EPA reports information on the condition of our nation's waters using probabilistic surveys. The National Aquatic Resource Surveys assess the status of and changes in water quality of the nation's coastal waters, lakes, rivers and streams, and wetlands.
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....
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.
Some laws and regulations governing aquatic resources exploitation and conservation in Nigeria. Ben O Ezenabor. Abstract. No Abstract Available Journal of Mining and Geology Vol.40(2) 2004: 167-170. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
This paper explores the early stages in the history of fishing in the Aegean Sea in Greece, and highlights its formative phases and its specific characteristics in different points in time. This is testified by various physical remains, such as fish bones, fishing tools, and representations in art, which are gathered in the course of archaeological research. The aquatic resources in the Aegean Sea have been exploited and managed for millennia by communities that lived near the water and often made a living from it. The earliest evidence for a systematic, intensive exploitation of marine resources in the Aegean Sea dates to the Mesolithic, eleven millennia ago. In the Neolithic period, the adoption of a sedentary, agro-pastoral way of life led to a reduction in the intensity of fishing and shellfish gathering. Its importance as an economic resource remained high only in certain regions of rich, eutrophic waters. In the Bronze Age, an era of social complexity and centralized economy, the exploitation of aquatic, mostly marine, resources became a complex, multi-faceted activity which involved subsistence, industry and ideology. The range of preferred fish and invertebrate species, the fishing technology, and the processing of fish and shellfish in order to produce elaborate foods or prestige items are all traceable aspects of the complex relationship between humans and the aquatic resources throughout the prehistory of fishing and shellfish gathering in the Aegean area. The broadening of collaboration between archaeology and physical sciences offers new means to explore these issues in a more thorough and nuanced manner.
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 project will continue work begun in project 103165, Community-based Natural Resources Management in the Pachitea River Watershed (Peru), extending the effort to other parts of the Peruvian Amazon where the Instituto del Bien Común is active. Researchers will endeavor to understand the fishing industry in four ...
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...
Neuenfeldt, Stefan; Köster, Fritz
ecosystem approach whichutilizes synergies in natural and technical sciencedisciplines. DTU Aqua advises the Danish Ministry ofFood, Agriculture and Fisheries and other publicauthorities, the commercial fisheries, theaquaculture industry and international commissions.DTU Aqua deals with all types ofaquatic...... 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...... 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...
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.
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.
Lund, Søren; Banta, Gary Thomas; Bunting, Stuart W
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...... 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...
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 ...
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…
... County, California, as part of the Special Area Management Plan (SAMP). A SAMP is a comprehensive aquatic resource planning effort in the context of Section 404 of the Clean Water Act (CWA). The U.S...
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...
Pathogen with its disease causing potential constitutes public health threat such as diseases breakout, risk of spread of pathogen related infections, loss of aquatic biodiversity, scarcity of public water supply and most importantly, increased rate of human mortality. Several researches in many regions of the world have ...
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...
A survey of aquatic snails around fish ponds in Okwe, Delta State was conducted to identify snails and their public health implications in the area. Snails were collected fortnightly within an hour of active snail search for a period of twelve months from randomly selected eight fish ponds using a scoop net attached to a long ...
Lichvar, Robert; Ericsson, Michael
.... Environmental Protection Agency, recently funded an effort to inventory and map the aquatic resources within the San Jacinto and portions of Santa Margarita River watersheds, Riverside County, California...
Gleason, Robert A.; Thamke, Joanna N.; Smith, Bruce D.; Tangen, Brian A.; Chesley-Preston, Tara; Preston, Todd M.
U.S. Geological Survey scientists and cooperating partners are examining the potential risk to aquatic resources (for example, wetlands, streams) by contamination from saline waters (brine) produced by petroleum development in the Williston Basin of Montana, North Dakota, and South Dakota. The primary goals of this study are to provide a science-based approach to assess potential risk of brine contamination to aquatic systems and to help focus limited monitoring and mitigation resources on the areas of greatest need. These goals will be accomplished through field investigations that quantify brine movement and risk assessments using remotely-sensed and other spatial datasets.
Farag, Aïda M.; Harper, David D.; Senecal, Anna C.; Hubert, Arthur E.; Reddy, K.J.
The purpose of this chapter is to provide a summary of issues and findings related to the potential effects of coalbed natural gas (CBNG) development on fish and other aquatic resources. We reviewed CBNG issues from across the United States and used the Powder River Basin of Wyoming as a case study to exemplify some pertinent issues. The quality of water produced during CBNG extraction is quite variable. High total dissolved solids in many CBNG produced waters are of concern relative to fish and other aquatic organisms. Untreated CBNG produced water has the potential to be toxic to fish and aquatic organisms. Of particular concern at some locations in the Powder River basin are elevated concentrations of sodium bicarbonate which have been shown to be toxic to some species of larval fish and aquatic invertebrates. The areas affected by direct toxicity were limited to headwaters and small tributaries studied in the basin. The potential effects of organic compounds used during well drilling and CBNG production on water quality, fish, and aquatic organisms are not well defined. Water produced from CBNG wells that is low in salts or has been treated to remove salts may be discharged into ephemeral or perennially-flowing streams. Higher flows in small streams can enhance erosion and affect habitat for fish and aquatic organisms. In Great Plains rivers, such as the Powder River, fish and aquatic invertebrate communities are structured by extreme environmental conditions. Direct discharge of CBNG produced water during periods of very low or no surface flow may cause shifts in the aquatic community structure. Additional effects of CBNG development on fish and aquatic organisms may stem from road building and pipeline construction, roads crossing streams and ephemeral water courses, the possible spread of invasive organisms, potential spills of toxic substances, and increased harvest of sport fish.
A. P. F. Pires
Full Text Available Abstract Resource identity and composition structure bacterial community, which in turn determines the magnitude of bacterial processes and ecological services. However, the complex interaction between resource identity and bacterial community composition (BCC has been poorly understood so far. Using aquatic microcosms, we tested whether and how resource identity interacts with BCC in regulating bacterial respiration and bacterial functional diversity. Different aquatic macrophyte leachates were used as different carbon resources while BCC was manipulated through successional changes of bacterial populations in batch cultures. We observed that the same BCC treatment respired differently on each carbon resource; these resources also supported different amounts of bacterial functional diversity. There was no clear linear pattern of bacterial respiration in relation to time succession of bacterial communities in all leachates, i.e. differences on bacterial respiration between different BCC were rather idiosyncratic. Resource identity regulated the magnitude of respiration of each BCC, e.g. Ultricularia foliosa leachate sustained the greatest bacterial functional diversity and lowest rates of bacterial respiration in all BCC. We conclude that both resource identity and the BCC interact affecting the pattern and the magnitude of bacterial respiration in aquatic ecosystems.
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
Acceptable topics include aquatic biology, aquatic resources management, aquatic ecotoxicology and pollution, fish physiology, nutrition, health, breeding, population dynamics, fish processing and preservation. Categories of articles ... Articles must be technically sound and written in English. The review of manuscript is ...
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) de...
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.
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...
Honda, Takuya; Kamioka, Hiroharu
The purpose of this study was to report on the health benefits and curative effects of aquatic exercise. 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. Aquatic exercise had significant effects on pain relief and related outcome measurements for locomotor diseases. Patients may become more active, and improve their quality of life, as a result of aquatic exercise.
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
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
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
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.
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-economic...
Lazarus, E.; Bell, K. P.
Common-pool resource problems can arise in aquatic systems such as lakes, rivers, and open coastlines where individual land-use decisions produce collective, emergent effects at the watershed scale. A body of highly generalized modeling experiments has illustrated ways in which simple, opposing tendencies among individuals—imitative versus self-initiated actions, for example—can result in richly complex behaviors. If the dynamics of those opposing tendencies are translated into different land uses (development, extraction, working land, conservation), each entailing a different environmental consequence, then feedbacks between land-use decisions and resulting changes to the physical environment (which in turn influence subsequent land-use decisions) cause the environmental and social systems of the watershed to become coupled. We present the early results of an exploratory, spatially-extended model that couples a simplified riparian system to a hypothetical group of landowners, each of whom can choose between property development, placing property under a conservation easement, or taking no action and effectively maintaining the property's status quo. As in the generalized experiments, landowner behavior depends on two sets of opposing tendencies, one of which is imitation versus self-initiation. The other is a preference for property consolidation or subdivision; large property holdings can be subdivided into smaller parcels, and small parcels can be bought up by an owner to amass a larger property. Land-use decisions taken by landowners in the model affect the riparian system in process-based ways (sedimentation, eutrophication, water quality) that then inform subsequent social interactions and decisions. Isolating the basic dynamics of this kind of socio-environmental system allows us to pursue a number of questions relevant to resource management. What social and environmental circumstances in this framework result in continuous conservation corridors as
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
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...
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.
Seyyed Sadreddin Shojaeddin
Full Text Available Objectives: Aquatic exercise is one of the major activities that recommend to elderly people. The purpose of this study was to examine the effects of aquatic endurance exercise on the mental health, physical symptoms, social performance, anxiety and depression of the male elders. Methods & Materials: In this study, 30 male elders were selected and randomly divided into control and experimental groups. First, all subjects completed General Health Questionnaire (GHQ. Then the experimental group received 6 weeks aquatic endurance exercise (three sessions per week for six weeks and the control group performed their daily routine activities. After the training intervention, both groups again completed the GHQ - 28. Data analysis with paired and independent samples t-test was performed. Results: The results showed that aquatic endurance exercise has significant effect on mental health (P=0.000, physical symptoms (P=0.000, social performance (P=0.000, anxiety (P=0.034 and depression (P=0.000 of the experimental groups, while in the control group who had not participated in aquatic endurance exercises, no significant changes were observed. The results also showed that there is a significant difference (P=0.001 between the average score of mental general health of experimental and control group after the exercise. Conclusion: Based on this study it can be concluded that aquatic endurance exercise has a positive impact to geriatric psychiatric assessment on the mental general health, physical symptoms, social performance, anxiety and depression.
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
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
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.
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 ...
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
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
Dubova O. L.
Full Text Available The results of studying dependencies of levels of polychlorinated biphenyls (PCBs and chlorinated pesticides in the liver and muscles of the main commercial fish species of the Baltic Sea (sprat, herring, cod, flounder, the Vistula and the Curonian Bay (pike-perch, bream, roach on the fishing area, season and fish species have been considered. Determination of PCBs and pesticides has been carried out in accordance with MVI MN 2352–2005 "Method for simultaneous determination of residual amounts of PCBs and organochlorine pesticides in fish and fish products by gas-liquid chromatography". Separation, identification and quantification have been performed by the gas chromatography Varian 3400 on the DB-1701 column, 30 m 0.25 mm 0.25 m, the column temperature 150–250 °C, the detector one – 300 °C. Identification and quantification have been performed by retention time of individual PCB congeners by the internal standard. The content of PCBs in liver of the Curonian and Vistula Bays fish is much lower than in liver of aquatic biological resources (ABR of the Baltic Sea. Hexachlorocyclohexane (HCH and dichlorodiphenyltrichloroethane (DDT are accumulated more intensively in liver of fish caught in the southern part of the Baltic Sea. β-HCH and γ-HCH prevail in the liver and muscle tissue of ABR samples as individual organochlorine pesticides (OCPs. The all three isomers of HCH are present in cod liver. Accumulation ratio in cod liver compared to that in the muscle tissue content reaches 7-8 units HCH for isomers, and for DDT and metabolites – 10-12 units. It has been proposed that the secondary admission of HCH in the aquatic environment and in ABG (delivery from sediments takes place. Organochlorine pesticides such as hexachlorobenzene, heptachlor and aldrin are present in the Baltic Sea ABR in quantities below the detection limit used in the analysis methods. In spring and summer, there is an increased level of HCH and DDT in
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?
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.
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...
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...
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
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.
Klare, Michael T; Levy, Barry S; Sidel, Victor W
Competition for resources between or within nations is likely to become an increasingly common cause of armed conflict. Competition for petroleum is especially likely to trigger armed conflict because petroleum is a highly valuable resource whose supply is destined to contract. Wars fought over petroleum and other resources can create public health concerns by causing morbidity and mortality, damaging societal infrastructure, diverting resources, uprooting people, and violating human rights. Public health workers and the organizations with which they are affiliated can help prevent resource wars and minimize their consequences by (1) promoting renewable energy and conservation, (2) documenting the impact of past and potential future resource wars, (3) protecting the human rights of affected noncombatant civilian populations during armed conflict, and (4) developing and advocating for policies that promote peaceful dispute resolution.
Eric D. Romaniszyn; John J. Jr. Hutchens; J. Bruce Wallance
We characterised aquatic and terrestrial invertebrate drift in six south-western North Carolina streams and their implications for trout production. Streams of this region typically have low standing stock and production of trout because of low benthic productivity. However, little is known about the contribution of terrestrial invertebrates entering drift, the factors...
Hiroharu Kamioka, Hiroharu; Honda,Takuya
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 ther...
Preston, Todd M; Chesley-Preston, Tara L
Contamination to aquatic resources from co-produced water (brine) associated with energy development has been documented in the northeastern portion of the Williston Basin; an area mantled by glacial drift. The presence and magnitude of brine contamination can be determined using the contamination index (CI) value from water samples. Recently, the U.S. Geological Survey published a section (~2.59 km(2)) level risk assessment of brine contamination to aquatic resources for Sheridan County, Montana, using oilfield and hydrogeological parameters. Our goal was to improve the Sheridan County assessment (SCA) and evaluate the use of this new Williston Basin assessment (WBA) across 31 counties mantled by glacial drift in the Williston Basin. To determine if the WBA model improved the SCA model, results from both assessments were compared to CI values from 37 surface and groundwater samples collected to evaluate the SCA. The WBA (R(2)=0.65) outperformed the SCA (R(2)=0.52) indicating improved model performance. Applicability across the Williston Basin was evaluated by comparing WBA results to CI values from 123 surface water samples collected from 97 sections. Based on the WBA, the majority (83.5%) of sections lacked an oil well and had minimal risk. Sections with one or more oil wells comprised low (8.4%), moderate (6.5%), or high (1.7%) risk areas. The percentage of contaminated water samples, percentage of sections with at least one contaminated sample, and the average CI value of contaminated samples increased from low to high risk indicating applicability across the Williston Basin. Furthermore, the WBA performed better compared to only the contaminated samples (R(2)=0.62) versus all samples (R(2)=0.38). This demonstrates that the WBA was successful at identifying sections, but not individual aquatic resources, with an increased risk of contamination; therefore, WBA results can prioritize future sampling within areas of increased risk. Copyright © 2014 Elsevier B
Jarvis, Amanda L; Bernot, Melody J; Bernot, Randall J
Pharmaceutical pollutants are commonly detected in freshwater ecosystems around the world and have biological effects on aquatic organisms. However, current understanding of the influence this contaminant class has on freshwater communities and ecosystems is lacking. Recently the scientific community has called for research focusing on certain pharmaceuticals due to their ubiquity and potential toxicity. Carbamazepine is one of these pharmaceuticals. To better understand the effect carbamazepine has on life history characteristics of aquatic organisms and consumer-resource interactions, we quantified the influence of carbamazepine on the development, growth and behavior of mayfly nymphs (Stenonema sp.) and the alterations in food consumer-resource interactions between Stenonema and algae (Chaetophora). Microcosms were assembled in a factorial design containing algae and mayfly nymphs native to central Indiana and dosed with environmentally relevant concentrations of carbamazepine. From this ecotoxicological experiment we were able to infer that carbamazepine at 2,000 ng/L influenced the development and behavior of Stenonema nymphs and the body dimensions of adult individuals. However, it appears that carbamazepine does not influence consumer-resource interactions at concentrations found in surface waters. The pharmaceutical carbamazepine may influence the behavior, growth and development of mayflies, which could have significant consequences at the population, community and ecosystem level.
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...
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.
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.
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.
Rao, Mohan; Rao, Krishna D; Kumar, A K Shiva; Chatterjee, Mirai; Sundararaman, Thiagarajan
India has a severe shortage of human resources for health. It has a shortage of qualified health workers and the workforce is concentrated in urban areas. Bringing qualified health workers to rural, remote, and underserved areas is very challenging. Many Indians, especially those living in rural areas, receive care from unqualified providers. The migration of qualified allopathic doctors and nurses is substantial and further strains the system. Nurses do not have much authority or say within the health system, and the resources to train them are still inadequate. Little attention is paid during medical education to the medical and public health needs of the population, and the rapid privatisation of medical and nursing education has implications for its quality and governance. Such issues are a result of underinvestment in and poor governance of the health sector--two issues that the government urgently needs to address. A comprehensive national policy for human resources is needed to achieve universal health care in India. The public sector will need to redesign appropriate packages of monetary and non-monetary incentives to encourage qualified health workers to work in rural and remote areas. Such a policy might also encourage task-shifting and mainstreaming doctors and practitioners who practice traditional Indian medicine (ayurveda, yoga and naturopathy, unani, and siddha) and homoeopathy to work in these areas while adopting other innovative ways of augmenting human resources for health. At the same time, additional investments will be needed to improve the relevance, quantity, and quality of nursing, medical, and public health education in the country. Copyright © 2011 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.
Health sciences students' contribution to human resources for health strategy: A rural health careers day for grade 12 learners in the North West Province of South ... scholarship programme, which highlighted the challenges faced by students from rural communities who try to gain access to institutions of higher education.
