-type zebrafish. In recent years annual imports of new zebrafish lines to ZIRC have increased tremendously. In addition, after 15 years of research, we have identified some of the most virulent pathogens affecting zebrafish that should be avoided in large production facilities, such as ZIRC. Therefore, while importing a high volume of new lines we prioritize safeguarding ...
Wickrama, Kandauda K A S; Lee, Tae Kyoung; O'Neal, Catherine Walker; Kwon, Josephine A
Although research has established the impact of early stress, including stressful life contexts, and early resources, such as educational attainment, on various adolescent health outcomes, previous research has not adequately investigated "integrative models" incorporating both stress and resource mediational pathways to explain how early socioeconomic adversity impacts physical health outcomes, particularly in early life stages. Data on early childhood/adolescent stress and socioeconomic resources as well as biomarkers indicating physical health status in young adulthood were collected from 11,798 respondents (54 % female) over a 13-year period from youth participating in the National Study of Adolescent Health (Add Health). Physical health risk in young adulthood was measured using a composite index of nine regulatory biomarkers of cardiovascular and metabolic systems. Heterogeneity in stress and socioeconomic resource pathways was assessed using latent class analysis to identify clusters, or classes, of stress and socioeconomic resource trajectories. The influence of early socioeconomic adversity on young adults' physical health risk, as measured by biomarkers, was estimated, and the role of stress and socioeconomic resource trajectory classes as linking mechanisms was assessed. There was evidence for the influence of early socioeconomic adversity on young adults' physical health risk directly and indirectly through stress and socioeconomic resource trajectory classes over the early life course. These findings suggest that health models should be broadened to incorporate both stress and resource experiences simultaneously. Furthermore, these findings have prevention and intervention implications, including the importance of early socioeconomic adversity and key intervention points for "turning" the trajectories of at-risk youth.
Full Text Available This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China.We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI and Gini coefficient. Data envelopment analysis (DEA was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA was used to determine input/output indicators.The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742% were observed to be technically efficient constituting the "best practice frontier". The other 8 (25.8% provinces were technically inefficient.Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.
Tanggaard Andersen, Pernille; Holst Algren, Maria; Fromsejer Heiberg, Regina
Research has demonstrated that living in a deprived neighborhood contributes to the occurrence and development of poor health. Furthermore evidence shows that social networks are fundamental resources in preventing poor mental health. Neighborhood relationships and networks are vital for sustaining...... and improving quality of life. However, to determine potentials for public health action, the health impact of various types of network resources need to be explored and the association between socioeconomic position and self-rated health needs to be analysed to determine whether it is partially explained...... by social network resources. This is the main aim of this article. Cross-sectional data from one deprived neighborhood located in Denmark were collected in 2008 and 2013 using a postal health survey. The target group was defined as adults older than 16 years. In 2008, 408 residents participated...
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Apr 1, 2004 ... the Health Sector Reform Secretariat, the Director of Preventive Services, and the .... In October of 1993, IDRC convened an international conference to ...... Non Communicable Disease Control (e.g., cardiovascular disease).
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Full Text Available ... GET E-MAIL UPDATES External Link Disclaimer National Diabetes Education Program HealthSense Home Make a Plan Articles ... about NDEP videos on Youtube here Hyperglycemia and Diabetes 2 Hyperglycemia, or high blood sugar, can occur ...
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Full Text Available ... managing your diabetes and preventing kidney disease. Player Controls Use these controls to control the play back ... professional K-8th grade Community health worker Community organization Age Select one: Child Teen and young adult ...
Full Text Available ... onset of the disease. MOVE! This national weight management program is designed to help veterans lose weight, ... Person with prediabetes Person at risk for diabetes Family member, friend, or caregiver Health care professional Teacher ...
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Full Text Available ... risk assesment, and include an activity tracker and fat and calorie counter to help you implement a ... Community health worker Community organization Age Select one: Child Teen and young adult Adult Older adult (65+) ...
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country. Objective: The objective of this needs assessment was to identify the need for ... not to eliminate, the effect of the prevailing inadequate ... Federal Ministry of Health (FMOH),to develop the ... manage outsourcing of these activities, and.
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Full Text Available ... health worker Community organization Age Select one: Child Teen and young ... The National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892-2560, Telephone: 301.496.3583
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Full Text Available ... the text smaller. U.S. Department of Health and Human Services HOME | CONTACT US | JOBS AT NIDDK | RSS ... living with diabetes and developing habits for healthy eating and physical activity through small, sensible steps. Manage ...
Full Text Available ... of Health and Human Services HOME | CONTACT US | JOBS AT NIDDK | RSS FEEDS | GET E-MAIL UPDATES ... Act | Accessibility | Disclaimers | Copyright | Sitemap | For Staff Only | Jobs at NIDDK | Contact Us The National Institute of ...
Full Text Available ... E-MAIL UPDATES External Link Disclaimer National Diabetes Education Program HealthSense Home Make a Plan Articles About ... Active at Any Size This booklet addresses the special challenges for very large people who are physically ...
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Bosca, Diego; Moner, David; Maldonado, Jose Alberto; Robles, Montserrat
Messaging standards, and specifically HL7 v2, are heavily used for the communication and interoperability of Health Information Systems. HL7 FHIR was created as an evolution of the messaging standards to achieve semantic interoperability. FHIR is somehow similar to other approaches like the dual model methodology as both are based on the precise modeling of clinical information. In this paper, we demonstrate how we can apply the dual model methodology to standards like FHIR. We show the usefulness of this approach for data transformation between FHIR and other specifications such as HL7 CDA, EN ISO 13606, and openEHR. We also discuss the advantages and disadvantages of defining archetypes over FHIR, and the consequences and outcomes of this approach. Finally, we exemplify this approach by creating a testing data server that supports both FHIR resources and archetypes.
André, Adriana Maria; Ciampone, Maria Helena Trench; Santelle, Odete
To identify factors producing new trends in basic health care unit management and changes in management models. This was a prospective study with ten health care unit managers and ten specialists in the field of Health in São Paulo, Southeastern Brazil, in 2010. The Delphi methodology was adopted. There were four stages of data collection, three quantitative and the fourth qualitative. The first three rounds dealt with changing trends in management models, manager profiles and required competencies, and the Mann-Whitney test was used in the analysis. The fourth round took the form of a panel of those involved, using thematic analysis. The main factors which are driving change in basic health care units were identified, as were changes in management models. There was consensus that this process is influenced by the difficulties in managing teams and by politics. The managers were found to be up-to-date with trends in the wider context, with the arrival of social health organizations, but they are not yet anticipating these within the institutions. Not only the content, but the professional development aspect of training courses in this area should be reviewed. Selection and recruitment, training and assessment of these professionals should be guided by these competencies aligned to the health service mission, vision, values and management models.
Recent official documents pertaining to healthcare delivery system reform in China have focused mainly on infrastructure, equipment, management, insurance and drug policies. There has been little if any attention paid to human resources for health. Given the time and resources required to train qualified primary care ...
Aisling A. Jennings
Conclusion: This study provides a prototype for the development of an online dementia educational resource and demonstrates the value of a dementia-specific services and supports directory for primary care based health professionals.
Posnett, J; Gottrup, F; Lundgren, H; Saal, G
Most of the literature focuses on the resources required to manage particular wound types, rather than the cost of wounds to health-care organisations. Until this information is available, wound care is unlikely to be a management priority.
.Conclusion: Understanding the resource utilization implications, health, and well-being of cancer survivors can inform approaches to interventions for improving long-term care. Keywords: cancer survivor, epidemiology, survivorship, function, health care resource utilization, costs
Brännlund, Annica; Edlund, Jonas
Research has established that school performance relates: (i) negatively with poor mental health during childhood and (ii) positively with family socioeconomic resources. In this article, we examine the potentially moderating effects of family resources on the relationship between school performance and poor mental health, using register data covering all children born in Sweden in 1990. The dependent variable is graduation from upper secondary school. We perform separate analyses for girls a...
Ruzek, J I; Yeager, C M
Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings. Much evidence indicates an enormous negative impact of mental health problems in low- and middle-income countries (LMICs), and many of these problems are caused, or worsened, by exposure to wars, conflicts, natural and human-caused disasters, and other traumatic events. Though specific mental health treatments have been found to be efficacious and cost-effective for low-resource settings, most individuals living in these areas do not have access to them. Low-intensity task-sharing interventions will help, but there is a limit to the scalability and sustainability of human resources in these settings. To address the needs of trauma survivors, it will be important to develop and implement Internet and mobile technology resources to help reduce the scarcity, inequity, and inefficiency of current mental health services in LMICs. Mobile and Internet resources are experiencing a rapid growth in LMICs and can help address time, stigma, and cost barriers and connect those who have been socially isolated by traumatic events. This review discusses current research in technological interventions in low-resource settings and outlines key issues and future challenges and opportunities. Though formidable challenges exist for large-scale deployment of mobile and Internet mental health technologies, work to date indicates that these technologies are indeed feasible to develop, evaluate, and deliver to those in need of mental health services, and that they can be effective.
Full Text Available A cascade-pond system consists of six ponds located at Universitas Indonesia Campus, Depok. Its catchment area is dominated by high density urban area with moderate to high imperviousness. Some of riparian buffers surrounds six ponds are also occupied by high imperviousness that may lead some ecohydrological problems i.e. water quality degradation, declining freshwater biodiversity and food web changes. The aim of this study is assessing the current state of cascade-pond system health. The assessment of macroinvertebrate indices is based on SingScore that have been developed by Public Utilities Board of Singapore for macroinvertebrate biotic index. Impervious cover data is obtained from high-resolution imageries and processed using ArcGIS 10.5. Qualitative statistics methods, Chi-squared test describes the relationship of macroinvertebrate indices with catchment area imperviousness and aquatic buffer zone. The health assessment based on macroinvertebrates indices shows that the lower ponds are relatively healthier than the upper one. There is also any significant relationship between macroinvertebrate indices with impervious cover based on chi square test and cross tabulation analysis.
Pereira-Salgado, Amanda; Boyd, Leanne; Johnson, Matthew
In 2013, 'National Safety and Quality Health Service Standards' accreditation became mandatory for most health care services in Australia. Developing and maintaining accreditation education is challenging for health care services, particularly those in regional and rural settings. With accreditation imminent, there was a need to support health care services through the process. A needs analysis identified limited availability of open access online resources for national accreditation education. A standardized set of online accreditation education resources was the agreed solution to assist regional and rural health care services meet compulsory requirements. Education resources were developed over 3 months with project planning, implementation and assessment based on a program logic model. Resource evaluation was undertaken after the first 3 months of resource availability to establish initial usage and stakeholder perceptions. From 1 January 2015 to 31 March 2015, resource usage was 20 272, comprising 12 989 downloads, 3594 course completions and 3689 page views. Focus groups were conducted at two rural and one metropolitan hospital (n = 16), with rural hospitals reporting more benefits. Main user-based recommendations for future resource development were automatic access to customizable versions, ensuring suitability to intended audience, consistency between resource content and assessment tasks and availability of short and long length versions to meet differing users' needs. Further accreditation education resource development should continue to be collaborative, consider longer development timeframes and user-based recommendations. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Tsuno Yoko Sumikawa
Full Text Available Abstract Background The salutogenic model states that coping resources are defined within sociocultural and historical contexts and that various social and historical factors influence the availability of such resources. Though previous studies have suggested the need for an interregional comparison of psychological and social resources, few studies have undertaken such an investigation. The aim of this study is to investigate the associations among coping resources, sense of coherence (SOC, and health status in a comparison of urban and rural residents. Methods General residents (aged 30–69 years in two areas were targeted for the current study. Through a random sampling selection, 1,000 residents from each area were picked, and an anonymous questionnaire was mailed to each resident. Ultimately, 269 and 363 valid responses from the urban and rural areas, respectively, were analyzed. SOC, both social and psychological resources, and mental health were assessed. To examine relationships between SOC and resources associated with mental health, mental health was defined as a dependent variable. Hierarchical multiple regression was conducted with variables entered from sociodemographic characteristics, social and psychological resources, and SOC. Results Regarding regional characteristics, social capital and participation in community activities were significantly greater in the rural area than in the urban area. Urban residents reported significantly higher self-esteem and optimism than rural residents. SOC showed the most significant association with mental health in both areas. Mental health was significantly associated with physical activity limitations and life stressors in both areas. However, the associations were weakened when social and psychological resources and SOC were added, which demonstrated their buffering effect on the negative influence of life stressors on health. When SOC was added, the association of self-esteem with mental
Full Text Available ... Your Everyday Guide from the National Institute on Aging This guide has many types of exercise and physical activity for at all activity levels, and has tips to help you be active in ways that suit your lifestyle, interests, health, ...
Full Text Available ... GET E-MAIL UPDATES External Link Disclaimer National Diabetes Education Program HealthSense Home Make a Plan Articles About ... Rewards. Your GAME PLAN to Prevent Type 2 Diabetes: Information for Patients These three booklets help with diabetes risk assesment, ...
Full Text Available ... you get on the right track. Cope with Stress and Emotions AADE7 Self-Care Behaviors Handouts - Healthy Coping These ... healthy Be active Manage my weight Cope with stress and emotions Set goals Stop smoking Prevent diabetes-related health ...
Full Text Available ... the National Institute on Aging This guide has many types of exercise and physical activity for at all activity levels, and has tips to help you be active in ways that suit your lifestyle, interests, health, and budget. Eat Healthy A Healthier You This easy-to-use ...
Full Text Available To print this page, please use your browser's File menu and select print. To email this page, please copy the link ... keep it off, and improve their health. The materials can also be used by non-VA patients. ...
Full Text Available ... This guide has many types of exercise and physical activity for at all activity levels, and has tips to help you be active in ways that suit your lifestyle, interests, health, and budget. Eat Healthy A Healthier You This ...
Full Text Available ... the text smaller. U.S. Department of Health and Human Services HOME | CONTACT US | JOBS AT NIDDK | RSS ... Cope with Stress and Emotions AADE7 Self-Care Behaviors Handouts - Healthy Coping These handouts provide facts, tips, ...
Making use of information and communication technology (ICT) to ensure equitable access to health services in developing countries is becoming more and more feasible. Since the conference, Bridges to African Development via the Internet (Bamako, 2000), several ICT initiatives have appeared in Mali, such as the ...
... Part D grantees' level of participation in state-sponsored initiatives for the development of health... provide outpatient or ambulatory family-centered primary medical care for women, infants, children, and... from denying coverage to children with pre-existing conditions such as HIV/AIDS, cancelling coverage...
Full Text Available ... and provides tips and ideas to become more active and healthier—no matter what your size. Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging ... and has tips to help you be active in ways that suit your lifestyle, interests, health, ...
Perez, Adriana; Fleury, Julie; Shearer, Nelma
The prevalence of cardiovascular disease risk factors in Hispanic women has been substantiated across studies. While many studies have focused on the impact of these risk factors, few qualitative studies have addressed cultural and contextual meanings of cardiovascular health promotion in this population. This research explored cultural resources for cardiovascular health promotion among older Hispanic women. A qualitative descriptive methodological design using focus groups with 7 Hispanic women was used. Culture provided an overarching perspective, guiding identification and choice of resources and supports in order to promote cardiovascular health. Themes included Living Tradition, Caring for Family, Connecting with Friends, Having Faith, and Moving as Life. Data provide an initial step toward generating a more complete understanding of perceived cultural resources for cardiovascular health in older Hispanic women. Researchers and clinicians are increasingly recognizing that individuals, families and communities uniquely define cultural and contextual meaning of cardiovascular health promotion.
Bowser, Diana; Sparkes, Susan Powers; Mitchell, Andrew; Bossert, Thomas J; Bärnighausen, Till; Gedik, Gulin; Atun, Rifat
Since the early 2000s, there have been large increases in donor financing of human resources for health (HRH), yet few studies have examined their effects on health systems. To determine the scope and impact of investments in HRH by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the largest investor in HRH outside national governments. We used mixed research methodology to analyse budget allocations and expenditures for HRH, including training, for 138 countries receiving money from the Global Fund during funding rounds 1-7. From these aggregate figures, we then identified 27 countries with the largest funding for human resources and training and examined all HRH-related performance indicators tracked in Global Fund grant reports. We used the results of these quantitative analyses to select six countries with substantial funding and varied characteristics-representing different regions and income levels for further in-depth study: Bangladesh (South and West Asia, low income), Ethiopia (Eastern Africa, low income), Honduras (Latin America, lower-middle income), Indonesia (South and West Asia, lower-middle income), Malawi (Southern Africa, low income) and Ukraine (Eastern Europe and Central Asia, upper-middle income). We used qualitative methods to gather information in each of the six countries through 159 interviews with key informants from 83 organizations. Using comparative case-study analysis, we examined Global Fund's interactions with other donors, as well as its HRH support and co-ordination within national health systems. Around US$1.4 billion (23% of total US$5.1 billion) of grant funding was allocated to HRH by the 138 Global Fund recipient countries. In funding rounds 1-7, the six countries we studied in detail were awarded a total of 47 grants amounting to US$1.2 billion and HRH budgets of US$276 million, of which approximately half were invested in disease-focused in-service and short-term training activities. Countries employed
This study examined racial disparities in health among women, in particular, the relationship between social status and both the development of psychosocial resources and good health. These relationships were investigated using a sample of 869 women from the 2007 wave of the U.S. Panel Study of Income Dynamics, Child Development Supplement. While Black women developed the intrapersonal rewards of self-efficacy and self-esteem through socioeconomic status, they did not experience the same degree of health benefits with these advantages as White women. Models relating both self-rated health and chronic conditions suggested that, instead, highly educated Black women were at a persistent health disadvantage relative to Whites, even at the same levels of psychosocial resources. That being said, Black women with higher self-efficacy, and particularly, higher self-esteem, were more likely than Black women with lower levels of these resources to report being in better health. Thus, resources may improve health within a disadvantaged group while still not bringing them up to the level of health experienced by their advantaged counterparts. Overall, the findings demonstrated that research should not treat women as a homogenous group, assuming that mechanisms affecting health operate the same for women regardless of their race.
Full Text Available Abstract As online information portals accumulate metadata descriptions of Web resources, it becomes necessary to develop effective ways for visualising and navigating the resultant huge metadata repositories as well as the different semantic relationships and attributes of described Web resources. Graphical maps provide a good method to visualise, understand and navigate a world that is too large and complex to be seen directly like the Web. Several examples of maps designed as a navigational aid for Web resources are presented in this review with an emphasis on maps of medical and health-related resources. The latter include HealthCyberMap maps http://healthcybermap.semanticweb.org/, which can be classified as conceptual information space maps, and the very abstract and geometric Visual Net maps of PubMed http://map.net (for demos. Information resources can be also organised and navigated based on their geographic attributes. Some of the maps presented in this review use a Kohonen Self-Organising Map algorithm, and only HealthCyberMap uses a Geographic Information System to classify Web resource data and render the maps. Maps based on familiar metaphors taken from users' everyday life are much easier to understand. Associative and pictorial map icons that enable instant recognition and comprehension are preferred to geometric ones and are key to successful maps for browsing medical/health Internet information resources.
Full Text Available The mechanisms of realization of resource approach are exposed in organization of pedagogical education. There were defined the ways of providing health-saving teacher training, namely: assessment criteria of adjustment of social order and personal professional development needs, means of implementing the tasks of pedagogical education concept according to the resource approach. The methods of maintainance and strengthening of health of future teachers are specified in the process of professional preparation. It is marked that resource approach unites requirement to the competence of teacher, provides the account of age-dependent features of organism of student and periods of becoming of personality of student and teacher. Resource approach is given by possibility to take into account the specific of labour and level of knowledge, abilities and skills of every student. Resource approach harmonizes the actual aspects of complex of the modern scientific going near education of students and professional preparation of future teachers.
table sugar (sucrose), sugars in fruit ( fructose ), honey ( fructose and glucose ), sugar in milk (lactose), maple syrup , and molasses. Some are added in... Water 17 3 Eating for Optimal Health and Fitness 19 Dietary Guidelines for Americans 19 The Food Guide Pyramid 20 Food Labels 22 Selecting Nutrient...Worksheet 2-2. Calculate Your Protein Requirements 10 Worksheet 2-3. Determine Your Maximum Fat Limit 12 Worksheet 2-4. Calculate Your Daily Water
Elizabeth L. Tung
Full Text Available Neighborhood crime may be an important social determinant of health in many high-poverty, urban communities, yet little is known about its relationship with access to health-enabling resources. We recruited an address-based probability sample of 267 participants (ages ≥35 years on Chicago's South Side between 2012 and 2013. Participants were queried about their perceptions of neighborhood safety and prior experiences of neighborhood crime. Survey data were paired to a comprehensive, directly-observed census of the built environment on the South Side of Chicago. Multivariable logistic regression models were used to examine access to health-enabling resources (potential and realized access as a function of neighborhood crime (self-reported neighborhood safety and prior experience of theft or property crime, adjusting for sociodemographic characteristics and self-reported health status. Low potential access was defined as a resident having nearest resources >1 mile from home; poor realized access was defined as bypassing nearby potential resources to use resources >1 mile from home. Poor neighborhood safety was associated with low potential access to large grocery stores (AOR = 1.73, 95% CI = 1.04, 2.87, pharmacies (AOR = 2.24, 95% CI = 1.33, 3.77, and fitness resources (AOR = 1.93, 95% CI = 1.15, 3.24, but not small grocery stores. Any prior experience of neighborhood crime was associated with higher adjusted odds of bypassing nearby pharmacies (AOR = 3.78, 95% CI = 1.11, 12.87. Neighborhood crime may be associated with important barriers to accessing health-enabling resources in urban communities with high rates of crime. Keywords: Built environment, Neighborhood crime, Access to resources, Social determinants of health, Obesity, Hypertension
Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba; Mekasha Habtegiorgis, Bitsatab; Teshome Gebregeorgise, Dawit; Essah, Nana Am; Khan, Sara A; Brown, Andrew N
The health supply chain is often the weakest link in achieving the health-related Millennium Development Goals and universal health coverage, requiring trained professionals who are often unavailable. In Ethiopia there have been recent developments in the area of health supply chain management. The aim of this study was to explore the current status of the development of human resources in health supply chain management in Ethiopia and to identify important factors affecting this development. A series of face-to-face interviews with key stakeholders was carried out in 2014. The interviews were conducted using a semi-structured interview guide. The interview guide comprised 51 questions. A qualitative analysis of transcripts was made. A total of 25 interviews were conducted. Three themes were identified: General changes: recognition, commitment and resources, Education and training, and Barriers and enablers. Results confirm the development of human resources in health supply chain management in many areas. However, several problems were identified including lack of coordination, partly due to the large number of stakeholders; reported high staff mobility; and a lack of overall strategy regarding the job/career structures necessary for maintaining human resources. Rural areas have a particular set of problems, including in transportation of goods and personnel, attracting and keeping personnel, and in communication and access to information. Ethiopia is on the way to developing a nationwide viable system for health supply chain management. However, there are still challenges. Short-term challenges include the importance of highlighting strategies and programs for human resources in health supply chain management. In the long term, commitments to financial support must be obtained. A strategy is needed for the further development and sustainability of human resources in the health supply chain in Ethiopia.
This report on governance in Brazil's unified health system assesses resource allocation and management, planning and budgeting functions, and budget execution at different levels of government for public expenditures on health services. The emphasis is on understanding the incentives generated for service providers, and the overall soundness of the accountabilities established in the publ...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA) Advisory Committee on HIV, Viral... announcements of meetings and other committee management activities, for both the Centers for Disease Control...
To better understand the organisation of care for older persons, data are being collected to reduce the imbalance between 'disease information\\' and 'resource information\\' – information that addresses older persons\\' needs in terms of mental health care. This review presents some results from the continent. Mental health ...
Jonker, A.A.G.C.; Comijs, H.; Knipscheer, C.P.M.; Deeg, D.J.H.
Objectives: Research in older persons with deteriorative health shows a decrease in well-being. The aim of this study was to examine the role of psychological coping resources in the association between health decline and well-being, in a longitudinal design. Method: Data were used from the
Alstveit, Marit; Karlsen, Bjørg
The number of women in paid employment is increasing. However, when becoming a mother for the first time, many seem unprepared for the challenge of balancing motherhood and work as well as for the impact on their health. The aim of this study was to investigate the health resources and strategies of employed women in Norway during pregnancy and early motherhood by means of salutogenic theory. A hypothetical-deductive interpretive approach based on Antonovsky's salutogenic theory was applied in a secondary analysis. A total of six themes were identified; three were classified as health resources when experiencing tension and three as health strategies. Salutogenic theory seems to be a useful framework for illuminating the health resources and strategies adopted by employed women who become mothers. The identified health resources when experiencing tension and the health strategies applied may have implications for maternity care professionals and employers in promoting the health of such women and supporting them to combine work and family life. PMID:25945258
Adjei, S; Maniple, E; I, Dokotala; Mpoza, K; PM, Pamba; Pearl, E; Dieleman, M.A.; Hilhorst, Thea
ATraditionally, faith-based health organisations have been important health care providers in many remote and other under-serviced areas. Currently, these facilities bear the brunt of the competition for scarce human resources. It is important for faith-based organisations to learn from recent
Batenburg, R.; Kuhlmann, E.
Background: Across many countries, shortages and inefficient use of qualified healthcare staff – together with changes in the composition of the health professional workforce by age, gender and citizenship – have created an urgent call for health human resources policy, planning and management. In
Cooper, Sara L.; Lezotte, Dennis; Jacobellis, Jillian; DiGuiseppi, Carolyn
This study examines whether availability of mental health resources in the county of residence is associated with subsequent suicidal behavior after a previous suicide attempt. Among 10,922 individuals who attempted suicide in Colorado between 1998 and 2002, residence in a county that offered a minimum safety-net of mental health services…
Humphries, S V
This paper discusses 5 crises that are confronted by mankind: 1) population pressure, 2) the environment, 3) food, 4) energy, and 5) raw materials. Developing countries are those with rapid population growth rates while developed countries have slow growth rates. Sweden, Austria, East and West Germany, and Luxemburg were the only 5 countries with zero population growth in 1980. Other developed countries such as Canada and the USA double in population every 88 and 99 years, respectively. In contrast, developing countries such as Kenya, Zimbabwe, Zambia, and South Africa double every 18, 21, 22, and 25 years respectively. Such population increases cause problems in the environment, transportation, education, crime, and riots. The level of foreign aid for food to developing countries needs to increase or else the economic gap between rich and poor nations will increase on an average from 5:1 to 8:1 in Latin America and to 20:1 in South Asia. Availability of food has increaseed in developed countries whereas in developing countries it has dropped. Use of tropical forest lands as well as the sea bed for a source of food is difficult. There ia an upper limit to the fresh water runoff from land areas of the earth and fresh water is non-renewable. There is also a scarcity of other non-renewable resources, including at least 20 minerals. Finally, the standard of living in prosperous countries must be lowered at the same time as raising it in developing countries.
Full Text Available Jessica S Grignon,1,2 Jenny H Ledikwe,1,2 Ditsapelo Makati,2 Robert Nyangah,2 Baraedi W Sento,2 Bazghina-werq Semo1,2 1Department of Global Health, University of Washington, Seattle, WA, USA; 2International Training and Education Center for Health, Gaborone, Botswana Abstract: To address health systems challenges in limited-resource settings, global health initiatives, particularly the President's Emergency Plan for AIDS Relief, have seconded health workers to the public sector. Implementation considerations for secondment as a health workforce development strategy are not well documented. The purpose of this article is to present outcomes, best practices, and lessons learned from a President's Emergency Plan for AIDS Relief-funded secondment program in Botswana. Outcomes are documented across four World Health Organization health systems' building blocks. Best practices include documentation of joint stakeholder expectations, collaborative recruitment, and early identification of counterparts. Lessons learned include inadequate ownership, a two-tier employment system, and ill-defined position duration. These findings can inform program and policy development to maximize the benefit of health workforce secondment. Secondment requires substantial investment, and emphasis should be placed on high-level technical positions responsible for building systems, developing health workers, and strengthening government to translate policy into programs. Keywords: human resources, health policy, health worker, HIV/AIDS, PEPFAR
Full Text Available Steven M McPhail1,2 1Centre for Functioning and Health Research, Metro South Health, 2Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia Abstract: Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied. There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to
An evaluation of the relations between flow regime components, stream characteristics, species traits and meta-demographic rates of warmwater stream fishes: Implications for aquatic resource management
Peterson, James T.; Shea, C.P.
Fishery biologists are increasingly recognizing the importance of considering the dynamic nature of streams when developing streamflow policies. Such approaches require information on how flow regimes influence the physical environment and how those factors, in turn, affect species-specific demographic rates. A more cost-effective alternative could be the use of dynamic occupancy models to predict how species are likely to respond to changes in flow. To appraise the efficacy of this approach, we evaluated relative support for hypothesized effects of seasonal streamflow components, stream channel characteristics, and fish species traits on local extinction, colonization, and recruitment (meta-demographic rates) of stream fishes. We used 4 years of seasonal fish collection data from 23 streams to fit multistate, multiseason occupancy models for 42 fish species in the lower Flint River Basin, Georgia. Modelling results suggested that meta-demographic rates were influenced by streamflows, particularly short-term (10-day) flows. Flow effects on meta-demographic rates also varied with stream size, channel morphology, and fish species traits. Small-bodied species with generalized life-history characteristics were more resilient to flow variability than large-bodied species with specialized life-history characteristics. Using this approach, we simplified the modelling framework, thereby facilitating the development of dynamic, spatially explicit evaluations of the ecological consequences of water resource development activities over broad geographic areas. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
Andi Leny Susyanty
(GAIN UCI 2010–2014 stated that the general problems of decline in immunization coverage and quality of service were caused by several things, one of which is the lack of quantity, quality and distribution of human resources. Methods: A cross-sectional mix-method study to investigate human resources in vaccine management had been conducted in two provinces in 2012. Primary data were collected by interviewing stakeholders thoroughly, secondary data collection and observation were also carried out. Analysis was done by scoring for data concerning education, length of employment, training experience and knowledge. Result:The number of Vaccine management officers are still lacking. While the immunization guidelines required minimal two officers for each health centers. Officers’ knowledge in primary health centers is still inadequate, especially in terms of the vaccine and Coldchain (Ice Lined Refrigerators. Officers at Provincial Health Office had been trained in vaccine management, but not all officers at District Health Office and Primary Health Centers had received training yet. Suggestion: This study suggests the addition of the quantity and quality of human resources in vaccine management, because the officers can affect the quality of the vaccines, because vaccines need a special handling to maintain the quality to provide immunity and prevent the occurrence of diseases that can be prevented by immunization (PD3I.Key words: vaccine, human resources, training, knowledge
Hasler, B; Delabouglise, A; Babo Martins, S
The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.