Kucher, Greta; Moore, Kelsey; Rodia, Rachel; Moser, Christy Szczech
Aquatic therapy has long been highlighted in the literature as a potentially powerful therapeutic intervention. This review will highlight basic definitions of aquatic therapy, review salient research, and identify specific diagnoses that may benefit from aquatic therapy. Online resources, blogs, and books that occupational therapists may find…
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.
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.
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.
Da Silva, Luciano Acordi; Menguer, Lorhan; Motta, Janaina; Dieke, Beatriz; Mariano, Sindianra; Tasca, Gladson; Zacaron, Rubya Pereira; Silveira, Paulo Cesar Lock; Aurino, Pinho Ricardo
The aquatic exercise is an effective non-pharmacological therapy for prevention and control of hypertension. The objective of the present study was to investigate the effect of aquatic exercise on mental health, functional autonomy, and oxidative dysfunction in hypertensive adults. Methodologically 29 adults (mean age 53 ± 7.5 years) were included in the study, and were randomly grouped as hypertensive (n = 16) and non-hypertensive (n = 13). Both groups underwent low-intensity aquatic exercise program for 12 weeks. Outcomes were evaluated at week 0 and 12. The values for the following parameters decreased in the hypertensive group post training: anxiety (-6.2 ± 2 score; 60%), Timed Up and Go test (-7.4 ± 0.3 sec; 30%), protein carbonylation (-0.15 ± 0.03 nmol/mg protein; 50%), nitric oxide (12.4 ± 6 nmol/mg protein; 62%), interleukin-6 (-27.6 ± 5.7 pg/mg protein; 46%), and tissue necrosis factor-alpha (-52.4 ± 3.8 pg/mg protein; 40%); however, the values of the following parameters increased before training: Berg score (56 ± 2; 7.8%), flexibility (27 ± 1 cm; 71%); glutathione (3.1 ± 1.3 nmol/mg protein; 138%), and superoxide dismutase (1.6 ± 0.4 nmol/mg; 166%). In conclusion, we suggest that low-intensity aquatic exercise program improved anxiety, functional autonomy, and oxidative dysfunction in hypertensive adults.
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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...
Dreyer, Lukas I; Dreyer, Sonja
A stratified randomized sample of 525 middle age (35-64 years old) men was used to study the relationships between self-reported level of church attendance (CA), self-reported religious faith (SRRF), religious well-being (RWB), existential well-being (EWB), self-actualization (SA), health, lifestyle, and participation in physical activity (PA). Religious measures (RWB, CA, and SRRF) were found to be dependent on psychosocial variables in terms of their relationships with PA, lifestyle, and health. On the other hand, psychosocial resourcefulness (SA, EWB, social support, and stress management) showed independent relationships with lifestyle, PA, and health. These findings indicate that the positive associations of psychological and sociological constructs with health are not related to or dependent upon ego syntonic religious identity.
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.
J.M. 1977. The case of the perturbed poodles. Mo. Conservationist 38(8):16-19. (65,88) 145. Vineyard , J.D. 1974. Spring resources of the Meramec...River Basin, Missouri (abstract). p. 39 in Meramec Valley Symposium. Mo. Speleology-T4(1): 39 pp. (76) 146. Vineyard , J.D., and G.L. Feder. 1974. Springs...implications. J. Wildl. Manage. 26(2):164- 172. (14,17) 297. Korschgen, L.J. 1966. Foods and nutrition of ruffed grouse in Missouri. J. Wildi. Manage
Magwaza, Nontokozo M; Nxumalo, Edward N; Mamba, Bhekie B; Msagati, Titus A M
Currently, there is a worldwide growing interest in the occurrence and diversity of fungi and their secondary metabolites in aquatic systems, especially concerning their role in water quality and human health. However, this concern is hampered by the scant information that is available in the literature about aquatic fungi and how they affect water quality. There are only few published reports that link certain species of aquatic fungi to human health. The common aquatic fungal species that have been reported so far in African aquatic systems belong to the hyphomycetes kingdom. This paper thus aims to survey the information about the occurrence and factors that control the distribution of different species of fungi in African aquatic systems, as well as their effect on water quality and the possible metabolic pathways that lead to the formation of toxic secondary metabolites that are responsible for the deterioration of water quality. This review will also investigate the analytical and bioanalytical procedures that have been reported for the identification of different species of waterborne fungi and their secondary metabolites.
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
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
Full Text Available Harmful algal blooms (HABs, harmful microorganisms (pathogens and toxic metals represent three major agents of water quality deterioration. Water quality of three northern lakes (Sardis, Enid, and Grenada and a central lake (Ross Barnett Reservoir of Mississippi, USA were examined in this study. While all these lakes are heavily used for recreational purposes, the Ross Barnett Reservoir serves additionally as the primary water supply for the City of Jackson, the capital city of Mississippi. The main goal of this study was to comprehensively assess the water quality of these lakes employing field and satellite data, and evaluate the potential human and aquatic health impacts. A time-series of true color images derived from satellite data indicated that algal blooms have been a recurring phenomenon in these lakes. Cyanobacteria, the algal group that predominantly occur in freshwater and form toxic blooms, were always present in these lakes and were most abundant on many occasions. The most toxic cyanotoxin, microcystin-LR, was found in all lakes, and its concentrations exceeded federal drinking water guidelines for children under six years of age many times. Potential bioaccumulation and biomagnification of microcystin-LR may pose serious risk to the aquatic ecosystem and human health including adults. Nutrient measurements indicated that all four lakes were eutrophic. Among bacterial populations, total coliforms and enterococci exceeded guideline values on several occasions. Arsenic, cadmium, chromium, and lead were found in the water of all the lakes, with arsenic exceeding the guideline values at two sites in Ross Barnett Reservoir. While it is apparent from this study that these lakes face many water quality issues, data across all seasons will be required to document potential trends and to devise management strategies. Use of remote sensing technology is recommended to monitor some of the water quality parameters such as suspended
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.
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
Shi, Yan-ting; Liu, Jie; Wang, Peng; Zhang, Xu-nuo; Wang, Jun-qiang; Guo, Liang
With the implementation of water environment management in key basins in China, the monitoring and evaluation system of basins are in urgent need of innovation and upgrading. In view of the heavy workload of existing evaluation methods and the cumbersome calculation of multi-factor weighting method, the idea of using entroy method to assess river health based on aquatic ecological function regionalization was put forward. According to the monitoring data of songhua river in the year of 2011-2015, the entropy weight method was used to calculate the weight of 9 evaluation factors of 29 monitoring sections, and the river health assessment was carried out. In the study area, the river health status of the biodiversity conservation function area (4.111 point) was good, the water conservation function area (3.371 point), the habitat maintenance functional area (3.262 point), the agricultural production maintenance functional area (3.695 point) and the urban supporting functional area (3.399 point) was light pollution.
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...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency... Services Administration, HHS. ACTION: Notice. SUMMARY: In compliance with the requirement for opportunity... Reduction Act of 1995), the Health Resources and Services Administration (HRSA) announces plans to submit an...
... 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...
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.
O'Neil Mary L
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 th...
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.
Sunday Emmanuel Olusola
Full Text Available In this study, the potential benefits of ten edible leaves (Manihot esculents, cassava leaf; Colocasia esculenta, cocoyam leaf; Talinum triagulare, water leaf; Telfairia occidentalis, fluted pumpkin leaf; Carica papaya, pawpaw leaf; Amaranthus chlorostachys, green leaf; Moringa oleifare, drumstick leaf; Vernonia amygdalina, bitter leaf; Ipomoea batatas, sweet potato leaf and Basella alba, Malabar spinach ‘Amunututu’ to aquatic animal nutrition and health were studied along with proximate, mineral and phytochemical compositions. Results show that theses edible leaves were a good source of protein and the highest crude protein was obtained in C. papaya (32.6% while the lowest in C. esculenta (14.7%. The highest and lowest total ash was found in T. triagulare (34.6% and C. papaya (11% respectively. The result showed that the edible leaves are rich in wide variety of secondary metabolites of phytochemical constituents such as tannins, alkaloids, flavonoids, saponins, glycosides oxalates and phytate which can act against different diseases. Results suggest that inclusion of edible leaves may be nutritionally beneficial and this could promote growth, immune system and enhance disease resistance properties and subsequently very potential to reduce the cost of highly priced supplementary feeds.
Kargarfard, Mehdi; Etemadifar, Masoud; Baker, Peter; Mehrabi, Maryam; Hayatbakhsh, Reza
To examine the effectiveness of aquatic exercise training on fatigue and health-related quality of life (HRQOL) in women with multiple sclerosis (MS). Randomized controlled trial, 4-week and 8-week follow-up. Referral center of a multiple sclerosis society. Women (N=32) diagnosed with relapsing-remitting MS (mean age ± SD, 32.6±8.0y) were recruited into this study. After undergoing baseline testing by a neurologist, participants were randomly assigned to either an intervention (aquatic exercise) or a control group. The intervention consisted of 8 weeks supervised aquatic exercise in a swimming pool (3 times a week, each session lasting 60min). At baseline, 4 weeks, and 8 weeks, fatigue and HRQOL were assessed by a blind assessor using the Modified Fatigue Impact Scale and the Multiple Sclerosis Quality of Life-54 questionnaire, respectively. A mixed-model approach to repeated-measures analysis of variance was used to detect within- and between-subject effects. Findings are based on 21 patients (10 from the exercise group and 11 from the control group) who had data available on outcomes. There was no significant difference between the 2 groups at the baseline. Patients in the aquatic exercise group showed significant improvements in fatigue and subscores of HRQOL after 4 and 8 weeks compared with the control group. Results obtained from the intention-to-treat analysis were consistent with those of per-protocol analysis. The findings suggest that aquatic exercise training can effectively improve fatigue and HRQOL of patients with MS and should be considered in the management of this relatively common public health problem. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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.
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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.
Insensitive Munitions: Aquatic Ecotoxicological Exposures Using 2,4-Dinitroanisole E nv ir on m en ta l L ab or at or y Alan J. Kennedy, Christopher... Ecotoxicological Exposures Using 2,4-Dinitroanisole Alan J. Kennedy, Jennifer G. Laird, and Sandra M. Brasfield Environmental Laboratory U.S. Army...nitroguanidine (NQ). While general aquatic ecotoxicological information is available for two of the IMX constituents (NTO and NQ), such data are not
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.
Dato, Virginia M.; Potter, Margaret A.; Fertman, Carl I.; Pistella, Christine L.
The capacity mapping approach can be used to identify existing community resources. As part of this approach, inventories are used to provide information for a capacity map. The authors describe the development of two inventories and a capacity map for public health workforce development. For the first inventory, the authors contacted 754 institutions to determine available public health training resources; 191 institutions reported resources, including 126 directly providing distance learnin...
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.
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Anell, Anders; Michael, Willis
The most frequently used bases for comparing international health care resources are health care expenditures, measured either as a fraction of gross domestic product (GDP) or per capita. There are several possible reasons for this, including the widespread availability of historic expenditure figures; the attractiveness of collapsing resource data into a common unit of measurement; and the present focus among OECD member countries and other governments on containing health care costs. Despit...
Anell, A; Willis, M
The most frequently used bases for comparing international health care resources are health care expenditures, measured either as a fraction of gross domestic product (GDP) or per capita. There are several possible reasons for this, including the widespread availability of historic expenditure figures; the attractiveness of collapsing resource data into a common unit of measurement; and the present focus among OECD member countries and other governments on containing health care costs. Despite important criticisms of this method, relatively few alternatives have been used in practice. A simple framework for comparing data underlying health care systems is presented in this article. It distinguishes measures of real resources, for example human resources, medicines and medical equipment, from measures of financial resources such as expenditures. Measures of real resources are further subdivided according to whether their factor prices are determined primarily in national or global markets. The approach is illustrated using a simple analysis of health care resource profiles for Denmark, France, Germany, Sweden, the United Kingdom, and the USA. Comparisons based on measures of both real resources and expenditures can be more useful than conventional comparisons of expenditures alone and can lead to important insights for the future management of health care systems.
Jones, Peter; Sopina, Liza Elizaveta; Ashton, Toni
of clinical/service managers in ED throughout New Zealand determined the type and cost of resources used for the target. Responses to the target were classified according to their impact in ED, the hospital and the community. Quantifiable resource changes were assigned a financial value and grouped...... into categories: structure (facilities/beds), staff and processes. Simple statistics were used to describe the data, and the correlation between expenditure and target performance was determined. Results There was 100% response to the survey. Most DHBs reported some expenditure specifically on the target...
Høy, Bente; Hall, E.O.C.; Wagner, L.
: In this integrative review from 2006, we selected theoretical and empirical articles published between 1990 and 2006, where self-care was related to elders' health promotion. Data were extracted from primary sources and included definitions of self-care, critical attributes, antecedents, goals and outcomes. We......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...... interactively compared data and display matrices to describe self-care as a health resource. RESULTS: Fifty-seven articles addressed health self-care and were integrated into a framework of self-care as a health resource of elders. Self-care was identified as a two-dimensional construct including action...
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 ...
Roč. 62, č. 6 (2007), s. 711-714 ISSN 0006-3088 Institutional research plan: CEZ:AV0Z60050516 Keywords : rootless aquatic plant * disorder of shoot apices * tissue microelement content Subject RIV: EF - Botanics Impact factor: 0.207, year: 2007
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
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 ... 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 ...
Full Text Available ... the text smaller. U.S. Department of Health and Human Services HOME | CONTACT US | JOBS AT NIDDK | RSS ... resources below to help you get on the right track. Cope with Stress and Emotions AADE7 Self- ...
Free online resources, many produced in the North American Pediatric Environmental Health Specialty Unit (PEHSU) network, covering general information, air quality, asthma, climate change, lead, mercury, mold, pesticides, and water.
National Aeronautics and Space Administration — The Natural Resource Protection and Child Health Indicators, 2013 Release, are produced in support of the U.S. Millennium Challenge Corporation as selection criteria...
National Aeronautics and Space Administration — The Natural Resource Protection and Child Health Indicators, 2012 Release, are produced in support of the U.S. Millennium Challenge Corporation as selection criteria...
National Aeronautics and Space Administration — The Natural Resource Protection and Child Health Indicators, 2016 Release, are produced in support of the U.S. Millennium Challenge Corporation as selection criteria...
National Aeronautics and Space Administration — The Natural Resource Protection and Child Health Indicators, 2015 Release, are produced in support of the U.S. Millennium Challenge Corporation as selection criteria...
National Aeronautics and Space Administration — The Natural Resource Protection and Child Health Indicators, 2014 Release, are produced in support of the U.S. Millennium Challenge Corporation as selection criteria...
Dato, Virginia M; Potter, Margaret A; Fertman, Carl I; Pistella, Christine L
The capacity mapping approach can be used to identify existing community resources. As part of this approach, inventories are used to provide information for a capacity map. The authors describe the development of two inventories and a capacity map for public health workforce development. For the first inventory, the authors contacted 754 institutions to determine available public health training resources; 191 institutions reported resources, including 126 directly providing distance learning technologies and courses or modules addressing important competency domains. Distance learning technologies included video conferencing facilities (61%) and satellite download facilities (50%). For the second inventory, the authors obtained information on 129 distance-accessible public health training modules. The workforce development capacity map produced from these two inventories revealed substantial resources available for use by individuals or agencies wishing to improve training in public health competencies.
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.
Hoekstra, Ann; Payeur, Brittany
To create a quick information evaluation tool (QIET) for judging the quality of online vaccination information sources. This information is intended to be used in a retail or a community pharmacy setting where immunizations are provided. The tool created can be used by immunization providers and patients to evaluate online sources of vaccination information. The tool is the result of a consensus from surveyed websites that provide ways to evaluate the reliability of online information. These websites were highlighted as reliable resources in the American Pharmacists Association's (APhA) Immunization Handbook. Several websites provide ways to evaluate the reliability of online vaccine information; however, none were found that provided a consensus from several websites and examples of how to evaluate online information. This tool provides that consensus. This tool provides a way to judge the merits of online immunization information using a single set of useful criteria in place of various criteria listed in many different sources. This tool will be successful if immunization providers and patients can use it to choose reliable sources of online vaccination information. Using the QIET, several non-APhA sources are evaluated. The QIET is a potential resource that can be used by future studies to evaluate the reliability of online vaccine information. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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
The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. Methods: During a ... of medical officers. Clinical officers constitute a crucial component of the health care team in Malawi for saving maternal and neonatal lives given the scarcity of physicians.
Jun 14, 2007 ... Centre for Reproductive Health, University of Malawi, College of Medicine, Blantyre, Malawi. Correspondence to: Staffan Bergström ... The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture ...
Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey
G?eita-Rodr?guez, Javier; Garc?a-Muro, Francisco; Cano-D?ez, Beatriz; Rodr?guez-Fern?ndez, ?ngel L.; Lambeck, Johan; Palacios-Ce?a, Domingo
Objective To identify intervention categories encountered by physical therapists working in aquatic therapy with disabled children, using the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). Methods Aquatic physical therapists were asked to describe concepts related to the functioning of disabled children and their contextual factors. Data were collected in three rounds using the Delphi technique. All answers were translated (?linked?) to the ICF...
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.
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 ... HealthSense Title/Keywords: Go Diabetes HealthSense provides easy access to resources to help you live well and ... Journey for Control This website is filled with information about living with diabetes and developing habits for ...
Objective: This review paper aims at demonstrating that mobile health services for HIV infection in resource-constrained countries may be particularly useful for HIV screening and treatment of HIV disease and associated co-morbidities, especially for people who have limited access to fixed health facilities, including remote ...
Achievements and Challenges of Resource Allocation for Health in a Decentralized System in Tanzania: Perspectives of National and District Level Officers. ... are restricted on the percentage they can allocate to different areas – so there is severe under-funding of disease prevention and health promotion initiatives at the ...
Full Text Available ... CONTACT US | JOBS AT NIDDK | RSS FEEDS | GET E-MAIL UPDATES External Link ... HealthSense Title/Keywords: Go Diabetes HealthSense provides easy access to resources to help you live well and meet your ...
ICTs for Equal Access to Human Resources in Health in Francophone Africa. 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 ...
Jan 2002 memorandum highlighting relevant portions of the 1992 404(q) Memorandum of Agreement (MOA) regarding elevating decision of specific individual permit cases. Cases that do not meet the ARNI resource threshold may not be elevated under the MOA.
Krumkamp, R.; Kretzschmar, M.; Rudge, J. W.; Ahmad, A.; Hanvoravongchai, P.; Westenhoefer, J.; Stein, M.; Putthasri, W.; Coker, R.
We used a mathematical model to describe a regional outbreak and extrapolate the underlying health-service resource needs. This model was designed to (i) estimate resource gaps and quantities of resources needed, (ii) show the effect of resource gaps, and (iii) highlight which particular resources
Full Text Available Jay M Margolis,1 Elizabeth T Masters,2 Joseph C Cappelleri,3 David M Smith,1 Steven Faulkner4 1Truven Health Analytics, Life Sciences, Outcomes Research, Bethesda, MD, 2Pfizer Inc, Outcomes & Evidence, New York, NY, 3Pfizer Inc, Statistics, Groton, CT, 4Pfizer Inc, North American Medical Affairs, Medical Outcomes Specialists, St Louis, MO, USA Objective: The management of fibromyalgia (FM, a chronic musculoskeletal disease, remains challenging, and patients with FM are often characterized by high health care resource utilization. This study sought to explore potential drivers of all-cause health care resource utilization and other factors associated with high resource use, using a large electronic health records (EHR database to explore data from patients diagnosed with FM. Methods: This was a retrospective analysis of de-identified EHR data from the Humedica database. Adults (≥18 years with FM were identified based on ≥2 International Classification of Diseases, Ninth Revision codes for FM (729.1 ≥30 days apart between January 1, 2008 and December 31, 2012 and were required to have evidence of ≥12 months continuous care pre- and post-index; first FM diagnosis was the index event; 12-month pre- and post-index reporting periods. Multivariable analysis evaluated relationships between variables and resource utilization. Results: Patients were predominantly female (81.4%, Caucasian (87.7%, with a mean (standard deviation age of 54.4 (14.8 years. The highest health care resource utilization was observed for the categories of “medication orders” and “physician office visits,” with 12-month post-index means of 21.2 (21.5 drug orders/patient and 15.1 (18.1 office visits/patient; the latter accounted for 73.3% of all health care visits. Opioids were the most common prescription medication, 44.3% of all patients. The chance of high resource use was significantly increased (P<0.001 26% among African-Americans vs Caucasians and for patients
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.
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...... 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....
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
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.
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.
Richardson, Janet; Grose, Jane; Jackson, Bethany; Gill, Jamie-Lee; Sadeghian, Hannah Becky; Hertel, Johannes; Kelsey, Janet
Climate change and resource scarcity pose significant threats to healthcare delivery. Nurses should develop the skills to cope with these challenges in the future. Skills sessions using sustainability scenarios can help nursing students to understand the effect climate change and resource scarcity will have on health care. Involving design students in clinical skills sessions can encourage multidisciplinary working and help to find solutions to promote healthcare sustainability.
Yu, Stella M; Huang, Zhihuan J; Schwalberg, Renee H; Kogan, Michael D
To examine the association between parental immigrant status and awareness of health and community resources to help address common family problems. Using the 1999 National Survey of America's Families, a survey of the health, economic, and social characteristics of children and adults, bivariate and multivariate analyses were conducted on 35,938 children to examine the relationship between parents' immigrant status (U.S.-born citizens, naturalized citizens, and noncitizens) and their responses to questions about their awareness of specific health and community resources. Compared to U.S.-born citizens, noncitizens were at the highest risk of not being aware of health and community resources for most outcomes, followed by naturalized citizens. The services of which noncitizens were most likely to be unaware were places to get help for family discord, child care issues, and family violence. Multivariate analyses indicate that parental race/ethnicity, education level, employment status, and child age were other significant independent risk factors. Immigrant parents are at particularly high risk of alienation from systems of health care and support services that are available to low-income and other vulnerable populations in the United States. These findings clearly document disparate awareness among parents of different immigrant status. Community and health resources should reach out to immigrant populations, in linguistically and culturally appropriate ways, to alert them to the availability of their services.
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.
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.
Aquatic ecosystems are a vital part of the urban water cycle (and of urban areas more broadly), and, if healthy, provide a range of goods and services valued by humans (Meyer 1997). For example, aquatic ecosystems (e.g., rivers, lakes, wetlands) provide potable water, food resou...
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 ...
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.
Golterman, Linda; Banasiak, Nancy C
This article describes a framework for evaluating the quality of health care information on the Internet and identifies strategies for accessing reliable child health resources. A number of methods are reviewed, including how to evaluate Web sites for quality using the Health Information Technology Institute evaluation criteria, how to identify trustworthy Web sites accredited by Health On the Net Foundation Code of Conduct, and the use of portals to access prescreened Web sites by organizations, such as the Medical Library Association. Pediatric nurses can use one or all of these strategies to develop a list of reliable Web sites as a supplement to patient and family teaching.
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.
Batterham, Stephanie I; Heywood, Sophie; Keating, Jennifer L
Aquatic and land based exercise are frequently prescribed to maintain function for people with arthritis. The relative efficacy of these rehabilitation strategies for this population has not been established.This review investigated the effects of aquatic compared to land based exercise on function, mobility or participants' perception of programs for people with arthritis. Medline, CINAHL, AMED and the Cochrane Central Register of Controlled Clinical Trials were searched up to July 2010. Ten randomised, controlled clinical trials that compared land to aquatic exercise for adults with arthritis were included. Study quality was assessed with the PEDro scale. Data relevant to the review question were systematically extracted by two independent reviewers. Standardised mean differences between groups for key outcomes were calculated. Meta-analyses were performed for function, mobility and indices that pooled health outcomes across multiple domains. No differences in outcomes were observed for the two rehabilitation strategies in meta-analysis. There was considerable variability between trials in key program characteristics including prescribed exercises and design quality. Components of exercise programs were poorly reported by the majority of trials. No research was found that examined participant preferences for aquatic compared to land based exercise, identifying this as an area for further research. Outcomes following aquatic exercise for adults with arthritis appear comparable to land based exercise. When people are unable to exercise on land, or find land based exercise difficult, aquatic programs provide an enabling alternative strategy.
Chen, Meng-Chun; Chen, Kuei-Min; Chu, Tsui-Ping
As caregivers undertake caregiving responsibilities over a long period of time, the burdens placed on them could lead to undue stress and affect their health. This correlation study examined the current situations and relationships among caregiver burden, health status, and learned resourcefulness (LR) of older caregivers who care for disabled older adults, and predicted the important factors that affect their caregiver burden. In all, 108 older caregivers were recruited from home care services of two hospitals. Structured questionnaire interviews were applied to collect data: the Caregiver Burden Scale, the SF-36 Health Survey (SF-36), and the Rosenbaum's Self-Control Schedule. Results indicated that the caregiver burden was negatively correlated with physical health, mental health, and LR. Physical and mental health were positively correlated with LR. The predictors of caregiver burden included LR, health status, economic status, and activities of daily living, which accounted for 58.60% of the total caregiver burden variance. © The Author(s) 2014.
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
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.
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.
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.
Governments, policymakers and donors are increasingly recognizing that human resources are the critical driver of health research in developing countries. This grant will support a consultation and symposium on the subject. Expert teams will carry out a review and consultation on such themes as: the skills needed to ...
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 ...
Abstract: Rwanda Human Resources for Health Program: Genesis and Evolution of the Nursing and Midwifery Program. ... Journal Home > Vol 2, No 2 (2015) > ... This poster described the process that led to the Rwanda HRH Program, how nursing and midwifery leadership determined and communicated their needs, and ...
Methods: Initially, national sensitization and consensus building workshop on human resources for public health supply chain management was held in Addis Ababa. ... Conclusion: Despite various efforts made to implement initiatives that increase the supply chain efficiencyover the past years, marked inadequacies still ...
Full Text Available ... 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 ...
Governments, policymakers and donors are increasingly recognizing that human resources are the critical driver of health research in developing countries. This grant will support a consultation and symposium on the subject. Expert teams will carry out a review and consultation on such themes as: the skills needed to ...
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…
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.
Rigoli, Felix; Rocha, Cristianne Famer; Foster, Allison Annette
This text presents the context and background, the methodology and some of the main results of the regional consultation on the critical challenges for human resources in health in the Americas. The Consultation, carried out in June and July 2005, was part of the strategy of the Pan American Health Organization (PAHO/WHO) for the organization of the VII Regional Meeting of the Observatories of Human Resources, held in Toronto (Canada). The main results and suggestions by the actors consulted with regard to the role of international cooperation in the countries of the Region are presented, so that the countries and international agencies can better formulate common strategies of development and strengthening of the work force in health.
This interim final rule establishes standards and procedures by which the U.S. Department of Health and Human Services (HHS) may require that certain contracts or orders that promote the national defense be given priority over other contracts or orders. This rule also sets new standards and procedures by which HHS may allocate materials, services, and facilities to promote the national defense. This rule will implement HHS's administration of priorities and allocations actions, and establish the Health Resources Priorities and Allocation System (HRPAS). The HRPAS will cover health resources pursuant to the authority under Section 101(c) of the Defense Production Act as delegated to HHS by Executive Order 13603. Priorities authorities (and other authorities delegated to the Secretary in E.O. 13603, but not covered by this regulation) may be re-delegated by the Secretary. The Secretary retains the authority for allocations.
Oliveira, Karla Regina Dias de; Liberal, Márcia Mello Costa de; Zucchi, Paola
To identify the financial resources and investments provided for preventive medicine programs by health insurance companies of all kinds. Data were collected from 30 large health insurance companies, with over 100 thousand individuals recorded, and registered at the Agência Nacional de Saúde Suplementar. It was possible to identify the percentage of participants of the programs in relation to the total number of beneficiaries of the health insurance companies, the prevention and promotion actions held in preventive medicine programs, the inclusion criteria for the programs, as well as the evaluation of human resources and organizational structure of the preventive medicine programs. Most of the respondents (46.7%) invested more than US$ 50,000.00 in preventive medicine program, while 26.7% invested more than US$ 500,000.00. The remaining, about 20%, invested less than US$ 50,000.00, and 3.3% did not report the value applied.
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
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 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.
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
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.
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
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.
Helfrich, Louis A. (Louis Anthony), 1942-; Parkhurst, James A. (James Albert)
Describes natural aquatic habitats, such as rivers, streams, springs, estuaries, bays, and various wetlands, and discusses the major differences between aquatic and terrestrial ecosystems. Part of a 12 part series on sustaining aquatic biodiversity in America.
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.
In this paper, human resource development problems facing rural health care facilities are identified and it is recognised that, particularly in the face of escalating demands for training arising from environmental pressures such as implementation of the structural efficiency principle, a coordinated approach to meet these problems is desirable. Such coordination is often sought via a regional staff development service. Accordingly, using the organisational life cycle as a conceptual framework, staff development services in five NSW health regions are examined. Ranging from a cafeteria style to a results-orientation, a diversity of strategic approaches to staff development is reflected.
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
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.
Kwak, Jin Il; Nam, Sun-Hwa; An, Youn-Joo
Since the Korean Ministry of the Environment established the Master Plan for Water Environment (2006-2015), the need to revise the water quality standards (WQSs) has driven government projects to expand the standards for the protection of human health and aquatic ecosystems. This study aimed to provide an historical overview of how these WQSs were established, amended, and expanded over the past 10 years in Korea. Here, major projects related to national monitoring in rivers and the amendment of WQSs were intensely reviewed, including projects on the categorization of hazardous chemicals potentially discharged into surface water, the chemical ranking and scoring methodology for surface water (CRAFT, Chemical RAnking of surFace water polluTants), whole effluent toxicity (WET) management systems, the 4th, 5th, and 6th revisions of the water quality standards for the protection of human health, and efforts toward developing the 7th revision. In this review, we assimilated the past and current status as well as future perspectives of Korean surface WQSs. This research provides information that aids our understanding of how surface WQSs have been expanded, and how scientific approaches to ensure water quality have been applied at each step of the process in Korea.
Chi, Y-Ling; Bump, Jesse B
International institutions provide well over US$10 billion in development assistance for health (DAH) annually and between 1990 and 2014, DAH disbursements totaled $458 billion but how do they decide who gets what, and for what purpose? In this article, we explore how allocation decisions were made by the nine convening agencies of the Equitable Access Initiative. We provide clear, plain language descriptions of the complete process from resource mobilization to allocation for the nine multilateral agencies with prominent agendas in global health. Then, through a comparative analysis we illuminate the choices and strategies employed in the nine international institutions. We find that resource allocation in all reviewed institutions follow a similar pattern, which we categorized in a framework of five steps: strategy definition, resource mobilization, eligibility of countries, support type and funds allocation. All the reviewed institutions generate resource allocation decisions through well-structured and fairly complex processes. Variations in those processes seem to reflect differences in institutional principles and goals. However, these processes have serious shortcomings. Technical problems include inadequate flexibility to account for or meet country needs. Although aid effectiveness and value for money are commonly referenced, we find that neither performance nor impact is a major criterion for allocating resources. We found very little formal consideration of the incentives generated by allocation choices. Political issues include non-transparent influence on allocation processes by donors and bureaucrats, and the common practice of earmarking funds to bypass the normal allocation process entirely. Ethical deficiencies include low accountability and transparency at international institutions, and limited participation by affected citizens or their representatives. We find that recipient countries have low influence on allocation processes themselves
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.
Banerjee, Ritesh; Ziegenfuss, Jeanette Y; Shah, Nilay D
This study sought to describe the incidence of transitions into and out of Medicaid, characterize the populations that transition and determine if health insurance instability is associated with changes in healthcare utilization. 2000-2004 Medical Expenditure Panel Survey (MEPS) was used to identify adults enrolled in Medicaid at any time during the survey period (n = 6,247). We estimate both static and dynamic panel data models to examine the effect of health insurance instability on health care resource utilization. We find that, after controlling for observed factors like employment and health status, and after specifying a dynamic model that attempts to capture time-dependent unobserved effects, individuals who have multiple transitions into and out of Medicaid have higher emergency room utilization, more office visits, more hospitalizations, and refill their prescriptions less often. Individuals with more than one transition in health insurance status over the study period were likely to have higher health care utilization than individuals with one or fewer transitions. If these effects are causal, in addition to individual benefits, there are potentially large benefits for Medicaid programs from reducing avoidable insurance instability. These results suggest the importance of including provisions to facilitate continuous enrollment in public programs as the United States pursues health reform.
Riley, Patricia L; Zuber, Alexandra; Vindigni, Stephen M; Gupta, Neeru; Verani, Andre R; Sunderland, Nadine L; Friedman, Michael; Zurn, Pascal; Okoro, Chijioke; Patrick, Heather; Campbell, James
Although attainment of the health-related Millennium Development Goals relies on countries having adequate numbers of human resources for health (HRH) and their appropriate distribution, global understanding of the systems used to generate information for monitoring HRH stock and flows, known as human resources information systems (HRIS), is minimal. While HRIS are increasingly recognized as integral to health system performance assessment, baseline information regarding their scope and capability around the world has been limited. We conducted a review of the available literature on HRIS implementation processes in order to draw this baseline. Our systematic search initially retrieved 11 923 articles in four languages published in peer-reviewed and grey literature. Following the selection of those articles which detailed HRIS implementation processes, reviews of their contents were conducted using two-person teams, each assigned to a national system. A data abstraction tool was developed and used to facilitate objective assessment. Ninety-five articles with relevant HRIS information were reviewed, mostly from the grey literature, which comprised 84 % of all documents. The articles represented 63 national HRIS and two regionally integrated systems. Whereas a high percentage of countries reported the capability to generate workforce supply and deployment data, few systems were documented as being used for HRH planning and decision-making. Of the systems examined, only 23 % explicitly stated they collect data on workforce attrition. The majority of countries experiencing crisis levels of HRH shortages (56 %) did not report data on health worker qualifications or professional credentialing as part of their HRIS. Although HRIS are critical for evidence-based human resource policy and practice, there is a dearth of information about these systems, including their current capabilities. The absence of standardized HRIS profiles (including documented processes for
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
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...
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
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.
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.
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.
Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey.