Hostenkamp, Gisela; Sørensen, Jan
Objective: Regular dietary intake of fish is associated with reduced risk of developing cardiovascular and other chronic diseases, and may improve general well-being. If fish eaters are healthier, they may use fewer health-care resources. The present study aimed to describe the reported intake...... of fish and fish products in a Danish general population, and to investigate whether fish consumption is associated with generic measures of self-reported health and consumption of health-care resources. Design: Data on eating patterns and health status for 3422 Danish adults were obtained by telephone...... interview in the Funen County Health Survey. These data were merged with individual-level register data on health-care utilisation. Survey respondents were categorised into those consuming fish at least once weekly (fish eaters) and those consuming fish less frequently (non-fish eaters). Results: People who...
Kakoma, Jean Baptiste
The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that.
Aquatic biology studies focused on studying the hydrothermal effects of Par Pond reservoir on periphyton, plankton, zooplankton, macrophytes, human pathogens, and microbial activity; the variability between the artificial streams of the Flowing Streams Laboratory and Upper Three Runs Creek; and the bacterial production of methane in Savannah River Plant aquatic systems
Fast, Angela M; Deibert, Christopher M; Hruby, Gregory W; Glassberg, Kenneth I
Many patients and their parents utilize the Internet for health-related information, but quality is largely uncontrolled and unregulated. The Health on the Net Foundation Code (HONcode) and DISCERN Plus were used to evaluate the pediatric urological search terms 'circumcision,' 'vesicoureteral reflux' and 'posterior urethral valves'. A google.com search was performed to identify the top 20 websites for each term. The HONcode toolbar was utilized to determine whether each website was HONcode accredited and report the overall frequency of accreditation for each term. The DISCERN Plus instrument was used to score each website in accordance with the DISCERN Handbook. High and low scoring criteria were then compared. A total of 60 websites were identified. For the search terms 'circumcision', 'posterior urethral valves' and 'vesicoureteral reflux', 25-30% of the websites were HONcode certified. Out of the maximum score of 80, the average DISCERN Plus score was 60 (SD = 12, range 38-78), 40 (SD = 12, range 22-69) and 45 (SD = 19, range 16-78), respectively. The lowest scoring DISCERN criteria included: 'Does it describe how the treatment choices affect overall quality of life?', 'Does it describe the risks of each treatment?' and 'Does it provide details of additional sources of support and information?' (1.35, 1.83 and 1.95 out of 5, respectively). These findings demonstrate the poor quality of information that patients and their parents may use in decision-making and treatment choices. The two lowest scoring DISCERN Plus criteria involved education on quality of life issues and risks of treatment. Physicians should know how to best use these tools to help guide patients and their parents to websites with valid information. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Al Mokh, S.
Antibiotics are considered as pollutants when they are present in aquatic ecosystems, ultimate receptacles of anthropogenic substances. These compounds are studied as their persistence in the environment or their effects on natural organisms. Numerous efforts have been made worldwide to assess the environmental quality of different water resources for the survival of aquatic species, but also for human consumption and health risk related. Towards goal, the optimization of analytical techniques for these compounds in aquatic systems remains a necessity. Our objective is to develop extraction and detection methods for 12 molecules of aminoglycosides and colistin in sewage treatment plants and hospitals waters. The lack of analytical methods for analysis of these compounds and the deficiency of studies for their detection in water is the reason for their study. Solid Phase Extraction (SPE) in classic mode (offline) or online followed by Liquid Chromatography analysis coupled with Mass Spectrometry (LC/MS/MS) is the most method commonly used for this type of analysis. The parameters are optimized and validated to ensure the best conditions for the environmental analysis. This technique was applied to real samples of wastewater treatment plants in Bordeaux and Lebanon. (author)
Anderson, Duane A.; Beamesderfer, Raymond C. [Oregon Dept. of Fish and Wildlife, Enterprise, OR (United States); Woodard, Bob [Washington Dept. of Fish and Wildlife, Olympia, WA (United States)
Information on fish populations, fisheries, and fish habitat is crucial to the success of ongoing program to protect, recover, enhance, and manage fish resources in the Columbia River Basin. However, pertinent data are often difficult to locate because it is scattered among many agencies and is often unpublished. The goal of this annual report is to bring many diverse data types and sources into a single comprehensive report on the status of anadromous fish runs in the Columbia River Basin and the environmental conditions that may affect that status. Brief summaries are provided to identify the type and scope of available information. This synopsis is intended to complement other more detailed reports to which readers are referred for comprehensive treatment of specific subjects. This first report focuses mainly on anadromous salmon and steelhead (primarily through 1994) but the authors intend to expand the scope of future issues to include resident species. This is the first of what the authors intend to be an annual report. They welcome constructive suggestions for improvements. This report is a product of the StreamNet (formerly Coordinated Information System and Northwest Environmental Data Base) project which is a part of the Bonneville Power Administration`s program to protect, mitigate, and enhance fish and wildlife affected by the development and operation of hydroelectric facilities on the Columbia River and its tributaries. The project is called for in the Fish and Wildlife Program of the Northwest Power Planning Council. The project`s objective is to promote exchange and dissemination of information in a standardized electronic format throughout the basin. This project is administered by the Pacific States Marine Fisheries Commission with active participation by tribal, state, and federal fish and wildlife agencies.
Anthony Farthing; Ernesto Priego
Recent literature suggests that a growing number of comics are being published on health-related topics, including aspects of mental health and social care (Williams 2012; Czerwiec et al 2015) and that comics are increasingly being used in higher education settings as information resources. This article offers insights from comics creators and disseminators and explores the wider context of comics production and distribution (with a focus on 'Graphic Medicine' or health-related comics) as par...
Robinson, Nuriya; Stoffel, Cynthia; Haider, Sadia
Women's health care efforts in low-resource settings are often focused primarily on prenatal and obstetric care. However, women all over the world experience significant morbidity and mortality related to cervical cancer, sexually transmitted infections, and urogynecologic conditions as well as gynecologic care provision including insufficient and ineffective family planning services. Health care providers with an interest in clinical care in low-resource settings should be aware of the scope of the burden of gynecologic issues and strategies in place to combat the problems. This review article discusses the important concerns both in the developing world as well as highlights similar disparities that exist in the United States by women's age, race and ethnicity, and socioeconomic status. Ultimately, this review article aims to inform and update health care providers on critical gynecologic issues in low-resource settings.
You, Sun-Ju; Chang, Hyun-Sook
The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.
James W Rudge
Full Text Available BACKGROUND: Southeast Asia has been the focus of considerable investment in pandemic influenza preparedness. Given the wide variation in socio-economic conditions, health system capacity across the region is likely to impact to varying degrees on pandemic mitigation operations. We aimed to estimate and compare the resource gaps, and potential mortalities associated with those gaps, for responding to pandemic influenza within and between six territories in Asia. METHODS AND FINDINGS: We collected health system resource data from Cambodia, Indonesia (Jakarta and Bali, Lao PDR, Taiwan, Thailand and Vietnam. We applied a mathematical transmission model to simulate a "mild-to-moderate" pandemic influenza scenario to estimate resource needs, gaps, and attributable mortalities at province level within each territory. The results show that wide variations exist in resource capacities between and within the six territories, with substantial mortalities predicted as a result of resource gaps (referred to here as "avoidable" mortalities, particularly in poorer areas. Severe nationwide shortages of mechanical ventilators were estimated to be a major cause of avoidable mortalities in all territories except Taiwan. Other resources (oseltamivir, hospital beds and human resources are inequitably distributed within countries. Estimates of resource gaps and avoidable mortalities were highly sensitive to model parameters defining the transmissibility and clinical severity of the pandemic scenario. However, geographic patterns observed within and across territories remained similar for the range of parameter values explored. CONCLUSIONS: The findings have important implications for where (both geographically and in terms of which resource types investment is most needed, and the potential impact of resource mobilization for mitigating the disease burden of an influenza pandemic. Effective mobilization of resources across administrative boundaries could go some way
Badr, Elsheikh; Mohamed, Nazar A; Afzal, Muhammad Mahmood; Bile, Khalif Mohamud
Human resources for health (HRH) in the Sudan were limited by shortages and the maldistribution of health workers, poor management, service fragmentation, poor retention of health workers in rural areas, and a weak health information system. A "country coordination and facilitation" process was implemented to strengthen the national HRH observatory, provide a coordination platform for key stakeholders, catalyse policy support and HRH planning, harmonize the mobilization of resources, strengthen HRH managerial structures, establish new training institutions and scale up the training of community health workers. The national government of the Sudan sanctioned state-level governance of the health system but many states lacked coherent HRH plans and policies. A paucity of training institutions constrained HRH production and the adequate and equitable deployment of health workers in rural areas. The country coordination and facilitation process prompted the establishment of a robust HRH information system and the development of the technical capacities and tools necessary for data analysis and evidence-based participatory decision-making and action. The success of the country coordination and facilitation process was substantiated by the stakeholders' coordinated support, which was built on solid evidence of the challenges in HRH and shared accountability in the planning and implementation of responses to those challenges. The support led to political commitment and the mobilization of resources for HRH. The leadership that was promoted and the educational institutions that were opened should facilitate the training, deployment and retention of the health workers needed to achieve universal health coverage.
Kennedy, Theodore A.
Identifying areas of scientific uncertainty is a critical step in the adaptive management process (Walters, 1986; Runge, Converse, and Lyons, 2011). To identify key areas of scientific uncertainty regarding biologic resources of importance to the Glen Canyon Dam Adaptive Management Program, the Grand Canyon Monitoring and Research Center (GCMRC) convened Knowledge Assessment Workshops in May and July 2005. One of the products of these workshops was a set of strategic science questions that highlighted key areas of scientific uncertainty. These questions were intended to frame and guide the research and monitoring activities conducted by the GCMRC in subsequent years. Questions were developed collaboratively by scientists and managers. The questions were not all of equal importance or merit—some questions were large scale and others were small scale. Nevertheless, these questions were adopted and have guided the research and monitoring efforts conducted by the GCMRC since 2005. A new round of Knowledge Assessment Workshops was convened by the GCMRC in June and October 2011 and January 2012 to determine whether the research and monitoring activities conducted since 2005 had successfully answered some of the strategic science questions. Oral presentations by scientists highlighting research findings were a centerpiece of all three of the 2011–12 workshops. Each presenter was also asked to provide an answer to the strategic science questions that were specific to the presenter’s research area. One limitation of this approach is that these answers represented the views of the handful of scientists who developed the presentations, and, as such, they did not incorporate other perspectives. Thus, the answers provided by presenters at the Knowledge Assessment Workshops may not have accurately captured the sentiments of the broader group of scientists involved in research and monitoring of the Colorado River in Glen and Grand Canyons. Yet a fundamental ingredient of
Rosewell, Alexander; Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony
Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency.
Riley, William; Briggs, Jill; McCullough, Mac
This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. For each of the methods, we selected a panel to represent a profile of Minnesota health departments. The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.
Bergman, Brenda Gail; Bump, Joseph K
Mercury (Hg) is a leading contaminant across U.S. water bodies, warranting concern for wildlife species that depend upon food from aquatic systems. The risk of Hg toxicity to large herbivores is little understood, even though some large herbivores consume aquatic vascular plants (macrophytes) that may hyper-accumulate Hg. We investigated whether total Hg and methylmercury (MeHg) in aquatic forage may be of concern to moose (Alces alces) and beaver (Castor canadensis) by measuring total Hg and MeHg concentrations, calculating sediment-water bioconcentration factors for macrophyte species these herbivores consume, and estimating herbivore daily Hg consumption. Abiotic factors impacting macrophyte Hg were assessed, as was the difference in Hg concentrations of macrophytes from glacial lakes and those created or expanded by beaver damming. The amount of aquatic-derived Hg that moose move from aquatic to terrestrial systems was calculated, in order to investigate the potential for movement of Hg across ecosystem compartments by large herbivores. Results indicate that the Hg exposure of generalist herbivores may be affected by macrophyte community composition more so than by many abiotic factors in the aquatic environment. Mercury concentrations varied greatly between macrophyte species, with relatively high concentrations in Utricularia vulgaris (>80 ng g(-1) in some sites), and negligible concentrations in Nuphar variegata (~6 ng g(-1)). Macrophyte total Hg concentration was correlated with water pH in predictable ways, but not with other variables generally associated with aquatic Hg concentrations, such as dissolved organic carbon. Moose estimated daily consumption of MeHg is equivalent to or below human reference levels, and far below wildlife reference levels. However, estimated beaver Hg consumption exceeds reference doses for humans, indicating the potential for sub-lethal nervous impairment. In regions of high moose density, moose may be ecologically important
Full Text Available Abstract This article considers some of the effects of health sector reform on human resources for health (HRH in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the public sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts. Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation. The increase in private sector provision has led health workers to move to the private sector. For those remaining in the public sector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements. Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.
Green, A.; Ali, B.; Naeem, A.; Ross, D.
This paper identifies key political and technical issues involved in the development of an appropriate resource allocation and budgetary system for the public health sector, using experience gained in the Province of Balochistan, Pakistan. The resource allocation and budgetary system is a critical, yet often neglected, component of any decentralization policy. Current systems are often based on historical incrementalism that is neither efficient nor equitable. This article describes technical...
Mi, Misa; Wu, Wendy; Qiu, Maylene; Zhang, Yingting; Wu, Lin; Li, Jie
This systematic review examines types of mobile devices used by health professions students, kinds of resources and tools accessed via mobile devices, and reasons for using the devices to access the resources and tools. The review included 20 studies selected from articles published in English between January 2010 and April 2015, retrieved from PubMed and other sources. Data extracted included participants, study designs, mobile devices used, mobile resources/apps accessed, outcome measures, and advantages of and barriers to using mobile devices. The review indicates significant variability across the studies in terms of research methods, types of mobile programs implemented, resources accessed, and outcomes. There were beneficial effects of using mobile devices to access resources as well as conspicuous challenges or barriers in using mobile devices.
Based on the current financial status and forthcoming changes in the health care system, governing boards give chief executive officers the responsibility to manage human, financial, and physical resources. The role and degree of involvement of chief executive officers in managing resources--the resource allocation process, retention and recruitment, technology adaptation, reimbursement, and expansion of the outpatient program--are illustrated in this article. A new strategy for diverting resources to tap into the outpatient market is the appropriate direction to choose during days when the economy is down and people are not seeking inpatient treatment as in the past. Reimbursement in the future will depend on customer satisfaction scores; therefore, a dedicated and loyal staff is the most important resource for any service organization.
Martineau, Tim; Mirzoev, Tolib; Pearson, Stephen; Ha, Bui Thi Thu; Xu, Qian; Ramani, K V; Liu, Xiaoyun
The failure to meet health goals such as the Millennium Development Goals (MDG) is partly due to the lack of appropriate resources for the effective implementation of health policies. The lack of coherence between the health policies and human resource (HR) strategy is one of the major causes. This article explores the relationship and the degree of coherence between health policy--in this case maternal health policy--processes and HR strategy in Vietnam, China and India in the period 2005-09. Four maternal health policy case studies were explored [skilled birth attendance (SBA), adolescent and sexual reproductive health, domestic violence and medical termination of pregnancy] across three countries through interviews with key respondents, document analysis and stakeholder meetings. Analysis for coherence between health policy and HR strategy was informed by a typology covering 'separation', 'fit' and 'dialogue'. Regarding coherence we found examples of complete separation between health policy and HR strategy, a good fit with the SBA policy though modified through 'dialogue' in Vietnam, and in one case a good fit between policy and strategy was developed through successive evaluations. Three key influences on coherence between health policy and HR strategy emerge from our findings: (1) health as the lead sector, (2) the nature of the policy instrument and (3) the presence of 'HR champions'. Finally, we present a simple algorithm to ensure that appropriate HR related actors are involved; HR is considered at the policy development stage with the option of modifying the policy if it cannot be adequately supported by the available health workforce; and ensuring that HR strategies are monitored to ensure continued coherence with the health policy. This approach will ensure that the health workforce contributes more effectively to meeting the MDGs and future health goals. Published by Oxford University Press in association with The London School of Hygiene and Tropical
Mollborn, Stefanie; Lawrence, Elizabeth; James-Hawkins, Laurie; Fomby, Paula
This study examines the puzzle of disparities experienced by U.S. teen parents’ young children, whose health and development increasingly lag behind those of peers while their parents are simultaneously experiencing socioeconomic improvements. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001–2007; N ≈ 8,600), we assess four dynamic patterns in socioeconomic resources that might account for these growing developmental and health disparities throughout early childhood and then test them in multilevel growth curve models. Persistently low socioeconomic resources constituted the strongest explanation, given that consistently low income, maternal education, and assets fully or partially account for growth in cognitive, behavioral, and health disparities experienced by teen parents’ children from infancy through kindergarten. That is, although teen parents gained socioeconomic resources over time, those resources remained relatively low, and the duration of exposure to limited resources explains observed growing disparities. Results suggest that policy interventions addressing the time dynamics of low socioeconomic resources in a household, in terms of both duration and developmental timing, are promising for reducing disparities experienced by teen parents’ children. PMID:24802282
This paper is the second from a series of three, addressing human resource practices using best practice examples. The analysis covered is based on the experiences of organisations that have won the Malcolm Baldrige National Quality Award (MBNQA) in the USA. The subcriteria covered in this benchmarking comparative analysis covers the following areas: human resource planning and management; employee involvement; employee education and training; employee performance and recognition; employee wellbeing and satisfaction. The paper concludes by reflecting on the likely implications for health-care professionals working in the human resource field.
Madden, Erin Fanning
Communities struggling with access to healthcare in the U.S. are often considered to be disadvantaged and lacking in resources. Yet, these communities develop and nurture valuable strategies for healthcare access that are underrecognized by health scholars. Combining medical sociology and critical race theory perspectives on cultural capital, this paper examines the health-relevant cultural resources, or Cultural Health Capital, in South Texas Mexican American border communities. Ethnographic data collected during 2011-2013 in Cameron and Hidalgo counties on the U.S.-Mexico border provide empirical evidence for expanding existing notions of health-relevant cultural capital. These Mexican American communities use a range of cultural resources to manage healthcare exclusion and negotiate care in alternative healthcare spaces like community clinics, flea markets and Mexican pharmacies. Navigational, social, familial, and linguistic skills and knowledge are used to access doctors and prescription drugs in these spaces despite social barriers to mainstream healthcare (e.g. cost, English language skills, etc.). Cultural capital used in marginalized communities to navigate limited healthcare options may not always fully counteract healthcare exclusion. Nevertheless, recognizing the cultural resources used in Mexican American communities to facilitate healthcare challenges deficit views and yields important findings for policymakers, healthcare providers, and advocates seeking to capitalize on community resources to improve healthcare access. Copyright © 2015 Elsevier Ltd. All rights reserved.
Boylan, Jennifer Morozink; Cundiff, Jenny M; Jakubowski, Karen P; Pardini, Dustin A; Matthews, Karen A
Exposure to low socioeconomic status (SES) in childhood predicts increased morbidity and mortality. However, little prospective evidence is available to test pathways linking low childhood SES to adult health. In the current study, indirect effects through positive parenting in adolescence and adult SES were tested in the association between childhood SES and adult health behaviors and psychological resources. Men (n = 305; 53% Black) were followed longitudinally from ages 7 to 32. SES was measured annually in childhood (ages 7-9) and again in adulthood (age 32) using the Hollingshead index. Parenting was assessed annually (ages 13-16) using caregivers' and boys' self-report of supervision, communication, and expectations for their son's future. Health behaviors (cigarette and alcohol use, fruit and vegetable consumption, and physical activity) and psychological resources (optimism, purpose in life, self-mastery, and self-esteem) were assessed in adulthood (age 32). Structural equation modeling showed that higher childhood SES was associated with more positive parenting in adolescence and higher adult SES. Higher childhood SES was indirectly associated with healthier behaviors and higher psychological resources in adulthood through pathways involving positive parenting during adolescence and SES in adulthood. Findings were consistent in both racial groups. Positive parenting in adolescence was an important pathway in understanding associations among childhood SES and health behaviors and psychological resources in adulthood. Low childhood SES was prospectively associated with healthier behaviors and greater psychological resources in part through more positive parenting in adolescence.
Trisolini, M G; Thomas, C P; Cashman, S B; Payne, S M
Resource utilization in home health care has become an issue of concern due to rising costs and recent initiatives to develop prospective payment systems for home health care. A number of issues remain unresolved for the development of prospective reimbursement in this sector, including the types of variables to be included as payment variables and appropriate measures of resource use. This study supplements previous work on home health case-mix by analyzing the factors affecting one aspect of resource use for skilled nursing visits--visit length--and explores the usefulness of several specially collected variables which are not routinely available in administrative records. A data collection instrument was developed with a focus group of skilled nurses, identifying a range of variables hypothesized to affect visit length. Five categories of variables were studied using multiple regression analysis: provider-related; patient's socio-economic status; patient's clinical status; patient's support services; and visit-specific. The final regression model identifies 9 variables which significantly affect visit time. Five of the 9 are visit-specific variables, a significant finding since these are not routinely collected. Case-mix systems which include visit time as a measure of resource use will need to investigate visit-specific variables, as this study indicates they could have the largest influence on visit time. Two other types of resources used in home health care, supplies and security drivers, were also investigated in less detail.
Harris, Claire; Green, Sally; Elshaug, Adam G
This is the tenth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. After more than a decade of research, there is little published evidence of active and successful disinvestment. The paucity of frameworks, methods and tools is reported to be a factor in the lack of success. However there are clear and consistent messages in the literature that can be used to inform development of a framework for operationalising disinvestment. This paper, along with the conceptual review of disinvestment in Paper 9 of this series, aims to integrate the findings of the SHARE Program with the existing disinvestment literature to address the lack of information regarding systematic organisation-wide approaches to disinvestment at the local health service level. A framework for disinvestment in a local healthcare setting is proposed. Definitions for essential terms and key concepts underpinning the framework have been made explicit to address the lack of consistent terminology. Given the negative connotations of the word 'disinvestment' and the problems inherent in considering disinvestment in isolation, the basis for the proposed framework is 'resource allocation' to address the spectrum of decision-making from investment to disinvestment. The focus is positive: optimising healthcare, improving health outcomes, using resources effectively. The framework is based on three components: a program for decision-making, projects to implement decisions and evaluate outcomes, and research to understand and improve the program and project activities. The program consists of principles for decision-making and settings that provide opportunities to introduce systematic prompts and triggers to initiate disinvestment. The projects follow the steps in the disinvestment process. Potential methods and tools are presented, however the framework does not stipulate project design or conduct; allowing
Mulcahy, Helen; Phelan, Agnes; Corcoran, Paul; Leahy-Warren, Patricia
The aim of the study was to review breastfeeding support provided by Public Health Nurses in Ireland. The objectives were to identify the availability of appropriate guiding policies, educational preparation, attitude of Public Health Nurses and the availability and use of other supportive services. Breastfeeding rates in Ireland are among the lowest in Europe. The main source of formal support for breastfeeding mothers in the community in Ireland is from Public Health Nurses who can make referral to other non-statutory resources. The nature of this support is determined by policies guiding clinical practice and education that increases breastfeeding confidence and competence of all personnel. Consequently, an assessment of breastfeeding resources requires an analysis of all these variables. A large quantitative, cross-sectional study was conducted, involving Public Health Nurses and mothers. This paper represents the results from the perspective of Public Health Nurses. Directors of Public Health Nursing (n = 24) and Public Health Nurses (n = 204) completed self-report questionnaires by mail and online. Data were analysed using the Statistical Package for Social Sciences and reported using descriptive and inferential statistics. Public Health Nurses are well educated to support breastfeeding and have a positive attitude and a high degree of self-assessed confidence and competence. A wide variety of non-statutory support exists for breastfeeding but is not always used to their full potential. Standardising educational requirements for Public Health Nurses in supporting breastfeeding is an area that requires attention. Ultimately, service delivery in relation to supporting breastfeeding mothers would benefit from being more timely and responsive. Awareness of support resources is necessary for Public Health Nurses to make appropriate referrals for breastfeeding mothers. Furthermore, Directors of Public Health Nursing need to encourage the breastfeeding supportive
Full Text Available Abstract Background Developed countries' gains in health human resources (HHR from developing countries with significantly lower ratios of health workers have raised questions about the ethics or fairness of recruitment from such countries. By attracting and/or facilitating migration for foreign-trained HHR, notably those from poorer, less well-resourced nations, recruitment practices and policies may be compromising the ability of developing countries to meet the health care needs of their own populations. Little is known, however, about actual recruitment practices. In this study we focus on Canada (a country with a long reliance on internationally trained HHR and recruiters working for Canadian health authorities. Methods We conducted interviews with health human resources recruiters employed by Canadian health authorities to describe their recruitment practices and perspectives and to determine whether and how they reflect ethical considerations. Results and discussion We describe the methods that recruiters used to recruit foreign-trained health professionals and the systemic challenges and policies that form the working context for recruiters and recruits. HHR recruiters' reflections on the global flow of health workers from poorer to richer countries mirror much of the content of global-level discourse with regard to HHR recruitment. A predominant market discourse related to shortages of HHR outweighed discussions of human rights and ethical approaches to recruitment policy and action that consider global health impacts. Conclusions We suggest that the concept of corporate social responsibility may provide a useful approach at the local organizational level for developing policies on ethical recruitment. Such local policies and subsequent practices may inform public debate on the health equity implications of the HHR flows from poorer to richer countries inherent in the global health worker labour market, which in turn could influence
Runnels, Vivien; Labonté, Ronald; Packer, Corinne
Developed countries' gains in health human resources (HHR) from developing countries with significantly lower ratios of health workers have raised questions about the ethics or fairness of recruitment from such countries. By attracting and/or facilitating migration for foreign-trained HHR, notably those from poorer, less well-resourced nations, recruitment practices and policies may be compromising the ability of developing countries to meet the health care needs of their own populations. Little is known, however, about actual recruitment practices. In this study we focus on Canada (a country with a long reliance on internationally trained HHR) and recruiters working for Canadian health authorities. We conducted interviews with health human resources recruiters employed by Canadian health authorities to describe their recruitment practices and perspectives and to determine whether and how they reflect ethical considerations. We describe the methods that recruiters used to recruit foreign-trained health professionals and the systemic challenges and policies that form the working context for recruiters and recruits. HHR recruiters' reflections on the global flow of health workers from poorer to richer countries mirror much of the content of global-level discourse with regard to HHR recruitment. A predominant market discourse related to shortages of HHR outweighed discussions of human rights and ethical approaches to recruitment policy and action that consider global health impacts. We suggest that the concept of corporate social responsibility may provide a useful approach at the local organizational level for developing policies on ethical recruitment. Such local policies and subsequent practices may inform public debate on the health equity implications of the HHR flows from poorer to richer countries inherent in the global health worker labour market, which in turn could influence political choices at all government and health system levels.
Link, Bruce G; Phelan, Jo C; Miech, Richard; Westin, Emily Leckman
A robust and very persistent association between indicators of socioeconomic status (SES) and the onset of life-threatening disease is a prominent concern of medical sociology. The persistence of the association over time and its generality across very different places suggests that no fixed set of intervening risk and protective factors can account for the connection. Instead, fundamental-cause theory views SES-related resources of knowledge, money, power prestige, and beneficial social connections as flexible resources that allow people to avoid risks and adopt protective strategies no matter what the risk and protective factors are in a given place or time. Recently, however, intelligence has been proposed as an alternative flexible resource that could fully account for the association between SES and health and thereby find its place as the epidemiologists' "elusive fundamental cause" (Gottfredson 2004). We examine the direct effects of intelligence test scores and adult SES in two data sets containing measures of intelligence, SES, and health. In analyses of prospective data from both the Wisconsin Longitudinal Study and the Health and Retirement Survey, we find little evidence of a direct effect of intelligence on health once adult education and income are held constant. In contrast, the significant effects of education and income on health change very little when intelligence is controlled. Although data limitations do not allow a definitive resolution of the issue, this evidence is inconsistent with the claim that intelligence is the elusive fundamental cause of health disparities, and instead supports the idea that the flexible resources people actively use to gain a health advantage are the SES-related resources of knowledge, money, power, prestige, and beneficial social connections.
The existence of appropriate institutional and human resource capacity underpins the viability and sustainability of a health reform process within a country. Building human resource capacity within the health sector involves building the capacity of health service providers, health managers and administers as well as the stewards of health. Although capacity building is linked to a generic process closely linked to the broader economic, social and developmental context, it has specific health system connotations which should be the focus of a concerted effort. These include quantitative issues, in-effective deployment and brain-drain, qualitative considerations which stem from gaps in the quality of undergraduate as well as discrepancies in the content and format of training and absence of this in service of training health professionals and gaps in regulation. As one of the fundamental corner stones of health reform the Gateway Paper calls attention to the need to avert these issues with the development of a well-defined policy in human resource development as an entry point. This should be based on an analysis of the human resource need and should clearly define career structures for all categories of healthcare providers, and articulate the mechanisms of their effective deployment. Creating a conducive an rewarding environment, institutionalizing personnel management reform which go beyond personnel actions and set standards of performance, and develop appropriate incentives around this, would be critical. It would also be important to pay due attention to the content and format of training at an undergraduate level, at a postgraduate level and with reference to ongoing education and the allied roles of continuing medical education programs and accreditation of health systems educational institutions. The Gateway Paper also lays stress on effective regulation to curb the practice of quackery.
Whiteley, Jennifer; Wagner, Jan-Samuel; Bushmakin, Andrew; Kopenhafer, Lewis; Dibonaventura, Marco; Racketa, Jill
The current study characterizes health-related quality of life, work productivity, and resource use among postmenopausal women by severity of vasomotor symptoms (VMS). Participants were selected from the 2010 US National Health and Wellness Survey. Women aged 40 to 75 years who did not report a history of menstrual bleeding or spotting for 1 year were eligible for analysis (N = 3,267). Cohorts of women with no VMS (n = 1,740), mild VMS (n = 931), moderate VMS (n = 462), and severe VMS (n = 134) were compared after controlling for demographic and health characteristics. Outcome measures were assessed using linear models and included health status, work productivity within the past 7 days, and healthcare resource use within the past 6 months. The mean age of women experiencing severe VMS was 57.92 years. After demographic and health characteristics had been controlled for, women experiencing severe and moderate VMS reported significantly lower mean health status scores compared with women with no symptoms (P women with severe, moderate, or mild symptoms than among women with no symptoms (P women experiencing VMS, women with severe and moderate symptoms had adjusted presenteeism of 24.28% and 14.3%, versus 4.33% in women with mild symptoms (P women with mild symptoms (P women, a greater severity of VMS is significantly associated with lower levels of health status and work productivity, and greater healthcare resource use.