Güeita-Rodríguez, Javier; García-Muro, Francisco; Cano-Díez, Beatriz; Rodríguez-Fernández, Ángel L; Lambeck, Johan; Palacios-Ceña, Domingo
To identify intervention categories encountered by physical therapists working in aquatic therapy with disabled children, using the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). Aquatic physical therapists were asked to describe concepts related to the functioning of disabled children and their contextual factors. Data were collected in three rounds using the Delphi technique. All answers were translated ('linked') to the ICF-CY and analyzed to determine the degree of consensus. Answers were linked and organized into four diagnostic groups. Overall, in the four groups, 41 Body Functions, 8 Body Structures, 36 Activities and Participation, and 6 Environmental Factors categories were identified as intervention targets. In addition, 8 Environmental Factors that influence aquatic physical therapy were identified. This study highlights the variety of intervention categories available to aquatic physical therapists when treating children in the water. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.
Subasinghe, R P; Bondad-Reantaso, M G
Aquaculture is the fastest growing food producing sector in the world and it is expected to produce significant quantities of fish in the coming years to meet the growing global demand for aquatic animal products. The expansion and diversification of the sector, along with globalisation and trade liberalisation have resulted in aquatic animals and animal products moving around the world rapidly, causing serious disease outbreaks stemming from incursions of pathogens through unregulated transboundary movements. It has become necessary to develop appropriate guidelines for establishing national regulatory frameworks to improve responsibility in transboundary movement of live aquatic animals. In 2000, the Food and Agriculture Organization of the United Nations (FAO), in collaboration with the Network of Aquaculture Centres in Asia-Pacific (NACA) and in partnership with 21 Asian countries, developed the Asia Regional Technical Guidelines on Health Management for the Responsible Movement of Live Aquatic Animals. The present article outlines the development process of the guidelines, the lessons learned from their implementation at national level and the way forward.
Rigoli, Felix; Dussault, Gilles
The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms.The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways - reacting to transformations, supporting, blocking and distorting the proposed ways of action.This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them.
Full Text Available Abstract The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms. The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways – reacting to transformations, supporting, blocking and distorting the proposed ways of action. This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them.
Tuffin, A; Tuffin, K; Watson, S
Talk about mental health and mental illness was examined using Potter and Wetherell's system of discourse analysis. Participants were 8 health coordinators (teachers) from a range of New Zealand secondary schools. They were interviewed on the topics of mental health and mental illness. Verbatim transcripts from the interviews were analyzed, and three mental health and illness linguistic resources were identified: a mental health as illness resource, a mental well-being resource, and a mental illness resource. Each resource was examined, and the practical consequences of this language use was discussed in relation to the role of teachers as frontline mental health professionals.
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.
Brooks, Bryan W; Lazorchak, James M; Howard, Meredith D A; Johnson, Mari-Vaughn V; Morton, Steve L; Perkins, Dawn A K; Reavie, Euan D; Scott, Geoffrey I; Smith, Stephanie A; Steevens, Jeffery A
In this Focus article, the authors ask a seemingly simple question: Are harmful algal blooms (HABs) becoming the greatest inland water quality threat to public health and aquatic ecosystems? When HAB events require restrictions on fisheries, recreation, and drinking water uses of inland water bodies significant economic consequences result. Unfortunately, the magnitude, frequency, and duration of HABs in inland waters are poorly understood across spatiotemporal scales and differentially engaged among states, tribes, and territories. Harmful algal bloom impacts are not as predictable as those from conventional chemical contaminants, for which water quality assessment and management programs were primarily developed, because interactions among multiple natural and anthropogenic factors determine the likelihood and severity to which a HAB will occur in a specific water body. These forcing factors can also affect toxin production. Beyond site-specific water quality degradation caused directly by HABs, the presence of HAB toxins can negatively influence routine surface water quality monitoring, assessment, and management practices. Harmful algal blooms present significant challenges for achieving water quality protection and restoration goals when these toxins confound interpretation of monitoring results and environmental quality standards implementation efforts for other chemicals and stressors. Whether HABs presently represent the greatest threat to inland water quality is debatable, though in inland waters of developed countries they typically cause more severe acute impacts to environmental quality than conventional chemical contamination events. The authors identify several timely research needs. Environmental toxicology, environmental chemistry, and risk-assessment expertise must interface with ecologists, engineers, and public health practitioners to engage the complexities of HAB assessment and management, to address the forcing factors for HAB formation, and
Background: Health human resource capacity is one of the major determinants of an effective health care delivery system. It is more importantly so in the Primary Health Care system, which is the key component of every health system. This study assessed the available and type of human resource for health in public primary ...
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.
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.
Campbell, James; Buchan, James; Cometto, Giorgio; David, Benedict; Dussault, Gilles; Fogstad, Helga; Fronteira, Inês; Lozano, Rafael; Nyonator, Frank; Pablos-Méndez, Ariel; Quain, Estelle E; Starrs, Ann; Tangcharoensathien, Viroj
Achieving universal health coverage (UHC) involves distributing resources, especially human resources for health (HRH), to match population needs. This paper explores the policy lessons on HRH from four countries that have achieved sustained improvements in UHC: Brazil, Ghana, Mexico and Thailand. Its purpose is to inform global policy and financial commitments on HRH in support of UHC. The paper reports on country experiences using an analytical framework that examines effective coverage in relation to the availability, accessibility, acceptability and quality (AAAQ) of HRH. The AAAQ dimensions make it possible to perform tracing analysis on HRH policy actions since 1990 in the four countries of interest in relation to national trends in workforce numbers and population mortality rates. The findings inform key principles for evidence-based decision-making on HRH in support of UHC. First, HRH are critical to the expansion of health service coverage and the package of benefits; second, HRH strategies in each of the AAAQ dimensions collectively support achievements in effective coverage; and third, success is achieved through partnerships involving health and non-health actors. Facing the unprecedented health and development challenges that affect all countries and transforming HRH evidence into policy and practice must be at the heart of UHC and the post-2015 development agenda. It is a political imperative requiring national commitment and leadership to maximize the impact of available financial and human resources, and improve healthy life expectancy, with the recognition that improvements in health care are enabled by a health workforce that is fit for purpose.
Riley Patricia L
Full Text Available Abstract Background Although attainment of the health-related Millennium Development Goals relies on countries having adequate numbers of human resources for health (HRH and their appropriate distribution, global understanding of the systems used to generate information for monitoring HRH stock and flows, known as human resources information systems (HRIS, is minimal. While HRIS are increasingly recognized as integral to health system performance assessment, baseline information regarding their scope and capability around the world has been limited. We conducted a review of the available literature on HRIS implementation processes in order to draw this baseline. Methods Our systematic search initially retrieved 11 923 articles in four languages published in peer-reviewed and grey literature. Following the selection of those articles which detailed HRIS implementation processes, reviews of their contents were conducted using two-person teams, each assigned to a national system. A data abstraction tool was developed and used to facilitate objective assessment. Results Ninety-five articles with relevant HRIS information were reviewed, mostly from the grey literature, which comprised 84 % of all documents. The articles represented 63 national HRIS and two regionally integrated systems. Whereas a high percentage of countries reported the capability to generate workforce supply and deployment data, few systems were documented as being used for HRH planning and decision-making. Of the systems examined, only 23 % explicitly stated they collect data on workforce attrition. The majority of countries experiencing crisis levels of HRH shortages (56 % did not report data on health worker qualifications or professional credentialing as part of their HRIS. Conclusion Although HRIS are critical for evidence-based human resource policy and practice, there is a dearth of information about these systems, including their current capabilities. The absence of
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.
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 resour...
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
Jacqueline Elizabeth Alcalde-Rabanal
Full Text Available Objective. To estimate human resources (HR needed to deliver prevention and health promotion actions to the population of 20 years and more in units of primary health care (UPHC. Materials and methods. We included 20 UPHC; one urban and one rural for each of the ten selected Mexican states. HR were estimated based on the time to do prevention and health promotion activities, from which a budget was calculated. Measures of central tendency and dispersion were reported, using the ANOVA test and the Wilcoxon test. Results. The number of health professionals estimated in UPHC with spent time is less than the number estimated with required time. Conclusions. The estimated density of health professionals per population needed to offer prevention and health promotion activities for people 20 years and more in UPHC is greater than the current density of health professionals.
EPA's Safe and Sustainable Water Resources (SSWR) research program is using an integrated systems approach to develop scientific and technological solutions to protect human health, and to protect and restore watersheds and aquatic ecosystems.
Moore, M R; Shaw, G
Australia is blessed with a great diversity of unique species in its fresh waters and in the marine environment around its coast. There is evidence that human and natural events are impacting on these species. Such impacts are associated with various agricultural, industrial, and domestic practices and with natural and anthropogenically driven climate change. Among the species most affected are those living in aquatic and marine environments. Some of these, such as cyanobacteria and dinoflagellates, have the potential for toxicity. Linked to this, there is the potential benefit of harnessing the pharmacologic potential of these toxins.
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
At the request of South Carolina Department of Health and Environmental Control (SCDHEC) and the Department of Energy (DOE), the Savannah River Laboratory was assigned the task of developing the release guides to protect aquatic biota. A review of aquatic radioecology literature by two leading experts in the field of radioecology concludes that exposure of aquatic biota at one rad per day or less will not produce detectable deleterious effects on aquatic organisms. On the basis of this report, DOE recommends the use of one rad per day as an interim dose standard to protect aquatic biota.
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Constable, Sophie Elizabeth; Dixon, Roselyn May; Dixon, Robert John
Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh-Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery.
Akashi, Hidechika; Osanai, Yasuyo; Akashi, Rumiko
Human resources are an important factor in establishing universal health coverage (UHC). We examined Japan's health policies related to development of human resources for health (HRH) toward establishing UHC, and tried to formulate a model for other countries wanting to introduce UHC through reviewing existing data and documents related to Japan's history in developing HRH. In the results, there were four phases of HRH development in Japan: Phase 1 involved a shortage of HRH; Phase 2 was characterized by rapid production of less-educated HRH; Phase 3 involved introduction of quality improvement procedures such as upgrade education for nursing staff or licensing examination for physicians; Phase 4 was characterized by a predominance of formal health professionals. To encourage transition between these phrases, Japan utilized several procedures, including: (i) offering shorter professional education, (ii) fewer admission requirements for professional education, (iii) widespread location of schools, and (iv) the aforementioned quality improvement procedures. Japan was able to introduce UHC during Phase 3, and Japanese health indicators have improved gradually through these phases. Consequently, the government of Japan focused on increasing the quantity of HRH through relaxed admission requirements, shorter education periods, and increasing the numbers of educational facilities, before introducing UHC. Subsequently, the government began focusing on improving quality through procedures such as upgrade education or licensing examination programs to enable less-educated HRH to become fully educated professionals. For governments wanting to introduce UHC, the Japanese model can be a suitable option for HRH development, particularly in resource-poor countries.
Kogstad, Ragnfrid Eline; Mönness, Erik; Sörensen, Tom
Several studies have illustrated the importance of social support and social networks for persons with mental health problems. Social networks may mean a reduced need for professional services, but also help to facilitate access to professional help. The interplay between social networks and professional services is complicated and invites further investigation. Compare aspects of clients' experiences with social networks to experiences with professional services and learn about the relationship between network resources and help from the public health service system. Quantitative analyses of a sample of 850 informants. Supportive networks exist for a majority of the informants and can also be a substitute for public/professional services in many respects. Regarding help to recover, social networks may offer qualities equal to those of professional services. Furthermore, there is a positive relationship between trust in a social network and trust in public professional services. Trust in a social network also increases the probability of achieving positive experiences with professional services. Our finding simply that more network qualities should be included in professional services, and also that professionals should assist vulnerable groups in building networks.
O'Neal, Catherine Walker; Lucier-Greer, Mallory; Mancini, Jay A; Ferraro, Anthony J; Ross, D Bruce
In addition to facing stressors that are typical of life course development (e.g., marital struggles, balancing work/family demands), military families face additional stress attributed to their military context (e.g., deployments, relocations). Using a systems framework and stress process perspective, this study examined military couples' relational health, as a gauge for how couples collectively cope and address challenges as a united front and how their relational health influences crucial health behaviors (sleeping and eating) through the promotion or erosion of psychological resources (N = 236 couples). This study evaluated a latent variable structural equation dyadic model whereby each partner's perspective of their family's relational health was hypothesized to influence their own eating and sleeping behaviors (actor effects), as well as the eating and sleeping behaviors of their spouse (partner effects). The role of psychological resources (high self-efficacy, few depressive symptoms, and minimal anxiety) as a mechanism linking family functioning to health behaviors was also examined. Overall, the findings supported the hypothesized model, particularly for actor (intraindividual) effects. Discussion is provided pertinent to service providers and researchers, including the importance of improving, or maintaining, family relational health, as a means for encouraging positive health behaviors among active duty military members and their spouses. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Gallagher, Jennifer E; Hutchinson, Lynn
Oral diseases affect most of the global population. The aim of this paper was to provide a contemporary analysis of 'human resources for oral health' (HROH) by examining the size and distribution of the dental workforce according to World Health Organization (WHO) region and in the most populous countries. Publically available data on HROH and population size were sourced from the WHO, Central Intelligence Agency, United Nations, World Bank and the UK registration body. Population-to-dentist and dental-workforce ratios were calculated according to WHO region and for the 25 most populous countries globally. Workforce trends over time were examined for one high-income country, the UK. The majority of the world's 1.6 million dentists are based in Europe and the Americas, such that 69% of the world's dentists serve 27% of the global population. Africa has only 1% of the global workforce and thus there are marked inequalities in access to dental personnel, as demonstrated by population to dental-workforce ratios. Gaps exist in dental-workforce data, most notably relating to mid-level clinical providers, such as dental hygienists and therapists, and HROH data are not regularly updated. Workforce expansion and migration may result in rapid changes in dentist numbers. Marked inequalities in the distribution of global HROH exist between regions and countries, with inequalities most apparent in areas of high population growth. Detailed contemporary data on all groups of HROH are required to inform global workforce reform in support of addressing population oral health needs. © 2018 FDI World Dental Federation.
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
Full Text Available Manufacturing front-line workers were more likely to experience mental health problems. Personal resources and professional tasks were the major factors of workers’ mental health. Therefore, this study was to explore the interrelationship of these three key factors. A questionnaire including the revised Occupational Stress Inventory (OSI-R and the Symptom Checklist (SCL-90 covered 480 manufacturing front-line workers to measure their personal resources, professional tasks and mental health. Results showed that among manufacturing front-line workers, the status of mental health and professional tasks were below the national average level, and the personal resources were relatively deficient as well. Correlation analysis indicated a negative relation between the indicators of mental health and professional tasks (except responsibility, while personal resources and mental health were significantly positive correlation. These findings suggested that personal resources and professional tasks were highly related to mental health in manufacturing front-line workers.
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 ...
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.
Projections of future Canadian ratios of ophthalmologists to population have fluctuated because of changes in numbers of residency spots and retirement rates. Although this ratio plateaued in recent years, the ratio of ophthalmologists to the population over 65 years of age is projected to steadily deteriorate. All graduating residents are going to be needed to meet the upcoming workload, yet current graduates are finding increasing difficulty obtaining full-time positions with operating room privileges. This problem is affecting all specialties who require hospital facilities, and exploration of this problem by the Royal College, Canadian Medical Association (CMA), Resident Doctors of Canada, and council of the Provincial Deputy Ministers of Health is presented. Proposed solutions to the current job shortages include residents starting in positions outside of major metropolitan areas, clinicians in practice giving up some operating room time to make way for new graduates, government increasing infrastructure commensurate with the increased number of medical school positions, and optimizing use of current resources by running operating rooms for longer hours and on the weekends. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Zienkiewicz, Ewa; Zienkiewicz, Tadeusz; Dziaduch, Sławomir
To examine disparities in access to the public in Poland, in association of the resources of health care, socio-economic development of Provinces and their level of urbanization. The Provinces were divided into four groups, using the quartile method, according to the urbanization and level of socio-economic development. The socio-economic development level was identified by the Human Development Index (HDI) for each Province. The urbanization level of each Province was determined by the Index of Urbanization (URBI). Disparities level to access to public health care was identified by taxonomic measure of accessibility (TMA), calculated using resources of health care data. TMA index was compared in the different regions, depending on the level of HDI and URBI. There was no linear relationship between accessibility to public healthcare and socio-economic development of each tested region, nor between accessibility to public health care in the Provinces and their urbanization level. During the study, the correlation between the TMA and HDI and URBI alsdo produced a negative result. An insufficient number of physicians and the limited value of contracts within the public health service may cause a drop in the availability of the public medical service sector, regardless of regional level of urbanization and socio-economic development.
and scaling up health professionals' education and training, calling for sustainable and contextual reforms which will strengthen health systems and improve population health outcomes. The World Health Organization's building blocks for effective health systems include a well-performing health workforce that is ...
Di Liang BM
Full Text Available 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.
Blansit, B D; Connor, E
Changes in the practice of medicine and technological developments offer librarians unprecedented opportunities to select and organize electronic resources, use the Web to deliver content throughout the organization, and improve knowledge at the point of need. The confusing array of available products, access routes, and pricing plans makes it difficult to anticipate the needs of users, identify the top resources, budget effectively, make sound collection management decisions, and organize the resources effectively and seamlessly. The electronic resource marketplace requires much vigilance, considerable patience, and continuous evaluation. There are several strategies that librarians can employ to stay ahead of the electronic resource curve, including taking advantage of free trials from publishers; marketing free trials and involving users in evaluating new products; watching and testing products marketed to the clientele; agreeing to beta test new products and services; working with aggregators or republishers; joining vendor advisory boards; benchmarking institutional resources against five to eight competitors; and forming or joining a consortium for group negotiating and purchasing. This article provides a brief snapshot of leading biomedical resources; showcases several libraries that have excelled in identifying, acquiring, and organizing electronic resources; and discusses strategies and trends of potential interest to biomedical librarians, especially those working in hospital settings.
Bajaj, Priyanka; Kanaujia, Pawan Kumar; Singh, Nambram Somendro; Sharma, Shalu; Kumar, Shakti; Virdi, Jugsharan Singh
Quinolone and β-lactam antibiotics constitute major mainstay of treatment against infections caused by pathogenic Escherichia coli. Presence of E. coli strains expressing co-resistance to both these antibiotic classes in urban aquatic environments which are consistently being used for various anthropogenic activities represents a serious public health concern. From a heterogeneous collection of 61 E. coli strains isolated from the river Yamuna traversing through the National Capital Territory of Delhi (India), those harboring blaCTX-M-15 (n = 10) or blaCMY-42 (n = 2) were investigated for co-resistance to quinolones and the molecular mechanisms thereof. Resistance was primarily attributed to amino acid substitutions in the quinolone resistance-determining regions (QRDRs) of GyrA (S83L ± D87N) and ParC (S80I ± E84K). One of the E. coli strains, viz., IPE, also carried substitutions in GyrB and ParE at positions Ser492→Asn and Ser458→Ala, respectively. The phenotypically susceptible strains nevertheless carried plasmid-mediated quinolone resistance (PMQR) gene, viz., qnrS, which showed co-transfer to the recipient quinolone-sensitive E. coli J53 along with the genes encoding β-lactamases and led to increase in minimal inhibitory concentrations of quinolone antibiotics. To the best of our knowledge, this represents first report of molecular characterization of quinolone co-resistance in E. coli harboring genes for ESBLs or AmpC β-lactamases from a natural aquatic environment of India. The study warrants true appreciation of the potential of urban aquatic environments in the emergence and spread of multi-drug resistance and underscores the need to characterize resistance genetic elements vis-à-vis their public health implications, irrespective of apparent phenotypic resistance.
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
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
Okumura, Megumi J; Knauer, Heather A; Calvin, Kris E; Takayama, John I
Background and Objectives Pediatricians face numerous challenges in providing care for children with special health care needs (CSHCN). Few studies have described health care resources available to support pediatricians to care for CSHCN. This study investigated available resources to care for CSHCN and factors associated with having a greater proportion of CSHCN in practice. Methods We conducted a statewide survey of active members of the American Academy of Pediatrics in California to study pediatric subspecialty care access, community and office resources and practice barriers. We performed a logistic regression model on having an "above average proportion" of CSHCN in practice, adjusting for demographics, practice type (rural vs. suburban/urban) and medical resources, care satisfaction, and ease of subspecialty access. Results Our response rate was 50.2% (n = 1290); 75% of respondents reported providing some primary care services, with many primary care pediatricians caring for a high proportion of CSHCN. Pediatricians reported an average of 28% CSHCN in their practices. Rural pediatricians lacked subspecialty access (10-59% reporting no access to the various subspecialties). Factors relating to higher CSHCN in practice included being in academic medical centers and satisfaction in caring for CSHCN. Conclusions Pediatricians report lack of access to mental health services, care coordination and case management. Academic medical centers and higher physician satisfaction in care delivery for CSHCN are associated with more CSHCN in practice. Promoting ways to support pediatricians, such as practice collaboration with behavioral specialists, may be necessary to encourage primary care pediatricians to provide medical homes for CSHCN.
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.
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…
Full Text Available ... E-MAIL UPDATES External Link Disclaimer National Diabetes Education Program HealthSense Home Make a Plan Articles About HealthSense Diabetes HealthSense Title/Keywords: Go Diabetes ...
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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
Lund, Crick; Boyce, Gerard; Flisher, Alan J.; Kafaar, Zuhayr; Dawes, Andrew
Background: Children and adolescents with mental health problems have poor service cover in low- and middle-income countries. Little is known about the resources that would be required to provide child and adolescent mental health services (CAMHS) in these countries. The purpose of this study was to calculate the human resources and associated…
Spiranovic, Caroline; Briggs, Kate; Kirkby, Kenneth; Mobsby, Caroline; Daniels, Brett
The yshareit project aims to increase awareness of and access to reputable e-mental health resources among young people. This is achieved by developing peer support networks, supported by e-mental health resources including the triage website, http://www.yshareit.com. Young people involved in the evaluation of the project described in this paper…
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.
Pandey, Anuja; Zodpey, Sanjay; Shrikhande, Sunanda; Sharma, Anjali
Public health laboratories play a critical role in disease surveillance and response. With changes in disease dynamics and transmission, their role has evolved over time, and they serve a range of important public health functions. For their effective functioning, it is important to have specialized manpower in these laboratories, which can contribute to their maximum utilization. The present manuscript is an attempt to explore the human resource capacity building initiatives for public health laboratories in India. Using three parallel methods we have attempted to gather information regarding various human resource capacity building initiatives for public health laboratories in India. Our study results show that there is a paucity of programs providing specialized training for human resources in public health laboratories in India. It highlights the urgent need to address this scarcity and introduce capacity building measures to generate human resources for public health laboratories to strengthen their role in public health action.
Full Text Available ... Diabetes Education Program HealthSense Home Make a Plan Articles About HealthSense Diabetes HealthSense Title/Keywords: Go Diabetes ... Use NDEP’s promotional kit , including a presentation, newsletter article, and flyer to promote Diabetes HealthSense in your ...
Full Text Available ... smaller. U.S. Department of Health and Human Services HOME | CONTACT US | JOBS AT NIDDK | RSS FEEDS | GET ... External Link Disclaimer National Diabetes Education Program HealthSense Home Make a Plan Articles About HealthSense Diabetes HealthSense ...
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Full Text Available ... share their stories about their diagnoses and support networks. Diabetes and Kidney Disease 12 Diabetes is the ... 65+) Type of Resource Select one: Printable documents Online programs In-person programs Videos and podcasts Presentations ...
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... benefits and quality, side-by-side with facts about price, will help each consumer make the best coverage..., and/or other innovative resources) used to educate the target audience to improve knowledge and...
Full Text Available ... Handouts - Healthy Coping These handouts provide facts, tips, advice, and activities for seven different areas of self- ... Community organization Age Select one: Child Teen and young adult Adult Older adult (65+) Type of Resource ...
Full Text Available ... the play back of videos. play pause rewind ... This easy-to-use resource guide helps you make smart choices from every food group, find balance between food and physical activity, ...
English in Australia, 1973
Contains seven short resources''--units, lessons, and activities on the power of observation, man and his earth, snakes, group discussion, colloquial and slang, the continuous story, and retelling a story. (DD)
Marcell, Arik V; Halpern-Felsher, Bonnie L
Adolescents' health care use is less than ideal, especially for more sensitive services. We know little about adolescents' preferred resources for help for health-related issues, and whether these resources vary by problem type. This study examined whether adolescents' preferred resources for help differed depending on the health issue studied. Two hundred ten high school students (54% females; 76.6% participation rate) completed a self-administered survey of four separate age- and gender-specific health case scenarios: an adolescent who has symptoms of pneumonia; smokes five cigarettes daily; plans to initiate sex; and has symptoms of depression. For each health scenario, participants rated the importance of getting help in general, how important it was to get help from specific resources (friends/siblings; significant adults; health care professionals; and mental health professionals), and highest rankings of specific resources. Most adolescents believed it somewhat or very important to get help in general for all scenarios (94% pneumonia; 81% cigarette; 88% depression) except the sex scenario (27%). Repeated measures analysis of variance revealed significant differences in participants' beliefs in the importance of getting help from each specific resource across the four scenarios (all p sex scenario; and a partner (33%), psychologist (23%), and friend (20%) for the depression scenario. Beliefs in the importance of getting help from specific resources also varied by age, gender, and beliefs in importance of getting help in general. Adolescents' preferred resources for help differ depending on the health issue in question, with adolescents preferring informal resources (friends and partners) and significant adults (parents) to go to for help for nonphysical health-related issues and physicians for physical health-related issues. Future preventive service efforts and research should also consider the importance of age and gender when examining adolescents
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,…
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
... State Offices Search the Organizations Database Center for Oral Health Systems Integration and Improvement (COHSII) COHSII is a ... needs of the MCH population. Brush Up on Oral Health This monthly newsletter provides Head Start staff with ...
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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
Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw
Background 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. Method 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. Results 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. Discussion 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
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
8 and should be supported by the health system. Shortages and inequities in the distribution of these health workers remain a common problem in many low and middle-income countries. In the least developed countries, there is a distribution of about. 1 health worker per 2400 people, compared with 1. 10 per 100 people in ...
White, B. Alex
An overview of the current oral health status of Americans looks at the epidemiology of oral/dental diseases, rates of use of dental services, and expenditures for dental health care. Substantial progress in improving oral health is seen as are particular challenges resulting from the aging and ethnic diversification of the population. (MSE)
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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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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.
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.
Aug 31, 2004 ... A wonderfully written and sorely needed guide to the promise of aquatic genetic resources … brimming with important pointers of ways to realize the potential of the little appreciated and frequently abused aquatic genetic resources. – Thomas Lovejoy (President, Heinz Center for Science, Economics and ...
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
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Malone, Winfred F.
This directory of information centers, selected abstracting and indexing publications, and a discussion of journal capabilities and limitations has been prepared by the Hazardous Materials Advisory Committee of the Environmental Protection Agency. For selected information resources, each of the 20 entries includes name and location of the…
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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.
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.
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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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They were asked questions on how often they encountered children with mental health problems, facilities for the care of mentally ill children in their schools, the symptoms that could signify mental health problems in a school child and their first line of action in a situation where a child is found to have such problems.
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.
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
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 ...
healthy body weight have a lower risk of developing psychological problems related to low self - esteem and low self -image. All of these issues are...near maximal exercise continues beyond 30 seconds, the muscle must use glucose (a simple CHO) to produce ATP. During this anaerobic energy process, the...sustained, fatigue is inevitable within 3-5 minutes.Nutrition and Exercise Resource Manual 31 3210 20 30 40 From Aerobic Energy Production From Anaerobic
Full Text Available Aquatic landscapes such as rivers, lakes, and seas played an important role in past human behaviour, affecting modes of subsistence, patterns of mobility, access to material resources, and technological choices and their developments. The interaction with aquatic landscapes was also influential in the establishment of economic and social structures and in the formation of communal identities. The aim of this special themed issue of Internet Archaeology is to contribute to a better understanding of different forms of human interaction with aquatic landscapes.
Maynard, Nancy G.
Remotely-sensed data and observations are providing powerful new tools for addressing climate and environment-related human health problems through increased capabilities for monitoring, risk mapping, and surveillance of parameters useful to such problems as vector-borne and infectious diseases, air and water quality, harmful algal blooms, UV (ultraviolet) radiation, contaminant and pathogen transport in air and water, and thermal stress. Remote sensing, geographic information systems (GIS), global positioning systems (GPS), improved computational capabilities, and interdisciplinary research between the Earth and health science communities are being combined in rich collaborative efforts resulting in more rapid problem-solving, early warning, and prevention in global health issues. Collaborative efforts among scientists from health and Earth sciences together with local decision-makers are enabling increased understanding of the relationships between changes in temperature, rainfall, wind, soil moisture, solar radiation, vegetation, and the patterns of extreme weather events and the occurrence and patterns of diseases (especially, infectious and vector-borne diseases) and other health problems. This increased understanding through improved information and data sharing, in turn, empowers local health and environmental officials to better predict health problems, take preventive measure, and improve response actions. This paper summarizes the remote sensing systems most useful for climate, environment and health studies of the Caribbean region and provides several examples of interdisciplinary research projects in the Caribbean currently using remote sensing technologies. These summaries include the use of remote sensing of algal blooms, pollution transport, coral reef monitoring, vectorborne disease studies, and potential health effects of African dust on Trinidad and Barbados.
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.
Vorona, A A; Syrkin, L D
The article is devoted to developing the principles and methods of resource assessment of mental health military contingent in terms of demographic decline and reform of the Armed Forces of the Russian Federation. From the standpoint of the concept of the mutual influence of the value-semantic components and the level of psychological adaptation resources demonstrates the possibility of evaluating resource capabilities of the psyche of military contingent.
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Full Text Available ... to prevent or delay the onset of the disease. MOVE! This national weight management program is designed to help veterans lose weight, keep it off, and improve their health. The materials can also be used by non- ...
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Sontag-Padilla, Lisa; Kase, Courtney Ann; Woodbridge, Michelle W.; Stein, Bradley D.
Analysis of visitors to CalMHSA-funded student mental health websites shows that visitors at educational institutions comprised the largest audience segment and promotional campaigns likely increased traffic.
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Full Text Available ... on the right track. Cope with Stress and Emotions AADE7 Self-Care Behaviors Handouts - Healthy Coping These ... active Manage my weight Cope with stress and emotions Set goals Stop smoking Prevent diabetes-related health ...
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Full Text Available ... ways that suit your lifestyle, interests, health, and budget. Eat Healthy A Healthier You This easy-to- ... onset of the disease. MOVE! This national weight management program is designed to help veterans lose weight, ...
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.
... COMMISSION Aspen Group Resources Corp., Commercial Concepts, Inc., Desert Health Products, Inc., Equalnet Communications Corp., Geneva Steel Holdings Corp., Orderpro Logistics, Inc. (n/k/a Securus Renewable Energy, Inc... Aspen Group Resources Corp. because it has not filed any periodic reports since the period ended...
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 ...
Full Text Available based generation of a questionnaire is used to provide tailored information for informed decision making in health care systems. Resource Management can only be optimized if the ICT-based representation is based on tailored information according...
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.
... market research, including the determination that the acquisition involves health-care resources; (3) The.... Statements of work or specifications must define the requirement and should, in most instances, include...
Dustin E Loomes
Full Text Available BACKGROUND: Infliximab therapy in patients with Crohn’s disease decreases resource use; however, the overall impact on health-related expenditures is unclear, especially beyond one year of study.
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.
Rezaei, S; Karyani, A K; Fallah, R; Matin, B K
This study aimed to evaluate inequalities in the geographical distribution of human and physical resources in the health sector of Kermanshah province, Islamic Republic of Iran. In a retrospective, cross-sectional study, data from the Statistical Centre of Iran were used to calculate inequality measures (Gini coefficient and index of dissimilarity) over the years 2005-11. The highest Gini coefficient for human resources was observed for pharmacists in 2005 (0.75) and the lowest for paramedics in 2010 and 2011 (0.10). The highest indices of dissimilarity were also for pharmacists in 2005 (29%) and paramedics in 2011 (3%). For physical resources, the highest and lowest Gini coefficients were for rehabilitation centres in 2010 (0.59) and health houses in 2011 (0.12) respectively. Generally, inequalities in the distribution of health care resources were lower at the end of the study period, although there was potential for more equitable distribution of pharmacists, specialists, health houses and beds.
.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
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
Dang, Hoang-Minh; Ngo, Victoria; Pollack, Amie; Sang, David; Lam, Trung T.; Nguyen, My Loc Thi; Le, Huynh-Nhu; Tran, Nam; Tran, Cong; Do, Khanh N.
In this paper, we discuss development of the Vietnam National University graduate Clinical Psychology Program, which has the goal of training both Vietnamese researchers who will develop and evaluate culturally appropriate mental health treatments, as well as Vietnamese clinicians who will implement and help disseminate these evidence-based treatments. We first review the background situation in Vietnam regarding mental health, and its infrastructure and training needs, and discuss the process through which the decision was made to develop a graduate program in clinical psychology as the best approach to address these needs. We then review the development process for the program and its current status, and our focus on the schools as a site for service provision and mental health task shifting. Finally, we outline future goals and plans for the program, and discuss the various challenges that the program has faced and our attempts to resolve them. PMID:21785513
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
Linda M. Parsons
Full Text Available Laboratory systems worldwide are challenged not only by the need to compete for scarce resources with other sections of national health care programmes, but also with the lack of understanding of the critical role that laboratories play in the accurate diagnosis and monitoring of patients suffering from high-burdens of disease. An effective approach to establishing cost-effective laboratory systems that provide rapid and accurate test results for optimal impact on patient care is to move away from disease-specific programmes and establish integrated laboratory services. An integrated laboratory network provides all primary diagnostic services needed for care and treatment without requiring patients to go to different laboratory facilities for specific tests. Such a network focuses on providing quality-assured basic laboratory testing through the use of common specimen collection, reporting and diagnostic platforms that can be used across diseases. An integrated laboratory system also provides specimen transport to specialised laboratories and an environment conducive to the introduction and use of new and more complex technologies that would benefit the patient population and public health systems as a whole. As such, this article described various strategies for, and practical examples of, the successful integration of laboratory services.
Parsons, Linda M; Somoskovi, Akos; Lee, Evan; Paramasivan, Chinnambedu N; Schneidman, Miriam; Birx, Deborah; Roscigno, Giorgio; Nkengasong, John
Laboratory systems worldwide are challenged not only by the need to compete for scarce resources with other sections of national health care programmes, but also with the lack of understanding of the critical role that laboratories play in the accurate diagnosis and monitoring of patients suffering from high-burdens of disease. An effective approach to establishing cost-effective laboratory systems that provide rapid and accurate test results for optimal impact on patient care is to move away from disease-specific programmes and establish integrated laboratory services. An integrated laboratory network provides all primary diagnostic services needed for care and treatment without requiring patients to go to different laboratory facilities for specific tests. Such a network focuses on providing quality-assured basic laboratory testing through the use of common specimen collection, reporting and diagnostic platforms that can be used across diseases. An integrated laboratory system also provides specimen transport to specialised laboratories and an environment conducive to the introduction and use of new and more complex technologies that would benefit the patient population and public health systems as a whole. As such, this article described various strategies for, and practical examples of, the successful integration of laboratory services.