Hassani, Seyed Abas; Mobaraki, Hossein; Bayat, Maboubeh; Mafimoradi, Shiva
In this paper the real role and place of human resource (HR) in health system reform will be discussed and determined within the whole system through the comprehensive Human Resource Management (HRM) model. Delphi survey and a questionnaire were used to 1) collect HR manager ideas and comments and 2) identify the main challenges of HRM. Then the results were discussed in an expert panel after being analyzed by content analysis method. Also, a deep focus study of recorded documents related to Health Human Resource Management was done. Then based on all achieved results, a rich picture was drawn to illustrate the right place of HRM in health sector. Finally, the authors revitalize the missed function of HRM within the health sector by drawing a holistic conceptual model. The most percentage of frequency about HR belongs to "Lack of reliable HR information system" (91%) and the least percentage of frequency belongs to "Low responsibility of HR" (28%). The most percentage of frequency about HR manager belongs to "Inattention to HR managers as key managers and consider them in background" (80%) and the least percentage of frequency belongs to "Lack of coordination between universities' policies" (30%). According to the conceptual framework, human resources employed in health system are viewed from two comprehensive approaches: instrumental approach and institutional. Unlike the common belief that looks HRM through the supportive approach, it is discussed that HRM not only has an instrumental role, but also do have a driver role.
Arnhold-Kerri, S; Sperlich, S
The present study examines the influence of socioeconomic position and the family's living conditions on children's self-reported quality of life. The aim is to analyse to what extent these relationships are mediated by maternal parenting resources (coping strategies, psychological health and maternal self-efficacy). We used data from 691 children (aged 8 - 12 years) and their mothers, collected in mother-child rehabilitation centres in Germany. The children's quality of life was measured by the KID-KINDL (self-report). Maternal parenting resources were measured by the SVF-60 (coping strategies), the SCL-K-9 (psychological health) and the FKE-K (maternal self-efficacy). Analyses of variance were used for estimating the effects of social factors on children's self-reported quality of life and on parenting resources. The relationship between children's quality of life and maternal parenting resources was assessed by computing correlation measures. The mediating effects of parenting resources on relationships between social factors and children's quality of life were estimated by means of multiple regression. Overall girls and boys showed high quality of life levels. A social gradient was only found for girls. The most significant influence was shown by receiving social welfare (t-test, p=0.000), flat size (VA, p=0.011) and single motherhood (t-test, p=0.011). The influence depends on the type of indicator for family living conditions as well as on specific dimensions of quality of life. Overall the influence of living conditions on the quality of life was small. Probably this is due to the sample being drawn from a clinical population. A social gradient was also found for maternal parenting resources: Psychological health as well as maternal self-efficacy were significantly different depending on whether families received social welfare or not (t-test, p=0.000; p=0.001). Single mothers showed more negative coping strategies and lower psychological health and maternal
Sidze, E.M.; Pradhan, J.; Beekink, E.; Maina, T.M.; Maina, B.W.
Understanding the flow of resources at the country level to reproductive health is essential for effective financing of this key component of health. This paper gives a comprehensive picture of the allocation of resources for reproductive health in Kenya and the challenges faced in the
Nigenda, Gustavo; Alcalde-Rabanal, Jaqueline; González-Robledo, Luz María; Serván-Mori, Edson; García-Saiso, Sebastián; Lozano, Rafael
To analyze efficiency indicators of human resources working at Mexico's Ministry of Health. Three dimensions of efficiency were explored: a) labor wastage, b) distribution of human resources (HR) across levels of care, and c) productivity. Health workers present significant levels of unemployment and underemployment; distribution does not meet international recommendations, and heterogeneous levels of productivity were found among states. Health and educational authorities should develop and implement a HR plan that takes into consideration the needs and demands of the covered population, and includes a clearly defined set of measures to regulate the future production of HR as well as their distribution among and within state health systems, and that allocates incentives to improve performance.
Månsdotter, Anna; Lindholm, Lars; Ohman, Ann
Women live longer than men in almost all countries, but men are more privileged in terms of power, influence, resources and probably morbidity. This investigation aims at illustrating how the choice of normative framework affects judgements about the fairness in these sex differences, and about desired societal change. The selected theories are welfare economics, health sector extra-welfarism, justice as fairness and feminist justice. By means of five Swedish proposals aiming at improving the population's health or "sex equity", facts and values are applied to resource allocation. Although we do not claim a specific ethical foundation, it seems to us that the feminist criterion has great potential in public health policy. The overall conclusion is that the normative framework must be explicitly discussed and stated in issues of women's and men's health.
Berger-Jenkins, Evelyn; McCord, Mary; Gallagher, Trish; Olfson, Mark
Despite evidence for its feasibility, the usage of mental health screening in primary care practices with overburdened providers and few referral options remains unclear. This study explores the effects of routine screening on mental health problem identification and management in a low-resource setting. Medical records of 5 to 12 year-old children presenting for well visits before and after screening was implemented were reviewed. Multivariate logistic regression was used to explore associations between study period and identification/management practices. Changes in the number of visits and wait times for a co-located referral service were assessed post hoc. Parents disclosed more mental health problems, and providers initiated more workups but referred fewer patients after screening was implemented. The proportion of new visits and wait times for the referral service did not change. Even in low-resource settings, screening may facilitate parental disclosure and increase clinical attention to mental health problems without overburdening referral services.
Niessen, Louis Wilhelmus
The book has described the dynamics of disease occurrence in populations and gives an overview of the major known health determinants of mortality decline, health risk factors and health services, and studies the health interventions options in two example diseases i.e. diabetes and stroke. We
Hektoen agar. Initial analyses suggest a strong correlation between phosphate concentrations and bacterial populations; a 66% decrease in phosphate resulted in a 35% reduction in bacterial populations and a 45% reduction in enteropathogenic populations. Likewise, a strong correlation was shown between calcium carbonate concentrations and bacterial reduction greater than that which can be attributed to the phosphate reduction alone. This was followed by the construction of various phosphate binding calcium carbonate filters, which used the ion exchange principle, including a spring loading filter, PVC pipe filter, and a galvanized filter. All were tested with the aid of Stoke's law formulation. The experiment was extremely successful in designing a working phosphate-binding and ammonia-reducing filter, and a large-scale agitator-clarifier filter system is currently being planned for construction in Madrona Marsh; this filter will reduce phosphate and ammonia levels substantially in the following years, bringing ecological, economical, and health-related improvements to the overall ecosystem and habitat.
This article: (1) explains the respiratory patterns of several freshwater insects; (2) describes the differences and mechanisms of spiracular cutaneous, and gill respiration; and (3) discusses behavioral aspects of selected aquatic insects. (ML)
Documents pertaining to the 2016 Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Selenium (Freshwater). These documents include what the safe levels of Selenium are in water for the majority of species.
Documents related to EPA's final 2013 Aquatic Life Ambient Water Quality Criteria for Ammonia (Freshwater). These documents pertain to the safe levels of Ammonia in water that should protect to the majority of species.
Documents pertain to Aquatic Life Ambient Water Quality criteria for Copper (2007 Freshwater, 2016 Estuarine/marine). These documents contain the safe levels of Copper in water that should protect to the majority of species.
U.S. Environmental Protection Agency — The Aquatic Life Benchmarks is an EPA-developed set of criteria for freshwater species. These benchmarks are based on toxicity values reviewed by EPA and used in the...
The overall aim of this thesis was to increase the knowledge of the public health economic aspects of chlamydia and other STIs, in terms of risk, prevention and resources. In Study I, we examined the association between demographic, socioeconomic and lifestyle factors and the risk of self-reported chlamydial infection among young adults in the Stockholm public health cohort. We found that the risk of self-reported chlamydia infection among young adults in Sweden was associated with lowe...
Medina, Santiago L.; Altman, Nolan R.
To describe the resources and strategies required to establish a health outcomes and economics center in radiology.Methods. Human and nonhuman resources required to perform sound outcomes and economics studies in radiology are reviewed.Results. Human resources needed include skilled medical and nonmedical staff. Nonhuman resources required are: (1) communication and information network; (2) education tools and training programs; (3) budgetary strategies; and (4) sources of income. Effective utilization of these resources allows the performance of robust operational and clinical research projects in decision analysis, cost-effectiveness, diagnostic performance (sensitivity, specificity, and ROC curves), and clinical analytical and experimental studies.Conclusion. As new radiologic technology and techniques are introduced in medicine, society is increasingly demanding sound clinical studies that will determine the impact of radiologic studies on patient outcome. Health-care funding is scarce, and therefore third-party payers and hospitals are demanding more efficiency and productivity from radiologic service providers. To meet these challenges, radiology departments could establish health outcomes and economics centers to study the clinical effectiveness of imaging and its impact on patient outcome. (orig.)
Abstracts of reports are presented from a meeting on Molecular Ecology of Aquatic Microbes. Topics included: opportunities offered to aquatic ecology by molecular biology; the role of aquatic microbes in biogeochemical cycles; characterization of the microbial community; the effect of the environment on aquatic microbes; and the targeting of specific biological processes.
Osborne-Gowey, J.; Strittholt, J.; Bergquist, J.; Ward, B. C.; Sheehan, T.; Comendant, T.; Bachelet, D. M.
The world’s aquatic resources are experiencing anthropogenic pressures on an unprecedented scale and aquatic organisms are experiencing widespread population changes and ecosystem-scale habitat alterations. Climate change is likely to exacerbate these threats, in some cases reducing the range of native North American fishes by 20-100% (depending on the location of the population and the model assumptions). Scientists around the globe are generating large volumes of data that vary in quality, format, supporting documentation, and accessibility. Moreover, diverse models are being run at various temporal and spatial scales as scientists attempt to understand previous (and project future) human impacts to aquatic species and their habitats. Conservation scientists often struggle to synthesize this wealth of information for developing practical on-the-ground management strategies. As a result, the best available science is often not utilized in the decision-making and adaptive management processes. As aquatic conservation problems around the globe become more serious and the demand to solve them grows more urgent, scientists and land-use managers need a new way to bring strategic, science-based, and action-oriented approaches to aquatic conservation. The Conservation Biology Institute (CBI), with partners such as ESRI, is developing an Aquatic Center as part of a dynamic, web-based resource (Data Basin; http: databasin.org) that centralizes usable aquatic datasets and provides analytical tools to visualize, analyze, and communicate findings for practical applications. To illustrate its utility, we present example datasets of varying spatial scales and synthesize multiple studies to arrive at novel solutions to aquatic threats.
Kraus, Johanna M.; Pomeranz, Justin F.; Todd, Andrew S.; Walters, David M.; Schmidt, Travis S.; Wanty, Richard B.
Stream food webs are connected with their riparian zones through cross-ecosystem movements of energy and nutrients. The use and impact of terrestrial subsidies on aquatic consumers is determined in part by in situ biomass of aquatic prey. Thus, stressors such as aquatic pollutants that greatly reduce aquatic secondary production could increase the need for and reliance of stream consumers on terrestrial resource subsidies.
Rajamani, Sripriya; Chen, Elizabeth S; Lindemann, Elizabeth; Aldekhyyel, Ranyah; Wang, Yan; Melton, Genevieve B
Reports by the National Academy of Medicine and leading public health organizations advocate including occupational information as part of an individual's social context. Given recent National Academy of Medicine recommendations on occupation-related data in the electronic health record, there is a critical need for improved representation. The National Institute for Occupational Safety and Health has developed an Occupational Data for Health (ODH) model, currently in draft format. This study aimed to validate the ODH model by mapping occupation-related elements from resources representing recommendations, standards, public health reports and surveys, and research measures, along with preliminary evaluation of associated value sets. All 247 occupation-related items across 20 resources mapped to the ODH model. Recommended value sets had high variability across the evaluated resources. This study demonstrates the ODH model's value, the multifaceted nature of occupation information, and the critical need for occupation value sets to support clinical care, population health, and research. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Soldo, Beth J.; Pagán, José A.; McCabe, John; deBlois, Madeleine; Field, Samuel H.; Asch, David A.; Cannuscio, Carolyn
Objectives. We examined associations between material resources and late-life declines in health. Methods. We used logistic regression to estimate the odds of declines in self-rated health and incident walking limitations associated with material disadvantages in a prospective panel representative of US adults aged 51 years and older (N = 15 441). Results. Disadvantages in health care (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.23, 1.58), food (OR = 1.69; 95% CI = 1.29, 2.22), and housing (OR = 1.20; 95% CI = 1.07, 1.35) were independently associated with declines in self-rated health, whereas only health care (OR = 1.43; 95% CI = 1.29, 1.58) and food (OR = 1.64; 95% CI = 1.31, 2.05) disadvantage predicted incident walking limitations. Participants experiencing multiple material disadvantages were particularly susceptible to worsening health and functional decline. These effects were sustained after we controlled for numerous covariates, including baseline health status and comorbidities. The relations between health declines and non-Hispanic Black race/ethnicity, poverty, marital status, and education were attenuated or eliminated after we controlled for material disadvantage. Conclusions. Material disadvantages, which are highly policy relevant, appear related to health in ways not captured by education and poverty. Policies to improve health should address a range of basic human needs, rather than health care alone. PMID:19890175
Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba
management. The aim of this study was to explore the current status of the development of human resources in health supply chain management in Ethiopia and to identify important factors affecting this development. METHODS: A series of face-to-face interviews with key stakeholders was carried out in 2014...... and training, and Barriers and enablers. Results confirm the development of human resources in health supply chain management in many areas. However, several problems were identified including lack of coordination, partly due to the large number of stakeholders; reported high staff mobility; and a lack...... of overall strategy regarding the job/career structures necessary for maintaining human resources. Rural areas have a particular set of problems, including in transportation of goods and personnel, attracting and keeping personnel, and in communication and access to information. CONCLUSIONS: Ethiopia...
Callaghan, Lynne; Doherty, Alan; Lea, Susan J; Webster, Daniel
Students on health and social care degree programmes spend 50% of their time on practice placements. Because of the diversity of settings and the need to evidence their work, it is vital to understand the information and resource needs of placement students. The aim of this investigation was to understand the needs of placement students in terms of accessing resources whilst they are in the field in order to inform a guide to meet these needs. Focus groups were conducted with students on midwifery, social work and post-registration health professions degree programmes on three different sites across the region. Data were analysed using Thematic Content Analysis. Three themes emerged from the data: inequality, user education needs and students' solutions and strategies. It is essential to speak to placement students in order to understand their needs in terms of accessing and using library resources. The timing and content of information skills training is key to meeting student needs while on placement.
Lee, Jaehoon; Hulse, Nathan C; Wood, Grant M; Oniki, Thomas A; Huff, Stanley M
In this study we developed a Fast Healthcare Interoperability Resources (FHIR) profile to support exchanging a full pedigree based family health history (FHH) information across multiple systems and applications used by clinicians, patients, and researchers. We used previously developed clinical element models (CEMs) that are capable of representing the FHH information, and derived essential data elements including attributes, constraints, and value sets. We analyzed gaps between the FHH CEM elements and existing FHIR resources. Based on the analysis, we developed a profile that consists of 1) FHIR resources for essential FHH data elements, 2) extensions for additional elements that were not covered by the resources, and 3) a structured definition to integrate patient and family member information in a FHIR message. We implemented the profile using an open-source based FHIR framework and validated it using patient-entered FHH data that was captured through a locally developed FHH tool.
This paper addresses issues of allocating public resources efficiently between mental health conditions that are associated with different levels of disability, and presents an adaptation of an established framework to help decision-making in this area. The adapted framework refers to psychological interventions that are universal, indicated,…
... Services Administration and Centers for Disease Control and Prevention I hereby delegate to the Administrator, Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and Prevention (CDC), with authority to redelegate, the authority vested in the Secretary of the...