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 ... share their stories about their diagnoses and support networks. Diabetes and Kidney Disease 12 Diabetes is the ... Use NDEP’s promotional kit , including a presentation, newsletter article, and flyer to promote Diabetes HealthSense in your ...
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 ... are at risk for the disease. Live well. Eat healthy. Be active. It’s not easy, but it’s ... that suit your lifestyle, interests, health, and budget. Eat Healthy A Healthier You This easy-to-use ...
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, ...
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 ...
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Full Text Available ... E-MAIL UPDATES External Link Disclaimer National Diabetes Education Program HealthSense Home Make a Plan Articles About ... and healthier—no matter what your size. Exercise & Physical Activity: Your Everyday Guide from the National Institute ...
Background: Communication and use of medical information is an important factor in the delivery of quality health services in a timely fashion. This is of great importance to the researchers since they are faced with several millions of medical information packages and locating the précised or the core ones becomes ...
Albert, Don P.; And Others
Maintains that the use of geographic information systems (GIS) to analyze spatial dimensions of health care and disease ecology is becoming a realistic prospect for investigators in the social sciences. Contends that enough information is available to provide instructors with materials for classroom units. (CFR)
goals only when effective health supply chain management is in place (1). Supply chain management encompasses activities like planning and managing, locating sources and procuring logistics, among others. It also includes coordination and collaboration with channel partnerssuch as suppliers, intermediaries, third.
Apr 1, 2004 ... A method for calculating and presenting Burden of Disease data (the BoD tool) and district health accounting were developed to help policy makers better understand the effects of the burden of disease in ...... information on vital statistics and the local burden of disease in a graphical format for planning.
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.
Abbass-Dick, Jennifer; Brolly, Michele; Huizinga, Joanne; Newport, Amber; Xie, Fangli; George, Stephanie; Sterken, Elisabeth
The traditional practice of breastfeeding has been negatively affected by the historical trauma experienced by the Canadian Indigenous community. Culturally relevant information and support should be created to enable the communities to reclaim this traditionally revered infant feeding method. The objective of this participatory design study was to work in partnership with Indigenous communities to create an eHealth breastfeeding resource for Indigenous families. In partnership with Indigenous mothers and care providers in Ontario, Canada, an eHealth breastfeeding resource was designed based on their recommendations. Once the new resource was created, it was evaluated by additional Indigenous mothers. The participants indicated the resource was culturally relevant and that they liked the content and design. Using a participatory design when creating services and programs in partnership with Indigenous communities ensures the creation of resources that meet their needs, are culturally relevant, and align with cultural beliefs.
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.
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
Kogstad, Ragnfrid Eline; Mønness, Erik Neslein
English: Background: Several studies have illustrated the importance of social support and social networks for persons with mental health problems. Social networks may mean a reduced need for professional services, but also help to facilitate access to professional help. The interplay between social networks and professional services is complicated and invites further investigation. Aim: Compare aspects of clients’ experiences with social networks to experiences with professio...
Kogstad, Ragnfrid Eline; Mønness, Erik Neslein; Sørensen, Tom
Dette er forfatters pre-print versjon av artikkelen. Artikkelen slik den foreligger her er ikke fagfellevurdert, og mangler forlagets layout, sidetall og siste korrekturrettelser. Publisert, fagfellevurdert artikkel finnes på: http://www.springerlink.com/content/r088142300078157/fulltext.pdf Engelsk sammendrag (abstract): Background: Several studies have illustrated the importance of social support and social networks for persons with mental health problems. Social networks may mean a redu...
Jaleel K. Abdul-Adil
Full Text Available Modern Rap music is a very popular, powerful, and controversial form of contemporary youth media. Despite clearly counter-productive aspects of certain lyrics, videos, and other cultural elements, Rap music also offers prosocial material that can enhance the appeal and impact of mental health interventions. This article describes the Young Warriors program as an example of a Rap-based program that promotes positive development in urban ethnic minority youth. Future directions and similar scholarly efforts are also highlighted.
Hart, Leah J; Carr, Catherine; Fullerton, Judith T
Task analysis is a descriptive study methodology that has wide application in the health professions. Task analysis is particularly useful in assessment and definition of the knowledge, skills, and behaviors that define the scope of practice of a health profession or occupation. Jhpiego, a US-based nongovernmental organization, has adapted traditional task analysis methods in several countries in assessment of workforce education and practice issues. Four case studies are presented to describe the utility and adaptability of the task analysis approach. Traditional task analysis field survey methods were used in assessment of the general and maternal-child health nursing workforce in Mozambique that led to curriculum redesign, reducing the number of education pathways from 4 to 2. The process of health system strengthening in Liberia, following a long history of civil war conflict, included a traditional task analysis study conducted among 119 registered nurses and 46 certified midwives who had graduated in the last 6 months to 2 years to determine gaps in education and preparation. An innovative approach for data collection that involves "playing cards" to document participant opinions (Task Master, Mining for Data) was developed by Jhpiego for application in other countries. Results of a task analysis involving 54 nurses and 100 nurse-midwives conducted in Lesotho were used to verify the newly drafted scope and standards of practice for nurses and to inform planning for a competency-based preservice curriculum for nursing. The Nursing and Midwifery Council developed a 100-question licensing examination for new graduates following a task analysis in Botswana. The task analysis process in each country resulted in recommendations that were action oriented and were implemented by the country governments. For maximal utility and ongoing impact, a task analysis study should be repeated on a periodic basis and more frequently in countries undergoing rapid change in
This paper compares the Cunningham Dax Collection with other, similar collections around the world, of art by people with an experience of mental illness. The Cunningham Dax Collection is one of the largest collections of art by people with an experience of mental illness and psychological trauma in the world. Unlike most other collections, which focus on artworks by people with psychosis, mania and depression, the Cunningham Dax Collection covers a broad range of experiences, including anxiety disorders, dementia, autism and psychological trauma, as well as works by children made during their treatment for emotional problems. While most other collections emphasize the artistic qualities of the works, the Cunningham Dax Collection emphasizes both their artistic and psychological dimensions. Its educational program is recognized for its approach against stigma, by simultaneously promoting mental health literacy and highlighting the creativity of people with mental illness through art. It also distinguishes itself from others by its assertive touring program to rural and regional centres, and internationally. This program aims to build capacity for mental health promotion and suicide prevention by encouraging local communities to come together and use the visiting exhibitions to launch local mental health awareness activities.
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.
Pearce, Jamie; Witten, Karen; Bartie, Phil
Recent studies suggest an association between the contextual attributes of neighbourhoods and the health status of residents. However, there has been a scarcity of studies that have directly measured the material characteristics of neighbourhoods theorised to have an impact on health and health inequalities. This paper describes the development of an innovative methodology to measure geographical access to a range of community resources that have been empirically linked to health. Geographical information systems (GIS) were applied to develop precise measures of community resource accessibility for small areas at a national scale. Locational access to shopping, education, recreation, and health facilities was established for all 38,350 census meshblocks across New Zealand. Using GIS, distance measures were calculated from the population weighted centroid of each meshblock to 16 specific types of facilities theorised as potentially health related. From these data, indices of community resource accessibility for all New Zealand neighbourhoods were constructed. Clear regional variations in geographical accessibility to community resources exist across the country, particularly between urban and rural areas of New Zealand. For example, the average travel time to the nearest food shop ranged from less than one minute to more than 244 minutes. Noticeable differences were also apparent between neighbourhoods within urban areas. Recent advances in GIS and computing capacity have made it feasible to directly measure access to health related community resources at the neighbourhood level. The construction of access indices for specific community resources will enable health researchers to examine with greater precision, variations in the material characteristics of neighbourhoods and the pathways through which neighbourhoods impact on specific health outcomes.
Objectives: The human resource crisis facing the Zambian health sector has potential to derail existing health programs including millennium development goals. This paper will highlight the underpinning factors, analyze current interventions and propose alternative solutions to this crisis. Design: The study was done ...
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 ...
... 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...
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
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
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
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 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.
A protracted conflict affects human resources for health (HRH) in multiple ways. In most cases, the inflicted damage constitutes the main obstacle to health sector recovery. Interventions aimed at healing derelict human resources are however fraught with difficulties of a political, technical, financial and administrative order. The experience accumulated in past recovery processes has made some important players aware of the cost incurred by neglecting human resource development. Several transitions from conflict to peace have been documented, even if largely in unpublished reports. This paper presents condensed descriptions of some African HRH-related recovery processes, which provide useful lessons. The technical work demanded to resuscitate a derelict health workforce is fairly well understood. In most situations, the highest hurdles lie outside of the health domain, and are of a political and administrative nature. Success stories are rare. But useful lessons are taught by failure as well as by success. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.
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
Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba
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......INTRODUCTION: 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. METHODS: A series of face-to-face interviews with key stakeholders was carried out in 2014...
Barnfather, J S; Ronis, D L
The purpose of this study was to test a model drawn from the modeling and role-modelpan>ing theory depicting relationships among psychosocial resources, perceived stress, and health for undereducated adults. A purposive sample of 171 adults enrolled at an urban adult education center completed several self-report measures: Modified Erikson Psychological Stage Inventory, Basic Need Satisfaction Inventory, Perceived Stress, and Positive Health Index. Based on a structural equation modeling analysis, psychosocial development and basic need satisfaction had significant direct effects on health, with the expected positive signs. Psychosocial development had the strongest direct effect on health and also had a strong direct effect on basic need satisfaction and an indirect effect on health. Support for the hypothesized model has important implications for nursing and other community-based care provider interventions regarding health, including strengthening psychosocial resources. Copyright 2000 John Wiley & Sons, Inc.
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.
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.
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.
Farthing, Anthony; Priego, Ernesto
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...
Lesbian, gay, bisexual, and transgender (LGBT) persons, while widely diverse in many ways, share health disparities related to the stigma and discrimination they experience, including disproportionate rates of psychiatric disorders, substance abuse, and suicide. Lesbians, gay men, bisexuals, and the transgender communities have additional health concerns and disparities unique to each population. This paper highlights the national recognition of these health issues and disparities and presents web-based information resources about them and their mitigation.
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
Rinaldi, M.; Castrignanò, A.; Mastrorilli, M.; Rana, G.; Ventrella, D.; Acutis, M.; D'Urso, G.; Mattia, F.
An efficient management of water resources is crucial point for Italy and in particular for southern areas characterized by Mediterranean climate in order to improve the economical and environmental sustainability of the agricultural activity. A three-year Project (2005-2008) has been funded by the Italian Ministry of Agriculture and Forestry Policies; it involves four Italian research institutions: the Agricultural Research Council (ISA, Bari), the National Research Council (ISSIA, Bari) and two Universities (Federico II-Naples and Milan). It is focused on the remote sensing, the plant and the climate and, for interdisciplinary relationships, the project working group consists of agronomists, engineers and physicists. The aims of the Project are: a) to produce a Decision Support System (DSS) combining remote sensing information, spatial data and simulation models to manage water resources in irrigation districts; b) to simulate irrigation scenarios to evaluate the effects of water stress on crop yield using agro-ecological indicators; c) to identify the most sensitive areas to drought risk in Southern Italy. The tools used in this Project will be: 1. Remote sensing images, topographic maps, soil and land use maps; 2. Geographic Information Systems; 3. Geostatistic methodologies; 4. Ground truth measurements (land use, canopy and soil temperatures, soil and plant water status, Normalized Difference Vegetation Index, Crop Water Stress Index, Leaf Area Index, actual evapotranspiration, crop coefficients, crop yield, agro-ecological indicators); 5. Crop simulation models. The Project is structured in four work packages with specific objectives, high degree of interaction and information exchange: 1) Remote Sensing and Image Analysis; 2) Cropping Systems; 3) Modelling and Softwares Development; 4) Stakeholders. The final product will be a DSS with the purpose of integrating remote sensing images, to estimate crop and soil variables related to drought, to assimilate
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.
Full Text Available Issue: 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. Context: 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. Action: 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. Outcome: 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. Discussion: 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.
Tariq M. Hassan
Full Text Available Despite their rigorous training, studies have shown that physicians experience higher rates of mental illness, substance abuse, and suicide compared to the general population. An online questionnaire was sent to a random sample of physicians across Canada to assess physicians’ knowledge of the incidence of mental illness among physicians and their attitudes towards disclosure and treatment in a hypothetical situation where one developed a mental illness. We received 139 responses reflecting mostly primary care physicians and nonsurgical specialists. The majority of respondents underestimated the incidence of mental illness in physicians. The most important factors influencing respondent’s will to disclose their illness included career implications, professional integrity, and social stigma. Preference for selecting mental health treatment services, as either outpatients or inpatients, was mostly influenced by quality of care and confidentiality, with lower importance of convenience and social stigma. Results from this study suggest that the attitudes of physicians towards becoming mentally ill are complex and may be affected by the individual’s previous diagnosis of mental illness and the presence of a family member with a history of mental illness. Other factors include the individual’s medical specialty and level of experience. As mental illness is common among physicians, one must be conscious of these when offering treatment options.
Full Text Available Over the past few years, aquatic cycling has become a trending fitness activity. However, the literature has not been reviewed exhaustively. Therefore, using scoping review methodology, the aim of this review was to explore the current state of the literature concerning aquatic cycling. This study specifically focused on study designs, populations and outcomes. A comprehensive search of seven databases (PubMed, MEDLINE, Cinahl, Embase, PEDro,Web of Science, WorldCat was conducted up to 30th September 2016. GoogleScholar, World Cat, ResearchGate, specific aquatic therapy websites and aquatic therapy journals were searched to identify additional literature. Full-text publications in English, German or Dutch were included. Studies were included when the intervention involved head-out cycling carried out in 10° to 35° Celsius water. Exclusion criteria were the use of wet suits or confounding interventions that would affect participants' homeostasis. 63 articles were included and the study parameters of these studies were summarized. Using three grouping themes, included studies were categorised as 1 single session tests comparing aquatic versus land cycling, or 2 aquatic cycling only sessions investigating different exercise conditions and 3 aquatic cycling intervention programmes. Although the experimental conditions differed noticeably across the studies, shared characteristics were identified. Cardiovascular parameters were investigated by many of the studies with the results suggesting that the cardiac demand of aquatic cycling seems similar to land-based cycling. Only six studies evaluated the effect of aquatic cycling interventions. Therefore, future research should investigate the effects of aquatic cycling interventions, preferably in individuals that are expected to gain health benefits from aquatic cycling. Moreover, this comprehensive outline of available literature could serve as a starting point for systematic reviews or clinical
Rewald, Stefanie; Mesters, Ilse; Lenssen, Antoine F; Bansi, Jens; Lambeck, Johan; de Bie, Rob A; Waller, Benjamin
Over the past few years, aquatic cycling has become a trending fitness activity. However, the literature has not been reviewed exhaustively. Therefore, using scoping review methodology, the aim of this review was to explore the current state of the literature concerning aquatic cycling. This study specifically focused on study designs, populations and outcomes. A comprehensive search of seven databases (PubMed, MEDLINE, Cinahl, Embase, PEDro,Web of Science, WorldCat) was conducted up to 30th September 2016. GoogleScholar, World Cat, ResearchGate, specific aquatic therapy websites and aquatic therapy journals were searched to identify additional literature. Full-text publications in English, German or Dutch were included. Studies were included when the intervention involved head-out cycling carried out in 10° to 35° Celsius water. Exclusion criteria were the use of wet suits or confounding interventions that would affect participants' homeostasis. 63 articles were included and the study parameters of these studies were summarized. Using three grouping themes, included studies were categorised as 1) single session tests comparing aquatic versus land cycling, or 2) aquatic cycling only sessions investigating different exercise conditions and 3) aquatic cycling intervention programmes. Although the experimental conditions differed noticeably across the studies, shared characteristics were identified. Cardiovascular parameters were investigated by many of the studies with the results suggesting that the cardiac demand of aquatic cycling seems similar to land-based cycling. Only six studies evaluated the effect of aquatic cycling interventions. Therefore, future research should investigate the effects of aquatic cycling interventions, preferably in individuals that are expected to gain health benefits from aquatic cycling. Moreover, this comprehensive outline of available literature could serve as a starting point for systematic reviews or clinical studies on the
Bansi, Jens; Lambeck, Johan; de Bie, Rob A.; Waller, Benjamin
Over the past few years, aquatic cycling has become a trending fitness activity. However, the literature has not been reviewed exhaustively. Therefore, using scoping review methodology, the aim of this review was to explore the current state of the literature concerning aquatic cycling. This study specifically focused on study designs, populations and outcomes. A comprehensive search of seven databases (PubMed, MEDLINE, Cinahl, Embase, PEDro,Web of Science, WorldCat) was conducted up to 30th September 2016. GoogleScholar, World Cat, ResearchGate, specific aquatic therapy websites and aquatic therapy journals were searched to identify additional literature. Full-text publications in English, German or Dutch were included. Studies were included when the intervention involved head-out cycling carried out in 10° to 35° Celsius water. Exclusion criteria were the use of wet suits or confounding interventions that would affect participants’ homeostasis. 63 articles were included and the study parameters of these studies were summarized. Using three grouping themes, included studies were categorised as 1) single session tests comparing aquatic versus land cycling, or 2) aquatic cycling only sessions investigating different exercise conditions and 3) aquatic cycling intervention programmes. Although the experimental conditions differed noticeably across the studies, shared characteristics were identified. Cardiovascular parameters were investigated by many of the studies with the results suggesting that the cardiac demand of aquatic cycling seems similar to land-based cycling. Only six studies evaluated the effect of aquatic cycling interventions. Therefore, future research should investigate the effects of aquatic cycling interventions, preferably in individuals that are expected to gain health benefits from aquatic cycling. Moreover, this comprehensive outline of available literature could serve as a starting point for systematic reviews or clinical studies on the
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.