Wallace, Alison; Joss, Nerida
Without deliberate and resourced translation, research evidence is unlikely to inform policy and practice. This paper describes the processes and practical solutions used to translate evaluation research findings to improve the readability of print materials in a large scale worksite health programme. It is argued that a knowledge brokering and…
Randall, G. Kevin; Martin, Peter; Bishop, Alex J.; Johnson, Mary Ann; Poon, Leonard W.
This study examined the mediating and moderating role of social resources on the association between age and change in functional health for three age groups of older adults. Data were provided by those in their 60s, 80s, and 100s who participated in the first two phases of the Georgia Centenarian study. Analyses confirmed the study's hypothesis…
Burke, Sloane C.; Snyder, Shonna L.
As college health education professors attempt to engage the Web 2.0 generation of learners, use of innovative video technology resources such as YouTube can be integrated to provide relevant and targeted information to supplement college course content, create a sense of "classroom community," and enrich the learning environment for all…
Tilahun, Binyam; Fritz, Fleur
With the increasing implementation of different health information systems in developing countries, there is a growing need to measure the main determinants of their success. The results of this evaluation study on the determinants of HIS success in five low resource setting hospitals show that service quality is the main determinant factor for information system success in those kind of settings.
Full Text Available the primary healthcare levels in order to improve the delivery of services within various communities. They further provide the issues that the mhealth service providers should take into account when providing m-health solutions to the resource constrained...
Reginald Tucker reads an abridged version of the Emerging Infectious Diseases Another Dimension, ZombiesâA Pop Culture Resource for Public Health Awareness. Created: 4/24/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 4/24/2013.
Mickelson, Grace; Suter, Esther; Deutschlander, Siegrid; Bainbridge, Lesley; Harrison, Liz; Grymonpre, Ruby; Hepp, Shelanne
The current gap in research on inter-professional collaboration and health human resources outcomes is explored by the Western Canadian Interprofessional Health Collaborative (WCIHC). In a recent research planning workshop with the four western provinces, 82 stakeholders from various sectors including health, provincial governments, research and education engaged with WCIHC to consider aligning their respective research agendas relevant to inter-professional collaboration and health human resources. Key research recommendations from a recent knowledge synthesis on inter-professional collaboration and health human resources as well as current provincial health priorities framed the discussions at the workshop. This knowledge exchange has helped to consolidate a shared current understanding of inter-professional education and practice and health workforce planning and management among the participating stakeholders. Ultimately, through a focused research program, a well-aligned approach between sectors to finding health human resources solutions will result in sustainable health systems reform. Copyright © 2013 Longwoods Publishing.
There is a paucity of evidence on how health care professionals view e-learning as a means of education to achieve safer health care. To address this gap, the reflections of health care professionals who used the resources on BMJ Learning were captured and analyzed. Key themes emerged from the analysis. Health care professionals are keen to put their e-learning into action to achieve safer health care and to learn how to follow guidelines that will help them achieve safer health care. Learners wanted their learning to remain grounded in reality. Finally, many commented that it was difficult for their individual learning to have a real impact when the culture of the organization did not change.
Liang, Di; Zhang, Donglan; Huang, Jiayan; Schweitzer, Stuart
China's rapid and sustained economic growth offers an opportunity to ask whether the advantages of growth diffuse throughout an economy, or remain localized in areas where the growth has been the greatest. A critical policy area in China has been the health system, and health inequality has become an issue that has led the government to broaden national health insurance programs. This study investigates whether health system resources and performance have converged over the past 30 years across China's 31 provinces. To examine geographic variation of health system resources and performance at the provincial level, we measure the degree of sigma convergence and beta convergence in indicators of health system resources (structure), health services utilization (process), and outcome. All data are from officially published sources: the China Health Statistics Year Book and the China Statistics Year Book. Sigma convergence is found for resource indicators, whereas it is not observed for either process or outcome indicators, indicating that disparities only narrowed in health system resources. Beta convergence is found in most indicators, except for 2 procedure indicators, reflecting that provinces with poorer resources were catching up. Convergence found in this study probably reflects the mixed outcome of government input, and market forces. Thus, left alone, the equitable distribution of health care resources may not occur naturally during a period of economic growth. Governmental and societal efforts are needed to reduce geographic health variation and promote health equity. © The Author(s) 2016.
Teklehaimanot, Hailay D; Teklehaimanot, Awash
Ethiopia is one of the sub-Saharan countries most affected by high disease burden, aggravated by a shortage and imbalance of human resources, geographical distance, and socioeconomic factors. In 2004, the government introduced the Health Extension Program (HEP), a primary care delivery strategy, to address the challenges and achieve the World Health Organization Millennium Development Goals (MDGs) within a context of limited resources. The health system was reformed to create a platform for integration and institutionalization of the HEP with appropriate human capacity, infrastructure, and management structures. Human resources were developed through training of female health workers recruited from their prospective villages, designed to limit the high staff turnover and address gender, social and cultural factors in order to provide services acceptable to each community. The service delivery modalities include household, community and health facility care. Thus, the most basic health post infrastructure, designed to rapidly and cost-effectively scale up HEP, was built in each village. In line with the country's decentralized management system, the HEP service delivery is under the jurisdiction of the district authorities. The nationwide implementation of HEP progressed in line with its target goals. In all, 40 training institutions were established, and over 30,000 Health Extension Workers have been trained and deployed to approximately 15,000 villages. The potential health service coverage reached 92.1% in 2011, up from 64% in 2004. While most health indicators have improved, performance in skilled delivery and postnatal care has not been satisfactory. While HEP is considered the most important institutional framework for achieving the health MDGs in Ethiopia, quality of service, utilization rate, access and referral linkage to emergency obstetric care, management, and evaluation of the program are the key challenges that need immediate attention. This article
Willcox, Merlin L; Peersman, Wim; Daou, Pierre; Diakité, Chiaka; Bajunirwe, Francis; Mubangizi, Vincent; Mahmoud, Eman Hassan; Moosa, Shabir; Phaladze, Nthabiseng; Nkomazana, Oathokwa; Khogali, Mustafa; Diallo, Drissa; De Maeseneer, Jan; Mant, David
The World Health Organization defines a "critical shortage" of health workers as being fewer than 2.28 health workers per 1000 population and failing to attain 80% coverage for deliveries by skilled birth attendants. We aimed to quantify the number of health workers in five African countries and the proportion of these currently working in primary health care facilities, to compare this to estimates of numbers needed and to assess how the situation has changed in recent years. This study is a review of published and unpublished "grey" literature on human resources for health in five disparate countries: Mali, Sudan, Uganda, Botswana and South Africa. Health worker density has increased steadily since 2000 in South Africa and Botswana which already meet WHO targets but has not significantly increased since 2004 in Sudan, Mali and Uganda which have a critical shortage of health workers. In all five countries, a minority of doctors, nurses and midwives are working in primary health care, and shortages of qualified staff are greatest in rural areas. In Uganda, shortages are greater in primary health care settings than at higher levels. In Mali, few community health centres have a midwife or a doctor. Even South Africa has a shortage of doctors in primary health care in poorer districts. Although most countries recognize village health workers, traditional healers and traditional birth attendants, there are insufficient data on their numbers. There is an "inverse primary health care law" in the countries studied: staffing is inversely related to poverty and level of need, and health worker density is not increasing in the lowest income countries. Unless there is money to recruit and retain staff in these areas, training programmes will not improve health worker density because the trained staff will simply leave to work elsewhere. Information systems need to be improved in a way that informs policy on the health workforce. It may be possible to use existing resources
Full Text Available Abstract Background For any wide-ranging effort to scale up health-related priority interventions, human resources for health (HRH are likely to be a key to success. This study explores constraints related to human resources in the health sector for achieving the Millennium Development Goals (MDGs in low-income countries. Methods and framework The analysis drew on information from a variety of publicly-available sources and principally on data presented in published papers in peer-reviewed journals. For classifying HRH constraints an analytical framework was used that considers constraints at five levels: individual characteristics, the health service delivery level, the health sector level, training capacities and the sociopolitical and economic context of a country. Results and discussion At individual level, the decision to enter, remain and serve in the health sector workforce is influenced by a series of social, economic, cultural and gender-related determinants. For example, to cover the health needs of the poorest it is necessary to employ personnel with specific social, ethnic and cultural characteristics. At health-service level, the commitment of health staff is determined by a number of organizational and management factors. The workplace environment has a great impact not only on health worker performance, but also on the comprehensiveness and efficiency of health service delivery. At health-sector level, the use of monetary and nonmonetary incentives is of crucial importance for having the accurate skill mix at the appropriate place. Scaling up of priority interventions is likely to require significant investments in initial and continuous training. Given the lead time required to produce new health workers, such investments must occur in the early phases of scaling up. At the same time coherent national HRH policies are required for giving direction on HRH development and linking HRH into health-sector reform issues, the scaling
Rainer, S R; Papp, E
The occupational and environmental health nurse entrepreneur can avoid business failure by engaging in a planning process that maximizes financial resources. Successful financial management involves understanding key financial reports and using those reports as management tools to "keep score" on the business. The prices the occupational and environmental health nurse entrepreneur charges for services will have a direct effect on the success of the business. Payroll, earnings, and expense records are useful management tools to help the occupational and environmental health nurse entrepreneur track the business and meet legal requirements.
Full Text Available This paper examines the effectiveness of Taiwanese environmental health policies, whose aim is to improve environmental quality by reducing tire waste via the Tire Resource Recovery Program. The results confirm that implemented environmental health policies improve the overall health of the population (i.e. a decrease in death caused by bronchitis and other respiratory diseases. Current policy expenditures are far below the optimal level, as it is estimated that a ten percent increase in the subsidy would decrease the number of deaths caused by bronchitis and other respiratory diseases by 0.58% per county/city per year on average.
Garman, Andrew N; Polavarapu, Nandakishor; Grady, Jane C; Canar, W Jeffrey
Personnel costs typically account for 60% or more of total operating expenses in health systems, and as such become a necessary focus in most if not all substantive health reform adaptations. This study sought to assess whether strategic alignment of the human resource (HR) and learning functions was associated with greater adaptive capacity in U.S. health systems. Data were gathered using a survey that was distributed electronically to chief human resource officers from two U.S.-based associations. The survey included questions about organizational structure, strategic human resource management, strategic learning, and organizational response to health reform. Significant correlations were found between strategic alignment of HR and HR's involvement in responses related to cost control (r = 0.46, p strategic alignment of organizational learning and HR involvement with these responses. Results suggest that HR structure may affect an organization's capacity for adaptive response. Top-management teams in health systems should consider positioning HR as part of the core leadership team, with a reporting relationship that allows HR to maximally participate in formulating and implementing organizational adaptation.
Wasielewski, Helen; Alcock, Joe; Aktipis, Athena
Diet has been known to play an important role in human health since at least the time period of the ancient Greek physician Hippocrates. In the last decade, research has revealed that microorganisms inhabiting the digestive tract, known as the gut microbiota, are critical factors in human health. This paper draws on concepts of cooperation and conflict from ecology and evolutionary biology to make predictions about host-microbiota interactions involving nutrients. To optimally extract energy from some resources (e.g., fiber), hosts require cooperation from microbes. Other nutrients can be utilized by both hosts and microbes (e.g., simple sugars, iron) in their ingested form, which may lead to greater conflict over these resources. This framework predicts that some negative health effects of foods are driven by the direct effects of these foods on human physiology and by indirect effects resulting from microbiome-host competition and conflict (e.g., increased invasiveness and inflammation). Similarly, beneficial effects of some foods on host health may be enhanced by resource sharing and other cooperative behaviors between host and microbes that may downregulate inflammation and virulence. Given that some foods cultivate cooperation between hosts and microbes while others agitate conflict, host-microbe interactions may be novel targets for interventions aimed at improving nutrition and human health. © 2016 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.
Bhatnagar, Aarushi; Scott, Kerry; Govender, Veloshnee; George, Asha
A country's health workforce plays a vital role not only in serving the health needs of the population but also in supporting economic prosperity. Moreover, a well-funded and well-supported health workforce is vital to achieving universal health coverage and Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages. This perspective article highlights the potential of underutilized health policy and systems research (HPSR) approaches for developing more effective human resources for health policy. The example of health worker motivation is used to showcase four types of HPSR (exploratory, influence, explanatory and emancipatory) that move beyond describing the extent of a problem. Most of the current literature aiming to understand determinants and dynamics of motivation is descriptive in nature. While this is an important basis for all research pursuits, it often gives little information about mechanisms to improve motivation and strategies for intervention. Motivation is an essential determinant of health worker performance, particularly for those working in difficult conditions, such as those facing many health workers in low- and middle-income countries. Motivation mediates health workforce performance in multiple ways: internally governing health worker behaviour; informing decisions on becoming a health worker; workplace location and ability to perform; and influencing willingness to engage politically. The four fresh research approaches described can help policy-makers better understand why health workers behave the way they do, how interventions can improve performance, the mechanisms that lead to change, and strategies for empowering health workers to be agents of change themselves.
Pyne, David B; Verhagen, Evert A; Mountjoy, Margo
In this review, we outline key principles for prevention of injury and illness in aquatic sports, detail the epidemiology of injury and illness in aquatic athletes at major international competitions and in training, and examine the relevant scientific evidence on nutrients for reducing the risk of illness and injury. Aquatic athletes are encouraged to consume a well-planned diet with sufficient calories, macronutrients (particularly carbohydrate and protein), and micronutrients (particularly iron, zinc, and vitamins A, D, E, B6, and B12) to maintain health and performance. Ingesting carbohydrate via sports drinks, gels, or sports foods during prolonged training sessions is beneficial in maintaining energy availability. Studies of foods or supplements containing plant polyphenols and selected strains of probiotic species are promising, but further research is required. In terms of injury, intake of vitamin D, protein, and total caloric intake, in combination with treatment and resistance training, promotes recovery back to full health and training.
Anderson, R Eleanor; Ahn, Roy; Nelson, Brett D; Chavez, Jean; de Redon, Emily; Burke, Thomas
In resource-limited settings, severe shortages of anesthetists and anesthesiologists lead to surgical delays that increase maternal and neonatal mortality and morbidity. To more clearly understand the individual components of the anesthesia gap pertaining to reproductive health surgeries and procedures in resource-limited settings. Medline, the Cochrane Library, CINAHL, Embase, and POPLINE were systematically searched for reports published before December 31, 2013. Search terms were related to obstetric surgery, resource-limited settings, and anesthesia. Studies that addressed the use of anesthesia in reproductive procedures in resource-limited settings were included. Reviewers independently evaluated the full text of identified studies, extracted information related to study objectives and conclusions, and identified the anesthesia gap. Overall, 14 publications met the inclusion criteria. A significant lack of infrastructure, equipment and supplies, and trained personnel were identified as key factors responsible for a lack of anesthesia services. A shortage of trained anesthesia providers, equipment, supplies, medications, and infrastructure, along with limitations in transportation in resource-limited settings have produced a wide gap between available anesthesia services and the demand for them for reproductive health surgeries and procedures. Safe, affordable, and scalable solutions to address the anesthesia gap are urgently needed. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Corrigan, Patrick W; Watson, Amy C
Advocates hope to influence the resource allocation decisions of legislators and other policy makers to capture more resources for mental health programs. Findings from social psychological research suggest factors that, if pursued, may improve advocacy efforts. In particular, allocation decisions are affected by policy makers' perceptions of the scarcity of resources, effectiveness of specific programs, needs of people who have problems that are served by these programs, and extent of personal responsibility for these problems. These perceptions are further influenced by political ideology. Conservatives are motivated by a tendency to punish persons who are perceived as having personal responsibility for their problems by withholding resources, whereas liberals are likely to avoid tough allocation decisions. Moreover, these perceptions are affected by political accountability, that is, whether politicians perceive that their constituents will closely monitor their decisions. Just as the quality of clinical interventions improves when informed by basic research on human behavior, the efforts of mental health advocates will be advanced when they understand the psychological forces that affect policy makers' decisions about resources.
Zinnen, Véronique; Paul, Elisabeth; Mwisongo, Aziza; Nyato, Daniel; Robert, Annie
An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to empirical evidence on human resource for health motivation factors to assist policy makers in promoting effective and realistic interventions. A cross-sectional survey was conducted in four rural Tanzanian districts to explore staff stability and health workers' motivation. Data were collected using qualitative and quantitative techniques, covering all levels and types of health facilities. Stability of staff was found to be quite high. Public institutions remained very attractive with better job security, salary and retirement benefits. Satisfaction over working conditions was very low owing to inadequate working equipment, work overload, lack of services, difficult environment, favouritism and 'empty promotions'. Positive incentives mentioned were support for career development and supportive supervision. Attracting new staff in rural areas appeared to be more difficult than retaining staff in place. The study concluded that strategies to better motivate health personnel should focus on adequate remuneration, positive working and living environment and supportive management. However, by multiplying health facilities, the latest Tanzanian human resource for health plan could jeopardize current positive results. Copyright © 2012 John Wiley & Sons, Ltd.
Dal Poz Mario R
Full Text Available Abstract Background Human resources are an essential element of a health system's inputs, and yet there is a huge disparity among countries in how human resource policies and strategies are developed and implemented. The analysis of the impacts of services on population health and well-being attracts more interest than analysis of the situation of the workforce in this area. This article presents an international comparison of the health workforce in terms of skill mix, sociodemographics and other labour force characteristics, in order to establish an evidence base for monitoring and evaluation of human resources for health. Methods Profiles of the health workforce are drawn for 18 countries with developed market and transitional economies, using data from labour force and income surveys compiled by the Luxembourg Income Study between 1989 and 1997. Further descriptive analyses of the health workforce are conducted for selected countries for which more detailed occupational information was available. Results Considerable cross-national variations were observed in terms of the share of the health workforce in the total labour market, with little discernible pattern by geographical region or type of economy. Increases in the share were found among most countries for which time-trend data were available. Large gender imbalances were often seen in terms of occupational distribution and earnings. In some cases, health professionals, especially physicians, were overrepresented among the foreign-born compared to the total labour force. Conclusions While differences across countries in the profile of the health workforce can be linked to the history and role of the health sector, at the same time some common patterns emerge, notably a growing trend of health occupations in the labour market. The evidence also suggests that gender inequity in the workforce remains an important shortcoming of many health systems. Certain unexpected patterns of
Syzdykova, Assel; Malta, André; Zolfo, Maria; Diro, Ermias; Oliveira, José Luis
Despite the great impact of information and communication technologies on clinical practice and on the quality of health services, this trend has been almost exclusive to developed countries, whereas countries with poor resources suffer from many economic and social issues that have hindered the real benefits of electronic health (eHealth) tools. As a component of eHealth systems, electronic health records (EHRs) play a fundamental role in patient management and effective medical care services. Thus, the adoption of EHRs in regions with a lack of infrastructure, untrained staff, and ill-equipped health care providers is an important task. However, the main barrier to adopting EHR software in low- and middle-income countries is the cost of its purchase and maintenance, which highlights the open-source approach as a good solution for these underserved areas. The aim of this study was to conduct a systematic review of open-source EHR systems based on the requirements and limitations of low-resource settings. First, we reviewed existing literature on the comparison of available open-source solutions. In close collaboration with the University of Gondar Hospital, Ethiopia, we identified common limitations in poor resource environments and also the main requirements that EHRs should support. Then, we extensively evaluated the current open-source EHR solutions, discussing their strengths and weaknesses, and their appropriateness to fulfill a predefined set of features relevant for low-resource settings. The evaluation methodology allowed assessment of several key aspects of available solutions that are as follows: (1) integrated applications, (2) configurable reports, (3) custom reports, (4) custom forms, (5) interoperability, (6) coding systems, (7) authentication methods, (8) patient portal, (9) access control model, (10) cryptographic features, (11) flexible data model, (12) offline support, (13) native client, (14) Web client,(15) other clients, (16) code
Lammintakanen, Johanna; Kivinen, Tuula; Kinnunen, Juha
The aim of this study is to describe primary health care managers' attitudes and views on recruitment and human resource development in general and to ascertain whether there are any differences in the views of managers in the southern and northern regions of Finland. A postal questionnaire was sent to 315 primary health care managers, of whom 55% responded. The data were analysed using descriptive statistics and cross-tabulation according to the location of the health centre. There were few differences in managers' attitudes and views on recruitment and human resource development. In the southern region, managers estimated that their organization would be less attractive to employees in the future and they were more positive about recruiting employees abroad. Furthermore, managers in the northern region were more positive regarding human resource development and its various practices. Although the results are preliminary in nature, it seems that managers in different regions have adopted different strategies in order to cope with the shrinking pool of new recruits. In the southern region, managers were looking abroad to find new employees, while in the northern region, managers put effort into retaining the employees in the organization with different human resource development practices.
Matsaganis, Matthew D; Wilkin, Holley A
This article contributes to the burgeoning literature on the social determinants of health disparities. The authors investigate how communication resources and collective efficacy, independently and in combination, shape residents' access to health enhancing resources (including healthcare services, sources of healthier food options, and public recreation spaces) in their communities. Using random digit dial telephone survey data from 833 residents of South Los Angeles communities the authors show that communicative social capital-that is, an information and problem-solving resource that accrues to residents as they become more integrated into their local communication network of neighbors, community organizations, and local media-plays a significant role in access to health resources. This relationship is complicated by individuals' health insurance and health status, as communicative social capital magnifies the sense of absence of resources for those who are in worse health and lack insurance. Communicative social capital builds collective efficacy, which is positively related to access to health-enhancing resources, but it also mediates the negative relationship between communicative social capital and access to health resources. Residents with richer stores of communicative social capital and collective efficacy report better access to health resources. The authors conclude with a discussion of implications of these findings and suggestions for future research.
Fidel C.T. Budy, MPH
Full Text Available Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia.
Budy, Fidel C.T.
Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD) exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia. PMID:27622002
Hansberry, David R; Kraus, Carl; Agarwal, Nitin; Baker, Stephen R; Gonzales, Sharon F
The Internet is frequently accessed by patients as a resource for medical knowledge. However, the provided material is typically written at a level well above the recommended 7th grade level. A clear understanding of the capabilities, limitations, risks, and benefits of interventional radiology by patients, both current and prospective, is hindered when the textual information offered to the public is pitched at a level of sophistication too high for general comprehension. In January 2013, all 25 patient education resources from the Cardiovascular and Interventional Radiology Society of Europe (CIRSE) Web site ( http://www.cirse.org ) and all 31 resources from the Society of Interventional Radiology (SIR) Web site ( http://www.sirweb.org ) were analyzed for their specific level of readability using ten quantitative scales: Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Gunning fog index, New Fog Count, Coleman-Liau index, FORCAST formula, Fry graph, Raygor Readability Estimate, and New Dale-Chall. Collectively, the patient education resources on the CIRSE Web site are written at the 12.3 grade level, while the resources on the SIR Web site are written at the 14.5 grade level. Educational health care materials available on both the CIRSE and the SIR Web sites are presented in language in the aggregate that could be too difficult for many lay people to fully understand. Given the complex nature of vascular and interventional radiology, it may be advantageous to rewrite these educational resources at a lower reading level to increase comprehension.
Brittain, Claire; Kremen, Claire; Garber, Andrea; Klein, Alexandra-Maria
Insect-pollinated crops provide important nutrients for human health. Pollination, water and nutrients available to crops can influence yield, but it is not known if the nutritional value of the crop is also influenced. Almonds are an important source of critical nutrients for human health such as unsaturated fat and vitamin E. We manipulated the pollination of almond trees and the resources available to the trees, to investigate the impact on the nutritional composition of the crop. The pollination treatments were: (a) exclusion of pollinators to initiate self-pollination and (b) hand cross-pollination; the plant resource treatments were: (c) reduced water and (d) no fertilizer. In an orchard in northern California, trees were exposed to a single treatment or a combination of two (one pollination and one resource). Both the fat and vitamin E composition of the nuts were highly influenced by pollination. Lower proportions of oleic to linoleic acid, which are less desirable from both a health and commercial perspective, were produced by the self-pollinated trees. However, higher levels of vitamin E were found in the self-pollinated nuts. In some cases, combined changes in pollination and plant resources sharpened the pollination effects, even when plant resources were not influencing the nutrients as an individual treatment. This study highlights the importance of insects as providers of cross-pollination for fruit quality that can affect human health, and, for the first time, shows that other environmental factors can sharpen the effect of pollination. This contributes to an emerging field of research investigating the complexity of interactions of ecosystem services affecting the nutritional value and commercial quality of crops. PMID:24587215
Méndez, Claudio A; Torres A, M Cristina
In Latin America, some health sector reforms have included steps to the implementation of autonomous hospitals. In Chile, the health system is implementing a reform that introduces a network of self-managed institutions. These organizations will be high complexity centers that involve greater technical diversity, cost centers and mechanisms to evaluate users' satisfaction. For human resources in health, the implementation of these centers creates challenges in the planning of service provision and a change from the traditional management style of the teams to one based on networks. These challenges include the estimation of gaps in medical specialists and in other professions in the health sector. In order to be successful with self-management, Chile needs to establish universal and local policies that address training and the organization of health service provisioning in these institutions.
Yasnoff, W A
US HealthLink is a new, comprehensive online medical information system designed specifically for health care professionals. Available to individuals for a fixed fee, it includes literature, news, diagnostic decision support, drug interactions, electronic mail, and bulletin boards. It also provides user-specific current awareness via clipping service, and fax delivery of both clipping and electronic mail information. US HealthLink can now be utilized to access a wide variety of medical information sources inexpensively.
Mays, Glen P; Mamaril, Cezar B
To examine whether local expenditures for public health activities influence area-level medical spending for Medicare beneficiaries. Six census surveys of the nation's 2,900 local public health agencies were conducted between 1993 and 2013, linked with contemporaneous information on population demographics, socioeconomic characteristics, and area-level Medicare spending estimates from the Dartmouth Atlas of Health Care. Measures derive from agency survey data and aggregated Medicare claims. A longitudinal cohort design follows the geographic areas served by local public health agencies. Multivariate, fixed-effects, and instrumental-variables regression models estimate how area-level Medicare spending changes in response to shifts in local public health spending, controlling for observed and unmeasured confounders. A 10 percent increase in local public health spending per capita was associated with 0.8 percent reduction in adjusted Medicare expenditures per person after 1 year (p health insurance coverage, and health professional shortages. Expanded financing for public health activities may provide an effective way of constraining Medicare spending, particularly in low-resource communities. © Health Research and Educational Trust.
Harahap Nida P
Full Text Available Abstract Background In 2001 Indonesia embarked on a rapid decentralization of government finances and functions to district governments. One of the results is that government has less information about its most valuable resource, the people who provide the services. The objective of the work reported here is to determine the stock of human resources for health in 15 districts, their service status and primary place of work. It also assesses the effect of decentralization on management of human resources and the implications for the future. Methods We enumerated all health care providers (doctors, nurses and midwives, including information on their employment status and primary place of work, in each of 15 districts in Java. Data were collected by three teams, one for each province. Results Provider density (number of doctors, nurses and midwives/1000 population was low by international standards – 11 out of 15 districts had provider densities less than 1.0. Approximately half of all three professional groups were permanent public servants. Contractual employment was also important for both nurses and midwives. The private sector as the primary source of employment is most important for doctors (37% overall and increasingly so for midwives (10%. For those employed in the public sector, two-thirds of doctors and nurses work in health centres, while most midwives are located at village-level health facilities. Conclusion In the health system established after Independence, the facilities established were staffed through a period of obligatory service for all new graduates in medicine, nursing and midwifery. The last elements of that staffing system ended in 2007 and the government has not been able to replace it. The private sector is expanding and, despite the fact that it will be of increasing importance in the coming decades, government information about providers in private practice is decreasing. Despite the promise of decentralization to
Heywood, Peter F; Harahap, Nida P
In 2001 Indonesia embarked on a rapid decentralization of government finances and functions to district governments. One of the results is that government has less information about its most valuable resource, the people who provide the services. The objective of the work reported here is to determine the stock of human resources for health in 15 districts, their service status and primary place of work. It also assesses the effect of decentralization on management of human resources and the implications for the future. We enumerated all health care providers (doctors, nurses and midwives), including information on their employment status and primary place of work, in each of 15 districts in Java. Data were collected by three teams, one for each province. Provider density (number of doctors, nurses and midwives/1000 population) was low by international standards--11 out of 15 districts had provider densities less than 1.0. Approximately half of all three professional groups were permanent public servants. Contractual employment was also important for both nurses and midwives. The private sector as the primary source of employment is most important for doctors (37% overall) and increasingly so for midwives (10%). For those employed in the public sector, two-thirds of doctors and nurses work in health centres, while most midwives are located at village-level health facilities. In the health system established after Independence, the facilities established were staffed through a period of obligatory service for all new graduates in medicine, nursing and midwifery. The last elements of that staffing system ended in 2007 and the government has not been able to replace it. The private sector is expanding and, despite the fact that it will be of increasing importance in the coming decades, government information about providers in private practice is decreasing. Despite the promise of decentralization to increase sectoral "decision space" at the district level, the
Full Text Available Abstract Background The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Methods Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula. Results Comparing the current allocations of public sector health car resources with estimates using a needs based formula showed that regions with higher levels of need currently receive fewer resources than do regions with lower need. Conclusion To address the prevailing inequities in resource allocation, the Ministry of Health and Social Services should abandon the historical incrementalist method of budgeting/resource allocation and adopt a more appropriate allocation mechanism that incorporates measures of need for health care.
Zere, Eyob; Mandlhate, Custodia; Mbeeli, Thomas; Shangula, Kalumbi; Mutirua, Kauto; Kapenambili, William
The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula. Comparing the current allocations of public sector health car resources with estimates using a needs based formula showed that regions with higher levels of need currently receive fewer resources than do regions with lower need. To address the prevailing inequities in resource allocation, the Ministry of Health and Social Services should abandon the historical incrementalist method of budgeting/resource allocation and adopt a more appropriate allocation mechanism that incorporates measures of need for health care.