Kapo, Katherine E; Holmes, Christopher M; Dyer, Scott D; de Zwart, Dick; Posthuma, Leo
Eco-epidemiological studies utilizing existing monitoring program data provide a cost-effective means to bridge the gap between the ecological status and chemical status of watersheds and to develop hypotheses of stressor attribution that can influence the design of higher-tier assessments and subsequent management. The present study describes the process of combining existing data and models to develop a robust starting point for eco-epidemiological analyses of watersheds over large geographic scales. Data resources from multiple federal and local agencies representing a range of biological, chemical, physical, toxicological, and other landscape factors across the state of Ohio, USA (2000-2007), were integrated with the National Hydrography Dataset Plus hydrologic model (US Environmental Protection Agency and US Geological Survey). A variety of variable reduction, selection, and optimization strategies were applied to develop eco-epidemiological data sets for fish and macroinvertebrate communities. The relative importance of landscape variables was compared across spatial scales (local catchment, watershed, near-stream) using conditional inference forests to determine the scales most relevant to variation in biological community condition. Conditional inference forest analysis applied to a holistic set of environmental variables yielded stressor-response hypotheses at the statewide and eco-regional levels. The analysis confirmed the dominant influence of state-level stressors such as physical habitat condition, while highlighting differences in predictive strength of other stressors based on ecoregional and land-use characteristics. This exercise lays the groundwork for subsequent work designed to move closer to causal inference. © 2014 SETAC.
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.
Eisenberg, Marla E; Lust, Katherine A; Hannan, Peter J; Porta, Carolyn
Institutional characteristics may help mitigate trauma associated with sexual assault. This study examines associations between resources on college campuses for sexual violence prevention and the emotional well-being of female students who have experienced sexual assault. There were 495 female college students who have experienced sexual assault who provided survey data in 2010-2011. Sexual violence resource data from 28 college campuses were combined with student survey data in multilevel analysis. Dependent variables include diagnosis with anxiety, depression, panic attacks, and PTSD, and models adjust for covariates and clustering of students within colleges. Participants attending colleges with more sexual violence resources had lower rates of mental health conditions than those attending colleges with fewer resources. Colleges are encouraged to expand their array of sexual violence resources to create a supportive environment for victims of sexual assault and to connect affected students with appropriate services.
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.
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.
Tung, Elizabeth L; Boyd, Kelly; Lindau, Stacy Tessler; Peek, Monica E
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.
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
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...... 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...... in the survey, and 405 residents participated in 2013. Our main explanatory variables were indicators of socioeconomic positions and social network resources. The analyses were conducted using univariate and bivariate analyses and multiple logistic regressions. The results showed that there was a significant...
Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. For patients requiring terminal care, we are guided less by principles of justice and more by the duty to relieve suffering and society's commitment to protecting the professional's obligation to uphold principles of beneficence, compassion and non-abandonment. A fair deliberation process is necessary to allow these strong moral commitments to serve as reasons when setting priorities in resource poor countries.
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.
Hassani, Sa; Abolhallaje, M; Inanlo, S; Hosseini, H; Pourmohammadi, K; Bastani, P; Ramezanian, M; Marnani, A Barati
Due to consuming about 50%-80% of health resources, hospitals are the greatest and costly operational units in Iranian Health system. so allocation of resources specially human and space resources as the most expensive ones is really important for further controlling of costs, analysis of costs and making suitable policies for increasing the profitability and allocation of resources and improvement of quality. This paper intends to describe and analyze any allocation of resources in 530 university hospitals in Iran. The final goal of this research is to provide a data bank according which there is a basis for more scientific budget allocation of state's hospitals from the size and type of application points of view. The relevant index of person to bed was 2.04 for human resources. All hospitals more than 300 beds are located in benefiting areas from which 17 cases are educational and 2 cases are therapeutic. This is necessary to mention that the rate of management group forces to total personnel at deprived areas is about 2.5% more than benefiting areas. Because 60-80% of hospital costs are applied for human forces, all managers of hospitals are obliged to revise their policies in attraction and employment of human force in order to benefit from such a valuable resource and prevent from expensive costs. So any employment of personnel should be based upon real needs of hospital.
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...... to OCPs and may serve as the most effective bioindicators for monitoring OCP contamination in the water and suspended solids of Lake Chaohu. Megalobrama amblycephala, which contained the highest wet weight mean OCP concentration, is the most sensitive OCP indicator and can be used to assess the human...
Loomes, Dustin E; Teshima, Christopher; Jacobs, Philip; Fedorak, Richard N
Infliximab therapy in patients with Crohn's disease decreases resource use; however, the overall impact on health-related expenditures is unclear, especially beyond one year of study. A retrospective analysis of economic data one and two years before and after infliximab therapy was performed using patients who served as their own controls. Total health care resource use and direct health care costs were compared for patients with or without fistulae. Patients with one (n=66) and two (n=39) years of economic data before and after infliximab treatment had their resource use and direct health care costs estimated. In the year following initiation of infliximab therapy, there were significant decreases in health care use, reflected in total hospital days (495 to 155 [P<0.05]), inpatient colonoscopies (46 to 24 [P<0.05]), outpatient colonoscopies (58 to 33 [P<0.05]) and major surgeries (10 to 2 [P<0.05]). Direct health care costs of inpatient costs for luminal (-$1,747 [P<0.05]) and fistulizing disease (-$2,530 [P<0.05]), major surgeries (-$1240 [P<0.05]) and outpatient colonoscopies (-$184 [P<0.05]) were also significantly reduced before and after infliximab therapy. Total direct health care costs, including the drug cost of infliximab, increased ($21,416 [P<0.05]). In general, the trends in health care costs analyzed over four consecutive years paralleled the two consecutive-year analysis. Infliximab therapy in patients with Crohn's disease resulted in a significant decrease in both resource use and health care costs, but an increase in total direct health care costs once the cost of infliximab was added.
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.
Full Text Available Abstract Background There is increasing attention, globally and in countries, to monitoring and addressing the health systems and human resources inputs, processes and outputs that impede or facilitate progress towards achieving the Millennium Development Goals for maternal and child health. We reviewed the situation of human resources for health (HRH in 68 low- and middle-income countries that together account for over 95% of all maternal and child deaths. Methods We collected and analysed cross-nationally comparable data on HRH availability, distribution, roles and functions from new and existing sources, and information from country reviews of HRH interventions that are associated with positive impacts on health services delivery and population health outcomes. Results Findings from 68 countries demonstrate availability of doctors, nurses and midwives is positively correlated with coverage of skilled birth attendance. Most (78% of the target countries face acute shortages of highly skilled health personnel, and large variations persist within and across countries in workforce distribution, skills mix and skills utilization. Too few countries appropriately plan for, authorize and support nurses, midwives and community health workers to deliver essential maternal, newborn and child health-care interventions that could save lives. Conclusions Despite certain limitations of the data and findings, we identify some key areas where governments, international partners and other stakeholders can target efforts to ensure a sufficient, equitably distributed and efficiently utilized health workforce to achieve MDGs 4 and 5.
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
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
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.
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)
Godue, Charles; Cameron, Rick; Borrell, Rosa Maria
Since the year 2003, most countries of the Region of the Americas have experienced sustained economic growth and inclusive development policies. In the health sector, achieving universal access became the overarching goal. However, the structural limitations of the health workforce represented a formidable obstacle to change. National Health Authorities were confronted with the challenge of developing critical capacities to redress entrenched inequalities in access to qualified health personnel. Under the auspices of the Pan American Health Organization, the Ministers of Health of the Region adopted, in September 2007, twenty regional goals for Human Resources for Health 2007-2015, aligned with the renewed strategy of Primary Health Care. Subsequently, a set of indicators and a methodology were developed to assess the goals and to monitor progress at the country level. Fifteen countries carried out a baseline assessment in 2009 or 2010 and conducted a second assessment in 2013. Although differences were noted across goals and between countries, the results suggested improvements in all twenty goals overall. The goals linked to the distribution of personnel, the management of migration, and the cooperation with education institutions appeared to be more resilient to change. The twenty Regional Goals for Human Resources for Health provided a common vision for action and a framework for cooperation within and among countries, and was a catalyst for change. Faced with evolving challenges, the countries should consider adopting a new shared agenda that builds on progress made and further supports intergovernmental policy alignment and capacity building in health workforce development, governance and management.
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.
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
Suárez-Varela, M M; Llopis Gonzalez, A; Tejerizo Perez, M L
"Avoidable" mortality may be defined as causes of death whose occurrence is closely related to medical intervention. Areas with particular health care delivery problems can be identified through a geographical comparison of these "avoidable deaths." Mortality data for Valencia from 1982 to 1990 were examined to determine whether or not the availability of medical care resources in the area influenced the occurrence of avoidable deaths. We identified variations in mortality from avoidable causes, grouped according to the differences in levels of urbanization and health care resources, in the 537 municipalities of the Valencian community. (In Spain, the municipality is the lowest administrative division.) Linear regression analysis was performed to predict or estimate this relationship. Only in a small number of avoidable causes did the mortality trend for males differ significantly from 0 (p urbanization and health care resources. A direct association between these two variables was observed in males with regards to pneumonia, tuberculosis, chronic rheumatic heart disease, and bacterial infection. In females, a relationship between "avoidable" mortality rates and the differences in urbanization and health care resources was found in cervical cancer, pneumonia, abdominal hernias, and cholecystitis. Mortality from asthma and cardiovascular disease (in both males and females) declined faster in urbanized, high income areas than in rural areas. The results clearly demonstrate the considerable mortality risk associated with living in urban areas. On the contrary, we found very little correlation between health service access and mortality.
Helms, Ronald; Gutierrez, Ricky S; Reeves-Gutierrez, Debra
U.S. county jails hold large populations of mentally ill inmates but have rarely been researched quantitatively to assess their collective capacity for providing mental health treatment. This research uses ordinal logit and a partial parallel slopes model and a large sample of U.S. counties to assess conceptualized links between local institutional and structural indicators and jail mental health resourcing. Strong church networks and high rates of adult education completion are associated with enhanced jail mental health resourcing. Urbanized areas and areas with deep economic ties to manufacturing appear supportive of a strong jail mental health system. Conversely, conservative political environments and areas with strong medical and mental health networks based in the community are correlated with reduced jail mental health resourcing. Evidence from this research adds to a growing understanding of the need for enhanced community mental health service and diagnostic capabilities in our nation's jails, noting the characteristics and correlates of model program jurisdictions and jurisdictions where program enhancements are most likely in order. © The Author(s) 2015.
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
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
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.
Wister, Andrew V; Malloy-Weir, Leslie J; Rootman, Irving; Desjardins, Richard
The goal of this study is to examine the role of lifelong educational and learning practices and resources in enabling health literacy. A subsample of older adults (n = 2,979) derived from the 2003 seven country IALSS (Canadian survey) was used. An expanded Andersen-Newman model that included lifelong learning enabling factors was used to develop predictors of health literacy. The formal education, lifelong and lifewide learning enabling factors exhibited the most robust associations with health literacy. These included education level; self-study in the form of reading manuals, reference books and journals; computer/Internet use, use of the library; leisure reading of books; reading letters, notes and e-mails; and volunteerism. Findings are discussed in relation to the development and maintenance of health literacy over the life course. Programs and policies that encourage lifelong and lifewide educational resources and practices by older persons are needed.
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.
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
Kristina H. Lewis
Full Text Available Background. We examined cross-sectional relationships of social resources with health behaviors in adults ages 18–93 years. Methods. Baseline data from a 2009 risk behavior intervention trial were used to measure social resources, physical activity, and fruit and vegetable intake in 2,440 adults. To evaluate associations overall and within 4 age groups (18–34, 35–49, 50–64, and 65–93 y, we used multivariable regression. Results. Mean (SD age was 49.4 (15 years, physical activity was 346 (304 minutes/week, and fruit and vegetable intake was 3.4 (2.4 servings/day. Mean social resource score was 1.2 (0–4 scale in 18–34 year olds, 1.1 in all other age groups (P=0.04. In multivariable models, for each one-point increment in social resource score, the odds ratio for getting 150–959 minutes of physical activity/wk (compared to <150 min/wk was 3.7 (95% CI 3.0–4.6. Each one-point increment in score was also associated with 29% (95% CI: 23–35% more servings of fruit and vegetables. We did not observe effect modification by age group. Conclusions. Although younger adults reported slightly higher resources than older adults, the magnitude of association between social resources and healthful behaviors did not differ between them.
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.)
Simonavicius, Erikas; Robson, Debbie; McEwen, Andy; Brose, Leonie S
Around thirty percent of smokers have a mental health problem. Smoking cessation has been associated with mental health benefits, but smoking prevalence remains high in populations with mental health problems. This study aimed to assess mental health related knowledge, practice, and training needs of practitioners supporting smoking cessation. UK stop smoking practitioners (n=717) recruited via a database of a national provider of smoking cessation training in June 2016 sufficiently completed an online survey about available resources, knowledge, confidence, and training needs related to smoking cessation and mental health. Responses were described and compared between practitioners with a mental health lead and those without such a lead in their service using chi-square statistics and t-tests. A considerable proportion agreed (37%) or were undecided (28.9%) that smoking helped people with mental health problems feel better and agreed (17.2%) or were undecided (30.2%) that cessation would exacerbate mental health symptoms. Only 11.6% said their service had designated funding for smokers with mental health problems and 26.5% were or had a staff member who was a dedicated lead practitioner for mental health work. Practitioners from services that had a dedicated mental health lead were more confident in supporting smokers with different mental health problems and using different pharmacotherapies (all ptraining, particularly about smoking cessation effects on psychiatric medication (84.3% of n=632) and how to tailor stop smoking support to clients with mental health problems (82.4%). Practitioners who support smoking cessation have limited knowledge about mental health and smoking but are willing to learn and improve. However, they are hindered by a lack of resources. Copyright © 2017. Published by Elsevier Inc.
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.
McIntosh, Ian D
In cystic fibrosis clinics across Canada, the most common barrier that healthcare workers face when providing care to their patients is having too little time. The Health Human Resources Guidelines were developed to define specifically what amounts of time should be allocated for each discipline of cystic fibrosis clinical care and to provide a description of all the roles involved, reinforcing how these work together to provide comprehensive multidisciplinary care. With involvement from all cystic fibrosis clinics in Canada, through the use of a tailored survey, the Health Human Resources Guidelines are an exclusively Canadian document that has been developed for implementation across the country. The guidelines have been incorporated into a national Accreditation Site Visit program for use in evaluating and improving care across the country and have been distributed to all Canadian cystic fibrosis clinics. The guidelines provide hospital administrators with clear benchmarks for allocating personnel resources to the cystic fibrosis clinics hosted within their institutions.
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
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,…
Conclusion: The human resource crisis in Zambia has reached a disastrous stage with the health system at breaking point. Corrective measures have been started but these need to be strengthened and as comprehensive as can be. There is also need for innovation to consider other solutions that have not been tried ...
... 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...
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…
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…
Barnabas, Mandong; Ngbea, Joseph A; Innocent, Emmanuel; Malu, Keziah N
The task of a Pathologist is to provide an accurate specific and sufficiently comprehensive diagnosis to enable the clinician to develop an optimal plan for patient treatment and to a large extent possible, estimate prognosis. Modern Pathology practice is closely linked with all clinical departments and it serves as a bridge between the beginning of disease and how the disease ends. It is obvious that Pathology practice is central to patient care and it is the science behind the cure. However the paucity of pathologist in resource poor countries has posed a challenge to effective health care delivery. This is a review article aimed at reviewing the challenges of Pathology practice in poor resource environment. The author reviewed literature in Medline and other journal on challenges facing health care in developing countries of sub-Saharan region of Africa. Solutions to some of these challenges were also provided and the way forward for the practice of Pathology in Africa. Literature review showed that there were negative factors that affected the effective practice of pathology. These factors are:-Lack of political will of most Governments to appropriately provide resources, according to United Nation standard. Absence of National Health Insurance Policy, population control, and infrastructural support. Poor funding, training and, lack of motivation which is prevalent in most resource poor countries. Private Partnership with public health institution, donor agencies and non-government agencies is believed to be the only solution to good clinical practice including pathology practice.
Andersson, Paula; Varde, E; Diderichsen, Finn
Since the Stockholm County Council introduced a system of purchasers and providers there has been a quest for population-based resource allocation models to allocate monies to purchasers of health care. In contrast to models used in Britain, Swedish models have been based on individual level data...
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.
Human resources for health (HRH) policy and planning is highly challenging in any setting but the more so in underdeveloped countries. Ethiopia has relatively vast and distinctive experience in accelerated training, use of substitute categories/task-shifting… from which important lessons could be drawn. Based on thorough ...
A.T. Ekubo; J.F.N. Abowei
Water pollution is a major problem in the global context. Yet aquatic resources consists of extremely wide range of floral and fauna resources which offer a broad array of goods with potential utilitarian application in agriculture, innovative industry and the pharmaceutical industry which renders valuable benefits and services. The slow poisoning of the waters is witnessed in Nigeria and the destruction of vegetation and agricultural land by oil spills which occur during petroleum operations...
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.
Inglehart, Marita Rohr; Zuzo, Gabrielle A; Wilson, Joshua J
The percentage of U.S. children with poor oral health continues to be high. Kindergarten/elementary school educators could play an important role in teaching students about oral health promotion. The objectives were to assess which oral health-related web-based resources teachers consider most helpful and how teachers' attitudes, knowledge, and behavioural intentions concerning oral health-related teaching change between before and after having access to a resource website. Web-based survey data were collected from 95 kindergarten/elementary school educators before and after they accessed a website with oral health-related information for teachers (web-link: http://media.dent.umich.edu/teachoralhealth/index.html). Most teachers accessed lesson plans about 'Teeth and smiling' (90%) and 'Taking care of your teeth' (88%) and the fewest accessed information about 'Nutrition and health' (42%) and 'Information for parents' (39%). On average, all materials were perceived as useful (5-point scale with 5 = 'very useful', range = 3.80 to 4.04). Responses to the question on how important dental health is for a child's ability to learn improved significantly from before to after the educational intervention (5-point scale with 5 = 'very important', 3.78 vs 4.44). Knowledge increased and behavioural intentions improved as well. The percentage of teachers who reported that they had included oral health-related material in the past was 47% and the percentage who intended to include it in the future was 65% (p kindergarten/elementary school educators with web-based resource materials improves their attitudes, increases their knowledge and leads to positive behavioural intentions concerning educating their students about oral health.
Reynolds, Julia; Griffiths, Kathleen M; Cunningham, John A; Bennett, Kylie; Bennett, Anthony
Research into e-mental health technologies has developed rapidly in the last 15 years. Applications such as Internet-delivered cognitive behavioral therapy interventions have accumulated considerable evidence of efficacy and some evidence of effectiveness. These programs have achieved similar outcomes to face-to-face therapy, while requiring much less clinician time. There is now burgeoning interest in integrating e-mental health resources with the broader mental health delivery system, particularly in primary care. The Australian government has supported the development and deployment of e-mental health resources, including websites that provide information, peer-to-peer support, automated self-help, and guided interventions. An ambitious national project has been commissioned to promote key resources to clinicians, to provide training in their use, and to evaluate the impact of promotion and training upon clinical practice. Previous initiatives have trained clinicians to use a single e-mental health program or a suite of related programs. In contrast, the current initiative will support community-based service providers to access a diverse array of resources developed and provided by many different groups. The objective of this paper was to develop a conceptual framework to support the use of e-mental health resources in routine primary health care. In particular, models of clinical practice are required to guide the use of the resources by diverse service providers and to inform professional training, promotional, and evaluation activities. Information about service providers' use of e-mental health resources was synthesized from a nonsystematic overview of published literature and the authors' experience of training primary care service providers. Five emerging clinical practice models are proposed: (1) promotion; (2) case management; (3) coaching; (4) symptom-focused treatment; and (5) comprehensive therapy. We also consider the service provider skills
Varga, Z M; Murray, K N
In this chapter we review the components of the fish health program at the Zebrafish International Resource Center. We describe health-monitoring strategies to assess individual and colony health, practices to prevent the spread of pathogens within the fish colony, and a biosecurity program designed to prevent entry of new fish pathogens. While this program is designed for a facility on a recirculating water system with expectations of high volumes of import and export, many of the components can be directly applied or modified for application in facilities of different sizes and with other programmatic goals. Copyright © 2016 Elsevier Inc. All rights reserved.
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.
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
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
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.
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.
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.
This grant will allow researchers the three regions, under the leadership of a technical advisory group from the International Institute for Sustainable Development (IISD), to examine selected IDRC-supported projects using Outcome Mapping methodology, identify successful interventions and describe how the behaviour of ...
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.
Park, Youngah; Sprung, Justin M
This study extends prior college student employment research by examining health as an outcome variable. Using 2-wave data from a sample of 216 student workers, this study examined work-school conflict as a predictor of psychological and physical health among working college students. Additionally, 3 resource-providing variables--work-school facilitation, supervisor work-school support, and personal fulfillment at work--were tested for buffering effects in the relation between work-school conflict and health. Results demonstrated that work-school conflict was a significant predictor of psychological health but not physical health. All 3 resource-providing variables ameliorated the negative relation between work-school conflict and psychological health, whereas only personal fulfillment weakened the positive relation between work-school conflict and physical symptoms. These findings suggest the benefits of work-school facilitation, supervisor work-school support, and personal fulfillment in minimizing the detrimental effects of work-school conflict on health outcomes. Theoretical and practical implications for researchers, educational institutions, and organizations are discussed.
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
Background Given that relatively little is known about the development of resilience in early childhood, this longitudinal study aimed to identify preschool resource factors associated with young children’s mental health resilience to family adversity. Methods A community sample of 474 young Australian children was assessed in preschool (mean age 4.59 years, 49% male), and again two years later after their transition into formal schooling. At each assessment, standard questionnaires were used to obtain ratings from both parents and teachers about the quality of children’s relationships with parents and teachers, children’s self-concept and self-control, mental health (Strengths and Difficulties Questionnaire), and family adversities (including stressful life events and socioeconomic disadvantage). Results Greater exposure to cumulative family adversities was associated with both greater teacher- and parent-reported child mental health difficulties two years later. Multiple methodologies for operationalizing resilience were used to identify resources associated with resilient mental health outcomes. Higher quality child–parent and child-teacher relationships, and greater child self-concept and self-control were associated with resilient mental health outcomes. With the exception of child-teacher relationships, these resources were also prospective antecedents of subsequent resilient mental health outcomes in children with no pre-existing mental health difficulties. Child–parent relationships and child self-concept generally had promotive effects, being equally beneficial for children facing both low- and high-adversity. Child self-control demonstrated a small protective effect on teacher-reported outcomes, with greater self-control conferring greater protection to children under conditions of high-adversity. Conclusions Findings suggest that early intervention and prevention strategies that focus on fostering child-adult relationship quality, self
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
Konan, K L; Doannio, J M C; Coulibaly, N G D; Ekaza, E; Marion, E; Assé, H; Kouassi, D; N'Goran, K E; Dosso, M; Marsollier, L; Aubry, J
Buruli ulcer (BU) disease, caused by Mycobacterium ulcerans, is a major public health problem in Côte d'Ivoire. Until now, the mode of BU transmission was unknown, but recent studies implicate aquatic Heteroptera in the chain of transmission. This study was launched in Côte d'Ivoire to search for specific genetic markers for M. ulcerans in these bugs, including the insertion sequence IS2404 and ketoreductase (Kr), both involved in the synthesis of mycolactone, a toxin produced by these mycobacteria. Samples of aquatic Heteroptera were collected monthly with deep nets from ponds near villages in the health districts of Dabou and Tiassalé. After identification and enumeration of the bugs, batches of the same taxon underwent real-time PCR to search for the IS2404 target and Kr. Saliva of 69 specimens of Diplonychus sp randomly selected in the samples was also analyzed by PCR. In all, 283 single-taxon batches were created. Thus, PCR identified 26 batches belonging to the families of Belostomatidae, Naucoridae, Corixidae, Ranatridae, and Nepidae as positive for both targets. The IS2404 insertion sequence and Kr were present in 6 of the 69 samples analyzed in the saliva of Diplonychus sp. These aquatic Heteroptera suspected of infection by M. ulcerans might release it into the environment because of their ability to fly. They might thus be the source of human contamination.
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
Windisch, Ricarda; de Savigny, Don; Onadja, Geneviève; Somda, Antoine; Wyss, Kaspar; Sié, Ali; Kouyaté, Bocar
Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
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.
Full Text Available 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.
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...
Documents pertaining to Acute and Chronic Ambient Water Quality Aquatic Life Criteria for Atrazine (Freshwater and Salt Water). This document contains the safe levels of Atrazine 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.
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 pertaining to 2016 Acute and Chronic Aquatic Life Ambient Water Quality Criteria for Cadmium (Freshwater, Estuarine/marine). These documents contain the safe levels of Cadmium in water that should protect to the majority of species.
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.
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.
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
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.
Hale, J F; Hollander, R B
Traditionally, health care/health promotion professionals have relied on a face-to-face format for their teaching and are now becoming increasingly involved with new and creative ways to use microcomputers in educational technology. These methodologies have their limitations. Each is limited by the number of participants who can be reached at a given time, the availability of local experts, the existence of the necessary hardware and software, and accessibility due to special characteristics of the audience. These limitations often dictate what presentations health professionals can offer, what media can be used, and which groups will attend. Health care/health promotion professionals must not lose sight of readily available, nontraditional, cost effective methods that serve to enhance high level wellness in a broad and diverse population. The alternative health promotion delivery systems of radio, audioconferencing, and teleconferencing, as discussed in this article, can be used in a variety of settings (school, university, community, and worksite), applied to all levels of health promotion and education (elementary through university education and community/worksite offerings), and can increase awareness of additional methods of communication of health-related information by health professionals.
To identify the individual and social experiences underlying the initiation and satisfaction with aquatic exercise among persons with MS. A convenience sample (n = 45) of persons aged ≥18 with MS who had engaged in water-based exercise within the previous six months completed a 60-90 min semi-structured telephone interview regarding their aquatic exercise experiences. An aquatic exercise history was not a prerequisite for the adoption of aquatic exercise. Rather, participants described aquatic exercise routines as stemming from recognition of a decline in physical function combined with encouragement and invitations to join aquatic programs. Despite regular visits, health care providers were not a common source of information regarding the feasibility of aquatic exercise. Participants' aquatic activities included MS-specific and generalized aquatics courses, with class satisfaction resting on the instructor, class "fit" and a feeling of acceptance. Communication regarding local aquatic opportunities is critical for ensuring aquatics engagement among persons with MS. Providers could play a stronger role in emphasizing the feasibility and benefits of aquatic programs. In addition, persons with MS should be encouraged to try local MS and more generalized aquatic programs in order to identify a program matching their social and physical goals. Implications for Rehabilitation Directed communication regarding aquatic opportunities is essential to prompting the initiation of aquatic exercise Both MS-specific and general aquatics classes can provide positive exercise experiences for persons with MS A history of regular exercise or aquatic experiences is not a prerequisite for the initiation of aquatic exercise among persons with MS Health care provider visits may represent missed opportunities for promoting aquatics; providers should consider the suitability of aquatics for all patients with MS, regardless of the patient's exercise history.
The morale of health personnel is fast becoming the major factor affecting both the sustainability and the quality of health care world-wide. Low morale mirrors problems ranging from declining balance of payments allocation to GNP, and a lack of support for the health system from the very top down to the rigid application of national pay, grading and career structures, and the stress of not being able to do the job properly. While many of these and other problems have been voiced again and again in the press and in the academic literature, much of the work on health manpower development has focused on the planning and production of personnel. This has been with the aim of producing specific categories of better-trained health workers with relevant qualifications, resulting in a heavy emphasis on a quantitative output. In this paper it is argued that the management of health personnel, the qualitative aspect of staff development, has been relatively neglected. Unless and until the management of human resource development receives the attention it needs, seeds of discontent, disillusion and dissatisfaction will ultimately lead to national health services losing their competitiveness as employers. The sustainability and quality of health programmes will then be in even greater jeopardy than they are at present. The planning, production and management components of health manpower development have developed haphazardly as verticle activities. A new term such as 'human resource development; the management of health personnel' might help ensure the concept of an integrated process contingent on economic, political, organizational and other important circumstances.
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
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.
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
Yaylali, Emine; Farnham, Paul G; Schneider, Karen L; Landers, Stewart J; Kouzouian, Oskian; Lasry, Arielle; Purcell, David W; Green, Timothy A; Sansom, Stephanie L
To develop a resource allocation model to optimize health departments' Centers for Disease Control and Prevention (CDC)-funded HIV prevention budgets to prevent the most new cases of HIV infection and to evaluate the model's implementation in 4 health departments. We developed a linear programming model combined with a Bernoulli process model that allocated a fixed budget among HIV prevention interventions and risk subpopulations to maximize the number of new infections prevented. The model, which required epidemiologic, behavioral, budgetary, and programmatic data, was implemented in health departments in Philadelphia, Chicago, Alabama, and Nebraska. The optimal allocation of funds, the site-specific cost per case of HIV infection prevented rankings by intervention, and the expected number of HIV cases prevented. The model suggested allocating funds to HIV testing and continuum-of-care interventions in all 4 health departments. The most cost-effective intervention for all sites was HIV testing in nonclinical settings for men who have sex with men, and the least cost-effective interventions were behavioral interventions for HIV-negative persons. The pilot sites required 3 to 4 months of technical assistance to develop data inputs and generate and interpret the results. Although the sites found the model easy to use in providing quantitative evidence for allocating HIV prevention resources, they criticized the exclusion of structural interventions and the use of the model to allocate only CDC funds. Resource allocation models have the potential to improve the allocation of limited HIV prevention resources and can be used as a decision-making guide for state and local health departments. Using such models may require substantial staff time and technical assistance. These model results emphasize the allocation of CDC funds toward testing and continuum-of-care interventions and populations at highest risk of HIV transmission.
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.
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.
... 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...
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...
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.
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
Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B
As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.
Güilgüiruca R, M; Herrera-Bascur, J
This article examines the influence of human resources policies on occupational health variables, such as engagement and job satisfaction, with regard to Chilean prison employees. 80 workers at the Women's Prison of Iquique were evaluated and results show that 77% and 88 % have a moderate to high score in terms of engagement and job satisfaction respectively. The 24% variation in engagement of the workers studied can be explained by policies aimed at promoting personal interests, while 32% of the variation in job satisfaction could be explained by policies of self-efficacy and personal interests. The above data permits the assertion to be made that human resources policies have a role that is relevant and necessary to modify and improve the occupational health conditions of these public sector workers.
Allen, Heidi; Baicker, Katherine; Taubman, Sarah; Wright, Bill; Finkelstein, Amy
In 2008 Oregon allocated access to its Medicaid expansion program, Oregon Health Plan Standard, by drawing names from a waiting list by lottery. The lottery was chosen by policy makers and stakeholders as the preferred way to allocate limited resources. At the same time, it also gave rise to the Oregon Health Insurance Experiment: an unprecedented opportunity to do a randomized evaluation - the gold standard in medical and scientific research - of the impact of expanding Medicaid. In this article we provide historical context for Oregon's decision to conduct a lottery, discuss the importance of randomized controlled designs for policy evaluation, and describe some of the practical challenges in successfully capitalizing on the research opportunity presented by the Oregon lottery through public-academic partnerships. Since policy makers will always face tough choices about how to distribute scarce resources, we urge thoughtful consideration of the opportunities to incorporate randomization that can substantially improve the evidence available to inform policy decisions without compromising policy goals.
Liyanagunawardena, Tharindu R; Aboshady, Omar A
Developing countries are suffering from increasing burdens presented by both non-communicable and emerging infectious diseases. Health education is an important step to fight against these mostly preventable diseases. E-learning has been shown to be one of the tools that address some of the training challenges experienced in developing countries by supporting efficient content delivery, decreasing costs and increasing access. Massive open online courses (MOOCs) are a recent innovative presentation of online learning that have attracted millions of learners from all over the world. In this commentary, we propose MOOCs as a potential tool to offer a tremendous opportunity to fulfil the unmet training needs of the health sector in developing countries in two complementary ways: as a resource for training healthcare professionals; and as a resource for the general public. Potential barriers to accessing MOOCs and possible solutions are also discussed.
McHenry, Megan S; Fischer, Lydia J; Chun, Yeona; Vreeman, Rachel C
The objective of this study is to conduct a systematic review of the literature of how portable electronic technologies with offline functionality are perceived and used to provide health education in resource-limited settings. Three reviewers evaluated articles and performed a bibliography search to identify studies describing health education delivered by portable electronic device with offline functionality in low- or middle-income countries. Data extracted included: study population; study design and type of analysis; type of technology used; method of use; setting of technology use; impact on caregivers, patients, or overall health outcomes; and reported limitations. Searches yielded 5514 unique titles. Out of 75 critically reviewed full-text articles, 10 met inclusion criteria. Study locations included Botswana, Peru, Kenya, Thailand, Nigeria, India, Ghana, and Tanzania. Topics addressed included: development of healthcare worker training modules, clinical decision support tools, patient education tools, perceptions and usability of portable electronic technology, and comparisons of technologies and/or mobile applications. Studies primarily looked at the assessment of developed educational modules on trainee health knowledge, perceptions and usability of technology, and comparisons of technologies. Overall, studies reported positive results for portable electronic device-based health education, frequently reporting increased provider/patient knowledge, improved patient outcomes in both quality of care and management, increased provider comfort level with technology, and an environment characterized by increased levels of technology-based, informal learning situations. Negative assessments included high investment costs, lack of technical support, and fear of device theft. While the research is limited, portable electronic educational resources present promising avenues to increase access to effective health education in resource-limited settings, contingent