Johnston, Niall; Sandys, Nichola; Geoghegan, Rosemary; O'Donovan, Diarmuid; Flaherty, Gerard
Increasingly, medical students from developed countries are undertaking international medical electives in developing countries. Medical students understand the many benefits of these electives, such as the opportunity to develop clinical skills, to gain insight into global health issues and to travel to interesting regions of the world. However, they may be much less aware of the risk to their health and wellbeing while abroad. Compounding this problem, medical students may not seek advice from travel medicine practitioners and often receive inadequate or no information from their medical school prior to departure. The PubMed database was searched for relevant literature relating to the health of medical elective students. Combinations of the following key words were used as search terms: 'international health elective', 'medical student' and 'health risks'. Articles were restricted to those published in English from 1997 through June 2017. A secondary review of the reference lists of these articles was performed. The grey literature was also searched for relevant material. This narrative literature review outlines the risks of clinical electives in resource-poor settings which include exposure to infectious illness, trauma, sexual health problems, excessive sun exposure, mental health issues and crime. Medical students may mitigate these health risks by being informed and well prepared for high-risk situations. The authors provide evidence-based travel advice which aims to improve pre-travel preparation and maximize student traveller safety. A safer and more enjoyable elective may be achieved if students follow road safety advice, take personal safety measures, demonstrate cultural awareness, attend to their psychological wellbeing and avoid risk-taking behaviours. This article may benefit global health educators, international elective coordinators and travel medicine practitioners. For students, a comprehensive elective checklist, an inventory of health kit
Friesen, Jason; Patterson, Dean; Munjal, Kevin
In the past 50 years, cardiopulmonary resuscitation (CPR) has gained widespread recognition as a life-saving skill that can be taught successfully to the general public. Cardiopulmonary resuscitation can be considered a cost-effective intervention that requires minimal classroom training and low-cost equipment and supplies; it is commonly taught throughout much of the developed world. But, the simplicity of CPR training and its access for the general public may be misleading, as outcomes for patients in cardiopulmonary arrest are poor and survival is dependent upon a comprehensive "chain-of-survival," which is something not achieved easily in resource-limited health care settings. In addition to the significant financial and physical resources needed to both train and develop basic CPR capabilities within a community, there is a range of ethical questions that should also be considered. This report describes some of the financial and ethical challenges that might result from CPR training in low- and middle-income countries (LMICs). It is determined that for many health care systems, CPR training may have financial and ethically-deleterious, unintended consequences. Evidence shows Basic Life Support (BLS) skills training in a community is an effective intervention to improve public health. But, health care systems with limited resources should include CPR training only after considering the full implications of that intervention.
Recognition of the pervasiveness of risk in everyday life in modern industrial society has elicited calls for greater efforts to protect individual and public health. Yet, it is increasingly clear that decisions to do so must often be made in the context of significant limits in the amounts of financial resources available for achieving that protection. Achieving risk-free work, residential, and community environments may be so expensive as to render a private business unit uncompetitive or as to divert resources from or prelude commencing with other governmental projects with equal or greater health benefit potential. Ethical low-level risk communication (LLRC) is something risk-generating entities are morally obligated to do. However, such communication also offers important opportunities for such entities to move toward achieving better balances between health and the costs of protecting it. In this paper, the authors elaborate on several features of an ethically ideal LLRC process, focusing on those with aspects they hope are not obvious or common knowledge. In discussing these features, they provide examples of conflicts between health risks and resource limits at the level of the individual private firm, the local community, or the national government, such that LLRC with the feature in question provides an opportunity for mitigating or at least clarifying the conflict in question
Stevens, Judy A; Phelan, Elizabeth A
Falls among people aged ≥65 years are the leading cause of both injury deaths and emergency department visits for trauma. Research shows that many falls are preventable. In the clinical setting, an effective fall intervention involves assessing and addressing an individual's fall risk factors. This individualized approach is recommended in the American and British Geriatrics Societies' (AGS/BGS) practice guideline. This article describes the development of STEADI (Stopping Elderly Accidents, Deaths, and Injuries), a fall prevention tool kit that contains an array of health care provider resources for assessing and addressing fall risk in clinical settings. As researchers at the Centers for Disease Control and Prevention's Injury Center, we reviewed relevant literature and conducted in-depth interviews with health care providers to determine current knowledge and practices related to older adult fall prevention. We developed draft resources based on the AGS/BGS guideline, incorporated provider input, and addressed identified knowledge and practice gaps. Draft resources were reviewed by six focus groups of health care providers and revised. The completed STEADI tool kit, Preventing Falls in Older Patients-A Provider Tool Kit, is designed to help health care providers incorporate fall risk assessment and individualized fall interventions into routine clinical practice and to link clinical care with community-based fall prevention programs.
Sato, Keiko; Yamazaki, Shin; Hayashino, Yasuaki; Takegami, Misa; Tokuda, Yasuharu; Takahashi, Osamu; Shimbo, Takuro; Hinohara, Shigeaki; Fukui, Tsuguya; Fukuhara, Shunichi
To investigate the association between hours worked, symptoms experienced, and health resource utilization. Data were collected from a nationally representative sample of households in Japan. We studied full-time male workers aged 18-65 yr who worked 100 h or more per month. First, we examined the association between hours worked and symptoms experienced. Second, we examined the association between hours worked and the type of health resource utilized, such as physician visits, over-the-counter (OTC) medication use, dietary supplement use, and complementary and alternative medicine (CAM) provider visits. We used a multivariable negative binominal model in each analysis. Of the 762 male workers, 598 reported experiencing symptoms at least once a month. We categorized participants based on the number of hours worked per month (h/mo): 100-200 h/mo, 201-250 h/mo, and over 250 h/mo. Compared with those working 201-250 h/mo, those working 100-200 h/mo had more frequent physician visits (rate ratio:1.67, 95% CI: 1.17 to 2.38) and those working over 250 h/mo had significantly lower rates of CAM provider visits and tended to use dietary supplements for symptoms. Participants who worked 201-250 h/mo used OTC medication most frequently. No significant association was observed between the number of hours worked and number of symptoms experienced. The more hours worked by full-time male workers, the more likely they were to use health resources that had a lower time requirement. Greater attention should be paid to patterns of health resource utilization among workers and their consequent influence on long-term health status.
McDaid, David; Knapp, Martin; Curran, Claire
There is growing demand for economic analysis to support strategic decision-making for mental health but the availability of economic evidence, in particular on system performance remains limited. The Mental Health Economics European Network (MHEEN) was set up in 2002 with the broad objective of developing a base for mental health economics information and subsequent work in 17 countries. Data on financing, expenditure and costs, provision of services, workforce, employment and capacity for economic evaluation were collected through bespoke questionnaires developed iteratively by the Network. This was augmented by a literature review and analysis of international databases. Findings on financing alone suggest that in many European countries mental health appears to be neglected while mechanisms for resource allocation are rarely linked to objective measure of population mental health needs. Numerous economic barriers and potential solutions were identified. Economic incentives may be one way of promoting change, although there is no 'one size fits all solution. There are significant benefits and synergies to be gained from the continuing development of networks such as MHEEN. In particular the analysis can be used to inform developments in Central and Eastern Europe. For instance there is much that can be learnt on both how the balance of care between institutional and non-institutional care has changed and on the role played by economic incentives in ensuring that resources were used to develop alternative community-based systems.
This report assesses for decision makers and those involved in coal resource development the environmental and health impacts of trace-element effects arising from significant increases in the use of coal, unless unusual precautions are invoked. Increasing demands for energy and the pressing need for decreased dependence of the United States on imported oil require greater use of coal to meet the nation's energy needs during the next decade. If coal production and consumption are increased at a greatly accelerated rate, concern arises over the release, mobilization, transportation, distribution, and assimilation of certain trace elements, with possible adverse effects on the environment and human health. It is, therefore, important to understand their geochemical pathways from coal and rocks via air, water, and soil to plants, animals, and ultimately humans, and their relation to health and disease. To address this problem, the Panel on Trace Element Geochemistry of Coal Resource Development Related to Health (PECH) was established. Certain assumptions were made by the Panel to highlight the central issues of trace elements and health and to avoid unwarranted duplication of other studies. Based on the charge to the Panel and these assumptions, this report describes the amounts and distribution of trace elements related to the coal source; the various methods of coal extraction, preparation, transportation, and use; and the disposal or recycling of the remaining residues or wastes. The known or projected health effects are discussed at the end of each section.
Baumann, Andrea; Crea-Arsenio, Mary; Akhtar-Danesh, Noori; Fleming-Carroll, Bonnie; Hunsberger, Mabel; Keatings, Margaret; Elfassy, Michael David; Kratina, Sarah
Background Health-care organizations provide services in a challenging environment, making the introduction of health human resources initiatives especially critical for safe patient care. Purpose To demonstrate how one specialty hospital in Ontario, Canada, leveraged an employment policy to stabilize its nursing workforce over a six-year period (2007 to 2012). Methods An observational cross-sectional study was conducted in which administrative data were analyzed to compare full-time status and retention of new nurses prepolicy and during the policy. The Professionalism and Environmental Factors in the Workplace Questionnaire® was used to compare new nurses hired into the study hospital with new nurses hired in other health-care settings. Results There was a significant increase in full-time employment and a decrease in part-time employment in the study hospital nursing workforce. On average, 26% of prepolicy new hires left the study hospital within one year of employment compared to 5% of new hires during policy implementation. The hospital nurses scored significantly higher than nurses employed in other health-care settings on 5 out of 13 subscales of professionalism. Conclusions Decision makers can use these findings to develop comprehensive health human resources guidelines and mechanisms that support strategic workforce planning to sustain and strengthen the health-care system.
Ricci, Karen; Lurie, Nicole; Stoto, Michael A; Wasserman, Jeffrey; Dausey, David J; Meade, Barbara; Diamond, Alexis; Molander, Roger C
... to evaluate the ability to receive and respond to case reports 24 hours a day, 7 days a week. We refined these tests by beta-testing them at 20 metropolitan area local public health agencies across the country over the course of 10 months. The contents of this manual will be of interest to public health professionals at the state and local l...
Mahoney, Beverly Saxton, Ed.; Olsen, Larry K., Ed.
This handbook provides background information on the health curriculum, as well as current, comprehensive information on publications, standards, and special materials for K-12 health education. The manual begins with an introduction, by P. Bruce Uhrmacher, which provides an overview of the ideologies and philosophies that have affected curriculum…
... 32 National Defense 4 2010-07-01 2010-07-01 true Notices to Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development (HUD). 644.336 Section 644.336... Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development...
de França, José Rivaldo Melo; do Rosário Costa, Nilson
The aim of this study is to discuss the Brazilian Federal participation in the financing health sector from 1995 to 2004, having the basis the resources of the institutional initiatives related to the indexation of expenses, considering the macroeconomic adjustment practiced in that period and the institutions role to protect the cash flow. Examining the performances of the institutional mechanism actually adopted with the purpose of guarantee the flow regularity and extension of the values, by the analisys of the Temporary Contribution on the Financial Movement (TCFM) and the Constitutional Amendment Number 29 (CA 29) whose initiatives has their efficiency questioned. It demonstrates the impact of the destination of such measures from the statistics analysis of the use of the resources of the TCFM regarding its levies and the indexation of Union resources effects measures from the CA 29 before and after the application of its determinations.
Leite, Valéria Rodrigues; Lima, Kenio Costa; de Vasconcelos, Cipriano Maia
This article investigates the issue of funding and the decentralization process in order to examine the composition, application and management of resources in the healthcare area. The sample surveyed involved 14 municipalities in the state of Rio Grande do Norte, Brazil. The research involved data gathering of financial transfers, the municipality's own resources and primary healthcare expenses. Management analysis included a survey of local managers and counselors. It was seen that the Unified Health System is funded mainly by federal transfers and municipal revenues and to a far lesser extent by state resources. Funds have been applied predominantly in primary healthcare. The management process saw centralization of actions in the city governments. Municipal secretarial offices and councils comply partially with legislation, though they have problems with autonomy and social control. The results show that planning and management instruments are limited, due to the contradictions inherent to the institutional, political and cultural context of the region.
Mutirua Kauto; Shangula Kalumbi; Mbeeli Thomas; Mandlhate Custodia; Zere Eyob; Kapenambili William
Abstract Background The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need t...
Ramamurthy, T; Chakraborty, S; Nair, G B; Bhattacharya, S K
The endemic and seasonal nature of cholera depends upon the survival of toxigenic Vibrio cholerae in various niches of the aquatic environment. To understand the transmission and ecology of V. cholerae, it is necessary to know which component in the aquatic ecosystem can harbor it and thus contribute to the endemic presence. Toxigenic V. cholerae is now recognized as an autochthonous member of the microflora in many aquatic environments based on its protracted survival and proliferation without losing the virulence determinants. This article summarizes knowledge about the ecology, survival strategies and elimination techniques of V. cholerae from natural waters with special reference to drinking water.
Full Text Available Resources are one of the essential indicators for the functioning of the health care system. Better health care provision is an essential prerequisite for the export of services. Traditionally a competitive health care system is linked to a number of factors (price, quality, reliability, products and services largely determined by the new technologies, innovations and implementation the new methods. The authors of this article analyzed and collected data from the European Commission Eurostat and OECD data. Current situation in health care in Latvia is characterized by populations’ restricted access to health care services, high out-of-pocket payments and poor health outcomes of the population. More than 10% of Latvian population can’t afford medical care. The ratio of public funding for healthcare in Latvia is among the lowest in EU countries. Latvia spends 5.3% (USD PPP 1217 of GDP on health, lower than the OCED country average of 8.9% (USD PPP 3453. Latvia is facing a dramatic gap between the availability of hospital beds and long term care beds and the lowest prevalence of general medical practitioners among all Baltic States 321.6 per 100 000. These mentioned factors may hinder the development of health care in Latvia and reduce the ability to participate in international health service market.
Prakasam, T.B.S.; Lue-Hing, C.
The collection, treatment, and disposal of domestic and industrial wastewater, garbage, and other wastes present considerable problems in urban and semiurban areas of developing countries. Major benefits of using integrated treatment and resource recovery systems include waste stabilization, recovering energy as biogas, producing food from algae and fish, irrigation, improved public health, and aquatic weed control and use. Information and research are needed, however, to assesss the appropriateness, benefits, and limitations of such technology on a large scale. System configuration depends on the types and quantities of wastes available for processing. There must be enough collectable waste for the system to be viable. Information should be gathered to asses whether there is a net public health benefit by implementing a waste treatment and resource recovery system. Benefits such as savings in medical expenses and increased worker productivity due to improved health may be difficult to quantify. The potential health risks created by implementing a resource recovery system should be studied. The most difficult issues to contend with are socioeconomic in nature. Often, the poor performance of a proven technology is attributed to a lack of proper understanding of its principles by the operators, lack of community interest, improper operator training, and poor management. Public education to motivate people to accept technologies that are beneficial to them is important
Sadatsafavi, Hessam; Walewski, John; Shepley, Mardelle M
Cost control of health care services is a strategic concern for organizations. To lower costs, some organizations reduce staffing levels. However, this may not be worth the trade-off, as the quality of services will likely be reduced, morale among health care providers tends to suffer, and patient satisfaction is likely to decline. The potential synergy between human resource management and facility design and operation was investigated to achieve the goal of providing cost containment strategies without sacrificing the quality of services and the commitment of employees. About 700 health care professionals from 10 acute-care hospitals participated in this cross-sectional study. The authors used structural equation modeling to test whether employees' evaluations of their physical work environment and human resource practices were significantly associated with lower job-related anxiety, higher job satisfaction, and higher organizational commitment. The analysis found that employees' evaluations of their physical work environment and human resource practices influenced their job-related feelings and attitudes. Perceived organizational support mediated this relationship. The study also found a small but positive interaction effect between the physical work environment and human resource practices. The influence of physical work environment was small, mainly because of the high predictive value of human resource practices and strong confounding variables included in the analysis. This study specifically showed the role of facility design in reducing job-related anxiety among caregivers. Preliminary evidence is provided that facility design can be used as a managerial tool for improving job-related attitudes and feelings of employees and earning their commitment. Providing a healthy and safe work environment can be perceived by employees as an indication that the organization respects them and cares about their well-being, which might be reciprocated with higher levels